FORM GST DRC-09
[See rule 143]
To
___________
----------------
Particulars of defaulter -
GSTIN –
Name -
Demand order no.:
Date:
Reference no. of recovery:
Date:
Period:
Order for recovery through specified officer under section 79
Whereas a sum of Rs. << -------->> on account of tax, cess, interest and penalty is payable under the provisions of the <<SGST/UTGST/ CGST/ IGST/ CESS>> Act by the aforesaid person who has failed to make payment of such amount. The details of arrears are given in the table below:
“Act |
Tax/Cess |
Interest |
Penalty |
Fee |
Others |
Total |
1 | 2 | 3 | 4 | 5 | 6 | 7 |
Integrated tax | ||||||
Central tax | ||||||
State/UT tax | ||||||
Cess | ||||||
Total |
<< Remarks>> |
You are, hereby, required under the provisions of
section 79 of the <<
Signature
Name
Designation
Place:
Date: