FORM 39

SECURITY BOND FOR STAY OF COLLECTION OF TAX, FEE OR OTHER

AMOUNT DISPUTED

See Rule 42

Before the Kerala Sales Tax Appellate Tribunal/Appellate Assistant Commissioner/Deputy Commissioner of Sales Tax/Board of Revenue/High Court

No..............of...................19..........................

Security Bond executed in favour of Governor of Kerala (hereinafter referred to as the Government and his successors in office and assigns)

Whereas ............has filed an appeal/application before the Sales Tax /Board of Revenue/High Court at ........against the order of..........it/its/his.........dated.........and the said appeal/application is pending, and wheras the said appellant/applicant has applied for direction in regard to the payment of the disputed tax, fee or other amount and has been called upon to furnish security accordingly, and in consideration whereof, I/We.......hereby personally undertake and bind my self/ourselves, my heirs/our heirs and legal representatives to pay the Government of Kerala the Sum of Rs........and mortgage/charge the properties specified in the Schedule hereunto annexed for the payment of the sum of Rs..................to the Government of Kerala and convenant that if the aforesaid appellant/applicant complies with all the directions in regard to the payment of tax/fee or other amount made by the Sales Tax Appellate Tribunal/Appellate Assistant Commissioner Deputy Commissioner of Sales Tax/Board of Revenue/High Court in the said appeal/application this bond shall be void and of no effect otherwise it shall remain in full force and effect.

In witness where of I/We........have hereunto affixed my/our hands and seal, this day of............19.....at ...........