FORM 1

(See rule 4)

Return regarding Water consumed during the month of ......................................

(*) For claiming rebate under col. 7 the assessee shall indicate in this column the analytical and other reports annexed to this return in support of this claim.

Signature of the consumer

Name

Address

ANNEXURE TO FORM I

Report of Analysis or treated effluent showing performance of the treatment plant - For the month of ......................................

                                                                           Sample collected on--------------------------                                                                          Sample tested on----------------------------------                                                                            By the laboratories-------------------------------

                                                                                                                                                                     Signature .....................................

                                                                                                Date .............................................

                                                                                             Name ..... .....................................

                                                                                        Address........................................

⁽¹⁾[FORM IA

[See Rule 4(2)]

Name of the Board:

No.                                                                               Dated:

Notice under Section 5(2) of the Water (Prevention and Control of Pollution) Cess Act, 1977) (36 of 1977)

To

Name and Address of the Consumer:

Assessment period:

Whereas you were required to furnish a return as provided under sub-section (1) of Section 5 of the Water (Prevention & Control of Pollution) Cess Act, 1977 (36 of 1977) read with the sub-rule (1) of Rule 4 of the Water (Prevention and Control of Pollution) Cess Rules, 1978, by the 5th of .........................................

And whereas you have failed to furnish the return by the said date:

Now, therefore, you are beytby called upon to furnish the return within 7 days from the date of receipt of this Notice.

In case no return is received within the said period of 7 days, action will be taken for making assessment as per sub-section (A) of section 6 of the aforesaid Act, ex-parte, besides initiating any other legal action as per law against you.

                                                                                                                                            Issuing authority

Place:                                                                                                             Name-------------------------------------------

Date:                                                                                                              Address----------------------------------------

                                                                                                                   --------------------------------------------------

FORM II

(see Rule 9)

(FORM OF MEMORANDUM OF APPEAL)

Before ............................................................ (**)...................................................... (here mention the name and designation of the authority)

Memorandum of appeal under section 13 of the Water (Prevention and Control of Pollution) Cess Act, 1977.

Appeal No of 19

(here furnish complete postal address)

Vs. Appellant

(here mention the name and designation

of assessing authority)

Respondent

The appellant named above, begs to prefer this memorandum of appeal against the order dated, passed by .................................... on the following facts and grounds:

FACTS

(here briefly mention the facts of the case)

GROUND

(here mention the grounds on which the appeal is made)

1.

2.

3.

4.

PRAYER

In the light of what is stated above, the appellant respectfully prays that he/she/it may be exempted from the payment of Cess.

he/she/it may be allowed a rebate of 70 per cent as provided for in the Act and the amount of Cess reduced to Rs ...........................................the amount of Cess has not been correctly assessed and that it may be reduced to Rs. ...........................the penalty imposed on him/her/it has been wrongfully imposed and should be set aside.the penalty impossed on him/her/it is excessive and should be suitably reduced on the basis of the facts as stated.

2. The amount of Rs. .......................... (Rupees ....................................................................................) as fee for this appeal has been paid to .................................................................................vide receipt No .................................... dated ............................

Place: Signature of the Appellant

Date Name

Address

⁽²⁾1[SCHEDULE

(See rule 6)

                                                                                                                                                 [No. 1(14)/91-PL/CPA]

N. BAGCHI, Director Pollution

Footnote: The Principal Rules were published in the Gazette of India vide Notification G.S.R. 378(E) dated the 4th July, 1978.

MINISTRY OF ENVIRONMENT AND FORESTS

New Delhi, the 28th February, 1992

S.O. 182(E).-In exercise of the powers conferred by sub-section (2) and sub-section (2A) of section 3 of the Water (Prevention and Control of Pollution) Cess Act, 1977 (36 of 1977) and in supersession of the notification of the Government of India in the Ministry of Works and Housing number G.S.R. 190(E), dated the 23rd March, 1978 except as respects things done or omitted to be done before such supersession, the Central Government hereby specifies -

(b) the rates of cess given in column (3) of the Table below as the rates of cess payable by a person carring on an industry specified in Schedule I of the aforesaid Act and by every local authority consuming water for domestic purpose calculated on the basis of the water consumed by him or it, for the purpose mentioned in the corresponding entry in column (1) thereof, if he or it fails to comply with any of the provisions of section 25 of the Water (Prevention and Control of Pollution) Act, 1974 (6 of 1974) or any of the standards laid down by the Central Government under the Environment (Protection) Act, 1986 (29 of 1986).

TABLE

                                                                                                                                                                          &n [No. 1(14)91-PL/CPA]

N. BAGCHI, Director, Control of Pollution

Published in the Gazette No. 166 dt. 5.3.1992

1. Inserted by Rule 4 of the Water (Prevention and Control of Pollution)Cess Amendment Rules, 1992,G.S.R. 311(E), dated 28.2.1992.

2. Added by Rule 5 of the Water (Prevention and control of Pollution)Cess Amendment Rules, 1992, G.S.R. ^{311(E) dated 28-2-1992.}