For payments from April 2007 onwards

Full Name Complete Address Telephone No. Assessee Code No. Commissionerate Name Commissionerate Code
Accounting Code of the service

G.A.R.-7 Proforma for Servicer Tax (Receipt & Payment Rules 26) Payments K I S H N A T O U R S & T R A V E L S 1 5 9 , D D A S F S F L A T S P O C K E T - 1 , D WA R K A N E W D E L H I 9 A D S 8 9 9 3 2 4 9 4 4 Pincode 1 1 0 0 7 5 I N P B 4 9 1 9 N S D 0 0 2 E L H I - I I E Division Code 0 2 Range Code 0 8
Amount Tendered in Rupees
BANKS COUNTERFOIL
RECEIVING BANK BRANCH STAMP

0 0 0 0 0 0

0 0 0 0 0 0

4 4 4 4 4 4

4 4 4 4 4 4

0 0 6 3

2 5 6 7 0

(In words) Rupees

Total 2 5 6 7 0 TWENTY FIVE THOUSAND SIX HUNDRED & SEVENTY ONLY

SOUTH INDIAN BANK

327280 02/01/2012 By Cash/Cheque/Draft/Pay Order No. Dated THE SOUTH INDIAN BANK LTD. SEC. 10, DWARAKA, NEW DELHI - 110045 Drawn on Signature of the Tender with date -----------------------------------------------------------------------------------------------------------------------------------------------Accounting Code of the service

Amount Tendered in Rupees

TAX PAYERS COUNTERFOIL

RECEIVING BANK BRANCH STAMP

0 0 0 0 0 0

0 0 0 0 0 0

4 4 4 4 4 4

4 4 4 4 4 4

0 0 6 3

2 5 6 7 0

Total
Received from Assessee Code No. (In words) Rupees

2 5 6 7 0 I N P B 4 9 1 9 N S D 0 0 2
Only

TWENTY FIVE TOHOUSAND SIX HUNDRED & SEVENTY ONLY

327280 02/01/2012 By Cash/Cheque/Draft/Pay Order No. Dated THE SOUTH INDIAN BANK LTD. SECTOR 10, DWARKA, NEW DELHI 45 Drawn on On account of Union Service Tax as detailed in this taxpayers counterfoil and on stamp affixed and signed therein.