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    Challan

    Uploaded by

    ggrajesh
    This document is a challan form submitted by M/s. Devendran Coal International Pvt Ltd to the Employees' State Insurance Corporation (ESIC) for depositing contributions for the month of September 2011. It contains details such as the employer code, name and address, contribution amounts of Rs. 1225 for employees and Rs. 3352 for the employer, total amount of Rs. 4577, and confirmation that the amount was paid by cash cheque. The form is made in quadruplicate to be distributed to the bank, ESIC, depositor, and for attachment with the return of contributions.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as DOC, PDF, TXT or read online from Scribd

    Challan

    Uploaded by

    ggrajesh
    1K views4 pages
    This document is a challan form submitted by M/s. Devendran Coal International Pvt Ltd to the Employees' State Insurance Corporation (ESIC) for depositing contributions for the month of September 2011. It contains details such as the employer code, name and address, contribution amounts of Rs. 1225 for employees and Rs. 3352 for the employer, total amount of Rs. 4577, and confirmation that the amount was paid by cash cheque. The form is made in quadruplicate to be distributed to the bank, ESIC, depositor, and for attachment with the return of contributions.

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    challan

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    This document is a challan form submitted by M/s. Devendran Coal International Pvt Ltd to the Employees' State Insurance Corporation (ESIC) for depositing contributions for the month of September 2011. It contains details such as the employer code, name and address, contribution amounts of Rs. 1225 for employees and Rs. 3352 for the employer, total amount of Rs. 4577, and confirmation that the amount was paid by cash cheque. The form is made in quadruplicate to be distributed to the bank, ESIC, depositor, and for attachment with the return of contributions.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    1K views4 pages

    Challan

    Uploaded by

    ggrajesh
    This document is a challan form submitted by M/s. Devendran Coal International Pvt Ltd to the Employees' State Insurance Corporation (ESIC) for depositing contributions for the month of September 2011. It contains details such as the employer code, name and address, contribution amounts of Rs. 1225 for employees and Rs. 3352 for the employer, total amount of Rs. 4577, and confirmation that the amount was paid by cash cheque. The form is made in quadruplicate to be distributed to the bank, ESIC, depositor, and for attachment with the return of contributions.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as DOC, PDF, TXT or read online from Scribd
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    EMPLOYEES STATE INSURANCE CORPORATION

    ORIGINAL
    For Bank

    Challan Form for Deposit in A/c No. 1


    Employers Code 5175787101
    Region code
    5

    Employer code
    7

    Industry
    Code
    7

    Date

    Month

    Year

    Bank & Branch Code*

    Name of
    Factory /
    Estt. &
    Address

    M/s.DEVENDRAN COAL INTERNATIONAL PVT LTD,


    2A&B, III FLOOR, RAJA ANNAMALAI BUILDING,
    NO.19,MARSHALLS ROAD, CHENNAI - 08.

    Mode of Payment [Tick ()]


    Cash

    Cheque/D.D.No.
    Dated:
    Drawn on (Name of the Bank/Branch)
    TAMILNAD MERCANTILE BANK LTD TTK ROAD, CHENNAI.

    Cheque
    D.D.
    Period of contribution

    Month - SEPTEMBER

    Regular Contribution

    Nature of Payment [Tick ()]


    Total Wages : Rs.

    Year - 2011

    Interest
    Others

    Damages

    No. of Employees: 7

    Rs.

    Ps.

    Employees Contribution
    1 2 2 5
    0 0
    Employers contribution
    3 3 5 2
    0 0
    Interest
    Damages
    Others
    Total
    4 5 7 7
    0 0
    Total amount (in words) (Four Thousand Five Hundred and Seventy Seven Only)
    ____________________________________________________________________________________
    R.O. Demand Letter No. & Date __________________________________________________________

    Bank
    Seal

    ______________________________________
    Signature

    ______________________________________
    Name & Designation Seal of Authorised Signatory
    ____________________________________________________________________________________
    Acknowledgement (to be filled by Depositor)
    ____________________________________________________________________________________
    Received Rs.4577.00
    (Rs. Four Thousand Five Hundred and Seventy Seven only)
    In Cash /by Cheque/DD No. .. Dated.. Subject to
    Realisation) Drawn on .... (Bank) in favour of ESIC A/c No.1

    * (For Bank Branch Code see on reverse)

    For use in Bank


    Bank Scroll No. .
    Date: .
    Authorised signature & Seal of the Receiving
    Bank

    Important: Affix Correct Code No. Name Seal


    and Period of contribution to avoid missing credit

    EMPLOYEES STATE INSURANCE CORPORATION

    DUPLICATE
    For ESIC through Bank

    Challan Form for Deposit in A/c No. 1


    Employers Code 5175787101
    Region code
    5

    Employer code
    7

    Industry
    Code
    7

    Date

    Month

    Year

    Bank & Branch Code*

    Name of
    Factory /
    Estt. &
    Address

    M/s.DEVENDRAN COAL INTERNATIONAL PVT LTD,


    2A&B, III FLOOR, RAJA ANNAMALAI BUILDING,
    NO.19,MARSHALLS ROAD, CHENNAI - 08.

    Mode of Payment [Tick ()]


    Cash

    Cheque/D.D.No.
    Dated:
    Drawn on (Name of the Bank/Branch)
    TAMILNAD MERCANTILE BANK LTD TTK ROAD, CHENNAI.

    Cheque
    D.D.
    Period of contribution

    Month - SEPTEMBER

    Regular Contribution

    Nature of Payment [Tick ()]


    Total Wages : Rs.

    Year - 2011

    Interest
    Others

    Damages

    No. of Employees: 7

    Rs.

    Ps.

