FORM 20

APPEAL

[See Rule 22]

BEFORE THE HIGH COURT OF KARNATAKA

Memorandum of Appeal against order, Section 18(4) of the Karnataka Tax on Professions, Trades, Callings and Employments Act, 1976.

Appeal against Order No.

Appellant

Versus

Respondent

Appeal against the order of the Commissioner of Profession Tax, dated. . . . . . . . . . . . . . . . and passed in . . . . . . . . . . . . . . . . . . . . . . . . .

(1) District in which the assessment was made.

(2) Assessment year.

(3) Assessing Authority passing the original order.

(4) Date of communication of the order of the Commissioner of Profession Tax.

(5) Address to which notice may be sent to the appellant.

(6) Address to which notice may be sent to the respondent.

(7) Relief claimed to appeal.

(a) Tax assessed by the assessing authority.

(b) Tax as modified and fixed by the Commissioner of Profession Tax.

(c) Relief claimed.

(d) Grounds of appeal,-

(i) State the facts disputed briefly

(ii) State the questions of law raised for decision by the High Court.

(Signed) Appellant(s)

(Signed) Authorised Representative, if any

VERIFICATION

I/We. . . . . . . . . . . . . . . . . . . . . . The appellant(s) do hereby declares that what is stated above is true to the best of my/our knowledge and belief.

Verified today the . . . . . . . . . . . . . . . . . . . . .day of . . . . . . . . . . . . . . . . . . . . . . .19

(Signed) Appellant(s)

(Signed) Authorised Representative, if any

N.B.-

(1) The appeal should be accompanied by a certified copy of the order of the Commissioner of Profession Tax appealed against.

(2) The appeal should be accompanied by a sum of Rs. 100.

(3) The appeal should be written in English and should set forth concisely and under district heads, the facts of the case, the grounds of appeal and the points of law raised consecutively.