1
Name of the Designated Officer
For Branch Use Only
Full Name
Non-TDS Payments (Challan 280/282/283/285/286/287)
TDS Payments (Challan 281)
Challan Identification Number (CIN)
Address
Date
DD
MM
YYYY
Signature
CBDT e-Payment Request Form
PAN No./ TAN
Assessment Year
-
Financial Year
-
ITNS 281 (0020) Company Deductees (200) TDS/TCS Payable By Taxpayer
(0021) Non-Company Deductees (400) TDS/TCS Regular Assessment
Challan Major Head Type of Payment
ITNS 280 (0020) Corporation Tax (Companies) (100) Advance Tax
(0021) Income Tax (Other than Companies) (102) Surtax
(107) Tax on Distributed Income
(110) Secondary Adjustment Tax
(111) Accretion Tax
(300) Self Assessment Tax
(106) Tax on Distributed Profit
ITNS 282 (0034) Securities Transaction Tax (100) Advance Tax
(0023) Hotel Receipts Tax (300) Self Assessment Tax
(0024) Interest Tax (400) Tax on Regular Assessment
(0028) Expenditure/ Other Tax (800) Commodities Transaction Tax
(0031) Estate Duty
(0032) Wealth Tax
(0033) Gift Tax
(400) Tax on Regular Assessment
Challan Major Head Type of Payment
Nature of Payment:
Payment Details
Payment Instructions
Acknowledgment
2
Miscellaneous
(400) Tax on Regular Assessment
ITNS 283 (0036) Banking Cash Transaction Tax (100) Advance Tax
Deductor for specified services Levy payable by Deductor/E-commerce operator
(0026) Fringe Benefits Tax (300) Self Assessment Tax
ITNS 285 (0045) Other Taxes and Duties on (119) Equalization Levy
Commodities and Services
E-commerce operator for Levy paid for Demand Raised by ITD
e-commerce supply or services
ITNS 286 (0028) Other Taxes on Income and Expenditure (111) Payment under Income Declaration
Scheme, 2016
ITNS 287 (0028) Other Taxes on Income and Expenditure (112) Payment under Pradhan Mantri Garib
Kalyan Yojana, 2016 (PMGKY)
Tax Amount
Surcharge
Education Cess
Interest
Penalty
Others
Total
Contact Number Authorized Signatory
Please debit our Axis Bank Current Account No. for an amount of `
(` ) towards CBDT e-payment).
Please find enclosed Cheque No. of Axis Bank Current Account No.
We understand that the Bank will make the CBDT e-Payment on our behalf based on this e-Payment Request Form submitted by us.
We also understand that submission of this e-Payment Request Form does not imply payment of tax, which is subject to availability of funds in our
Axis Bank Current Account as well as accessibility of TIN-NSDL Website.
We also confirm that discrepancy in the Challan/Challan Counterfoil, if any, will be brought to the notice of the Bank within one working day
for any possible rectification.
Received the request for CBDT e-Payment along with the Axis Bank Current Account Cheque No.
/Debit Authority for Axis Bank Current Account No. for an amount of
` (` )
subject to availability of funds as well as accessibility of TIN-NSDL Website.
For Axis Bank Limited
