FORM ST-3A

Memorandum for provisional deposit under rule 6 of the Service Tax Rules, 1994, for the month of ______ 19 ___

Sl. No

Provisional value of taxable service in terms of section 67 of the Act

Provisional amount of service tax @ 5% paid

Form TR-6 No. and date

Actual value of taxable service in terms of section 67

Actual amount of service tax payable

Difference between the amount of provisinally paid tax and the amount of service tax payable

Form TR-6 No. and date indicating payment under column (7)

Remarks

1

2

3

4

5

6

7

8

9

Reasons for making provisional deposit of Service Tax _________

* Attatch separate sheet for each month.