The Orissa Entry Tax - Forms
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FORM E33

[See sub-rule (1) of rule 23]

FORM OF APPEAL AGAINST ORDER OF ASSESSMENT, ORDER IMPOSING ENALTY OR LEVYING INTEREST UNDER THE OET ACT, 1999.

The __________________________

Date____________

The petition of Sri/Smt________________________(status)_______________of the business known as M/s.______________________(Name & address of the Dealer) bearing TIN/SRIN/ Identification No.___________________ whose principal place of business under the jurisdiction of the Sales Tax Officer/Assistant

Commissioner of Sales Tax,___________________Circle/Range/LTU is situated at_____________________,

P.O_______________,Dist_______________shewth as follows:-

1.	Under the Orissa Entry Tax Act, 1999, your petitioner's turnover of purchases and turnovers of sales of scheduled goods on which Entry tax is leviable have been determined at Rs._________________& Rs.____________ respectively for period from___________to _____________.
2.	Under section________of the Act, a penalty of Rs.________________has also been imposed on your petitioner.
3.	The order of the Sales Tax Officer/ Assistant Commissioner of Sales Tax, attached hereto, was received by the petitioner on dt__________________.
4.	During the period from ___________to __________, your petitioner's turnover of purchase and turnover of sales of scheduled goods on which E.T. is leviable under different rates of tax as per the statement attached hereto amounted to Rs.____________& Rs.___________ respectively.
5.	During the said period, your petitioner had no other turnover of purchase or sale of scheduled goods on which E.T. is leviable.
6.	Your petitioner's failure to apply for registration under the Act was not without sufficient causes.
7.	Your petitioner, therefore, prays that he may be assessed according to the figures given in Para 4 above.
8.	In the circumstances, it is submitted that your petitioner may be declared to be not liable to pay tax under the Act and the order of assessment and penalty annulled; or that the assessment and penalty may be set aside and the Sales Tax Officer/ Assistant Commissioner of Sales Tax, directed to pass a fresh order after such enquiry, as may be Directed.
	Signature

GROUNDS OF APPEAL

FORM OF VERIFICATION

I, Sri ___________________________________ , the petitioner named in the above petition, do declare that what is stated in this petition is true to the best of my information and belief, that a sum of Rs. _____________(Rupees _________________________________) being the tax admitted to be due or, and Rs. _____________(Rupees

_________________________) being the interest to be due and that Rs. ___________ ( in words) __________________________ being twenty percent of the amount in dispute as due, from me have been paid by Treasury Challan/Crossed Demand Draft as per detail given below:

Sl. No.	Tax Paid	Tax admitted in the return	Challan No./D.D. No. and date
1.
2.

Seal	Signature
Place: ------------------
Date: --------------------	Designation with seal)