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Proforma for forwarding the proposal for publishing of names and other details in r/o Service Tax (Provisional Attachment of Property) Rules, 2008
May, 23rd 2013

                                          [See rule 3(1)]

   Proforma for forwarding the proposal for publishing of names and other details

   1.    Name and address of the assessee or person:

   2.    Service Tax Code (STC) No. or Registration No. (if any):

   3.    Constitution of assessee:

         (Proprietorship or Partnership or Private Ltd or Public Ltd or Registered Trust or Society or
         Other (specify))

   4.    Commissionerate:

   5.    Division:

   6.    Details of show cause or demand notice:

   7.    Amount involved in the show cause notice:

   8.    Reasons for provisional attachment of property.

   9.    Address and other details of property;

   10.    Value of property proposed to be attached:

   11. Details of previous offences, if any:

   12. Comments, if any:

Date:                   Signatures of Assistant or Deputy Commissioner of Central Excise or Service
                                                                      (With name and official seal)
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