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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

1 

2 

3 

4 

5 

6 

7 

8 

9 

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 

1 

2 

3 

4 

5 

6 

7 

 

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