FORM VAT- XVIII [See rule 25(1)] Challan for remittance of tax deducted at source Under section 28(2) of the Goa Value Added Tax Act, 2005 (Act 9 of 2005). 0040 - Taxes on Sales, trade, etc. ............. Treasury/Sub -Treasury Remitted in ........... State Bank of India (Branch) ______________________ (1)Name and Address of the Employer (2) Registration No........ (3) TIN, if any available (4)Period to which payment relates from _______________to_________________ (5)Amount remitted in figure: 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 DUPLICATE (To be furnished by the employer to the Appropriate Assessing Authority alongwith the statement) Amount in words(Rupees........ ................... only) Place: Signature of the employer or Date: authorised representatives (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)
