INCOME-TAX RULES, 1962
FORM NO. 35
(See rule 45)
Appeal to the Commissioner of Income-tax (Appeals)
First Name Middle Name Last Name or Name of Entity PAN
TAN (if available)
Personal Information
Flat/ Door/ Block No. Name of Premises/ Building/ Village Road/ Street/ Post Office
Area/ Locality Town/City/District State
(Select)
Country Pin Code Phone No. with STD Email Address
(Select) code/ Mobile No.
Whether notices/ communication may be sent on email? Yes/ No
1 Assessment year in connection with which the appeal is preferred/ Enter Assessment Year
financial year in case appeal is filed against an order where assessment
Order against which
year is not relevant Financial Year
Appeal is filed
2 Details of the order appealed against
a Section and sub-section of the Income-tax Act,1961
b Date of Order
c Date of service of Order / Notice of Demand
3 Income-tax Authority passing the order appealed against
4 Whether an appeal in relation to any other assessment year/ financial year is pending in the case of the
Yes/ No
appellant with any Commissioner (Appeals)
4.1 If reply to 4 is Yes, then give following details.-
Pending Appeal
a Commissioner (Appeals), with whom the appeal is pending
b Appeal No. and date of filing of appeal
c Assessment year/ financial year in connection with which the appeal has been preferred
d Income-tax Authority passing the order appealed against
e Section and sub-section of the Income-tax Act, 1961, under which the order appealed against has been
passed
f Date of such Order
5 Section and sub-section of the Income-tax Act,1961 under which the appeal is preferred
6 If appeal relates to any assessment
a Amount of Income Assessed (in Rs.)
Appeal Details
b Total Addition to Income (in Rs.)
c In case of Loss, total disallowance of Loss in assessment (in Rs.)
d Amount of Addition/ Disallowance of Loss disputed in Appeal (in Rs.)
e Amount of Disputed Demand (in Rs.) – Enter Nil in case of Loss
7 If appeal relates to penalty:
a Amount of penalty as per Order (in Rs.)
b Amount of penalty disputed in Appeal (in Rs.)
8 Where a return has been filed by the appellant for the assessment year in connection with which the appeal Yes/No/ Not
is filed, whether tax due on income returned has been paid in full Applicable
8.1 If reply to 8 is Yes, then enter details of return and taxes paid
a Acknowledgement number
Details of Taxes paid
b Date of filing
c Total tax paid
9 Where no return has been filed by the appellant for the assessment year, whether an amount equal to the Yes/No/ Not
amount of advance tax as per section 249(4)(b) of the Income-tax Act, 1961 has been paid Applicable
9.1 If reply to 9 is Yes, then enter details
Tax Payments
BSR Code Date of payment Sl. No. Amount
Total
10 If the appeal relates to any tax deductible under section 195 of the Income-tax Act, 1961 and borne by the deductor, details of tax
deposited under section 195(1)
BSR Code Date of payment Sl. No. Amount
11 Statement of Facts
Facts of the case in brief (not exceeding 1000 words)
Appeal and additional evidence
Statement of facts, Grounds of
List of documentary evidence relied upon
12 Whether any documentary evidence other than the evidence produced during
the course of proceedings before the Income-tax Authority has been filed in Yes / No
terms of rule 46A
12.1 If reply to12 is Yes, furnish the list of such documentary evidence
13 Grounds of Appeal (each ground not exceeding 100 words)
1.
2.
3.
14 Whether there is delay in filing appeal Yes/ No
15 If reply to 13 is Yes, enter the grounds for condonation of delay (not exceeding 500 words)
Appeal filing
16 Details of Appeal Fees Paid
details
BSR Code Date of payment Sl. No. Amount
17 Address to which notices may be sent to the appellant
Form of verification
I, ____________________________the appellant, do hereby declare that what is stated above is true to the best
of my information and belief. It is also certified that no additional evidence other than the evidence stated in row
12.1 above has been filed.
Place Signature
Date
