PART 1 - A FORM III PART III

Profession Tax Registration Certificate No. For the Treasury Profession Tax Registration Certificate No.
B.S.T.R.C. No. If Any B.S.T.R.C. No. If Any
Profession Tax Registration Certificate No.
FORM III RETURN - CUM CHALLAN For Profession Tax Officer FORM III RETURN - CUM CHALLAN For the Payer
The Maharashtra State Tax on Professions, Trades, Calling B.S.T.R.C. No. If Any The Maharashtra State Tax on Professions, Trades, Calling
and Employment Act. 1975 and Rule 11, 11-A, 11-B, 11-C and Employment Act. 1975 and Rule 11, 11-A, 11-B, 11-C
0028, Other Taxes on Income & Expenditure - Taxes on profession, 0028, Other Taxes on Income & Expenditure - Taxes on profession,
Trades, Calling and Employments - Taxes on Employments. Trades, Calling and Employments - Taxes on Employments.
Employees Whose Monthly Rate of Tax No of Amount of Employees Whose Monthly Rate of No of Amount of
Salaries, Wages are pm In Rs. Employees Tax Deducted Salaries, Wages are Tax In Rs. Employees Tax Deducted

Upto Rs. 5000 Nil Nil Upto Rs. 5000 Nil Nil

Rs. 5001 to Rs. 10,000 175 Part II Rs. 5001 to Rs. 10,000 175

Rs. 10001 & Above
Rs. 10001 & Above (February)
200 FOR THE TREASURY Rs. 10001 & Above 200
FORM III - RETURN - CUM CHALLAN
The Maharashtra State Tax on Professions, Trades, Calling Rs. 10001 & Above (February) 300
300 and Employment Act. 1975 and Rule 11, 11-A, 11-B, 11-C
0028, Other Taxes on Income & Expenditure - Taxes on profession,
Trades, Calling and Employments - Taxes on Employments.

Tax Amount Rs. Tax Amount Rs. Tax Amount Rs.

Interest Amount Rs. Interest Amount Rs. Interest Amount Rs.
Less: Excess Paid Earlier Rs. Less: Excess Paid Earlier Rs. Less: Excess Paid Earlier Rs.
Net Amount Payable Rs. Net Amount Payable Rs. Net Amount Payable Rs.
P. Tax Registration Certificate No. Period From Period To P. Tax Registration Certificate No. Period From Period To P. Tax Registration Certificate No. Period From Period To

Name & Address Name & Address Name & Address

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

Date : Date : Date :

Place : Signature & Designation Place : Signature & Designation Place : Signature & Designation
For Treasury Use Only For Treasury Use Only For Treasury Use Only
Received Rs. (In Words) (in Figures) Received Rs. (In Words) (in Figures) Received Rs. (In Words) (in Figures)

Date of Entry : Challan No. Date of Entry : Challan No. Date of Entry : Challan No.

Treasurer Accountant Teasury Officer / Agent or Manager Treasurer Accountant Teasury Officer / Agent or Manager Treasurer Accountant Teasury Officer / Agent or Manager