FORM NO. 36B
[See rule 14]
Form of appeal to the Appellate Tribunal
In the Income-tax Appellate Tribunal
Appeal No. of

Appellant Versus Respondent
1. The State in which the assessment was made
2. Section under which the order appealed against was passed
3. Assessment year in connection with which the appeal is
preferred
3A. Total income declared by the assessee for the assessment
year referred to in item 3
3B. Total income as computed by the Assessing Officer for the
assessment year referred to in item 3
4. The Assessing Officer passing the original order
5. Copy of Order of Dispute Resolution Panel
6. Date of communication of the order appealed against
7. Address to which notices may be sent to the appellant
8. Address to which notices may be sent to the respondent
9. Relief claimed in appeal
GROUNDS OF APPEAL
Signature Signature
(Authorised representative, if any) (Appellant)
Verification
I the appellant, do hereby declare that what is stated above is true to the best of my information and belief. Verified today the day of
Signature
(Appellant)
Notes :
1. The memorandum of appeal must be in triplicate and should be accompanied by two copies (at least one of which should be a certified copy) of the order appealed against, two copies of the relevant order of the Assessing Officer, two copies of the grounds of objection before the Dispute Resolution Panel, two copies of the statement of facts, if any, filed before the said Dispute Resolution Panel and also
(a) the copy of directions of Dispute Resolution Panel.
(b) in the case of an appeal against an order under section 143 read with section 147, two copies of the original assessment order, if any.
2. The memorandum of appeal by an assessee under section 253(1) of the Income-tax Act must be accompanied by
a fee specified below :—
(a) where the total income of the assessee as computed by the Assessing Officer, in the case to which the appeal relates, is one hundred thousand rupees or less, five hundred rupees;
(b) where the total income of the assessee, computed as aforesaid, in the case to which the appeal relates is more than one hundred thousand rupees but not more than two hundred thousand rupees, one thousand five hundred rupees;
(c) where the total income of the assessee, computed as aforesaid, in the case to which the appeal relates is more than two hundred thousand rupees, one per cent of the assessed income, subject to a maximum of ten thousand rupees;
(d) no fee shall be payable in the case of a memorandum of cross-objections;
(e) an application for stay of demand shall be accompanied by a fee of five hundred rupees.
It is suggested that the fee should be credited in a branch of the authorised bank or a branch of the State Bank of India or a branch of the Reserve Bank of India after obtaining a challan and the triplicate challan sent to the Appellate Tribunal with a memorandum of appeal. The Appellate Tribunal will not accept cheques, drafts, hundies or other negotiable instruments.
3. The memorandum of appeal should be written in English or, if the appeal is filed in a Bench located in any such State as is for the time being notified by the President of the Appellate Tribunal for the purposes of rule 5A of the Income-tax (Appellate Tribunal) Rules, 1963, then, at the option of the appellant, in Hindi, and should set forth, concisely and under distinct heads, the grounds of appeal without any argument or narrative and such grounds should be numbered consecutively.
4. The number and year of appeal will be filled in the office of the Appellate Tribunal.
5. If the space provided is found insufficient, separate enclosures may be used for the purpose.