The Gujarat Value Added Tax Rules, 2006
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FORM 501

[See sub- rule (3) of rule 54]

Appeal or Second appeal under section 73 of the Gujarat Value Added Tax, 2003

(Space for court-fee stamps)

(State here the amount of court-fee stamps affixed)
(State here the amount of court-fee stamps affixed)

To,

The..................................................

........................................................

Date of order against which the appeal is made..................

Date of receipt of the order............................................................

Reasons if appeal/second appeal is not made within the time allowed:

Name and designation of the officer who passed the order....................................

1.	The notice of demand if any, is attached hereto.
2.	A certified copy of the order appealed against is attached hereto.
3.	The amount of tax and/or penalty in dispute.
4.	Statement of facts of the cases:
	(if necessary attach a separate sheet of paper)
5.	The applicant has paid the tax assessed and/or penalty imposed Under the order appealed against as detailed below:
6.	The appellant's first appeal against the order passed by.................. has been rejected/ dismissed / partly allowed.
7.	The applicant has not preferred any appeal against the aforesaid Order, before any authority, at any time.
8.	Enter here the ground relied on for the purpose of this appeal.
	( if necessary attach a separate sheet of paper).
9.	The appellant thereof prays:
10.	The applicant........................... named above, does hereby declare that what is stated herein is true.

	Signature...........................
Dated the.............................. 200
	(To be signed by the appellant or by agent duly authorized in writing in this behalf by the appellant).

Full address of the appellant:

................................................