CBDT e-Payment Request Form

For Branch Use Only

Challan Identification Number (CIN):
Name of the Designated Officer:
Date: Signature:

Full Name: PAN No./ TAN:

Address: Assessment Year:

Financial Year:

TDS PAYMENTS (CHALAN 281)

Challan Major Head Type of Payment
ITNS 281 (0020) COMPANY DEDUCTEES (200) TDS/TCS Payable by Taxpayer
(0021) NON-COMPANY DEDUCTEES (400) TDS/TCS Regular Assessment (Raised by I.T. Deptt.)

Nature of Payment:

NON- TDS PAYMENTS (CHALLAN 280/282/283)

Challan Major Head Type of Payment
(0020) INCOME-TAX ON COMPANIES (100) ADVANCE TAX
ITNS 280 (CORPORATION TAX)
(102) SURTAX
(0021) INCOME-TAX (OTHER THAN COMPANIES)
(106) TAX ON DISTRIBUTED PROFITS

(107) TAX ON DISTRIBUTED INCOME

(300) SELF ASSESSMENT TAX

(400) TAX ON REGULAR ASSESSMENT

(0034) SECURITIES TRANSACTION TAX

ITNS 282 (100) ADVANCE TAX
(0023) HOTEL RECIEPTS TAX
(300) SELF ASSESSMENT TAX
(0024) INTEREST TAX
(400) TAX ON REGULAR ASSESSMENT
(0028) EXPNDITURE/OTHER TAX

(0031) ESTATE DUTY

(0032) WEALTH TAX

(0033) GIFT TAX

(100) ADVANCE TAX

ITNS 283 (0036) BANKING CASH TRANSACTION TAX
(300) SELF ASSESSMENT TAX
(0026) FRINGE BENEFITS TAX
(400) TAX ON REGULAR ASSESSMENT
TDS PAYMENTS- (800) TDS on Sale of Property
(0020) COMPANY DEDUCTEES (0021) NON-COMPANY DEDUCTEES

PAN of Transferee (Buyer) :_________________________________________ PAN of Transferor(Seller) : _______________________________________________________

Name & Address of Transferee: ______________________________________ Name & Address of Transferor: ______________________________________________________

________________________________________________________________

Agreement/Booking Date: __________________________________________ Type of Property: Land Building (Shops, Apartment,Flats, Bunglows etc)

Property Addres:_________________________________________________________________
Total Value of consideration(Property Value): ______________
______________________________________________________________________________

Payment Type Lumpsum Installments

Tax Deposit Details: Date of Tax Deduction:_________________________________________________________

Total Amount paid/credited : ______________________________________ Date of Payment/Credit to transferor/seller:__________________________________________

TDS Rate : ______________________________________ Mode of payment of Tax: e-tax payment immediately (through net-banking facility)

TDS Amount : ______________________________________

e-tax payment on subsequent date (visiting any of Bank
Interest : ______________________________________
Branches)
Fee :_______________________________________

Total Payment :_______________________________________

Acknowledgement No (ACK No) as per NSDL Site : __________________________________

Value In words :__________________________________________

________________________________________________________________

PAYMENT DETAILS (Other than TDS on sale PAYMENT INSTRUCTIONS

of property) Please find enclosed Cheque Number Axis Bank

1. Tax Amount: Account No.

2. Surcharge: Please debit our Axis Bank Account No.

3. Education Cess:
For an amount of Rs. (Rupees
4. Interest:
)
5. Penalty:
towards CBDT e-Payment.
6. Others:

Total:

We understand that the Bank will make the CBDT e-Payment on our behalf based on this e-Payment Request Form submitted by us. We also understand that submission of this e-Payment
Request Form does not imply payment of tax, which is subject to availability of funds in our Axis Bank Account as well as accessibility of TIN-NSDL Website.

We also understand that no correction/rectification is possible at the Banks end for any discrepancy in tax payments made through e-payment by the Bank on our behalf.

Contact Number: Authorised Signatory

ACKNOWLEDGEMENT
Received the request for CBDT e-Payment along with the Axis Bank Account Cheque No. / Debit

Authority for Axis Bank Account No. ___________________________________________________________________________________________________

for an amount of Rs. (Rupees

subject to availability of funds as well as accessibility of TIN-NSDL Website.

For Axis Bank Limited