DRC_01

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FORM GST DRC - 03

[See rule 142(2)&142(3)]

L
Intimation of payment made voluntarily or made against the show cause notice (SCN) or statement

ARN :AD061224001805I Date :06/12/2024

A
1. GSTIN 06AIBPS3694K1ZS
2. Name JAGBIR SINGH
3. Cause of Payment Voluntary
4. Section under which voluntary payment is made 74(5)

N
5. Details of show cause notice, if payment is made within 30 days of Reference No:NA Date Of issue:NA
its issue
6. Financial Year 2017-2018

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7. Details of payment made including interest and penalty, if applicable (Amount in Rs.)
Sr. Tax Period Act Place of Tax/Cess Interest Penalty,if Fee Others Total Ledger Debit entry no. Date of
No. supply applicabl utilised debit entry
e (Cash/credit

F
)
1. JUL 2017- IGST Delhi 5,468.00 6,121.00 5,468.00 0.00 0.00 17,057.0 Cash DC061224000 06/12/2024
MAR 2018 0 7287
2. JUL 2017- CGST Haryana 31,547.0 35,317.0 31,547.0 0.00 0.00 98,411.0 Cash DC061224000 06/12/2024
MAR 2018 0 0 0 0 7287
3. JUL 2017- SGST Haryana 31,547.0 35,317.0 31,547.0 0.00 0.00 98,411.0 Cash DC061224000 06/12/2024
MAR 2018 0 0 0 0 7287

8. Reasons, if any -
Dear sir,
I have paid all the demand through cash ledger. you are requested to please unblock my ECL asap.
Thanks

9. Verification -

AL
N
I hereby solemnly affirm and declare that the information given hereinabove is true and correct to the best of my knowledge and belief and
nothing has been concealed therefrom .

F I Signature of Authorized Signatory


Name: Jagbir singh
Designation: proprietor
Date: 06/12/2024

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