Challan Form Performa
Here's a general proforma for a challan form:
[Challan Form]
[Header: Name of the Government Department/Authority/Agency]
[Challan No.: _______] [Date: _______]
[Section 1: Payer Information]
Name of the Payer: _______________________________________________________
Address of the Payer: _____________________________________________________
Contact Details (Phone/Email): _____________________________________________
[Section 2: Payment Details]
Type of Payment: [Tax/Fee/Fine/Other] ____________________________________
Purpose of Payment: _______________________________________________________
Amount (in figures): ________________________ (in words): ___________________
[Section 3: Payment Method]
Payment Method: [Cash/Cheque/Demand Draft/Online Transfer/Other] ___________
Payment Date: //_________ [DD/MM/YYYY]
Bank/Branch Name (if applicable): __________________________________________
Cheque/DD No. (if applicable): _____________________________________________
Account No. (if applicable): ________________________________________________
[Section 4: Verification]
I hereby declare that the information provided above is true and accurate to the best of my knowledge and belief.
Signature of Payer: ___________________________ Date: //_________
[Section 5: For Office Use Only]
Received the above payment of Rs. _________ on account of ______________________
Signature/Seal of Receiving Officer: __________________________________________
Please note that this is a generic format, and the actual layout and fields on the challan form may vary depending on the specific requirements of the government department or authority collecting the payment. It's essential to obtain the official challan form from the designated authority and fill it out accurately according to their instructions to ensure compliance and smooth processing of the payment.