Chhattisgarh Professional Tax Act - 1995 Forms "FORM 15"

FORM 15

[See Rule 19]

Order of assessment of employer/ person

Name of the employer/person …………………………………………………

Address of the employer/person …………………………………………………

Registration certificate …………………………………………………

Period of assessment …………………………………………………

Assessment case No. …………………………………………………

	As Returned			As determined
Employees whose annual salaries or wages are	no. of employees	Rate of tax	Amount of tax to be deducted	No. of employees	Rate of tax	Amount of tax to be deducted
(1)	(2)	(3)	(4)	(5)	(6)	(7)
Less than Rs. 40,001
Rs. 40,001 to 50,000
Rs. 50,001 to 60,000
Exceeding Rs. 60,000

	amount of tax as returned	amount of tax as determined
2. Particulars of profession trade/ calling category of the schedule under which (Liable to pay tax)
3. Penalty under section	(i)
	(ii)
	(iii)

4. Total amount of tax / Penalty
5. Amount paid along with
6. Balance payable / excess payment

Seal

Place Signature..........................

Date Designation......................