Self Assessment Tax Challan Ni

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*Important : Please see notes overleaf before filling up the challan.

Single Copy (to be sent to the ZAO)

Tax Applicable (Tick One) * Assessment


CHALLAN NO. (0020) INCOME-TAX ON COMPANIES
ITNS (CORPORATION TAX) Year
(0021) INCOME TAX
280 (OTHER THAN COMPANIES)
2010-2011

Permanent Account Number


ACNPN5967G
Full Name
PRABHAKAR VITHAL NIKAM

Complete Address with City & State


SECTOR NO 10 , PLOT NO 134, PRADHIKARAN, MIDC BHOSARI, PUNE, Maharashtra

Tel. No. 66300367 Pin 411026


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
Debit to A/c / Cheque credited on
Income Tax 32524
Surcharge 0
Education Cess 976 DD MM YY
Interest
SPACE FOR BANK SEAL
Penalty
Others

Total 33500 /-
Total (in words)
CRORES LACS THOUSANDS HUNDREDS TENS UNITS
Zero Zero Thirty Three Five Zero Zero

Paid in Cash/Debit to A/c/Cheque No. Dated

Drawn on
(Name of the Bank and Branch)

Date : 06/10/2010 Rs.


Signature of person making payment
Tear Off
Taxpayers Counterfoil (To be filled up by tax payer)
SPACE FOR BANK SEAL
PAN ACNPN5967G
Received from PRABHAKAR VITHAL NIKAM
(Name)
Cash/Debit to A/c / Cheque No. for Rs. 33500 /-
Rs. (in Words) Thirty Three Thousand Five Hundred Only
Drawn on
(Name of the Bank and Branch)
on account of
Income Tax on Companies
XXXXXXXX / Other than Companies
Type of Payment Self Assessment Tax (300) (To be filled up by person making the
payment)
2010-2011 Rs.
for the Assessment Year

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