ST - 9A [ See Rule 31 ] Memorandum of Appeal to the Tax Board Appeal No. : ________of ________ Appellants Respondants In the Rajasthan Tax Board Ref. : Appeal under Section 85 of the RST Act , 1994, against the Order dated _______ of Deputy Commissioner (Appeals)/Commissioner / District Level Screening Committee / State Level Screening Committee 1. Name(s) of the Appellant(s) : 2. Address to which notices may be sent to Appellant (s) and Respondant(s) : A. Appellant(s) B. Respondent(s) 3. Authority Passing the order in dispute : 4. Date of order appealed against : 5. Period of Assessment/incentives claimed : 6. Whether original or certified copy along with two true copies of the order appealed against is attached : 7. Relief Claimed in appeal before the Tax Board : (a) Where turnover is disputed (i) Disputed Turnover (ii) Tax Due on the disputed Turnover : (b) Where rate of tax is disputed (i) Turnover involved (ii) Amount of tax in dispute : (c) Where the order of penalty/interest is disputed (i) Section under which penalty/ interest is disputed (ii) Amount of penalty in dispute (iii) Amount of Interest in dispute (d) Any other relief claimed : 8. Grounds of appeal to the Tax Board Place : Signature(s) of Date : Appellant(s) and Status Verification The Appellant(s) __________________________ named above does/do hereby declare : (i) That the said order is appealable under section 85 of the RST Act, 1994 (ii) That no appeal from the said order is pending, and (iii) That what is stated here in is true to the best of his/her/their knowledge and belief and nothing has been concealed. Verified today the ____________ day of _________20_____. Signature Signature (Advocate /Authorised representative, if any) (Appellant(s)) 1. The application of appeal should be in triplicate and be accompanied by two copies of the order appealed against and two copies of the relevant order of the assessing authority, in addition to the original or certified copy. 2. The number and the year of appeal shall be filled in the office of the Tax Board. 3. Where the space provided in the application is found insufficient, separate enclosure may be used for the purpose.
