Tax Payment Certificate (Under Section 4) (For Quarterly Tax Payment)

[See Rule 12] Tax Payment Certificate (Under Section 4) (For Quarterly Tax Payment)

1. Registration No. of the vehicle ...................................Model …………………. 2. Date of Registration............................................................................................ 3. Name of the Owner ............................................................................................

4. Address..............................................................................................................

5. Gross Vehicle Weight.........................................................................................

6. Un-laden Weight......... ........................................................................................

7. Seating Capacity (Including Driver)....................................................................

8. Rate of Tax per Quarter Rs................................................................................

Year ……………………………………………………….…………………….

SI. No. Quarters Paid amount (in Rs.) Receipt No. Date Signature of the Taxation Officer 1. I Quarter From ………. to …………(Month) 2. II Quarter From ……. to …………(Month) 3. III Quarter From ……. to …………(Month) 4. IV Quarter From ……. to …………(Month)

Signature of the Taxation Officer Date .................................. Region/sub-region