FORM GST APL-01/03 W
[See rule 109C]
Application for Withdrawal of Appeal Application

1. GSTIN:

2. Name of Business (Legal) (in case appeal is filed under sub-section (1) of section 107)

3. Name and designation of the appellant (in case appeal is filed under sub-section (2) of section 107):

4. Order No.& Date:

5. ARN of the Appeal & Date:

6. Reasons for Withdrawal:

i. Acceptance of order of the adjudicating authority.

ii. Acceptance of order of a Higher Appellate Authority/ Court on similar subject matter

iii. Need to file appeal again after rectification of mistakes/omission in the filed appeal

iv. Amount involved in appeal is less than the monetary limit fixed for Appeal by the Board/Commissioner

v. Any other reason

7. Declaration (applicable in case appeal is filed under sub-section (1) of section 107):

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

Date:

Name of Applicant /Applicant Officer
Designation/ Status.