Department of Goods Tax Government of Arunachal Pradesh Form FU-04 (See Rule 49 of the Arunachal Pradesh Goods Tax Rules, 2005) << Date >> Reference No << Reference Number >> <<Address for Service>> {if different from the address of To principal place of business} <<Name of Dealer>> <<Address>> Notice & Order of assessment Whereas on the basis of information which has come to my knowledge, - << you have not furnished returns required under this Act by the prescribed date>> (or) << you have furnished incomplete or incorrect returns>> (or) << you have furnished a return which does not comply with the requirements of this Act>> (or) << you have furnished incomplete returns or incorrect returns>> (or) other reason << Specify the reasons>> in respect of tax period(s) mentioned in this notice. Now therefore, in exercise of powers conferred to me in terms of Section 34 of the Arunachal Pradesh Goods Tax Act 2005, I hereby assess the amount of tax, Interest and penalty payable by you in respect of the tax period(s) as follows- Period Amount of Tax, interest and Penalty assessed Reasons for the assessment <<Tax Period>> Tax Rs. <<Tax Assessed>> CST Rs. << CST Assessed>> Interest <<Interest Assessed>> Penalty <<Penalty Assessed>> <<Reasons>> You are hereby directed to pay amount of rupees <<Total Amount>> for the aforesaid tax period/s on or before << Date >>. You have a right to object against this order under Section 75 of the Act within two months from the date of service of notice of assessment. (Signature) (Designation) (Place) (Date) Department of Goods Tax Note: Please write your RC No. while communicating with the Arunachal Pradesh Goods Tax Department in this matter or in any other matter whatsoever.
