KARNATAKA TAX ON PROFESSIONS, TRADES, CALLINGS AND EMPLOYMENTS RULES, 1976 - FORMS
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FORM 27

[See rule 32(1)]

CERTIFICATE OF TAX AND OTHER AMOUNTS DUE

The Tax Recovery Officer,

.....................................

Sir,

This is to certify that .................. (Name)................... (RC / EC No.)

(Address)...............................................................................................

is in arrears of tax / penalty/interest* as shown in the following table. I request you to take action to recover the said amount of Rs............ under sub-rule (1) of Rule 32 of the Karnataka Tax on Professions, Trades, Callings and Employments Rules, 1976.

TABLE

Date of Assessment/re-assessment/other order	Date of Service of Demand Notice / other notice	Amount in Arrears	Whether tax, penalty or interest
1	2	3	4

	Total Rs.
			PTO

*Note: Strike out whichever is not applicable.

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