* Important : Please see notes overleaf before Single Copy (to be sent to the ZAO)

filling up the challan

Tax Applicable (Tick One)*
CHALLAN (0020) INCOME-TAX ON COMPANIES Assessment Year
NO./ (CORPORATION TAX)
2016-17
ITNS 280 (0021) INCOME TAX (OTHER THAN
COMPANIES)
Permanent Account Number
AIIPG9930D
Full Name
RAJIV GUPTA
Complete Address with City & State
312 Street no- 6 Durga Puri NEW DELHI DELHI

Tel. No.. 0 Pin 110093

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 credited on
Surcharge 0
Education Cess 0
Interest 0
D D M M Y Y
Penalty 0
Others 0
Total 25000
Total (in words)
CRORES LACS THOUSANDS HUNDREDS TENS UNITS SPACE FOR BANK SEAL
TWENTY ZERO ZERO ZERO
FIVE

Paid in Cash/Debit to A/c /Cheque No. -- Dated 11-03-2016

Drawn On
(Name of the Bank and Branch)
Dated 11-03-2016

Signature of person making payment

Taxpayers Counterfoil (To be filled up by tax payer) SPACE FOR BANK SEAL
PAN AIIPG9930D
Received from RAJIV GUPTA
(Name)

Cash/ Debit to A/c /Cheque No. -- For Rs. 25000

Rs. (in words) Twenty Five Thousand
Drawn on
(Name of the Bank and Branch)

on account of
Companies/Other than Companies/Tax
Income Tax on (Strike out whichever is not applicable)
Type of Payment Advance Tax

for the Assessment Year 2016-17