AXIS BANK
CBDT e-Payment Request Form
For Branch Use Only
Challan Identification Number (CIN):.
Name of the Designated Officer:
Date: Signature:.
PAN No./ TAN:
Full E^ame:
Address: Assessment Year:
Financial Year:
TDS PAYMENTS (CHALAN 281)
ChaiSan Major Head Type of Payment
• ITNS281 • (0020) COMPANY DEDUCTEES • (200) TDS/TCS Payable by Taxpayer
• (0021) NON-COMPANY DEDUC1 tbb • (400) TDS/TCS Regular Assessment (Raised by I.T. Deptt.)
Nature o f Payment:
NON- TDS PAYMENTS (CHALLAN 280/282/283)
Challan Major Head Type of Payment
• (0020) INCOME-TAX ON COMPANIES • (100) ADVANCE TAX
• ITNS280
(CORPORATION TAX)
• (102) SURTAX
• (0021) INCOME-TAX (OTHER THAN COMPANIES)
• (106) TAX ON DISTRIBU1 tU PROFITS
• (107) TAX ON DISTRIBUTED INCOME
• (300) SELF ASSESSMENT TAX
• (400) TAX ON REGULAR ASSESSMENT
• (0034) SECURITIES TRANSACTION TAX
• I T N S 282 • (100) ADVANCE TAX
• (0023) HOTEL RECIEFTS TAX
• (300) SELF ASSESSMENT TAX
• (0024) INTEREST TAX
• (400) TAX ON REGULAR ASSESSMENT
• (0028) EXPNDraiRE/OTHER TAX
• (0031) ESTATE DUTY
• (0032) WEALTH TAX
• (0033) GIFT TAX
• (100) ADVANCE TAX
• ITNS 283
• (0036) BANKING CASH TRANSACHON TAX
• (300) SELF ASSESSMENT TAX
• (0026) FRINGE BENEFTTS TAX
• (400) TAX ON REGULAR ASSESSMENT
AXIS BANK
PAYMENT DETAILS PAYMENT INSTRUCTIONS
• Please find enclosed Cheque Number Axis Bank
1. Tax Amount: Current Account No.
2. Surcharge: • Please debit our Axis Bank Current Account No.
3. Education Cess:
4. Interest: For and amount of Rs._ _(Rupees_
5. Penalty:
6. Others: towards CBDT e-Payment
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
Current Account as well as accessibility of TIN-NSDL Website.
We also confirm that discrepancy in the Challan/ Challan Counterfoil, if any; will be brought to the
notice of the Bank within one working day for any possible rectification.
Authorised Signatory
Contact Number:
ACKNOWLEDGEMENT
Received the request for CBDT e-Payment along with the Axis Bank Current Account Cheque
No. • I Debit Authority for Axis Bank Current Account No.
for an amount of R s . _ (Rupees
subject to availability of funds as well as accessibility of TIN-NSDL Website.
For Axis Bank Limited
