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Return of Taxable Banking Transactions

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...........                                                                                 2.  Address of the scheduled bank                                                             ....

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....        4.  Financial year (Transactions relating to which are reported)         -                       5.  Ward/Circle/Range                                   6.  Value of taxable banking transactions                 Code* (Schedule) Value (in Rs.) 01. (A[4])                   &nbs....

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....;   02. (A[7])                                                 03. (A[9])                                                 04. (A[11])                       Total                 &nbs....

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....es accompanying it is correct and complete and that the total value of taxable banking transactions and other particulars shown therein are truly stated and are in accordance with provisions of Chapter VII of the Finance Act, 2005 and Banking Cash Transaction Tax Rules, 2005. I further declare that I am making this return in my capacity as..........and I am also competent to make this return and verify it. Date ............................ Place .......................... (Name and Signature) *Codes in respect of taxable banking transaction S.No. Nature of transaction Code 1. Withdrawal of cash (by whatever mode) exceeding twenty-five thousand rupees on any single day from an account (other than a savings bank ....

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.... BSR Code of the Branch Code No. 1 Code No. 1 Code No. 1 Code No. 1 Value Tax Value Tax Value Tax Value Tax 1 2 3 4 5 6 7 8 9 10 11                                                                                         Total                 Schedule - B &....