[Form 4
[See rule 5(1)]
Form of order of discharge of dues under sub-section (4) Section 214 of the Finance Act, 2016 (28 of 2016)
Reference No.
Mr/Mrs/M/s. . (Name and address of the declarant) (hereinafter referred to as declarant) had made a declaration under sub-section (1) of section 214 of the Finance Act, 2016 (28 of 2016) on ; and
The designated authority by acknowledgement of even number in Form 2 dated . acknowledged the said declaration;
The Declarant has intimated as required under sub-section (3) of Section 214, the details of amount deposited by him against the said order in original-in-Form 3 dated ..
Now, therefore, in exercise of the powers conferred by sub-section (4) of section 214 read with section 216 of the Finance Act, 2016, the designated authority hereby issues order of discharge of due the said declarant -
(a) certifying the receipt of payment from the declarant towards full and final settlement of the amounts due from the declarant in terms of order-in-original No dated.;
(b) granting immunity, from all from all proceedings under the Act, in respect of the indirect tax dispute for which the declaration has been made under this Scheme.