Important Keyword:Appellate Tribunal, FORM GST APL – 05
Table of Contents
FORM GST APL – 05
[See rule 110(1)]
Appeal to the Appellate Tribunal
GSTIN/ Temporary ID /UIN –
Name of the appellant –
Address of the appellant –
Order appealed against- Number- Date-
Name and Address of the Authority passing the order appealed against –
Date of communication of the order appealed against –
Name of the representative –
Details of the case under dispute:
Brief issue of the case under dispute
Description and classification of goods/ services in dispute
Period of dispute
Amount under dispute:
Description
Central tax
State/ UT tax
Integrated tax
Cess
a) Tax/ Cess
b) Interest
c) Penalty
d) Fees
e) Other charges
Market value of seized goods
Whether the appellant wishes to be heard in person?
Statement of facts
Grounds of appeal
Prayer
Details of demand created, disputed and admitted
Particulars of demand
Particulars
Central tax
State/UT tax
Integrated tax
Cess
Total amount
Amount demanded/ rejected >, if any (A)
a) Tax/ Cess
<total >
<total >
b) Interest
< total >
c) Penalty
< total
>
d) Fees
<total >
e) Other charges
<total >
Amount under dispute (B)
a) Tax/ Cess
< total >
< total >
b) Interest
< total >
c) Penalty
< total >
d) Fees
< total >
e) Other charges
< total >
Amount admitted (C)
a) Tax/ Cess
< total >
< total >
b) Interest
< total >
c) Penalty
< total >
d) Fees
< total >
e) Other charges
< total >
Details of payment of admitted amount and pre-deposit:
Details of amount payable:
Particulars
Central tax
State/UT tax
Integrated tax
Cess
Total amount
a) Admitted amount
Tax/ Cess
<total >
<total >
< total
Interest
>
Penalty
<total
>
< total
Fees
>
Other charges
< total >
b) Pre-deposit
1[20% of
disputed
tax/cess but
not exceeding
Rs.50 crore
each in
respect of CGST, SGST or cess or not
Tax/ Cess
< total >
exceeding
Rs.100 crore
in respect of
IGST and
Rs.50 crore in
respect of
cess]
Details of payment of admitted amount and 2[(3[pre-deposit of 20% of the disputed tax and cess but not exceeding Rs. 50 crore each in respect of CGST, SGST or cess or not exceeding Rs.100 crore in respect of IGST and Rs. 50 crore in respect of cess]
Sr. No.
Description
Tax payable
Paid through Cash/ Credit Ledger
Debit entry no.
Amount of tax paid
Integrated tax
Central tax
State/UT tax
CESS
1
2
3
4
5
6
7
8
9
1.
Integrated
Cash Ledger
Credit
tax
Ledger
2.
Cash Ledger
Central tax
Credit Ledger
3.
State/UT tax
Cash Ledger
Credit Ledger
4.
CESS
Cash Ledger
Credit Ledger
Interest, penalty, late fee and any other amount payable and paid:
Sr. No.
Description
Amount payable
Debit entry no.
Amount 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)
4 [15. [Place of supply wise details of the integrated tax paid (admitted amount only) mentioned in the Table in sub-clause (a) of clause 14 (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 14 (item (a))]
Verification
I, < __________________>, hereby solemnly affirm and declare that the information given hereinabove is true and correct to the best of my knowledge and belief and nothing has been concealed therefrom.
Place: Date:
<Signature> Name of the Applicant: Designation /Status:
Substituted for “20% of disputed tax” vide Notification No. 03/2019-CT dated 29.01.2019 w.e.f. 01.02.2019.
Substituted vide Notification No. 03/2019-CT dated 29.01.2019 w.e.f. 01.02.2019.
Corrected by M.F. (D.R.) Corrigendum F. No. 20/06/16/2018-GST (Pt. 1), dated 05.02.2019.
Inserted (w.e.f. 01.02.2019) by Notification No. 03/2019-CT dated 29.01.2019.
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