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195. Prescribed form for appeal to the Income Tax Appellate Tribunal.- An appeal under section 134 shall be in the following form and be verified in the manner indicated therein:-
FORM OF APPEAL TO THE TRIBUNAL UNDER SECTION 134 OF INCOME
TAX ORDINANCE, 1979
IN THE INCOME TAX APPELLATE TRIBUNAL
No........................of 19
| Appellant | Vs. | Respondent |
| Income Tax Circle in which assessment was made and one in which it is located. | ||
| Assessment year to which the appeal relates | ||
| Section of the Income Tax Ordinance, 1979, under which Deputy Commissioner of Income Tax/Inspecting Additional Commissioner passed the order. | ||
| Appellate Additional Commissioner/Commissioner of Income Tax (Appeals) passing the appellate order. | ||
| Date of communication of the order appealed against. | ||
| Address to which notices may be sent to the appellant. | ||
| Address to which notices may be sent to the respondent. | ||
| Claim in appeal | ||
GROUNDS OF APPEAL
Signed
(Appellant)
Signed
(Authorised Representative, if any),
VERIFICATION
I,.........................., the appellant, do hereby declare that what is stated
above is true to the best of my information and belief.
Verified to day, the...................................day
of..........................................19
Signed
(Appellant)
N.B.-1. The memorandum of appeal (including the Grounds of Appeal when filed on a
separate paper) 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 and two copies of
the order of the Deputy Commissioner of Income Tax.
2. The memorandum of appeal in the case of an appeal by the assessee must be accompanied
by a fee of one hundred rupees. The appeal fee must be credited in the Treasury or a
Branch of the National Bank of Pakistan or the State Bank of Pakistan after obtaining a
challan from the Deputy Commissioner of Income Tax and
the triplicate portion of the challan sent to the Tribunal with the memorandum of appeal.
The Appellate Tribunal will not accept cheques, hundies or other negotiable instruments.
3. The memorandum of appeal should be set forth, concisely and under distinct heads, the
grounds of appeal without any argument or narrative and such grounds should be numbered
consecutively.
196. Prescribed Form for reference application.- An application
under sub-section (1) of section 136 requiring the Tribunal to refer to the High Court any
question of law shall be in the following form, namely:-
FORM OF REFERENCE APPLICATION UNDER SECTION 136(1) OF THE INCOME TAX
ORDINANCE, 1979.
IN THE INCOME TAX APPELLIATE TRIBUNAL
In the matter of the assessment
of.........................................................(name of the assessee).
R.S. No.........................................................of 19 (to be filled in by
the office of the Tribunal).
| Apellant | Vs. | Respondent |
| The Income Tax Circle in which assessment was made and the Zone in which it is located. | ||
| Name and number of appeal which gives rise to the reference. | ||
The applicant (s) state (s) as follows:-
1. that the appeal noted above was decided by the..........................Bench of the
Tribunal on........
2. that the notice of the order under sub-section (4) of section 135 of the Income Tax
Ordinance, 1979, was served on the applicant on...........................
3. that the facts which are admitted and/or found by the Tribunal and which are necessary
for drawing up a statement of the case, are stated in the enclosure for ready reference.
4. that the following questions of law arise out of the order of the Tribunal:-
(1)
(2)
(3)
5. that the applicant, therefore, requires under sub-section (1) of section 136 of the
aforesaid Ordinance that a statement of the case be drawn up and the questions of law
numbered................out of the questions of law referred to in paragraph 4 above be
referred to the High Court.
6. that the documents or copies thereof, as specified below (the translation in English of
the documents, where necessary, is annexed) be forwarded to the High Court with the
statement of the case.
Signed
(Appellant)
Signed
(Authorised Representative, if any).
N.B.- 1. The application must be made in triplicate.
2. The application made by an assessee must be accompanied by a fee of one hundred rupees.
The fee must be credited in the Treasury or a Branch of the National Bank of Pakistan or
the State Bank of Pakistan after obtaining a challan from the Deputy Commissioner of Income Tax and the triplicate
portion of the challan sent to the Tribunal with the application. The Appellate Tribunal
will not accept cheques, drafts, hundies or other negotiable instruments.
