BEFORE THE ASSISTANT COMMISSIONER (JUDICIAL) SALES-TAX ___________________________.

In the matter of XYZ for the Assessment Year _________.

Affidavit of Mr. A aged about ___ years S/o Mr. B R/o ___________________.

1. I, the above named deponent, am the proprietor of the firm above named and hence is fully conversant of the facts deposed below:

2. That the deponent received assessment order on ___________.

3. That appeal was to be filed by _________.

4. That deponent fell ill on ___________ and was under the treatment of Dr. X. who advised complete rest upto __________.

5. That the deponent filed the appeal on ________ alongwith medical certificate.

6. That in this way there is a delay of only 5 days for which an application under Section 5 of the Limitation Act has been filed alongwith memorandum of appeal.

7. That delay in filing the appeal is because of illness of the deponent for which deponent cannot be held responsible.

Deponent

VERIFICATION

I, A, the above named deponent do hereby verify that the contents of this memorandum of appeal from paras 1 to 7 are true to the best of my knowledge and belief.