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

[See Rule 12] Tax Payment Certificate (Under Section 4) (For Yearly 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 Year Rs................................................................................

Year ……………………………………………………….…………………….

SI. No. Year Paid amount (in Rs.) Receipt No. Date Signature of the Taxation Officer 1. Year ……… From ……. to …………(Month) 2. Year ……… From ……. to …………(Month) 3. Year ……… From ……. to …………(Month) 4. Year ……… From ……. to …………(Month) Signature of the Taxation Officer Date .................................. Region/sub-region