Forms - Appeal
Form GST APL-04A
Summary of the order and demand after issue of order by the Goods and Services Tax Appellate Tribunal
1[Form GST APL-04 A
[See rule 113(2)]
Summary of the order and demand after issue of order by the Goods and Services Tax Appellate Tribunal
Whether remand order: Yes / No
Order Reference no.-
Date of order-
1. GSTIN/Temporary ID/UIN –
2. Appeal Case Reference no. – Date:-
3. Name of the appellant –
4. Name of the Respondent –
5. Order appealed against –
a) Order Type -- Demand, Registration, Refund, Enforcement, Refund & Others
b) Ref Number – Date –
6. Personal Hearing – (All hearing dates)
7. Status of Order under Appeal- Confirmed/Modified/Rejected
Confirmed – Order under Appeal is confirmed
Modified – Order under Appeal is modified
Rejected - - Order under Appeal is annulled
8. Order in brief: (Free text, Max 2500 characters)–
9. If demand order, then whether demand quantified: (Yes/No) (If the answer is YES, the demand quantified as follows:)
Section-I
|
Particulars |
Central tax |
State/UT tax |
Integrated tax |
Cess |
Total |
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Disputed Amount |
Determined Amount |
Disputed Amount |
Determined Amount |
Disputed Amount |
Determined Amount |
Disputed Amount |
Determined Amount |
Disputed Amount |
Determined Amount |
|
|
1 |
2 |
3 |
4 |
5 |
6 |
7 |
8 |
9 |
10 |
11 |
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(a) Tax |
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(b) Interest |
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(c) Penalty |
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(d) Fees |
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(e) Others |
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(f) Refund |
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Section-II
|
Place of Supply/ Name of State/UT |
Demand |
Tax |
Interest |
Penalty |
Other |
Total |
|
1 |
2 |
3 |
4 |
5 |
6 |
7 |
|
Amount in dispute |
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Amount Determined |
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Add rows |
10. For Other orders and Demand orders which are not quantified
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Issues as raised by proper officer |
Issues as determined by Appellate/Revisional authority |
Order by GST Appellate Tribunal |
11. If remanded with directions:
a) Remanded to: (specify authority to whom remanded. Adjudicating Authority, Appellate authority, Revisional authority, any other)
b) Directions subject to which remanded, if any: (Free text, Max 1000 words)
Section-III (Anti-profiteering)
12. Order In brief: (Drop -Down Values)
a) Reduction in Price
b) Return to Recipient of Amount not passed on, along with interest
c) Deposit in Consumer Welfare Fund/s
d) Penalty Imposed (Amount to be specified)
e) Cancellation of Registration
Place:
Date:
Signature:
Designation:
Jurisdiction:]1
1. Inserted (w.e.f. 22.09.2025) vide Notification No. 13/2025 – Central Tax dated 17-09-2025