This form records the debits that have been charged on your behalf for payment of taxes.
Date: Date the debit has been generated.
Total Debit: Total debit that has been generated to your account.
Bank Name/Account: Name and number of the bank account to which the debit has been generated.
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.
* Contact your Tax Service Representative for fees associated with this report.