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Date of entry _________________ __________________ ________________ ____________ Treasury Accountant Treasury Officer FORM – 10 (See rule 15(2)) Challan (Quadruplicate to be given to the payer for his own use) The Madhya Pradesh Vritti Kar Adhiniyam, 1995 (028- Other taxes on income and expenditure – B Taxes on Professions, Trade, Callings and Employment) By whom rendered Name, Address, registration No. and case No. if any on whose behalf the money is paid Payment on account of Amount (1) (2) (3) (4) PART - IV PROFESSIONAL TAX RULES, 1995 337 (a) tax according to return for the period from _______ to _______ (b)_ tax demanded after assessment for the period from ________to _______ (c) Penalty (d)composition fees Value Rs._______(in words) Rs._____________ Total Rs.____________( in figures) Rs. ___________(in words) Date___________ Signature of the depositor (for use in the Treasury or the Bank)