Form GST ASMT – 17
[See rule 100(4)]

Application for withdrawal of assessment order issued under section 64

1. GSTIN /ID  
2. Name  
3. Details of the order Reference No. Date of issue of order
4. Tax Period, if any
5. Grounds for withdrawal
 

6. Verification
I________________________________________ hereby solemnly affirm and declare that the information given hereinabove is true and correct to the best of my knowledge and belief and nothing has been concealed therefrom.

Signature of Authorised Signatory

Name ___________

Designation / Status -------

Date-