Single Copy (to be sent to the ZAO)

CHALLAN NO./ ITNS 280

Tax Applicable (Tick one) (0020) INCOME-TAX ON COMPANIES (CORPORATION TAX) (0021) INCOME-TAX (OTHER THAN COMPANIES)

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Assessment Year 2013-14

Permanent Account Number BIDPS9019R Full Name ARVIND KESHAVPRASAD SINGH Complete Address with City & State ROOM NO 22, SHRI GANESH CHS LTD, SAHYADRI NAGAR BHANDUP (WEST), MUMBAI, MAHARASHTRA Phone No. Type of Payment (Tick One)
Advance Tax (100) Self Assessment Tax (300) Tax on Regular Assessment (400)

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400078 [ [ [ ] ] ]

Surtax (102) Tax on Distributed Profits of Domestic Companies (106) Tax on Distributed Income to Unit Holders (107)

DETAILS OF PAYMENTS Amount (In Rs. Only) Income Tax Surcharge Education Cess Interest Penalty Others Total Total (in words):
CRORES Zero LACS Zero THOUSANDS Twenty Seven HUNDERDS One TENS Eight UNITS Zero

FOR USE IN RECEIVING BANK

Debit to A/c / Cheque credited on

24276 0
DD MM YY

729 2175 0 0 27180 SPACE FOR BANK SEAL

Paid in Cash/Debit to A/c/Cheque No. Drawn on

Dated
(Name of the Bank and Branch)

Date:

03/08/2013 Signature of the Person making payment

Rs.

Taxpayers Counterfoil (To be filled up by tax payer) PAN Received from

Cash/Debit to A/c/Cheque No.

SPACE FOR BANK SEAL

BIDPS9019R ARVIND KESHAVPRASAD SINGH For Rs. 27180

Rs. (in Words) Drawn on

Twenty Seven Thousand One Hundred Eighty Only

(Name of the Bank and Branch)

On account of Type of Payment

Companies/Other than Companies Tax Self Assessment Tax 2013-14 Rs.

For the Assessment Year