06 January 2011
SPECIMEN STAY APPLICATION Appendix X Specimen Form of Application for Grant of Stay Before CIT(A)S tay Application No. ——— of ——————— in the case of —————— for the assessment year(s) ————— under the ————— Act —————— for stay of recovery of tax/interest/penalty/fine/other items. 1. Name and address of the applicant : 2. Act under which the demand is raised Income-tax etc.) for which stay (i.e., application is moved : 3. Assessment year(s) involved : 4. Date of filing of appeal before the CIT and its number, if known : 5. Form the demand give break up : Tax : Interest : Penalty : Fine : Others : (a) Amount already paid : (b) Amount outstanding : (c) Amount which is not disputed out of (b) : 6. (a) Details of application for stay made to the revenue authorities : 1. ITO (b) Result : 7. *Reasons for seeking stay : 8. (a) Whether the applicant is prepared to offer security : (b) If yes, in what Form : 9. Prayer stating exact amount sought to be stayed 10. If stay is sought in relation to a matter pending in reference before the High Court give full particulars of R. A. No. and date etc. : Date : Signature of the applicant. *Separate sheet may be used if space is not sufficient Note : 1. The application shall be made in triplicate and shall be neatly typed on one side of the paper with copies all the relevant document including demand notice, copies of correspondence with the Revenue authorities for stay of demand and copies of the letter refusing stay of demand. 2. The contents of the application shall be supported by an affidavit duly sworn in by the applicant or his authorised agent. 3. The application shall be presented by the applicant in person or by his authorised agent or sent by registered post to the Bench of the Tribunal where appeal was filed or which has got jurisdiction to hear the appeal.
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