Notes 1) Tax payments should be rounded to Rupees 2) Payment Sections and codes are printed overleaf

Name of LTU/ MTU/ RTO LTU/MTU/RTO Code Tax Year

Current Demand rrear Demand !ith Return Salary Month
(only for payment u/s 149)
Deduction at Source dvance Payment "isc#$ %thers
Payment Section Payment Section Code
&Section) &Description of Payment Section) ccount 'ead &N")
Taxpayer's Particlars &To be filled for payments other than !ithholdin( Taxes)
(To be filled in by the bank)
NTN CN)C $ Re(#$ )nc# No#
Taxpayer*s Name Status &+)
,usiness Name
ddress
!OR "#T$$OL%#N& T'()S ONLY
NTN$ -TN of !ithholdin( a(ent CN)C$ Re(#$ )nc# No#
&.here applicable)
Name of .ithholdin( a(ent
Details of taxpayers provided in electronic form / 0es No mount a(ainst
(Enter maximum of 10-taxpayers in one challan no limit if pro!ided electronically) .hich tax is bein( Tax
Sr* NTN/ CN#C Stats +,- Taxpayer's/.siness Name / 'ddress "ithheld 'mont
1#
2#
1#
2#
3#
4#
5#
6#
7#
18
TOT'L
'mont of tax in 0ords 1 Rs#
Cash "efund #d$ustment (by %epartment only)
Che9ue$ Pay %rder$ etc# No# Date /
,an: ,ranch Si2natre of %epositor
Treasury Challan No# ; Date ,an: Stamp ; ,ranch Code
&or use of 'omputer (ection of %ept) To be endorsed by the Treasury *fficer of #uthori+ed ,ank
Natre of Tax
Payment
Mode of
payment
&+) Status PU. <= Public Company> P3T <= Pvt# ?td# Company> SCOY < = Small Company> 'OP <= %P> #N% <= )ndividual
#T456 +Re74##-
OR#&#N'L for %epartment
INCOME TAX DEPARTMENT
T'( P'YM)NT R)C)#PT
Notes 1) Tax payments should be rounded to Rupees 2) Payment Sections and codes are printed overleaf
Name of LTU/ MTU/ RTO LTU/MTU/RTO Code Tax Year
Current Demand rrear Demand !ith Return Salary Month
(only for payment u/s 149)
Deduction at Source dvance Payment "isc#$ %thers
Payment Section Payment Section Code
&Section) &Description of Payment Section) ccount 'ead &N")
Taxpayer's Particlars &To be filled for payments other than !ithholdin( Taxes)
(To be filled in by the bank)
NTN CN)C $ Re(#$ )nc# No#
Taxpayer*s Name Status &+)
,usiness Name
ddress
!OR "#T$$OL%#N& T'()S ONLY
NTN$ -TN of !ithholdin( a(ent CN)C$ Re(#$ )nc# No#
&.here applicable)
Name of .ithholdin( a(ent
Details of taxpayers provided in electronic form / 0es No mount a(ainst
(Enter maximum of 10-taxpayers in one challan no limit if pro!ided electronically) .hich tax is bein( Tax
Sr* NTN/ CN#C Stats +,- Taxpayer's/.siness Name / 'ddress "ithheld 'mont
1#
2#
1#
2#
3#
4#
5#
6#
7#
18
TOT'L
'mont of tax in 0ords 1 Rs#
Cash "efund #d$ustment (by %epartment only)
Che9ue$ Pay %rder$ etc# No# Date /
,an: ,ranch Si2natre of %epositor
Treasury Challan No# ; Date ,an: Stamp ; ,ranch Code
&or use of 'omputer (ection of %ept) To be endorsed by the Treasury *fficer of #uthori+ed ,ank
Natre of Tax
Payment
Mode of
payment
&+) Status PU. <= Public Company> P3T <= Pvt# ?td# Company> SCOY < = Small Company> 'OP <= %P> #N% <= )ndividual
#T456 +Re74##-
%UPL#C'T) for Treasary/.an8
INCOME TAX DEPARTMENT
T'( P'YM)NT R)C)#PT
