FORM TR-6 FOR PAYMENT OF SERVICE TAX (CHALLAN)

Challan of amount paid into 
The ______________ (code No.)

Accounting Collectorate
(Code No.)

Name of the Bank/Branch with Code No.
_____________________

Division ____________ (Code No.)
Range _____________ (Code No.)

Name of the Focal Point Bank _____________________
(Code No.) _______________

Name and address of the assessee
_____________________________
_____________________________

(Code No. _______________ ) By whom tendered

Full Particulars of remittance and of authority

Head of accounts & Major Head (indicate against the appropriate Minor Head)

Accounting Code No.

By Cash Rs.   Ps.

By Cheque Draft / Pay Order etc. Rs.   Ps.

Counter Signature of the Departmental Officer (where required)

                              Total

(in words) Rs._______________________________________________________________

Date____________________

Signature of the tenderer

Received payment (in word)
Stamp
Rupee__________________________

Space for Focal Point Bank
indicating the date, amount
credited to Government Account.

Bank's Receipt Stamp:

Signature of the Authorised Officer of the Bank