FORM 2

[See rule 4]

CERTIFICATE FOR FULL AND FINAL SETTLEMENT OF TAX ARREARS UNDER SECTION 96 (2) OF THE FINANCE ACT, 2008 IN RESPECT OF DISPUTE RESOLUTION SCHEME, 2008

Whereas                                                                             (hereinafter referred to as declarant) has made a declaration under section 94 of the Finance Act, 2008;

                (Name and address of the declarant)  

And   whereas   the  designated  authority  by  order  dated              determined the amount of                                          rupees payable by the declarant in accordance with the provisions of the Scheme and granted a certificate setting forth therein the particulars of the tax arrears and the sum payable after such determination towards full and final settlement of tax arrears as per details given below;  

And whereas  the declarant  has paid                             rupees being the sum determined by the designated authority;

And whereas the declarant had declared in the declaration made under section 94 that no writ petition or appeal or reference before any High Court or the Supreme Court against any order in respect of the tax arrears has been filed by such declarant (strike off if not applicable);

or

And whereas the declarant had filed a writ petition/appeal/ reference

(mention the name of the High Court)

High Court or the Supreme Court against any order in respect of the tax arrears;

And whereas the declarant has withdrawn the said writ petition/appeal/reference and furnished proof of such withdrawal in accordance with the provisions contained in the proviso to sub- section (4) of section 96 (strike off if not applicable);

Now, therefore, in exercise of the powers conferred by sub-section (2) of section 96 of the Finance Act, 2008, the designated authority hereby issues this certificate to the said declarant:-  

(a)     certifying the receipt of payment from the declarant towards full and final settlement of tax arrears determined in the order dated                                      on the declaration made by the aforesaid declarant;

  (b)      granting immunity, subject to the provisions of the Scheme, from institution of any proceeding for imposition of penalty under the Finance Act, 1994, in respect of matters covered in the aforesaid declaration made by the declarant.

   Date :

Place :                                                        Name, Signature and Seal of Designated Authority To

(1)   The Declarant

(2)   Assessing/Adjudicating Officer

(3)   Commissioner of Income Tax/Customs/Central Excise

(4)   Concerned Appellate authorities/bodies