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(otemes ip nei) ou. > Pst > P00: Eaaltehitsmme Payment Form 0605 Joy 1999 (ENCS) Flin al applicable epaces, Mark all appropriate boxes with an "x" fre rere [] cana |] Paces Guana = Gas Daw (MMTOOTI ono citeas PATO P mart 222 ia) Go Gfosizeral = lal © [F7RowmPerod (MMT DOT YYYY) [8 Tax Type Code" "BCS No./tem No, (To be filed up by Ne GIR) ; ; . > LEE Se 0 ROO Code 7 Taspayer Canacaton [12 Le of SusneseTOcmipaton -[008] lo~ecl [ze i[loce]-[oar |] -, a > LReTalere. fs Teoae F Teepnane RunBer name +L BIGLEAP TRCHVOLOGIES IWC. SREE Last Name, Fest Name, Mila Name or ngviuas)/ Regieres Nama or Nenu) M8 Reese -(@2 CrryuaaD Siaw TOWER Sonn Blyo., ManoncinimG OY eaecesei | CRS) > 17 Mannorof Payment 78 ype of Payment ‘outa Payment er Avvbeinquent Account estaiment SeAssessment Lrenaies Prliinayina AacestmentDescioney Tax | [E]No.of instalment tax Depostadvance Payment Accouns RecelebleDelnquent Aout Pani! Income Tx Sacondistaimant Payment (oandiay frat jomers speemy [REGUTRATION FeES __| Payment Partu > Computation of Tax 13. Base Tox! Dopod Aavance Payment p ie * 500. 60 A ma aa = po 21 Tetal Amount Payable (Sum of toms 19 & 200) ‘Stamp of Recehing Offce ‘and Date of Receipt RECEIVED |CPB-SHANGRI-LA erancy JAN 08 2014 RDO CODE - 041 BRANCH CODE 010-075 | declare, under the penalties of perjury, that this ocument has been made in good fath, vesfed by me, and tothe best of my znowledge and betes rue and caret, pursuant to the provlons of the National nimal [prone By Debit Memo 2 7 $700: 00 aa 9 © 20 : J24Check * r . ~ 25 Tax Debit 25a 5B sel T were . . all ; aA 2s ise 20 ; ar c - i : fia vatatosevrss ORG ROG Deas Ora Baa wn EAT oe STREET ToT cesnnnns TT EONIRS HTH 06002009100

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