Panchayat:Repo18/Law Manual Page0533

ANNEXURE TO FORM No. IV (See Rule 18) Statement regarding notice of demand sent along with Application

	Serial No	Name of Taxpayer and Demand No.	Demand Amount	Date of sending Demand Notice	Date of service of Demand Notice	Present address of taxpayer if out of station by reason of transfer etc.	Date of returning of the second copy
	1	2	3	4	5	6	7

Signature (with date) Signature (with date) Head of Office/employer Secretary .........................Village Panchayat

In the case of person who is transferred from one office to another office in the same department, the Officer who relieves him shall enter the Profession Tax to be remitted by him in the Last Pay Certificate and shall realise and remit the amount and in the case of a person who retires from services, salary shall be disbursed only after realising the tax amount from his last salary [See Sub-rules (4) and (5) of Rule 20].