The Nagaland Value Added Tax Rules, 2005 - FORMS
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THE NAGALAND VAT RULES, 2005

FORM VAT-12

[See rule 55(2)]

Form of memorandum of appeal to the Appellate Authority other than the tribunal under Section 73(1) of the Nagaland VAT Act, 2005.

Before the .......................................................(Appeals), Nagaland

(State the Authority)

Appeal No..............................of 200.................

(To be filled in by the Office of the Appellate Authority, Nagaland)

M/S..................................		...................Appellant
	Versus
Assessing Authority/Taxing Authority.................. (District)......................... Respondent

The.................................. day of.......................... 20.....................

1.	Assessment year.....................
2.	Authority passing the order appealed against........................................
3.	Date of the order appealed against..........................................................
4.	Date of communication of the order appealed against.............................
5.	Address to which notice may be sent to the appellant...............................
6.	Relief claimed in appeal:-
	a.	Turnover determined by the Assessing Authority...................................
	b.	If turnover is disputed
		(i) disputed turnover.......................................................................
		(ii) tax due on the disputed turnover................................................
	c.	If rate of tax is disputed
		(i) turnover involved.....................................................
	d.	(ii) amount of tax disputed........................................... Any other relief claimed..................................................

The appellant has paid the tax assessed, interest levied and penalty imposed under the order appealed as shown below:-

	Amount paid before assessment	Paid after assessment			Balance due, if any, at the time of filing of appeal Amount
	Amount paid before assessment	Amount	Treasury Receipt No.	Date	Balance due, if any, at the time of filing of appeal Amount
(i) Out of admitted tax and interest.
(ii) Out of disputed tax, interest and penalty

7. Grounds of appeal (may be recorded in a separate sheet if the paper is insufficient) ..................................................

Signatures of appellant or his authorized Representative.

VERIFICATION

I/We.............................. appellant(s) named in the above memorandum of appeal do hereby declare that what is stated herein is true and correct to the best of my/our knowledge and belief.

Verified today the.................... day of................... 20..................

Signatures of appellant or his authorized Representative

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

For use in the office of the authority concerned

(Office seal)		Receipt No...................................
		Date of receipt..............................
		Signature of receiving officer/
		official.........................................
		Name: ........................................

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

ACKNOWLEDGEMENT

Received from M/s............................................. of district.................................... R.C No. (if any) ................................................ appeal along with the enclosures mentioned therein.

Place:
Date:		Signature of receiving officer/official with seal
		..........................................
	(Office seal)