Taxpayer's Counterfoil

...................................................................................
Name of the Assessee

UMESH SANJEEVA AMIN

Complete Address

MUMBAI MAHARASHTRA 400093

...................................................................................
PAN

Major Head

0021 - INCOME-TAX (OTHER THAN COMPANIES)

Minor Head

300 - SELF ASSESSMENT TAX

...................................................................................
Description of Tax

HDFC BANK LIMITED

Amount in Rupees

Basic Tax

11,604.00

Surcharge

0.00

Education Cess

348.00

Penalty

0.00

Others

0.00

Interest

2,698.00
TOTAL

14,650.00

Challan No

280

BSR Code

0510308

Date of Receipt

19/03/2016

Challan Serial No

09166

Assessment Year

2015-16

Bank Reference

09166

Drawn On

HDFC Bank Netbanking

Rupees (In words)

FOURTEEN THOUSAND SIX HUNDRED FIFTY ONLY

CIN

051030819031609166

Debit Account No.

02122320002681

Payment Realization Date

Please Save a copy of this Acknowledgement Receipt for your future reference.

19/03/2016 19:08:32