FORM IV
APPEAL
In The High Court of Andhra Pradesh at Hyderabad (Appellate Side)
Memorandum of Appeal against order
[Under Section 23(1)]
[See Rule 41 of A.P.G.S.T. Rules, 1957]

Appeal against the order of the (Commissioner of Commercial Taxes) dated and passed in.)

 
1.       District in which the assessment was made.

2.       Assessment Year.

3.       Assessing Authority passing the original order.

4.       State if the order was modified at anytime previously by any officer subordinate to the Commissioner of Commercial Taxes    and if so in what manner (state the results of modification briefly).                           

5.       Date of communication of the order of the Commissioner of Commercial Taxes.

6.       Address to which notice may be sent to the Appellant.

7.       Address to which notice may be sent to the respondent.

8.       Relief claimed in appeal.

(a)           Turnover determined by the assessing authority.

(b)           Turnover modified prior to suo motu by the (Commissioner of Commercial Taxes).

(c)           Relief claimed.

(d)           Grounds of appeal.

    (i)      State the facts disputed briefly.
   
    (ii)     State the question of law raised for decision by the High Court.

                                                                                                                                                           (Signed)Appellant(s)
                                                                                                                                                     
                                                                                                                                                           (Signed)Authorised Representative, if any.

VERIFICATION

I/We _______________________________________________________________________ the petitioner (s) do hereby declare that what is stated above is true to the best of my/our knowledge and belief.

Verified to day the__________________________day of __________________20

                                                                                                                                                                (Signed) Appellant(s)

                                                                                                (Signed) Authorised Representative, if any.

Note: 

1.The appeal should be accompanied by a certified copy of the order of the Commissioner of Commercial Taxes appealed against.

2.The appeal shall be accompanied by a fee calculated at the rate of two percent of the disputed tax and surcharge or penalty subject  to a minimum of Rs. 500/- and a maximum of Rs.2,000/-

3.The appeal should be written in English and should set forth concisely and under distinct heads, the facts of the case, the grounds of appeal and the points of law raised consecutively.