FORM III

[Sec rule 12]

Return of tax payable by registered employers under the West Bengal State Tax on Pro fession, Trades, Calling and Employment Act, 1979
( Please type or use capital letters / figures while furnishing the following information.) Period From……..… to….……
(a) Registration Certification No. [In the first three boxes, please insert zone prefix,e.g., RCN, RCE,etc.] (b)Enrolment Certificate No. [In the first three boxes, please insert zone prefix,e.g., ECN, ECE,etc.] (c) Name of the employer (d) Trade Name (e) Address (including Room No., Floor No.,Police Station, Sub-division and postal Index No., i.e.PIN ) (f) Telephone No. (if any) (g) E-mail I.D.(if any) (h) Website (if any) (i))Tax payable for the * quarter / *year………. Tax paid for the * quarter /* year…………… Tax payable / paid in excess for the * quarter /* year………… (j) Interest payable for the * quarter/* year…………….. Interest paid for the * quarter /* year…………. Interest payable / paid in excess for the * quarter /* year……… : : :. : : : : : : : : :

Summary of payments made for the quarter/year
Month April May Jun July August September October November December January February March Total payment for the year A separate statement showing the amount of tax deduction in accordance with the rate of tax specified in the Schedule to the Act in respect of the number of employees belonging to each salary-slab as specified in column against serialof the said Schedule is furnished herewith. The above statements are trun to the best of my knowledge and belief. Place : ………………………………. Date : ………………………………… * Strike out whichever is not applicable. Signature…………………………………….. Status………………………………………… [Please see the reverse] Tax (Rs.) Challan No. Date of payment Name of bank Interest Rs.) (in Challan No. Date of payment Name of bank

Employees whose monthly salaries or wages are

Number of Employees
Apr May June July Aug

MONTHS*
Sep Oct Nov Dec Jan Feb Mar

Rate of tax

Amount of tax deducted
Apr May June July Aug

MONTH*
Sep Oct Nov Dec Jan Feb Mar

Total

(i) Rs. 3000 or less (ii) Rs. 3001….below 5001 (iii) Rs. 5001 '' (iv) Rs. 6001 '' (v) Rs. 7001 '' '' '' '' '' 6001 7001 8001 9001

Nil Rs. 30 per month Rs. 40 Rs. 45 Rs. 50 Rs. 90 '' '' '' '' '' '' '' '' '' '' '' '' GRAND TOTAL 2710.00

(vi) Rs. 8001 '' (vii)Rs. 9001 '' (viii)Rs.15001 '' (ix) Rs. 25001 ''

'' 15001 '' '' 25001 40001

Rs.110 '' Rs.130 Rs.150 Rs.200 '' '' ''

(x) Rs. 40001 and above

* In case of quarterly / annual returns, Particulars in respect of the relevant month of every quarter / year only are required to be furnished.

Signature…………………………………………...………
( With date )

Status………………………………………………………..

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