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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 

Disputed Amount

Determined Amount

Disputed Amount

Determined Amount  

Disputed Amount 

Determined Amount  

Disputed Amount

Determined Amount  

Disputed Amount

Determined Amount

10 

11 

(a) Tax 

                   

(b) Interest 

                   

(c) Penalty 

                   

(d) Fees 

                   

(e) Others 

                   

(f) Refund 

                   

 Section-II 

Place of Supply/ Name of State/UT  

Demand 

Tax 

Interest 

Penalty 

Other 

Total 

 

Amount in dispute 

         
 

Amount Determined 

         
             
             

Add rows 

           

10. For Other orders and Demand orders which are not quantified 

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