This form records the debits that have been charged on your behalf for payment of taxes.
1. Date: Date the debit has been generated.
2. Total Debit: Total debit that has been generated to your account.
3. Bank Name/Account: Name and number of the bank account to which the debit has been generated.
4. Tax Type/Amount: Itemized list of the debits that have been charged on your behalf for the payment of taxes. This list is broken down by tax type and amount debited for each.