Certificate of settlement issued by the designated authority

[See section 8(1)] On the basis of the application made by ______________ (name of the applicant), who is carrying on/used to carry on the business in the trade, name of ____________________________ at __________________ (address) and who is/was holding R. C. (Local/Central/Luxury/Entry) No. ___________________ and TIN No. ____________________________________ under the _________________________ (name of the relevant Act), it is certified that:— *(1) Arrears of tax, interest or penalty arisen on account of the order of assessment for the period from _________ to ________ against which, no appeal is preferred upto _______ has been settled under sub-section (1) of section 8 of the Settlement of Appeals and Arrears under Goa Sales Tax, Central Sales Tax, Goa Tax on Luxuries and Goa Tax on Entry of Goods Act, 2009. *(2) Arrears of tax, interest and penalty arisen for the assessment period ________________ which was pending in review/appeal/revision before __________________ (name of the appropriate review/appellate/revisional authority), being review/appeal/revision case No. ________________, has been settled under sub-section (1) of section 8 of the Goa (Recovery of Arrears of Tax through Settlement) Act, 2009. The applicant on the above application has paid a net amount of Rs............................... as final settlement, which has been accepted. ISSUED this ________ day of __________. Signature Designation (Appropriate designated authority) (Seal) *Strike out whichever is not applicable. N.B.: Endorse one copy of the settlement certificate Part A, Part B, and Part C to the Commissioner