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CCF 000038

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lulsegedeshete825
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26 views1 page

CCF 000038

Uploaded by

lulsegedeshete825
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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"Th

rh'IC 11-11C thJi hcr? 1"11111r


DOMESTIC TAX ELECTRONIC PAYMENT

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BANK NAME
?OM
BANK BRANCH

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Source of fund Bank Account Cash

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Tax Payer's/Account Holder's Name

i'7,11C ti4.,e, 1)0,1-i ,101-11 civrir: . p


DI c- nAdao c_yroi.,‘\-.()yoviAer s --c•
Payer's Account Number 01030\
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1,,19.44: W/f),:i. /-"1" , 5 A worLi,cLco_9 643verrimesalue..
Beneficiary's Name .:
AtA*M\-j rivirgVy-o, 0 P409,NOtArnra.
:PC")"),1: W/11,:i. di."irli ,ivri.
np_vs 3v-o-nch niphre .
Beneficiary's Account Number
thr,no. 1:th m1ti1l4vrc ,(IC1
1 crocgt[7-32-769 -2' 2Y11-5ts9 (1-(9?--ti • A
Amount (in figure) ETB 2\/ 3C'' I tl
rrM11. MI (144.K/A.

Amount (in words) ETB. ITLUO 4410 t., ,Sancli\l'Irt.f., \ili


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f)titt:Y Yntilf.V4.
Payment Details 1 -11)C__O rne:ra7

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MOR LC 03 t cis
Domestic Tax Payment - Ref. No. r7,11C rto A ,e tivr C
Taxpayer Identification Number (TIN)

P7114" 1/.41"1"PC //1.9* w./?•P 11`7A X' A411-?•::

I/We the undersigned here by authorize the bank to effect payment electronically to the above mentioned
beneficiary as per the stated details throu thiopian Automated Transfer System (EATS). --..i-iec;"-,-....,
........, 4,,,t4
17\ S \
e'Hie N./11114d C.7-11 (1,4'''/ "7,0-111"/Stamp)
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Tax payers/Account Holder's Signatur ,', lif 1
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&IN(' fi el>r'P'N'i:
For Bank branch's use only
1-1CRC,
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