Form A-VII Application for Revision under section 73 of the Bihar Value Added Tax Act, 2005 [See rule 45(4)] Before the Commercial Taxes Tribunal, Bihar, Patna I .................................................................................................... (full name), son of ................................................................................................................. (full name) hereby prefer this application for revision of the order dated ....................................................... passed by ........................................................................................................... and furnish the following particulars for that purpose - 1. Name and style of the business ........................................................................................................................................................................................ ........................................................................................................................................................................................ 2. Registration Number ........................................................................................................................................................................................ 3. Address to which the communication should ordinarily be dispatched: (a) Mohalla/Road .......................................................................... (b) Village/Town ................................................................................ (c) Post Office ................................................................................... (d) Police Station .............................................................................. (e) Sub-Division ........................................................................... (f) District ................................................................................................. (g) Pincode ............................................................................................... (h) Telephone ........................................................................................ 4. Period to which the application relates .............................................................................................................................................................. 5. Details of Turnover and Tax Assessed (To be furnished only in case of an application for revision concerning an assessment/re-assessment) As determined by As determined in As admitted by Particulars Assessing Authority appeal or revision the Applicant (1) (2) (3) (4) (a) Gross Turnover ................................................................. ...................................................... ...................................................... (b) Taxable Turnover ................................................................. ...................................................... ...................................................... (c) Total Amount of Tax ................................................................. ...................................................... ...................................................... Re-assessed (d) Section under which ................................................................. ...................................................... ...................................................... Re-assessment made 6. Amount of Penalty, if any, imposed and the section under which it was imposed ................................................................................................................................................. 7. Details of payments made: Challan Number Date Amount 1. ................................................................. ................................................................. ................................................................. 2. ................................................................. ................................................................. ................................................................. 8. Amounts in dispute: (a) Tax Rs. ................................................................... (b) Penalty Rs. ................................................................... (c) Total Rs. ................................................................... - 2 - 9. List of Papers and Documents filed: (a) Challan No. ................................................... dated ................................................. showing deposit of fee payable on this application. (b) Certified copy of the appellate/re-visional order against which this application has been preferred. (c) True-typed copies of the final orders at the original stage, appellate stage and the preceding revisional stage or stages, if any. (d) Two extra copies of this application. 10. Statement of facts of the case and prayer: (a) The facts of the case are as follows ......................................................................................................................................................................................................................................................................................... ......................................................................................................................................................................................................................................................................................... (b) The points at issue are as follows ......................................................................................................................................................................................................................................................................................... ......................................................................................................................................................................................................................................................................................... (c) The grounds for revision are as follows ......................................................................................................................................................................................................................................................................................... ......................................................................................................................................................................................................................................................................................... (d) The relief sought is as follows ......................................................................................................................................................................................................................................................................................... ......................................................................................................................................................................................................................................................................................... VERIFICATION I do hereby declare that the above particulars and statements are correct and complete to the best of my knowledge and belief. Place ................................................... Signature of Applicant .............................................................................. Date ................................................... Status .................................................................................... ACKNOWLEDGEMENT Received on ........................................... from ............................................................................................... an application for revision in Form A-VII, for the period ................................................ together with/without the papers and documents specified at item 9 of the application. The revision number allotted is ....................................................................... of ............................................................. . Signature of Receiving Authority ............................................................ Designation ............................................................................................................................
