Single(Copy to be sent the ZAO)
Tax Applicable(Tick One)*
CHALLAN NO./ (0020) INCOME-TAX ON COMPANIES Assessment Year
ITNS (CORPORATION TAX)
280 (0021) INCOME TAX 2019-20
(OTHER THAN COMPANIES)
Permanent Account Number
Full Name
Complete Address With City and State
Tel. No. Pin 160047
Type of Payment(Tick One)
Advance Tax(100) Surtax(102)
Self Assessment Tax (300) Tax on Distributed Profits of Domestic Companies(106)
Tax on Regular Assessment(400) Tax on Distributed Income to Unit Holders(107)
DETAILS OF PAYMENTS Amount(in Rs.only) FOR USE IN RECEIVING BANK
Income Tax 25000 debit to A/c /Cheque Credit on
Surcharge 0
Health & Education Cess 0 DD MM YY
Interest 0 SPACE FOR BANK SEAL
Penalty 0
Others 0
Total 25000
Total(in words)
CRORES LACS THOUSANDS HUNDREDS TENS UNITS
TWENTY FIVE ZERO
Paid in Cash/Debit to Ac/Cheque No Cash Dated
Drawn on
(Name of Bank and Branch)
Date 12/03/2019 Signature of person making Payment Rs.
Taxpayers Counterfoil(To be Filed up by the tax payer ) SPACE FOR BANK SEAL
PAN
Received From
Cash/Debit to Ac/Cheque No Cash For Rs. 25000
Rs in Words TWENTY FIVE THOUSAND Only
Drawn on
(Name of the Bank and Branch)
On Account of Other than Companies
Income Tax on
Type of Payments Advance Tax
for the Assessment Year 2019-20 Code 1322 Rs.