FORM GST APL – 03
[See rule 109(1)]
Application to the Appellate Authority under sub-section (2) of Section 107
1. Name and designation of the appellant
Name-
Designation-
Jurisdiction-
State/Center-
Name of the State
2. GSTIN/ Temporary ID /UIN
3. Order no Date-
4. Designation and address of the officer passing the order appealed against
5. Date of communication of the order appealed against
6. Details of the case under dispute-
(i) Brief issue of the case under dispute
(ii) Description and classification of goods/ services in dispute-
(iii) Period of dispute-
(iv) Amount under dispute-
7. Statement of facts –
8. Grounds of appeal –
9. Prayer –
10. Amount of demand in dispute, if any –
Place:
Date: Signature>
Name of the Applicant Officer:
Designation:
Jurisdiction: