20083004 Cbdt E-payment Request Form

e-Payment Request Form Full Name: _____________________________________ Address:

______________________________________

__________________________________ Challan ITNS 280

PAN No./ TAN: Assessment Year: Financial Year:

Major Head

Type of Payment (100) ADVANCE TAX

(0020) INCOME-TAX ON COMPANIES (CORPORATION TAX)

(102) SURTAX

(0021) INCOME-TAX (OTHER THAN COMPANIES)

(106) TAX ON DISTRIBUTED PROFITS (107) TAX ON DISTRIBUTED INCOME (300) SELF ASSESSMENT TAX (400) TAX ON REGULAR ASSESSMENT

ITNS 281

ITNS 282

(0020) COMPANY DEDUCTEES

(200) TDS/TCS Payable by Taxpayer

(0021) NON-COMPANY DEDUCTEES

(400) TDS/TCS Regular Assessment (Raised by I.T. Deptt.)

(0034) SECURITIES TRANSACTION TAX

(100) ADVANCE TAX

(0023) HOTEL RECIEPTS TAX

(300) SELF ASSESSMENT TAX

(0024) INTEREST TAX

(400) TAX ON REGULAR ASSESSMENT

(0028) EXPNDITURE/OTHER TAX (0031) ESTATE DUTY (0032) WEALTH TAX (0033) GIFT TAX

ITNS 283

(0036) BANKING CASH TRANSACTION TAX

(100) ADVANCE TAX

(0026) FRINGE BENEFITS TAX

(300) SELF ASSESSMENT TAX (400) TAX ON REGULAR ASSESSMENT

PAYMENT DETAILS 1. 2. 3. 4. 5. 6.

Tax Amount: ________________ Surcharge: ________________ Education Cess: ________________ Interest: ________________ Penalty: ________________ Others: ________________

Total:

PAYMENT INSTRUCTIONS Please find enclosed Cheque Number _____________ on our Current Account No.______________________ Amounting to Rs._______________________ (Rupees________________________________________________________) towards CBDT e-Payment. We confirm that any discrepancy in the Challan, if any, will be brought to the notice of the Bank within one working day for any rectification.

________________

Authorised Signatory For Branch Use Only

Challan Identification Number (CIN): ______________________________________________ Name of the Designated Officer: __________________________ Signature:_______________