Application for waiver of interest or penalty or both under section 128A(1), in respect of an order issued under section 73 or section 107 or section 108

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.... Section under which order is issued Drop down 4 Whether any appeal or writ petition is filed against order before the Appellate Authority/ Appellate Tribunal/ High Court/ Supreme Court Drop down 5 If Yes in '4', whether the order for withdrawal of appeal or writ petition is issued ? Drop down 6 Whether demand order involves demand of erroneous refunds Drop down Table 3 (Amount in Rs.) 3. Financial Year Amount demanded in the order (A) Out of the amount mentioned in (A), demand pertaining only to ITC which has been denied solely on account of contravention of section 16(4) and not on any other grounds, and which has now become eligible as per section 16(5) or section 16(6) (B) IGST CGST SGST CESS Total Tax in....

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....tioned in Table 2 of this form. 4. If an application is filed/ has been filed by the department against the order mentioned in Table 2 or if any proceedings are initiated under sub-section (1) of section 108 against the said order, and the Appellate Authority or the Appellate Tribunal or the court or the Revisional Authority, as the case may be, issues an order enhancing my tax liability, I undertake to pay the additional amount of tax payable within three months from the date of the said order of the Appellate Authority or the Appellate Tribunal or the court or the Revisional Authority, as the case may be, as per second proviso to sub-section (1) of section 128A. 5. I declare that all information provided by me is accurate and truthful....