FORM GST ADT – 04

[See rule 102(2)]

Reference No.:                                                                                                                                                       Date:

To,

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GSTIN ………………………………..
Name ……………………………………
Address ………………………………….

 Information of Findings upon Special Audit

Your books of account and records for the F.Y.…………… has been examined by -------------- (chartered accountant/cost accountant) and this Audit Report is prepared on the basis of information available / documents furnished by you and the findings/discrepancies are as under:

[Upload pdf file containing audit observation]

You are directed to discharge your statutory liabilities in this regard as per the provisions of the Act and the rules made thereunder, failing which proceedings as deemed fit may be initiated against you under the provisions of the Act.

Signature ………………………….

Name ……………………………..

Designation ……………………….