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Declaration under sub-section (1) of section 107 of the Act

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..... 2. Address of the declarant .....

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..... 3. Telephone No. .....

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..... 6. Details of tax dues* A. Service Tax .....

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..... y be, the Part B' of Form ST-3, as existed during relevant period may be used and calculation of tax dues may be furnished tax return period wise, and service wise if the tax dues relates to more than one service] VERIFICATION I........................(name in block letters) son/daughter of Shri........................ solemnly declare that I have read and understood the Service Tax Voluntary Compliance Encouragement Scheme as contained in Chapter VI of the Finance Act 2013, and to the best of my knowledge and belief - (a) the information given in this declaration and the enclosures accompanying it are correct and complete and the amount of tax dues and other particulars shown therein are truly stated; (b) the .....

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..... (To be assigned by the department) Instructions: 1. The Scheme has been prescribed in the Chapter VI of the Act. The provisions contained therein may please be read carefully (refer www.cbec.gov.in). 2. This Form shall be submitted to the Central Excise Officer notified as designated authority under section 105(c) of the Act. 3. The tax dues may be computed separately for each service if the tax dues relates to more than one service during the period of declaration. 4. For calculation of tax dues, the manner as prescribed at S. No. 3F (I), or as the case may .....

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