(VIJAY KAUSHIK)
Under Secretary to the Government of India
1. | Full Name of the applicant: |
2. | (i) Postal address of the applicant : (ii) E-mail address of the applicant, if any |
3. | (i) Address for communication: (ii) Telephone No. |
4. | (i) Permanent Account No : (ii) IEC No : (iii) Status : [see note 2] |
5. | (i) Commissioner of Customs having jurisdiction over the applicant :
(ii) Postal address of the Commissioner of Customs having jurisdiction over the applicant: |
6. | Details of the Show Cause Notice issued to the applicant (a) Show Cause Notice No. and date (b) Period of dispute in the notice (c) Duty demanded in the notice (in Rs.) (d) Dispute in connection with which the application for settlement is made. (e) Adjudicating authority before whom the notice is pending adjudication. |
7. | (i) Whether Bill(s) of Entry or Shipping Bill(s), as the case may
be, showing full particulars of the goods and customs duty paid was/were
filed. (ii) Whether the disputed goods were entered in the Bill(s) of Entry or Shipping Bill(s). If so, details thereof. Note: Self-attested copies of relevant Bill(s) of Entry /Shipping Bill(s) to be enclosed. |
8. | Date of seizure, if any. |
9. | Brief facts of the case and particulars of the issues to be settled.
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10. | (a) Amount of duty accepted as payable for settlement. (in Rs. ) (b) Interest on the said admitted duty.(in Rs.) |
11. | Payment details of the duty accepted, by the applicant along with
interest as at (10) above. (TR-6 challan No. and date). |
12. | Whether any application for settlement has been filed by the
applicant before any Bench of Settlement Commission on or before 31st
May,2007 , if so, details thereof: (a) Application No. and date (b) Amount admitted for settlement (c) Details of final order of the Commission (d) Whether settlement amount has been paid in terms of the order |
13. | Whether any application for settlement (other than the present one)
has been filed by the applicant before any Bench of Settlement
Commission on or after 1st June , 2007 . If yes, the following
information may be provided: (a) Application No. and date (b) Show cause notice No. and date (c) Amount of admitted duty (d) Issue involved (e) Status of the application, if decided, then (i) Settlement order No. and date (ii) Details of deposit of settlement amount |
14. | If any other application, filed by the applicant, on or after 1st
June , 2007, is pending before the Settlement Commission, then whether
the present application for settlement involves issue identical to the
issue in respect of which the other application is pending before the
Settlement Commission as on date. |
Signature of the applicant
Deponent
Note:
1. The application fee should be credited in a branch of the authorized bank or
a branch of the State Bank of India or a branch of Reserve Bank of India and the
triplicate copy of the challan sent to the Settlement Commission with the
application. The Settlement Commission will not accept cheques, drafts, hundies
or other negotiable instruments.
2. Please state whether individual, Hindu undivided family, company, firm, an
association of persons, etc.
3. Details of the additional amount of Customs duty accepted as payable and
interest thereon referred to in item 10 of the application shall be furnished in
annexure to this application.
4. Original copy of the TR-6 challan indicating amount of duty accepted as
payable for settlement and interest thereon, referred to in item 10, be retained
by the applicant, duplicate be endorsed to Customs Officer having jurisdiction
over the applicant, triplicate be endorsed to the jurisdictional Chief Accounts
Officer of the Customs Commissionerate, quadruplicate be retained by the bank
and quintuplicate copy be enclosed with this application form.
Signature of the applicant
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