PART-I FOR TREASURY PART-II FOR THE PROFESSION

TAX OFFICER
PART-III FOR TAX PAYER
1) III 1) III 1) III
2) IIIB 2) IIIB 2) IIIB
3) VIII (Select the applicable One) 3) VIII (Select the applicable One) 3) VIII (Select the applicable One)
Department Date:- 11/05/2011 Department Date:- 11/05/2011 Department Date:- 11/05/2011
(TIN) (TIN) (TIN)
FROM FROM FROM
01/02/2011 01/02/2011 01/02/2011
Code
Amount in
Rs.
Remarks if any:- Code
Amount in
Rs.
Remarks if any:- Code
Amount in
Rs.
Remarks if any:-
1
10,000
1
10,000
1
10,000
2
111
2
111
2
111
3
-
3
-
3
-
4
-
4
-
4
-
5
-
5
-
5
-
6
-
6
-
6
-
7
-
7
-
7
-
Amount in words:- Amount in words:- Amount in words:-
Total
Ten Thousand One
Hundred Eleven Only
Ten Thousand One
Hundred Eleven Only
Ten Thousand One
Hundred Eleven Only
Bank CIN
No.
Bank CIN
No.
Bank CIN
No.
Date Date Date
Time Time Time
Scroll No. Scroll No. Scroll No.
Type of
Payment
PT (RC/EC) NUMBER
2 7 2 0 0 0 7 0 0 0 4 P (Select the applicable one)
1) RC
Profession Tax Act,
1975
Name of
Branch
Name of
Branch
Name of
Branch
Name of Bank
Name of
Bank
Name of
Bank
Payment Details For use in Receiving Ban
Signature of Person who has made payment Signature of Person who has made payment
Payment Details For use in Receiving Ban Payment Details For use in Receiving Ban
Signature of Person who has made payment
FOR BANK/TREASURY FOR BANK/TREASURY FOR BANK/TREASURY
Total Total 10,111 10,111 10,111
Composition Money
Fine
Fees Fees Fees
Advance Payment
Amount of Tax
Fine Fine
Interest Amount Interest Amount Interest Amount
Penalty Amount Penalty Amount Penalty Amount
28/02/2011
Amount of Tax Amount of Tax
Composition Money Composition Money
Advance Payment Advance Payment
NASHIK - 422103
Nashik
Account Head Details Account Head Details Account Head Details
TO TO TO
28/02/2011 28/02/2011
MALEGAON,
2 7 2 0 0 0 7 0 0 0 4 P
Period Period Period
Location Location Nashik Location Nashik
Payee Details
2 7 2 0 0 0 7 0 0 0 4 P
Profession Tax Act,
1975
Payee Details
PT (RC/EC) NUMBER 1) RC
Type of
Payment
PT (RC/EC) NUMBER
2) EC
(Select the applicable one)
Department of
Sales Tax
Profession Tax Act,
1975
Type of
Payment
1) RC
2) EC
(Select the applicable one)
2) EC
Payee Details
Department of
Sales Tax
Department of
Sales Tax
MTR -6
CHALAN CHALAN CHALAN
(See Rule 11, 11C, 11E and 20 of the Profession Tax Rules 1975)
ACCOUNT HEAD:-00280012 ACCOUNT HEAD:-00280012 ACCOUNT HEAD:-00280012
MTR -6 MTR -6
(See Rule 11, 11C, 11E and 20 of the Profession Tax Rules 1975) (See Rule 11, 11C, 11E and 20 of the Profession Tax Rules 1975)
Form-ID Form-ID Form-ID GRN GRN GRN
Full Name of the Tax payer
XYZ LIMITED EOU DIV.
MALEGAON,
NASHIK - 422103
Full Name of the Tax payer
XYZ LIMITED EOU DIV.
MALEGAON,
NASHIK - 422103
Full Name of the Tax payer
XYZ LIMITED EOU DIV.
PART-I FOR TREASURY PART-II FOR THE PROFESSION
TAX OFFICER
1) III 1) III
2) IIIB 2) IIIB
3) VIII (Select the applicable One) 3) VIII (Select the applicable One)
Department Date:- Department Date:-
(TIN) (TIN)
FROM FROM
Code
Amount in
Rs.
Remarks if any:- Code
Amount in
Rs.
Remarks if any:-
1 1
2 2
3 3
4 4
5 5
6 6
7 7
Amount in words:- Amount in words:-
Total
Total
Fees Fees
Advance Payment Advance Payment
Interest Amount Interest Amount
Penalty Amount Penalty Amount
Composition Money Composition Money
Account Head Details Account Head Details
Amount of Tax Amount of Tax
Fine Fine
TO TO
Period Period
Location
Full Name of the Tax payer
Location
Full Name of the Tax payer
(Select the applicable one) (Select the applicable one)
2) EC
1) RC PT (RC/EC) NUMBER 1) RC PT (RC/EC) NUMBER
Type of
Payment
Profession Tax Act,
1975
Payee Details
Type of
Payment
Profession Tax Act,
1975
Payee Details
2) EC
Department of
Sales Tax
Department of
Sales Tax
GRN Form-ID GRN Form-ID
(See Rule 11, 11C, 11E and 20 of the Profession Tax Rules 1975) (See Rule 11, 11C, 11E and 20 of the Profession Tax Rules 1975)
ACCOUNT HEAD:-00280012 ACCOUNT HEAD:-00280012
CHALAN CHALAN
MTR -6 MTR -6
Bank CIN
No.
Bank CIN
No.
Date Date
Time Time
Scroll No. Scroll No.
Name of
Branch
Name of
Branch
Name of Bank
Name of
Bank
FOR BANK/TREASURY FOR BANK/TREASURY
Payment Details For use in Receiving Ban Payment Details For use in Receiving Ban
Signature of Person who has made payment Signature of Person who has made payment
PART-III FOR TAX PAYER
1) III
2) IIIB
3) VIII (Select the applicable One)
Department Date:-
(TIN)
FROM
Code
Amount in
Rs.
Remarks if any:-
1
2
3
4
5
6
7
Amount in words:-
Total
Fine
Fees
Advance Payment
Interest Amount
Penalty Amount
Composition Money
Account Head Details
Amount of Tax
TO
Period
Location
Full Name of the Tax payer
2) EC
(Select the applicable one)
Type of
Payment
Profession Tax Act,
1975
Payee Details
1) RC PT (RC/EC) NUMBER
GRN Form-ID
Department of
Sales Tax
(See Rule 11, 11C, 11E and 20 of the Profession Tax Rules 1975)
ACCOUNT HEAD:-00280012
CHALAN
MTR -6
Bank CIN
No.
Date
Time
Scroll No.
Name of
Branch
Name of
Bank
FOR BANK/TREASURY
Payment Details For use in Receiving Ban
Signature of Person who has made payment