FORM GST APL-07
[See rule 111]

(Application to the Appellate Tribunal under sub section (3) of Section 112)

1. Name and designation of the appellant/Office of Appellant:

(a). Name

(b). Designation

(c). Jurisdiction

(d). State/Centre

2. GSTIN/Temporary ID/UIN (of the respondent) -

3. Name of the respondent

4. Address of the respondent

5. Order appealed against –                             Number -                                                  Date -

6. Complete Designation, along with jurisdiction of the Appellate Authority/Revisional Authority passing the order appealed against –

7. Date of communication of the order appealed against –

8. Details of the case under dispute:

a. Brief issue of the case under dispute

b. Period of dispute –

c. Case Summary (As per Annexure A)

d. Market value of seized goods, where one of the issues involved is seizure/confiscation of goods

9. About Respondent (As per Annexure B)

10. Is place of supply involved in the dispute- Yes/No

11. Statement of facts (As per Annexure C)

12. Grounds of appeal –

13. Prayer –

14. Category of case under dispute or Issues involved – (as per Annexure D )

15. Details of demand:

I hereby declare that I have been duly authorized/directed by the Commissioner in accordance with sub-section (3) of Section 112 of the Act to file this application before the Appellate Tribunal and a true copy of the said direction/authorization is being uploaded herewith

Place:

Date:

<Signature>

Name of the Officer:
Designation:
Jurisdiction:

Annexure A

Case Summary

(indicate Amount in INR, wherever quantified and wherever applicable, not exceeding 1000 characters in each cell)

Annexure B

About Respondent

Annexure C

Statement of Facts (Case History)

(indicate Amount in INR, wherever quantified and wherever applicable, Not exceeding 1000 characters in each cell, Upload documents if necessary)

Annexure D

(Category of case under dispute or issues involved )