Memorandum of appeal

To, The Profession Tax Appellate Authority ............................................................... I, hereby appeal and furnish the necessary particulars : (1) Registration Certificate No. ......................... (2) Name of the Employer/person ......................... (3) Style of profession/trade/calling ......................... (4) Address ......................... (5) Period involved under impugned order against which appeal is preferred. ......................... (6) (a) Name of the authority who passed the impugned order ......................... (b) Date of order ......................... (c) Date of service of demand notice ......................... (d) Amount demanded : (i) Tax ......................... (ii) Penalty ......................... Total ......................... (e) Amount of admitted tax ......................... (f) Amount paid : (i) Tax ......................... (ii) Penalty ......................... Total ......................... (g) Amount in dispute ......................... (7) Grounds on which appeal has been preferred. ......................... A certified copy of the impugned order and a copy of challan in proof of payment of tax/penalty are enclosed. The above statements are true to the best of my knowledge and belief. Place.......................... Signature................................. Date.......................... Status.......................................