KARNATAKA TAX ON PROFESSIONS, TRADES, CALLINGS AND EMPLOYMENTS RULES, 1976 - FORMS
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FORM 10

[See Rule 19(2)]

	ORIGINAL
	(For the Payer)

Paying in slip for making payment to the Collecting Agents The Karnataka Tax on Professions, Trades, Callings and

Employments Act, 1976.

Paying in slip for tax, interest, penalty and composition money paid to . . . . . . . . . . . . . . . . . . . . .

(Name of the Collecting Agent)

for the period from . . . . . . . . . . . . . . . . . . . . . . . .to . . . . . . . . . . . . . . . . . . . . . . . .

	Payment on account of	Amount (in figures)
		Rs.	Ps.
By whom tendered
. . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . .
Name and address of the person in whose behalf the money is paid	(a) Tax
	(b) Interest
	(c) Penalty
	(d) Composition money
. . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . .		___________________
. . . . . . . . . . . . . . . . . . . . . .	Total
Enrolment Certificate No.		___________________
Rupees (in words). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Date:		Signature
____________________________________________________________________________________________
(To be used by the Collecting Agent)
Received the payment of Rupees. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .(in figures)
Rupees. . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (in words)

Date:
Slip No.		Receiving Officer.

FORM 10

[See Rule 19(2)]

	DUPLICATE
	(For the Collecting Agent)

Paying in slip for making payment to the Collecting Agents.

The Karnataka Tax on Professions, Trades, Callings and Employments Act, 1976.

Paying in slip for tax, interest, penalty and composition money paid to. . . . . . . . . . . .

(Name of the Collecting Agent)

for the period from. . . . . . . . . . . . . . . . . . . . . .to. . . . . . . . . . . . . . . . . . . . .

	Payment on account of	Amount (in figures)
		Rs.	Ps.
By whom tendered
. . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . .
Name and address of the person in whose behalf the money is paid	(a) Tax
	(b) Interst
	(c) Penalty
	(d) Composition money
. . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . .		____________________
	Total
		____________________
Enrolment Certificate No.
Rupees (in words). . . . . . . . . . . . . . . . . . . . . .

Date:		Signature
____________________________________________________________________________________________
(To be used by the Collecting Agent)
Received the payment of Rupees. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (in figures)
Rupees. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . (in words)
Date:
Slip No.		Receiving Officer.