"THE ASSAM VALUE ADDED TAX RULES, 2005

FORM-78

Revision petition filed under section 82

[See rule 47A]

(In triplicate)

To

The Commissioner of Taxes, Assam

Dated .............................. day of 200...

1. Name and address of the petitioner.

2. Registration No..............

3. Unit in which the assessment was made.

4. Assessment year.

5. Authority passing the original order in dispute.

6. Date of communication of the order against which the revision is filed.

7. Relief claimed in the revision petition.

(a) Turnover determined by the Prescribed Authority if disputed.

(b) Reasons of dispute.

(c) Any other dispute and relief claimed.

8. Ground of revision in brief.

VERIFICATION

I/We ............................................... enclose herewith the certified copy of the order and do hereby declare that the facts stated above are true to the best of my knowledge and belief.