FORM VAT - 2
(See rule 3, 28, 32, 37 And 46)
                                                           CHALLAN
                                  Invoice of Tax paid into Treasury/Sub Treasury/Branch of
                       State Bank of India/State Bank of Patiala or any other Bank authorized to transact
                          Government business and credited to the Head of Account "0040-Taxes on
                                               Sales, Trade etc-102 State VAT".
District                                 Faridkot(FKT-00-509)
Period                                   From           01/04/16                      To        30/06/16
Last Date of Payment                     01/08/16
1. By Whom tendered                      AMIT PURI
2. Name of the Person                    M/S GANPATI MEDICAL AGENCY
Complete Address                         QUILA ROAD KOTKAPURA
VRN/TRN                                  03322190719
(a) Voluntary Tax VAT/TOT / Advance
                                         Rs.1793
Tax
(b) Additonal Demand :                   Rs.0
(c) Penalty U/S :                        Rs.0
(d) Interest :                           Rs.18
(e) other Deposits :                     Rs.0
(f) Total in Figures :                   Rs.1811
(g) 89% of the amount at 2 (f)           Rs.1612
(h) : Addional Tax Payable under
                                          Rs.0
section 8 - B
(i) 80% of the amount at 2 (h) above      Rs.0
(j) Total amount deposited 2(g) + 2(i)
                                       Rs.1612
    (IN FIGURES)
(k) TOTAL AMOUNT DEPOSITED IN
WORDS "0040 Taxes on sales, Trade Rs. One Thousand And Six Hundred And Twelve Rupees Only
etc - 102 State VAT "
(l) PMF : 11% of 2(f)
                                       Rs.199
credited in account of PMF
(m) PIMF : 20% of 2(h)
                                       Rs.0
credited in account of PMIDF
TOTAL TAX IN FIGURES
       Total of (Treasury)              VAT 11%                Additional Tax 20%
                                                                                           Grand Total
       2(g) + 2(i)                      2(l) PMF               PIMF 2 (m)
         1612                            199                    0                          1811.00
TOTAL TAX IN WORDS                        Rs. One Thousand And Eight Hundred And Eleven Rupees Only
Bank Receipt No : IKB9876838
Date and Time of transaction:01/08/2016&05:55:49 PM
Certified that all the particulars given above are correct.
Signature of the depositor
                                                                                                     (Designated Officer)
                                                                                                 Seal of Designated Officer