Chhattisgarh Professional Tax Act - 1995 Forms "FORM 06"

FORM 6

[See Rule 9]

Certificate to be furnished by a person who is simultaneously

Engaged in employment of more than one employer.

I..........................................................................(name of the person) engaged in employment with The following employer, namely:-

	Name of the employer	Address of the employer
1.
2.
3.
4.

And that i shall get myself registered and pay the tax/ I have got myself registered under the registration certificate No.......................... Dated…................... And shall pay the tax/ *have paid the tax stated therein myself.

Place : …………………

Date : ………………… Signature