Eobi Contribution Payment Slip Form – Fill Out and Use This PDF

Identification

221021

1 . Em ploy er ’s Regist r at ion No

2 . Sub Office Code

3 . Em ploy er ’s Nam e

Cur r ent Cont r ibut ions

4 . Cont r ibut ion's Mont h ( s) :

Fr om

To

m

m

y

y

m

m

y y

5 . No. of I nsur ed Per sons:

7 . Em ploy er ’

R S

Cont r ibut ions

6 . Tot al Am ount Paid as

R S

8 . Em ploy ee’s

as Wages/ Salar ies:

Cont r ibut ions

Arrears of Contributions

9 . Dem and & Show Cause No:

10 . Dat e

m m y

y

11 . Am ount :

R S

12 . Em ploy er ’s Cont r ibut ion Ar r ear s for per iod

13 . Em ploy er ’s Cont r ibut ions

Fr om :

To

R S:

m

m

y

y

m

m

y

y

15 . Em ploy ee’s Cont r ibut ion Ar r ear s for per iod

14 . Em ploy er ’s St at ut or y I ncr ease

Fr om :

To

R S:

m

m

y

y

m

m

y

y

16 . Em ploy ee’s Cont r ibut ions

R S:

17 . Em ploy ee’s St at ut or y I ncr ease

R S:

Payment Details

18 . Tot al Am ount

R S:

( 7, 8, 13, 14, 16, 17)

Deposit or ’s Nam e & Signat ur e

Wit h seal of Est ablishm ent

In Words

19 . Cont r ibut ion Paid Thr ough

Cash

Checque/ Dem and Dr aft / Pay Or der No: _____________________

Dr aw n on Bank & Br anch: _______________________________

For Bank Use Only

Br anch Code:

Receipt Dat e:

d d m m y y

Docum ent No:

Cr edit t o: EOBI Collect ion A/ C

ECCA, NBP Br anch Kar achi ( 0 02)

Aut hor ized Signat ur e:

________________________________

Aut hor ized Signat ur e:

________________________________

Please see ov er leaf for I nst r uct ions

Identification

221021

1 . Em ploy er ’s Regist r at ion No

2 . Sub Office Code

3 . Em ploy er ’s Nam e

Cur r ent Cont r ibut ions

4 . Cont r ibut ion's Mont h ( s) :

Fr om

To

m

m

y

y

m

m

y y

5 . No. of I nsur ed Per sons:

7 . Em ploy er ’

R S

Cont r ibut ions

6 . Tot al Am ount Paid as

R S

8 . Em ploy ee’s

as Wages/ Salar ies:

Cont r ibut ions

Arrears of Contributions

9 . Dem and & Show Cause No:

10 . Dat e

m m y

y

11 . Am ount :

R S

12 . Em ploy er ’s Cont r ibut ion Ar r ear s for per iod

13 . Em ploy er ’s Cont r ibut ions

Fr om :

To

R S:

m

m

y

y

m

m

y

y

15 . Em ploy ee’s Cont r ibut ion Ar r ear s for per iod

14 . Em ploy er ’s St at ut or y I ncr ease

Fr om :

To

R S:

m

m

y

y

m

m

y

y

16 . Em ploy ee’s Cont r ibut ions

R S:

17 . Em ploy ee’s St at ut or y I ncr ease

R S:

Payment Details

18 . Tot al Am ount

R S:

( 7, 8, 13, 14, 16, 17)

Deposit or ’s Nam e & Signat ur e

Wit h seal of Est ablishm ent

In Words

19 . Cont r ibut ion Paid Thr ough

Cash

Checque/ Dem and Dr aft / Pay Or der No: _____________________

Dr aw n on Bank & Br anch: _______________________________

For Bank Use Only

Br anch Code:

Receipt Dat e:

d d m m y y

Docum ent No:

Cr edit t o: EOBI Collect ion A/ C