197. Annual Statement under section 139 regarding salary during the
financial year.- A return under section 139
STATEMENT UNDER SECTION 139 OF THE INCOME TAX ORDINANCE, 1979, FOR
THE YEAR FROM 1ST JULY, 19-----------AT 30TH JUNE 19----------
| Name of the employer | ___________________________ |
| (Name of the person
responsible for paying the salary etc. if not the employer). |
___________________________ |
| Address. | ___________________________ |
| National Tax Number of the employer. | ___________________________ |
Serial No. |
Name of employee |
National Tax Number |
Address |
Appointment or nature of appointment |
1 |
2 |
3 |
4 |
5 |
| Period for which salary and allowances etc. paid. | Salary, Special pay wages | Pensions, gratuities, annuities. | Honorarium/Rewards, fees, commissions, bonous or profits paid in lieu of or in addition to Salary and wages (including payments made at or in connect-ion with the termination of the employment and advance of salary etc. but excluding those specified columns-----to------ paid during the year. | |
6 |
7 |
8 |
9 |
|
| Signature____________________________ | |
| Dated_________________ | Designation__________________________ |
STATEMENT UNDER SECTION 140 OF THE INCOME TAX ORDINANCE, 1979 FOR THE YEAR 1ST JULY, 19---- TO 30TH JUNE, 19-------IN RESPECT OF RESIDENT/NON RESIDENT SHARE-HOLDERS.
Name of the company________________________________________________________________
Address.
National Tax Number.
Sl. No. |
Name of the shareholder |
Address |
National Tax Number |
‘Number’ and description of shares held by the share holder |
Date of declaration of dividends/ bonus shares |
1 |
2 |
3 |
4 |
5 |
6 |
Nature of dividends/ bonus shares final/ interim |
‘Amount
of dividend' |
Amount of tax deducted |
Date of deposit to government treasury |
Treasury challan No. |
Remarks |
7 |
8 |
9 |
10 |
11 |
12 |
Cash-allowances |
||||||
Compensatory allowances |
Dearness |
House rent allowance |
Conveyance allowance |
entertainment allowance |
Medical allowance |
Any other Allowance and/or leave encashment |
10 |
11 |
12 |
13 |
14 |
15 |
16 |
Value of rent free accommodation or any concession in rent free accommodation provided by the employer on account of |
|||||
Remuneration domestic and personal services provided to the employee |
Rent free unfurnished accommodation |
Rent free furnished accommodation |
Accommodation hired by employee with rent payable by employer |
Accommodation provided at a concession rate |
Utilities |
17 |
18 |
19 |
20 |
21 |
22 |
Value of free conveyance provided by the employer |
||||
Medical hospitalisation fees, expenses paid |
Conveyance provided executively for personal or private used and taxable under rule 11 |
Conveyance used partly for personal and partly for business purpose and taxable under rule 13 |
Conveyance used exclusively for business purposes and taxable under rule 14 |
Value of free or concessional passage provided by the employer |
23 |
24 |
25 |
26 |
27 |
Employer’s contribution |
||||
| Recognised provident fund | Recognised superannuation fund | Interest credited to employer’s account in a recognized provident/super annuation fund | Value of any benefit or annuity provided by the employer free of cost or at a concessional rate, or any other sum not included in the preceding columns such as food-free or at concessional rate | Amount but not paid given full particulars with due date and period for which payable |
28 |
29 |
30 |
31 |
32 |
Contribution to |
|||||
Total of columns to |
Amount liable to tax under 16 Income Tax of the section Ordinance |
Beneveolent fund |
Group insurance |
Contribution to provident or superannuation fund, life insurance premium, other investments |
Taxable income |
33 |
34 |
35 |
36 |
37 |
38 |
Tax payable |
Tax deducted and deposited to credit of Federal Government |
Date on which deposited |
Treasury Challan No. |
Remarks |
39 |
40 |
41 |
42 |
43 |
I, the Principal Officer of the Company, hereby certify that the above statement
contains a complete list of-
(1) the resident, non-resident shareholders which are companies and to whom a dividend was
distributed in the period from 1st July, 19------, to 30th June, 19--------; and
(2) Other resident/non-resident shareholders of the company to whom a dividend or
aggregate dividend exceeding Rs. 15,000 was or were distributed in the period from the 1st
July 19-----, to 30th June, 19
| Signature of the Principal Officer…………………… | |
| Dated 19. | Name…………………………………………………… |
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