    Employees Contribution
    1 2 2 5
    0 0
    Employers contribution
    3 3 5 2
    0 0
    Interest
    Damages
    Others
    Total
    4 5 7 7
    0 0
    Total amount (in words) (Four Thousand Five Hundred and Seventy Seven Only)
    ____________________________________________________________________________________
    R.O. Demand Letter No. & Date __________________________________________________________

    Bank
    Seal

    ______________________________________
    Signature

    ______________________________________
    Name & Designation Seal of Authorised Signatory
    ____________________________________________________________________________________
    Acknowledgement (to be filled by Depositor)
    ____________________________________________________________________________________
    Received Rs.4577.00
    (Rs. Four Thousand Five Hundred and Seventy Seven only)
    In Cash /by Cheque/DD No. .. Dated.. Subject to
    Realisation) Drawn on .... (Bank) in favour of ESIC A/c No.1

    * (For Bank Branch Code see on reverse)

    For use in Bank


    Bank Scroll No. .
    Date: .
    Authorised signature & Seal of the Receiving
    Bank

    Important: Affix Correct Code No. Name Seal


    and Period of contribution to avoid missing credit

    EMPLOYEES STATE INSURANCE CORPORATION

    TRIPLICATE
    For Depositor

    Challan Form for Deposit in A/c No. 1


    Employers Code 5175787101
    Region code
    5

    Employer code
    7

    Industry
    Code
    7

    Date

    Month

    Year

    Bank & Branch Code*

    Name of
    Factory /
    Estt. &
    Address

    M/s.DEVENDRAN COAL INTERNATIONAL PVT LTD,


    2A&B, III FLOOR, RAJA ANNAMALAI BUILDING,
    NO.19,MARSHALLS ROAD, CHENNAI - 08.

    Mode of Payment [Tick ()]


    Cash

    Cheque/D.D.No.
    Dated:
    Drawn on (Name of the Bank/Branch)
    TAMILNAD MERCANTILE BANK LTD TTK ROAD, CHENNAI.

    Cheque
    D.D.
    Period of contribution

    Month - SEPTEMBER

    Regular Contribution

    Nature of Payment [Tick ()]


    Total Wages : Rs.

    Year - 2011

    Interest
    Others

    Damages

    No. of Employees: 7

    Rs.

    Ps.

    Employees Contribution
    1 2 2 5
    0 0
    Employers contribution
    3 3 5 2
    0 0
    Interest
    Damages
    Others
    Total
    4 5 7 7
    0 0
    Total amount (in words) (Four Thousand Five Hundred and Seventy Seven Only)
    ____________________________________________________________________________________
    R.O. Demand Letter No. & Date __________________________________________________________

    Bank
    Seal

    ______________________________________
    Signature

    ______________________________________
    Name & Designation Seal of Authorised Signatory
    ____________________________________________________________________________________
    Acknowledgement (to be filled by Depositor)
    ____________________________________________________________________________________
    Received Rs.4577.00
    (Rs. Four Thousand Five Hundred and Seventy Seven only)
    In Cash /by Cheque/DD No. .. Dated.. Subject to
    Realisation) Drawn on .... (Bank) in favour of ESIC A/c No.1

    * (For Bank Branch Code see on reverse)

    For use in Bank


    Bank Scroll No. .
    Date: .
    Authorised signature & Seal of the Receiving
    Bank

    Important: Affix Correct Code No. Name Seal


    and Period of contribution to avoid missing credit

    EMPLOYEES STATE INSURANCE CORPORATION

    QUADRUPLICATE
    For Depositor to be attached
    with Return of contributions

    Challan Form for Deposit in A/c No. 1


    Employers Code 5175787101
    Region code
    5

    Employer code
    7

    Industry
    Code
    7

    Date

    Month

    Year

    Bank & Branch Code*

    Name of
    Factory /
    Estt. &
    Address

    M/s.DEVENDRAN COAL INTERNATIONAL PVT LTD,


    2A&B, III FLOOR, RAJA ANNAMALAI BUILDING,
    NO.19,MARSHALLS ROAD, CHENNAI - 08.

    Mode of Payment [Tick ()]


    Cash

    Cheque/D.D.No.
    Dated:
    Drawn on (Name of the Bank/Branch)
    TAMILNAD MERCANTILE BANK LTD TTK ROAD, CHENNAI.

    Cheque
    D.D.
    Period of contribution

    Month - SEPTEMBER

    Regular Contribution

    Nature of Payment [Tick ()]


    Total Wages : Rs.

    Year - 2011

    Interest
    Others

    Damages

    No. of Employees: 7

    Rs.

    Ps.

    Employees Contribution
    1 2 2 5
    0 0
    Employers contribution
    3 3 5 2
    0 0
    Interest
    Damages
    Others
    Total
    4 5 7 7
    0 0
    Total amount (in words) (Four Thousand Five Hundred and Seventy Seven Only)
    ____________________________________________________________________________________
    R.O. Demand Letter No. & Date __________________________________________________________

    Bank
    Seal

    ______________________________________
    Signature

    ______________________________________
    Name & Designation Seal of Authorised Signatory
    ____________________________________________________________________________________
    Acknowledgement (to be filled by Depositor)
    ____________________________________________________________________________________
    Received Rs.4577.00
    (Rs. Four Thousand Five Hundred and Seventy Seven only)
    In Cash /by Cheque/DD No. .. Dated.. Subject to
    Realisation) Drawn on .... (Bank) in favour of ESIC A/c No.1

    * (For Bank Branch Code see on reverse)

    For use in Bank


    Bank Scroll No. .
    Date: .
    Authorised signature & Seal of the Receiving
    Bank

    Important: Affix Correct Code No. Name Seal


    and Period of contribution to avoid missing credit

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