KARNATAKA TAX ON PROFESSIONS, TRADES, CALLINGS AND EMPLOYMENTS RULES, 1976 - FORMS
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FORM 18

[See Rule 20]

Form of appeal against an order of assessment/penalty/interest under Karnataka Tax on Professionals, Trades, Callings and Employments Act, 1976.

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(i)	Registration Certificate No.. . . . . . . . . . . . . . . . . . . . . .
	Enrolment Certificate No.. . . . . . . . . . . . . . . . . . . . . . . . . .
(ii)	Name of the assessee and status. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(iii)	Style of Profession, Trade, Calling etc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(iv)	Location and address. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
(v)	Period involved under impugned orders against which Appeal/Revision is preferred i.e., from. . . . . . . . . . . . . . . . . . . . to. . . . . . . . . . . . . . . . . . . . . . . . .
(vi)	(a) Name of the authrity who passed the impugned order
	(b) Date of passing of the impugned order. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
	(c) Date of service of Notice of Demand. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
	(d) Amount of	(i) Tax. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
		(ii) Penalty. . . . . . . . . . . . . . . . . . . . . . . . . . .
		(iii) Interest. . . . . . . . . . . . . . . . . . . . . . . . . . .
		Total
	(e) Amount of admitted Tax. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
	(f) Amount paid	(i) Tax. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
		(ii) Penalty. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
		(iii) Interest. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
	(g) Amount in dispute Grounds.	. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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		(Signed) Appellant(s)
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		(Signed) Authorised Representative (if any).

VERIFICATION

I/We. . . . . . . . . . . . . . . . . . . . . . . . . . . the appellant(s) named in the above appeal do hereby declare that what is stated therein is true to the best of my/our knowledge and belief.

Verified today the . . . . . . . . . . . . . . . . . . . . . .day of. . . . . . . . . . . . . . . . . . . .

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(Signed) Appellant(s)

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(Signed) Authorised Representative (if any).