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Date:
Signature of person making payment Rs. 51000.00
Taxpayers Counterfoil (To be filled up by tax payer) SPACE FOR BANK SEAL
PAN A D J P K 5 7 4 1 N
Received from P AWAN S I NG L A
(Name)
Cash/ Debit to A/c /Cheque No. For Rs. 51000
Rs. (in words) Fifty One Thousand only
Drawn on
(Name of the Bank and Branch)
maxutils.com/fdn/
http://maxutils.com/fdn/
*NOTES
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