FORM 18 (See rule 31 and rule 37) Appeal against an order of assessment and/or penalty under section 14 of the Goa Tax on Luxuries Act, 1988 To, The ......... ........... Date the ..... (i) Registration No. .... (ii) Name of the hotelier ....... (iii) Status ..... (write here individual, Hindu undivided family, firm, limited company, association of persons, etc. as the case may be) (iv) Style of business ...... (v) Location of business .... (vi) Address to which communication should ordinarily be despatched.. (vii) Name of officer who passed the order .... (viii) Designation ... (ix) Period to which the appeal relates ..... (x) Date of order ... (xi) Date of service of notice .... (xii) Amount of demand ..... Tax ..... Penalty ...... Total ..... (xiii) Amount of paid ... Tax ..... Penalty ...... Total ..... (xiv) Amount in dispute .. (xv) Amount of fee paid ... The petition of .... S/o...............on behalf of the holder whose particulars have been mentioned above, showeth as follows;- (1) Under the Goa Tax on Luxuries Act, 1988, your petitioner has been assessed on a taxable turnover of Rs....... for the period mentioned above. (2) A penalty of Rs. ..... has been imposed on you petitioner. (3) Your petitioner's gross turnover and taxable turnover, according to the previous of the Act, of the business place mentioned above for the period mentioned above amounted to ...... and Rs. ..... respectively. (4) Such turnover was actually received/ receivable during the said period and your petitioner had no other receipt proceeds during the said period (5) Your petitioner has submitted proper return of his turnover of receipts to the Office of ..... under section 13 of the Act and has compiled with all the terms of notice of assessment served on him by the ....... under section 14 of the Act. (6) Your petitioner was prevented by sufficient cause from making the return required by section 13 or did not receive the notice issued under section 14/16 or had not reasonable opportunity to comply or was prevented by sufficient cause from complying with terms of the notice or from producing evidence, as more particularly specified in the statement of grounds of appeal hereto attached. (7) Your petitioner did not conceal the particulars of his gross and taxable turnover or deliberately furnish inaccurate particulars thereof, but as will be seen from the best of his knowledge and belief. (8) Your petitioner, therefore prays that he may be assessed accordingly or that he may be declared not to be chargeable under the Act or that the assessment may be called and/ or/ remanded for re-assessment or that the order imposing a penalty upon your petitioner may be set aside. (9) A certified copy of the order appealed against is attaced. GROUNDS OF APPEAL (Enter here a Concise statement of the reasons on which you rely for the purpose of this appeal). I, ............. the petitioner named in the above petition, do hereby declare that what is stated herein is true to the best of my information and belief and that the tax admitted by me to be due in respect of the order of assessment appealed against has been paid by treasury challan No. ...... dated ....... Signature: ........ Designation: ....... (To be signed by the appellant or by any agent duly authorised in writing in this behalf by the appellant). Note: - Strike out phrases or paragraph not applicable.
