Omitted

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..... 2. Details of the seller (a) Name .....

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..... Name of premises/Building .....

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..... Town/City/District .....

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..... (c) Has address of the seller since submitting the last return Tick as applicable Yes No 3. Details of gross amount debited/received under section 206C(1) and tax collected thereon: Buyer Gross amount debited/receiv .....

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..... Sl. No. Challan Number Date of payment Amount of tax paid (Rs.) Name and address of the bank (1) (2) (3) (4) (5) Total 5. Details of payments deb .....

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..... Total (b) In the case of buyers, other than companies: Sl. No. Permanent Account Number (PAN) Name of buyer Address of the buyer Total value of the purchase(s) Amount debited/ received (Rs.) Amount of tax collected Date on which tax collected Date on which tax collected .....

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