THE BIHAR GOODS AND SERVICES TAX FORMS 2017
DEMANDS AND RECOVERY

FORM GST DRC - 04

[See rule 142(2)]

Reference No:

Date:

To
_______________ GSTIN/ID
----------------------- Name
_______________ Address
Tax Period -------------	F.Y. ----------
ARN -	Date -

Acknowledgement of acceptance of payment made voluntarily

The payment made by you vide application referred to above is hereby acknowledged to the extent of the amount paid and for the reasons stated therein.

	Signature
	Name
	Designation

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