Application for intimating discrepancy relating to payment

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..... 4. Date of generation of challan from Common Portal 5. Common Portal Identification Number (CPIN) 6. Mode of payment (tick one) Net banking __ CC/DC __ NEFT/RTGS __ 1 [ IMPS__ ] O .....

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..... UT Tax Integrated Tax Cess 13. Verification (by authorized signatory) I hereby solemnly affirm and declare that the information given herein above is true and correct to the best of my knowledge and belief. Signature .....

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