FORM IV

(See rule 8 (cc) (i))

BRUHAT BANGALORE MAHANAGARA PALIKE

SELF ASSESSMENT OF PROPERTY TAX FORM / RETURN

NOTE : IF THERE IS ANY CHANGE IN USAGE OR ADDITIONAL CONSTRUCTION FROM THE PREVIOUS YEAR THEN USE BLUE FORM V
This form can be used for full year payment of tax or payment by installment. [please read the instructions before filing the return]

PART I
1 Year of Assessment 2018-2019 P.I.D No. 66-1-150/1-2
Khata No.
Revenue Survey No.
SAS 2008-09 Application No.
2 13339973 Application No 1500039689
Have you filled a revised return for the previous year ? If yes, date of filling Application No.
Name of the Owner Shri/Smt
3 (If jointly held, mention any one name) HOLDER (M/S. J.R. GRAPHIC ARTS)

Contact Nos. Residential No 0 Office No 0 Mobile No 9845140132

4 BESCOM BWSSB BOREWELL AVAILABILITY Yes

Usage (Tick as
5 Residential Non-Residential Both Others
applicable)
‫ݱ‬
Vacant Site Red oxide or
Nature of Property Other Flooring Tiled /Sheet Apt.Complex Hutments Vacant
With Storage Cement flooring

‫ݱ‬
6 Address of the Property 150/1-2, DR M.H MARIGOWDA ROAD MADIWALA, Madiwala (66), Bangalore -560068
Ward No. (Old) 66 Name of the Ward(Old) Madiwala
Ward No. (New) 152 Name of the Ward (New) Sudduguntepalya
7 Postal Address 150/1-2, HOSUR ROAD MADIWALA, -, -, 560068

PART-II

8 Details of tax paid for the year 2018-2019

a Property Tax Paid for the year 2018-2019 Rs. 183825.00

b Cess @ 24% Rs. 44118.00

c Total Property tax (a+b) Rs. 227943.00

d Rebate availed if any, (if filed before 30/04/2018) Rs. 0.00

e Total tax paid for (c-d) Rs. 227943.00

f Amount deducted for tax paid in advance,if any Rs. 0.00

g Rs.
If property tax is paid
h 1st Installment Receipt No. 18192014678 and Date 31/05/2018 Rs. 233702.00
in installments
Rs.

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9 Computation of property tax for the year 2018-2019

i Property Tax payable for [(as per column 8(a)] Rs. 183825.00

j Cess @ 24% of (i) Rs. 44118.00

k Total Property tax payable (i+j) Rs. 227943.00

l Rebate @ 5% of (k) (if filed before 30/04/2018) Rs. 0.00

m Total tax payable after rebate (k-l) Rs. 227943.00

n Deduct advance tax paid during 2018-2019 if any (i.e. balance amount left after adjusting for 2018-2019) Rs. 0.00

o Interest payable 2% per Month up to the date of payment Rs. 0.00

p Penalty of Rs.100/- if return is filed after 29th November Rs. 0.00

q SWM Cess if applicable Rs. 1200.00

r Arrers (if any during 2018-2019) Rs. 0.00

s Net Property tax payable for the year 2018-2019 Rs. 229143.00
Rounded off to the next higher rupee if more than 0.50 paise or a rupee lower if is less than 0.50 paise

Computation of SWM cess Details

Hotel/Kalyana
Usage of the Property Residential Buildings Commercial Buildings Industrial Buildings Total
Mantapas/Nursing Home

Plinth Area (in Sq ft) 0 0 0 0 0

Rate Per Month 0 0 0 0

SWM Cess Payable 0 0 0 0 0

I/we further certify that the details furnished above are true and correct to the best of my / our knowledge and the particulars furnished in this
form have been duly filled by me / us, and I/we understand that for false declarations there will be penal actions.

Signature of the property owner / person liable to pay property tax

Name in block letters: HOLDER (M/S. J.R. GRAPHIC ARTS)

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