[See rule 158(1)]

Application for Deferred Payment/Payment in Instalments


1.  Name of the taxable person-

2. GSTIN –

3. Period ______________

In accordance with the provisions of section 80 of the Act, I request you to allow me extension of time up to ———– for payment of tax/ other dues or to allow me to pay such tax/other dues in ——- instalments for reasons stated below:


I hereby solemnly affirm and declare that the information given hereinabove is true and correct to the best of my knowledge and belief and nothing has been concealed therefrom.

Signature of Authorized Signatory  ————————————————————

Name ————————————————–

Place –

Date  –


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