FORM VAT- V ORIGINAL [See rule 24(3)] (To be retained by the payer) CHALLAN 0040 - Taxes on Sales, Trade, etc. ................ Challan of tax, licence and registration fees and other receipts paid Treasury/Sub -Treasury into the .......... ...... State Bank of India (Branch) for the period from .....to....... Name and address of the dealer on whose behalf money is paid............ .............. .............. By whom tendered........ Payment on account of Amount (in figures) Rs. 105-Value Added Tax 01-Tax Collection 02-Composition of Tax 03-Licence & Registration Fees 04-Interest 800-Others receipts 81-Other items Total .............. Rupees (in words) ............................. Dated:..... ................ Signature of dealer or depositor) (For use in the Treasury/Bank) 1. Received payment of Rs.......................... (in figures) Rupees................................. (in words) 2. Date of entry......... 3. Chalan/Scroll No. ....... ______________________ ______________________________________ (Signature of Accountant) (Signature of Treasury/Bank Officer/Manager) (Stamp of Treasury/Bank)
