Form of declaration under Section 94 of the Finance Act, 2008 in respect of Dispute Resolution Scheme, 2008

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........ Sir/Madam, I hereby make a declaration under section 94 of the Finance Act, 2008. 1. Name of the declarant ................................................................................ (in block letters) 2. Address :............................. ...................................................................... .........................................................................

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....alty ** The Scheme does not apply to any order or notice issued under section 73A of the Finance Act, 1994 VERIFICATION I ............ ............ (name in block letters) son/daughter of Shri .................. solemnly declare that to the best of my knowledge and belief - (a) the information given in this declaration and statements and annexure accompanying it is correct and complete and am....