S.T. XXXIX FORM [See rule 57 (1) (a) (ii) and (c) of the Himachal Pradesh General Sales Tax Rules, 1970] Form of memorandum of appeal to the appellate authorities other than the Sales Tax Tribunal, under section 30 (a) and (b) of the Himachal Pradesh General Sales Tax Act, 1968. (Space for court fee stamp) Value of court fee stamp affixed. Before the *........................ Appellate Authority **......................... M/s. ................... Appellant(s) Versus .............................. Respondent. 1. Assessment year 2. District in which assessment was made 3. Authority passing the order in dispute. 4. Date of passing order appealed against 5. Address to which notice may be sent to the appellant(s) 6. Address to which notice may be sent to the respondent. 7. Relief claimed in appeal: a. Turnover determined by the Assessing Authority b. If turnover is disputed:- i. disputed turnover; and ii. sales tax on disputed turnover. (c ) If rate of sales tax is disputed:- i. Turnover involved; and ii. Amount of sales tax disputed. (d) If the order of penalty/ interest is disputed: i. section under which penalty imposed: ii. Amount of Penalty in dispute; and iii. Amount of interest in dispute. (e) Any other relief claimed. 8. Whether the additional demand (i.e. sales tax, penalty and interest) created by the Assessing Authority has been deposited into the Government Treasury or not? 9. Grounds of appeal. (Fill in here) Signature of the Appellant(s) of his/ their duty authorized agent. Verification: I/We ................ Appellant(s) named in the above appeal do hereby declare that what is stated above from para I to..... of the appeal, is true to the best of my/ our knowledge and belief. (Verified................ this...... the day of 19.... Signature of the Appellant(s) of his/ their duty authorized agent.