FORM OF DECLARATION UNDER SUB SECTION (1) OF SECTION 214 OF THE FINANCE ACT, 2016 (28 OF 2016), IN RESPECT OF INDIRECT TAX DISPUTE RESOLUTION SCHEME, 2016

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CA. Anand Tirpathi | Published on: 03-11-2026 | 25 min read

Form 1 - Indirect Tax Dispute Resolution Scheme, 2016

F No 1080/06/DLA/IDRS/2016

-1-

Form 1

[See rule 3(1)]

FORM OF DECLARATION UNDER SUB SECTION (1) OF SECTION 214 OF THE
FINANCE ACT, 2016 (28 OF 2016), IN RESPECT OF INDIRECT TAX DISPUTE
RESOLUTION SCHEME, 2016

IN DUPLICATE

To,

The Designated Authority
............................................
............................................

Sir/Madam,

I hereby make a declaration under sub section (1) of section 214 of the Finance Act, 2016 (28 of 2016).

Name of the declarant (in block letters)

Registration Number

Address (as mentioned in order in original against which appeal has been filed before Commissioner (Appeals)

Telephone number

Order in original number

Date of order in original

Amounts demanded

Duty/ Tax
Interest
Penalty

Commissioner (Appeals) before whom appeal is pending

Appeal No.

Amounts deposited

Duty/ Tax
Interest
Penalty

Any other information

VERIFICATION

I, ..................................................................... (name in block letters) son/daughter/of Shri ............................................ solemnly declare that to the best of my knowledge and belief, -

(a)

the information given in this declaration is correct and complete and amount due and other particulars shown therein are truly stated ;

F No 1080/06/DLA/IDRS/2016

-2-

(b)	I am not disqualified in any manner from making a declaration under the Scheme with reference to the provisions of section 215 of Finance Act, 2016.
(c)	I further declare that I am making this declaration in my capacity as ................... [(designation) (please specify if you are making a declaration on behalf of declarant)] and that I am competent to make this declaration and verify it.
Place	Signature of person making declaration
Date	Name of person making declaration

Instructions for filling the Form

This Form should be submitted to the Commissioner of Customs or the Commissiner of Central Excise notified as designated authority under section 87(b)(ii) of the Finance (No. 2) Act, 1998.
Use separate Form for each appeal in respect of which declaration is being made.
No column shall be left blank. Wherever the entry is not relevant the column shall be filled in as 'Not applicable'.
In Row 2, registration number is to be filed only in respect of registered Central Excise and Service Tax Assessee. In respect of all others the row should be shown as “Not applicable”.
In case of any deposits made in the matter against the amounts demanded please indicate the same in row 10.
Any other information relevant to the case may be briefly indicated under row 11.

About the Author

Written by CA. Anand Tirpathi â€¢ 03-11-2026

CA. Anand Tirpathi is a Chartered Accountant with experience in statutory compliance, internal controls, and accounting process optimization. He has advised multiple businesses on improving operational efficiency through structured accounting and inventory systems. His writing focuses on clarity, compliance, and risk reduction for MSMEs.

Verified Content 25 min read Support: +91 9205471661, 7428779101

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