FORM DA
[See rule 4A and 4AA]
Form of application for settlement of cases under section 22C(1) of Wealth-tax Act, 1957
IN THE SETTLEMENT COMMISSION ....................... *Settlement Application No. ....... 19...... 19.......
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................................................. Signed (Applicant) |
Verification
I, .........................................................................................................................................................................
Son/daughter/wife of ............................ do hereby solemnly declare that to the best of my knowledge and belief, what is stated above and in the Annexure [including the statement(s) and documents accompanying such Annexure is correct and complete. I further declare that I am making this application in my capacity as ............................................................................................................... and that I am competent to make this
(designation)
application and to verify it.
Verified today the ........................................... day of ........................... 19 ...............
Notes :
The application for settlement must be in quintuplicate.
The application for settlement must be accompanied by a fee of five hundred rupees. The fees should be credited in a branch of the authorised bank or branch of the Reserve Bank of India and the triplicate Challan sent to the Settlement Commission with the application for the settlement. The Settlement Commission will not accept cheques, drafts, hundies or other negotiable instruments.
*The number and year of application will be filled in the office of the Settlement Commission.
Please state whether individual, Hindu undivided family, or a company.
If the space provided is found insufficient, separate enclosures may be used for the purpose.
In case of assessment proceedings, indicate the designation of the Assessing Officer Deputy Commissioner before whom the proceedings are pending indicating also the date of services of notice under section 14(2)/section 17 of the Wealth tax Act, 1957, or, as the case of appellate proceeding, indicate the appellate authority before whom the appeal is filed and the date of filling of the appeal. In case of revision petition, indicate the date of filling the revision petition and whether the same is filed within time or not.
Full details of issues for which application for settlement is made, the nature and circumstances of the case and complexities of the investigation involved must be indicated against item 10. Where the application relates to more than the one assessment year, these details should be furnished for each assessment year.
The application amount for settlement of a case shall not be allowed to be withdrawn by the applicant.
The additional amount of wealth-tax payable on the wealth referred to in item 11 should be calculated in the manner laid down in sub-section (1A) to (1D) of section 22C.
The details reffered to in item 11 shall be given in the Annexure to this application.
ANNEXURE
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Place .................. | ................................ |
Date ................... | Signed (Applicant) |
Note : The Annexure should be accompained by ___
A statement(s) containing computation of net wealth of the applicant for the assessment year or years to which the application for settlement relates, in accordance with the provisions of the Act; and
A detailed statement of assets (moveable and immovable) and debts, located in India and outside, as on the valuation date
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