Form GST APL - 01
[See Rule 108(1)]
Appeal to Appellate Authority
(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
15. Details of payment of admitted amount and pre-deposit:-
(a) Details of payment required
(b) Details of payment of admitted amount and pre-deposit (pre-deposit 10% of the disputed tax and cess but not exceeding Rs. 25 crore each in respect of CGST, SGST or cess, or not exceeding Rs. 50 crore in respect of IGST and Rs. 25 crore in respect of cess)
(c) Interest, penalty, late fee and any other amount payable and paid
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 -
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
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.