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Application for rollback of an Advance Pricing Agreement

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..... 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) 2 [ Permanent Account Number or Aadhaar Number ] : (c) Address of the applicant: (d) Address for communication: (e) Locatio .....

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..... hich APA request is being made in Form 3CED by the applicant: 6. Particulars of additional Fee paid by the applicant: Amount in Rs. Challan No: Dated: 7. The details of previous years for which rollback is being sought: 8. Has the same international transaction been undertaken in any other year for which rollback is permissible but the same is not being requested for. I .....

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..... Details of pending proceedings including appeals for the years mentioned in 7 above in respect of international transaction(s) mentioned in 4 above : 15. Whether Appellate Tribunal has disposed of any appeal in respect of international transaction mentioned in 4 above for any of the years mentioned in 7 above? if yes, then details may be provided: I declare that the information furnished in .....

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