FORM V

[See Rule 12]

Returns of tax payable by employer under sub-section (i) of Section 7 of the Telangana
Tax on Professions, Trades, Callings and Employments Act, 1987

Return of tax payable for the month ending on:

Name of the employer:
Address:
Registration Certificate No.:
Number of employees during the month in respect of whom the tax is payable is as under:
Amount of
Employees whose monthly salaries or wages or Number of Rate of Tax per Tax
both are employees month
deduction
(i) 1[Upto 5,000
(ii) From 5,001 to 6,000
(iii) Form 6001 to 10,000
(iv) From 10,001 to 15,000
(v) From 15,001 to 20,000
(vi) Above 20,000]
Total Rs.

Add Simple interest payable (if any) on the

above amount at two per cent per month or
part thereof (Vide Section II of the Act).
Grand Total Rs.

Amount paid under Challan Rs……………………..Dated………………………

I certify that all the employees who are liable to pay the tax in my employ during the
period of return have been covered by the foregoing particulars. I also certify that the
necessary revision in the amount of tax deductible form the salary or wages of the
employees on account of variation in the salary or earned by them has been made
whenever necessary.
I, Shri………………………………………………..solemly declare that the above statements are true
to the best of my knowledge and belief.

Signature
Place: (Employer)
Status
Date:

(For Official use)

The return is accepted on verification
Tax assessed Rs.
 Tax paid Rs.
Balance Rs.

Assessing Authority

Note: Where the Return is not acceptable, separate order of assessment should be passed.

1.
Subs. By G.O. Ms. No. 171, Rev. (CT-IV), Dept., dt. 24-2-2011.
be passed.