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Application for rollback of an Advance Pricing Agreement

Income Tax - 03CEDA - [Form No. 3 CEDA] 1 (See sub-rule (5) of rule 10 MA) To, The Competent Authority of India or Director General of Income Tax (International Taxation) New Delhi Sir/Madam, This is to state that.............................. (Name of the Applicant)......wishes to negotiate an APA with the Central Board of Direct Taxes containing rollback provision. I am submitting herewith the necessary particulars hereunder: 1. Particulars of the applicant: (a) Full name of the applicant: (b) .....

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application for pre-filing meeting: (b) Date of pre-filing meeting(s) with the APA Team: 3. Whether application in Form 3CED is being filed simultaneously: 4. Details of international transaction(s) including Name(s) of the Associated Enterprises in respect of which rollback is requested for: 5. Whether the international transaction(s) is the same as that in respect of which APA request is being made in Form 3CED by the applicant: 6. Particulars of additional Fee paid by the applicant: Amount in .....

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en furnished on or before the due date: Yes/No 11. If yes, provide details including acknowledgement No., date of furnishing etc. 12. Whether audit report under section 92 E in respect of the international transaction referred to in 4 above for all the previous years mentioned in 7 above have been furnished on or before the due date: Yes/No 13. If yes, provide details including date of furnishing etc. 14. Details of pending proceedings including appeals for the years mentioned in 7 above in resp .....

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