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THE GOA GOODS AND SERVICES TAX FORMS 2017
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FORM GST APL-05/07 W

[See rule 113A]

Application for Withdrawal of Appeal /Application filed before the Appellate Tribunal

1. GSTIN:

2. Name of Business (Legal) (in case appeal is filed under sub-section (1) of section 112)

3. Name and designation of the appellant (in case appeal is filed under sub-section (3) of section 112):

4. Order No.& Date:

5. ARN of the Appeal & Date:

6. Reasons for Withdrawal:-

    i. Acceptance of order of the First Appellate Authority.

    ii. Acceptance of order of an Appellate Tribunal/ Court on similar subject matter

    iii. Need to file appeal/application again after rectification of mistakes/omission in the filed appeal/application

    iv. Amount involved in appeal is less than the monetary limit fixed for Appeal as per provisions of subsection (2) of section 112

    v. Amount involved in the application is less than the monetary limit fixed for application as per the provisions of sub-section (1) of section 120

    vi. Any other reason

7. Declaration (applicable in case appeal is filed under sub-section (1) of section 112):

I/We <Taxpayer Name> hereby solemnly affirm and declare that the information given herein is true and correct to the best of my/ our knowledge and belief and nothing has been concealed therefrom.

Place: Signature
   
Date: Name of Applicant /Applicant Officer
  Designation/ Status