1[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 a 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.

Place:                                                                                                                                               Signature                 

Date:                                                                                                                                                                                                                                                                                                                                                  Name of Applicant/Applicant Officer

                                                                                                                                                      Designation/ Status.]