You are hereby directed to make the
payment by <Date> failing which proceedings shall be initiated
against you to recover the outstanding dues.
Signature
Name
Designation
Jurisdiction
Address
To
_______________ (GSTIN/ID)
----------------------------Name
_______________ (Address )
Note -
1. Only applicable fields may be filled up.
2. Column nos. 2, 3, 4 and 5 of the Table at serial no. 5 i.e. tax rate,
turnover and tax period are not mandatory.
3. Place of Supply (POS) details shall be required only if the demand is
created under the IGST Act.”.