Appeal to Appellate Authority

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....sp;Penalty (d)&emsp;Fees (e)&emsp;Other charges (v) Market value of seized goods 10. Whether the appellant wishes to be heard in person - Yes/No 11. Statement of facts :- 12. Grounds of appeal :- 13. Prayer :- 14. Amount of demand created, admitted and disputed Particulars of demand/refund Particulars Central tax State/UT tax Integrated tax Cess Total amount Amount of demand created (A) (a)&emsp;Tax/Cess < total > < total > (b)&emsp;Interest < total > (c)&emsp;Penalty < total > (d)&emsp;Fees < total > (e)&emsp;Other charges < total > Amount of demand admitted (B) (a)&emsp;Tax/Cess < total > < total > (b)&emsp;Interest < total > (c)&emsp;Penalty < total > (d)&emsp;Fees < total > (e)&emsp;Other charges <....

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....nt paid Integrated tax Central tax State/UT tax CESS Integrated tax Central tax State/UT tax CESS 1 2 3 4 5 6 7 8 9 10 11"; 1. Interest 2. Penalty 3. Late fee 4. Others (specify) ] 16. Whether appeal is being filed after the prescribed period - Yes/No 17. If 'Yes' in item 17 - (a) Period of delay - (b) Reasons for delay - 2[18. Place of supply wise details of the integrated tax paid (admitted amount only) mentioned in the Table in sub-clause (a) of clause 15 (item (a)), if any Place of Supply (Name of State/UT) Demand Tax Interest Penalty Other Total 1 2 3 4 5 6 7". Admitted amount [in the Table in sub-clause (a) of clause 15 (item (a))] ] Verification I, < ______________________________....