Gst Challan Pmt 4

Government of India /State 
Department of  -------------- 

Form GST PMT –4 
(See Rule ----   ) 

Challan For Deposit of Goods and Services Tax 

CPIN  <<Auto Generated after submission 

of information>> 

Date  <<Current 
date>> 

Challan  Expiry  Date -- 

GSTIN 

Name 
Address 

<<Filled in/Auto 
populated>> 
<<Auto Populated>> 
<<Auto Populated>> 

Email address 

<<Auto Populated>> 

Mobile No. 

<<Auto Populated>> 

Details of Deposit 

Minor Head 

Tax 

Interest 

Penalty 

Fee 

Others  Total 

Government 

Major 
Head 

Government of 
India 

CGST 
IGST 
Sub- 
Total 
State (Name) 
SGST 
Total Challan Amount 
Total Amount in words 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 Mode of Payment (relevant Portion to become active when selected) 

o e-Payment 
(This will include all modes of e-payment such as 

CC/DC and net banking. Taxpayer will choose one of 

this) 

o Over the Counter (OTC) 

Bank (Where cash or instrument is 
proposed to be deposited) 

Details of Instrument 

o Cash 

o Cheque 

o Demand Draft 

o NEFT/RTGS 
Remitting Bank 
Name of the beneficiary account (Description’ GST payment’ 
to be   auto Populated) 
Name and Code of Beneficiary Bank (RBI and its code) 

To be auto-populated 

To be auto-populated 

Beneficiary Account Number (RBI Account Number) 
Note:  Charges to be over and above the amount intend to be deposited. 

To be auto-populated 

Paid Challan Information 

GSTIN 
Taxpayer Name 
Name of Bank 
Amount 
Bank Reference No. (BRN)/UTR 
CIN 
Payment Date 
Bank Ack. No. (For Cheque / DD 
deposited at Bank’s counter) 

Note - UTR stands for Unique Transaction Number for NeFT / RTGS payment.