Challan No.

/ITNS Tax Applicable Assessment Year

280 (0020) INCOME TAX ON COMPANIES (CORPORATION TAX) 2021-22
(0021) INCOME TAX OTHER THAN COMPANIES ✔
PAN: ALNPM4483B
Full Name : MADXXXXDHAN MODEM
Complete Address with City & State : Flat No. 707/708, SENINA, HIRANANDANI ESTATE, PATILPADA, Thane
Belapur Road, Thane, MAHARASHTRA, 400605
Tel. No. :

Type of Payment :
(100) Advance Tax (102) Surtax
(300) Self Assessment Tax (106) Profits of Domestic Companies
(400) Tax on Regular Assessment (800) TDS on Sale of Property
(110) Secondary Adjustment Tax (111) Accretion Tax ✔
(107) Tax on Distributed Income to Unit
Holders

Details of Payment FOR USE IN RECEIVING BANK

Amount (in Rs. only) Debit to A/c / Cheque credited on
Income Tax 20
Payment Status : Failed
Surcharge 0
Bank Reference No.: 70804236
Education Cess 0
Interest 0 SPACE FOR BANK SEAL
Penalty Code
Penalty 0
Others 0
Rs. 20
Total 20
Tax payer remarks. : ---
Total (in words) Rupees Twenty and Paise
Zero Only.
Crores Lakhs Thousands Hundreds Tens Units
Zero Zero Zero Zero Two Zero
Debit to A/c 026801514159
Date 02-12-2021
Drawn on Internet Banking Payment
through ICICI Bank

Taxpayers Counterfoil Payment Status : Failed

PAN: ALNPM4483B Bank Reference 70804236
No.:
Received From : MADXXXXDHAN MODEM
Paid in Cash / Debit to A/c / 026801514159 SPACE FOR BANK SEAL
Cheque No :
For Rs. : 20
Rs (in words) : Rupees Twenty and Paise Zero
Only.
Drawn on: Internet Banking Payment through Rs. 20
ICICI Bank

On Account of : (0021)Other than Companies Tax

Type of Payment (111)Accretion Tax
For the Assessment Year : 2021-22