Single(Copy to be sent the ZAO)

Tax Applicable(Tick One)* CHALLAN NO./ ITNS 280 (0020) INCOM !TA" ON COM#ANI S (CORPORATION TAX) (0021) INCOME TAX (OTHER THAN COMPANIES) 2013-14 Assessment Year

Permanent Account Number

DNHPS1482M u!! Name MRS VANDANA SHARMA Com"!ete A##ress $%t& C%t' an# State 222,Saini Vihar,Phase-1,Baltana,Zira !"r,M#hali,P$N%AB,140&04 Te!( No( 01'22'20&11 T(!e #) Pa(*ent+Ti, -ne. A#)ance Ta*(100) Se!+ Assessment Ta* (,00) Ta* on Re/u!ar Assessment(000) -ETAI3S O PAYMENTS Income Ta* Surc&ar/e E#ucat%on Cess Interest Pena!t' Ot&ers Tota! Amount(%n Rs(on!') Surta*(102) Ta* on -%str%bute# Pro+%ts o+ -omest%c Com"an%es(10.) Ta* on -%str%bute# Income to 1n%t Ho!#ers(102) /-R $S0 IN R010IVIN2 BAN3 P%n 140&04

DNHPS1482M

&4&2 0 0 448 0 0 &410 3ACS THO1SAN-S

SI5

#eb%t to A4c 4C&e5ue Cre#%t on -MM YY

SPACE OR 6AN7 SEA3

Tota!(%n 8or#s) CRORES H1N-RE-S

NIN0 1ash

TENS
-N0 -ate#

1NITS

Pa%# %n Cas&4-eb%t to Ac4C&e5ue No

-ra8n on
(Name o+ 6an9 an# 6ranc&) -ate

2.40242010

S%/nature o+ "erson ma9%n/ Pa'ment

Rs( SPACE OR 6AN7 SEA3

Ta*"a'ers Counter+o%!(To be %!e# u" b' t&e ta* "a'er ) PAN Rece%)e# orm Cas&4-eb%t to Ac4C&e5ue No -NHPS10:2M VANDANA SHARMA 1ash or Rs( &410 SI5 TH-$SAND NIN0 H$NDR0D T0N -nl( (Name o+ t&e 6an9 an# 6ranc&)

Rs %n $or#s
-ra8n on

On Account o+ -ther than 1#*!anies Income Ta* on Sel) Assess*ent Ta6 T'"e o+ Pa'ments
+or t&e Assessment Year 2013-14
Co#e 1727 Rs(