Notice of demand for payment of tax/penalty

To, Name____________ Address________ Registration No. ___________ *.You have been assessed/re-assessed under the Madhya Pradesh Vritti Kar Adhiniyam, 1995. * You having failed to pay the tax for the period ___________ to ________ has been determined under sub-section (1) of section 16 of the said Act. You are hereby directed to deposit the following amount in the treasury wi8thin thirty days from the due date of receipt of the notice and send a copy of the receipt challan in token of such payment within ______________ days sof the date of deposit. (1) Tax assessed --------------------- (2) Penalty _____________ Total _____________ Challan No. Date Amount (1) .................. .............. ............ (2) .................. .............. ............ (3) .................. .............. ............ (4) .................. .............. ............ Net demand rupees ______________(in figures) _____________(in words) Seal ....................................... Place.......................... Date........................... Signature Designation______________ *Strike out whichever is not applicable