Notes 1) Tax payments should be rounded to Rupees 2) Payment Sections and codes are printed overleaf
Name of LTU/ MTU/ RTO LTU/MTU/RTO Code Tax Year
Current Demand rrear Demand !ith Return Salary Month
(only for payment u/s 149)
Deduction at Source dvance Payment "isc#$ %thers
Payment Section Payment Section Code
&Section) &Description of Payment Section) ccount 'ead &N")
Taxpayer's Particlars &To be filled for payments other than !ithholdin( Taxes)
(To be filled in by the bank)
NTN CN)C $ Re(#$ )nc# No#
Taxpayer*s Name Status &+)
,usiness Name
ddress
!OR "#T$$OL%#N& T'()S ONLY
NTN$ -TN of !ithholdin( a(ent CN)C$ Re(#$ )nc# No#
&.here applicable)
Name of .ithholdin( a(ent
Details of taxpayers provided in electronic form / 0es No mount a(ainst
(Enter maximum of 10-taxpayers in one challan no limit if pro!ided electronically) .hich tax is bein( Tax
Sr* NTN/ CN#C Stats +,- Taxpayer's/.siness Name / 'ddress "ithheld 'mont
1#
2#
1#
2#
3#
4#
5#
6#
7#
18
TOT'L
'mont of tax in 0ords 1 Rs#
Cash "efund #d$ustment (by %epartment only)
Che9ue$ Pay %rder$ etc# No# Date /
,an: ,ranch Si2natre of %epositor
Treasury Challan No# ; Date ,an: Stamp ; ,ranch Code
&or use of 'omputer (ection of %ept) To be endorsed by the Treasury *fficer of #uthori+ed ,ank
Natre of Tax
Payment
Mode of
payment
&+) Status PU. <= Public Company> P3T <= Pvt# ?td# Company> SCOY < = Small Company> 'OP <= %P> #N% <= )ndividual
#T456 +Re74##-
TR#PL#C'T) for Taxpayer/
%edctin2 'thority
%epartment +'-
INCOME TAX DEPARTMENT
T'( P'YM)NT R)C)#PT
Notes 1) Tax payments should be rounded to Rupees 2) Payment Sections and codes are printed overleaf
Name of LTU/ MTU/ RTO LTU/MTU/RTO Code Tax Year
Current Demand rrear Demand !ith Return Salary Month
(only for payment u/s 149)
Deduction at Source dvance Payment "isc#$ %thers
Payment Section Payment Section Code
&Section) &Description of Payment Section) ccount 'ead &N")
Taxpayer's Particlars &To be filled for payments other than !ithholdin( Taxes)
(To be filled in by the bank)
NTN CN)C $ Re(#$ )nc# No#
Taxpayer*s Name Status &+)
,usiness Name
ddress
!OR "#T$$OL%#N& T'()S ONLY
NTN$ -TN of !ithholdin( a(ent CN)C$ Re(#$ )nc# No#
&.here applicable)
Name of .ithholdin( a(ent
Details of taxpayers provided in electronic form / 0es No mount a(ainst
(Enter maximum of 10-taxpayers in one challan no limit if pro!ided electronically) .hich tax is bein( Tax
Sr* NTN/ CN#C Stats +,- Taxpayer's/.siness Name / 'ddress "ithheld 'mont
1#
2#
1#
2#
3#
4#
5#
6#
7#
18
TOT'L
'mont of tax in 0ords 1 Rs#
Cash "efund #d$ustment (by %epartment only)
Che9ue$ Pay %rder$ etc# No# Date /
,an: ,ranch Si2natre of %epositor
Treasury Challan No# ; Date ,an: Stamp ; ,ranch Code
&or use of 'omputer (ection of %ept) To be endorsed by the Treasury *fficer of #uthori+ed ,ank
Natre of Tax
Payment
Mode of
payment
&+) Status PU. <= Public Company> P3T <= Pvt# ?td# Company> SCOY < = Small Company> 'OP <= %P> #N% <= )ndividual
#T456 +Re74##-
9U'%R#PL#C'T) for Taxpayer
INCOME TAX DEPARTMENT
T'( P'YM)NT R)C)#PT