FORM GST DRC – 21

[See rule 158(2)]

Reference No << — >>                                                          << Date >>

To GSTIN

Name Address

Demand Order No.                                                                                                       Date:

Reference number of recovery:                                                                                       Date: Period –

Application Reference No. (ARN) –                                                                                                        Date –

Order for acceptance/rejection of application for deferred payment / payment in instalments

This has reference to your above referred application, filed under section 80 of the Act. Your application for deferred payment / payment of tax/other dues in instalments has been examined and in this connection, you are allowed to pay tax and other dues by————————————————————————– (date) or in this

connection you are allowed to pay the tax and other dues amounting to rupees ——- in ——-

monthly instalments.

OR

This has reference to your above referred application, filed under section 80 of the Act. Your application for deferred payment / payment of tax/other dues in instalments has been examined and it has not been found possible to accede to your request for the following reasons:

Place: Date:

Signature Name Designation

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