Intimation of deposit of Government dues

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..... 3. Period from To .....

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..... 7 8 09 10 11 12 6. Details of previous payments, if any, made in respect of dues mentioned at 4 above S. No. Date of deposit Details of outstanding dues deposited Tax Interest Penalty Other Total Interest for delay, if any (@ 15% p.a.) .....

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..... _____________________ Designation / Status __________________________________________ Place Date Day .....

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