EXAMPLE FROM FENI MUNICIPALITY

FENI MUNICIPALITY

[Duplicate copy should be written by Carbon Paper]

Book No.

Form No. 10 (See Rule 53)

Collection Department : 4 No. Name of Mohalla/Area : Mizan Maidan/ 9 No. Ward Assessment Register Holding No. of its No. Old – New

                                                                                                                                                                                                                          Old- 132

                                                                                                                                                                        ( Five stored building including two shop)

                                                Name of the Taxpayer : Md. Ruhul Amin

According to the following description for the purpose of Municipal Tax in Total ( 2550/00) In word : Two thousand five hundred fifty) was received with understand.

`	Arrear demand		Last year 20				Present Year 2008-2009				Total
	Time	Taka	1st Quart.	2nd Quart.	3rd Quart.	4th Quart.	1st Quart.	2nd Quart.	3rd Quart.	4th Quart
House Tax		-					262/50	262/50	262/50	262/50	1050/00 1050/00 450/00 2550/00
Conservancy Tax		-					262/50	262/50	262/50	262/50
Lighting Tax		-					112/50	112/50	112/50	112/50
Warrant Fees										Total

Date : 18/06/2009 AD.

Sd/- Illegible Collector

Sd/- Illegible Chairman Feni Municipality