FORM VI[See Rule 14(2)]

ORIGINAL
(For the Payer)

Paying in slip for making Payment to the Collecting Agents The A.P.Tax on Professions, Trades, Callings and
Employments Act, 1987

Paying in slip for tax, interest, penalty and composition money paid to _______________________
_________________________________________________(Name of The Collecting Agent) for the period
from___________________________________to___________________________________
By whom tendered.

Payment on Account of

Amount (in
figures)
Rs.

Name and address of the

person in whose behalf the
money is paid

(a)

Ps.

Tax

(b)

Interest

(c)

Penalty

(d)

Composition Money

TOTAL

_______________

_______________

Enrolment Certificate No.:

Rupees (in words) __________________________________________________________________

Date
:
(Signature) ____________________
_________________________________________________________________________________________
(To be used by the Collecting Agent)

Received the payment of Rupees ___________________ (in figures) Rupees __________________

_________________________________________________________________________(in words)

Date: Slip No.

Receiving Officer