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The Orissa Value Added Tax Rules, 2005 FORMS
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FORM VAT-317

CHALLAN FORM

(To be printed in quadruplicate)

( See sub-rule (6) of rule 57)

   
  DD MM YYYY

To     -     -        

SCROLL No ___________________ Treasury
(To be allotted by Bank) Bank

Challan No. ____________________0040-Sales Tax (b) Receipts under the State Sales Tax Act.

By whom tendered ___________________________________________________________________

Name and address of the dealer _________________________________________________________

 
TIN/SRIN                  

 

Period to which payment relates:

  DD MM YYYY

From     -     -        

  DD MM YYYY

To     -     -        

(i) Tax deducted at source   Rs. ________________
(ii) Tax admitted in return   Rs. ________________
(iii) Interest admitted   Rs. ________________
(iv) Recovery against demand    
  (a) Tax Rs. ________________
  (b) Interest Rs. ________________
  (c) Penalty Rs. ________________
  (d) Security Rs. ________________
  (e) Others (Specify) Rs. ________________
  Total (i) to (iv) Rs. ________________
  (in words) ____________________________________________________

Signature of the Depositor

_____________________________________________________________________________________________________________

(For use in the Treasury)

1. Received payment of Rs. _____________________(in words)_________________________________

2. Date of entry________________________________________________________________________

Treasurer/ Accountant

Treasury Officer/

Agent or Manager"