FORM III

[Sec rule 12]

Return of tax payable by registered employers under the West Bengal State Tax on
Pro fession, Trades, Calling and Employment Act, 1979
( Please type or use capital letters / figures while furnishing the following information.)
Period
From……..… to….……
(a) Registration Certification No.
[In the first three boxes, please insert zone prefix,e.g., RCN, RCE,etc.]
(b)Enrolment Certificate No.
[In the first three boxes, please insert zone prefix,e.g., ECN, ECE,etc.]
(c) Name of the employer :
(d) Trade Name :
(e) Address (including Room No., Floor No.,Police Station, Sub-division and
postal Index No., i.e.PIN ) :.
(f) Telephone No. (if any) :
(g) E-mail I.D.(if any) :
(h) Website (if any) :
(i))Tax payable for the * quarter / *year………. :
Tax paid for the * quarter /* year…………… :
Tax payable / paid in excess for the * quarter /* year………… :
(j) Interest payable for the * quarter/* year…………….. :
Interest paid for the * quarter /* year…………. :
Interest payable / paid in excess for the * quarter /* year……… :

Summary of payments made for the quarter/year

Interest
Challan Date of Name of Challan Date of Name of
Month Tax (Rs.) (in
No. payment bank No. payment bank
Rs.)
April
May
Jun
July
August
September
October
November
December
January
February
March
Total payment
for the year

A separate statement showing the amount of tax deduction in accordance with the rate of tax specified in the Schedule to the Act in
respect of the number of employees belonging to each salary-slab as specified in column against serialof the said Schedule is furnished
herewith.

The above statements are trun to the best of my knowledge and belief.

Place : ………………………………. Signature……………………………………..

Date : ………………………………… Status…………………………………………
* Strike out whichever is not applicable. [Please see the reverse]
 Employees whose monthly Number of Employees Amount of tax deducted
Rate of tax Total
salaries or wages are MONTHS* MONTH*

Apr May June July Aug Sep Oct Nov Dec Jan Feb Mar Apr May June July Aug Sep Oct Nov Dec Jan Feb Mar

(i) Rs. 3000 or less Nil

(ii) Rs. 3001….below 5001 Rs. 30 per month
(iii) Rs. 5001 '' '' 6001 Rs. 40 '' ''
(iv) Rs. 6001 '' '' 7001 Rs. 45 '' ''

(v) Rs. 7001 '' '' 8001 Rs. 50 '' ''

(vi) Rs. 8001 '' '' 9001 Rs. 90 '' ''

(vii)Rs. 9001 '' '' 15001 Rs.110 '' ''
(viii)Rs.15001 '' '' 25001 Rs.130 '' ''
(ix) Rs. 25001 '' '' 40001 Rs.150 '' ''
(x) Rs. 40001 and above Rs.200 '' ''
GRAND TOTAL 2710.00

* In case of quarterly / annual returns, Particulars in respect of the relevant month of every quarter / year only are required to be furnished.

Signature…………………………………………...………
( With date )
Status………………………………………………………..