GOVERNMENT OF JHARKHAND COMMERCIAL TAXES DEPARTMENT [See Rule 48(3)] Application for Stay of Recovery in Appeal/Revision Instructions: 1. Enclose proof of payment of undisputed demand (if any) 2. Enclose proof of filing of Appeal. 3. This Form should be verified and signed by: a. Proprietor, in case of Proprietorship concern b. Managing Partner, in case of Partnership firm and where there is no Managing Partner, by all the partners if there is no registered partnership deed and in case of a registered partnership deed by any one of them. c. Managing Director or authorized signatory, in case of a Company d. Karta, in case of Hindu Undivided Family e. Authorised Signatory, in all other cases 1. Name of the Dealer ___________________________________ 2. Registration No. (TIN) ___________________________________ 3. Address Building Name/Number ___________________________ Area/Road ___________________________ Locality/Market ___________________________ Pin Code ___________________________ Email Id ___________________________ Telephone Number(s) ___________________________ Fax Number(s) ___________________________ 4. Date of the order being appealed against ___ ___ / ___ ___ / ___ ___ ___ ___ (Please enclose copy of the above order) DD / MM / YYYY 5. Date of service of said order ___ ___ / ___ ___ / ___ ___ ___ ___ DD / MM / YYYY 6. Section, under which order passed ________________________________ 7. Disputed amount Rs. _____________________________ 8. Date on which appeal is filed ___ ___ / ___ ___ / ___ ___ ___ ___ DD / MM / YYYY 9. Amount for which stay is requested Rs. _____________________________ 10. Reasons for stay of recovery of the disputed amount Enclose additional sheet(s) in case you are not able to provide all details in this space Enclose all documents/ evidence that you want considered regarding your application Verification I certify that the above information and its enclosures (if any) is true and correct to the best of my knowledge and belief and nothing has been concealed. Signature Full name of Applicant Designation Date Place
