FORM ST. XI-A CHALLAN (To be retained in the Treasury) Invoice of the tax paid into Treasury/Sub-Treasury/ Branch of the State Bank of India or/the State Bank of Patiala and credited under the Head of Account (0-40-Sales Tax)-Receipts from the Punjab General Sales Tax Act. (Voluntary payment for the quarter ending....................19................. 1 2 3 4 By whom Name, address and Registration Payment on account of Amount tendered Number of dealer on whose behalf money is paid. Voluntary deposit of the (i) Sales Tax, or (ii)Purchase Tax, under section 10 _____________ Total Dated.............the............19.......... Signature of dealer of depositor Amount received Treasury Accountant Treasury Officer/Sub-Treasury Officer/ Agent, State Bank of India/Manager, State Bank of Patiala. Treasurer Stamp of Treasury. FORM ST. XI-A CHALLAN (To be retained by the dealer) Treasury/Sub-Treasury/Branch of the State Bank of India/ or the State Bank of Patiala. District___________________________________________________________________________ (i) By whom tendered___________________________________________________________ (ii) Name, address and registration number of dealer on whose behalf money is paid___________ __________________________________________________________________________ Received the sum of Rupees______________________on account of (voluntary deposit of tax) for the quarter ending_____________________________and credited under the Head of Account (0-40--Sales Tax)--Receipts from the Punjab General Sales Tax Act. Treasurer / Treasury Officer / Sub-Treasury Officer/Agent, State Bank of India/Manager, State Bank of Patiala. Dated_________19_________
