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....e Act under which demand is created: 5. Details of demand : (Amount in Rs.) 4[Sr. No. Tax Rate Turnover Tax Period Act POS (Place of Supply) Tax Interest Penalty Fee Others Total From To 1 2 3 4 5 6 7 8 9 10 11 12 13 Total ] You are hereby directed to make the payment by failing which proceedings shall be initiated against you to recover the out....

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....nd released, place of supply, others (specify) 3. Description of goods / services - Sr. No. HSN Description 4. Details of demand (Amount in Rs.) Sr. No. Tax rate Turnover Place of supply Act Tax/ Cess Interest Penalty 1 2 3 4 5 6 7 8 5. Amount deposited Sr. No. Tax Period Act Tax/ Cess Interest Penalty Others Total 1 2 3 4 5 6 7 8 Total Signature Name Des....