3 Fold Application Form with Postage by wfb81115

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									 APPLICATION FORM FOR INTERBANK GIRO

  a) PAYMENT AND REFUND OF PROPERTY TAX
  b) PAYMENT OF TV LICENCE FEE                                                                                                 INLAND REVENUE
                                                                                                                               AUTHORITY
                                                                                                                               OF SINGAPORE

Part 1: FOR APPLICANT’S COMPLETION
Please write within the shaded areas.
(This form may take you about 3 - 5 minutes to complete if you have your bank passbook / statement on hand.
Please do not fax the GIRO form to us as the bank requires original signature for verification.)

Date                                                                                                                   55 Newton Road
                                                                                                                       Revenue House
                                                                                                                       Singapore 307987
Name and Address of Taxpayer(s)                                                                                        Tel: 1800-356 8300


                                                                         Please tick √ only one option to select type of Fee/Tax.
                                                                                  Property Tax and TV Licence fee **
                                                                                  TV Licence fee only **    Property Tax only
                                                                         ** Note: GIRO for TV licence fee is applicable only if IRAS is billing you the
                                                                                    TV licence fee on behalf of MDA
To: Bank Name & Branch
                                                                                  One-time GIRO                         Monthly GIRO

                                                                         Property Address
                                                                         (For land a/c, please specify the Mukim/TS & Lot no.)
                                                                          Note: For multiple properties, please attach a separate list of PTX
Taxpayer’s Property Tax Reference Number                                        reference numbers. The list should be signed by authorized
                                                                                signatory.



(a) I/We hereby instruct you to process the Comptroller of Property Tax's instruction to debit my/our account for the
    purpose of settling any property tax raised on the abovementioned property.
(b) Any refund of Property Tax will be credited to my/our account.
(c) You are entitled to reject the Comptroller of Property Tax's debit instruction if my/our account does not have
    sufficient funds, and you may impose a fee upon me/us in such an event. You may also at your discretion allow the
    debit even if it results in an overdraft on the account, and I/we shall be responsible for any charge(s) incurred
    accordingly.
(d) This authorisation will remain in force until terminated by your written notice sent to my/our address last known to you
    or upon receipt of my/our revocation though the Comptroller of Property Tax.

Bank Account Holder's name(s)                                                     Signature(s)/Thumbprint(s) */Company stamp


Bank Account No.

Account Holder’s NRIC/FIN/ROC No.

Contact (Tel/Fax) Number(s) of Taxpayer(s)
                                                                         (As in Bank/Finance Company’s records)
* For thumbprint(s), please go to the Bank’s / Finance Company’s respective branch with your identification document(s).


Part 2: FOR THE COMPTROLLER OF PROPERTY TAX’S COMPLETION

    Bank       Branch       IRAS Property Tax Bank A/c No.                             Taxpayer's Property Tax Reference Number

 7 3 7 5 0 0 1 9 0 1 3 4 7                   4    3   7    7

    Bank       Branch          Account No. to be debited



Part 3: FOR BANK’S COMPLETION
To: THE COMPTROLLER OF PROPERTY TAX
This Application is hereby REJECTED (please tick √) for the following reason(s):
( ) Signature/Thumbprint # differs from Bank’s records             ( ) Wrong Account Number
( ) Signature/Thumbprint # incomplete/unclear #                     ( ) Amendments not countersigned by customer
( ) Account operated by Signature/Thumbprint #                      ( ) Others : ___________________________

_______________________                       _______________________                    _________               ___________
Name of Approving Officer                                  Authorised Signature           Date                Verified by IRAS
                                                                                          # Please delete where inapplicable
                                                                                                                     Singapore only.
                                                                                                                     Postage will be

                                                                                                                     addressee. For




Please print this page on a separate piece of paper and fold it into an envelope by
                                                                                                                        posting in
                                                                                                                         paid by




following the instruction below. Please do not print this page on the reverse side of
the GIRO form. This is to prevent the form from being torn during the mail handling
process.
3 easy steps to use this postage-paid return envelope:
           1)   Fold along the




                                                                                                                                                                                           THE COMPTROLLER OF INCOME TAX
                dotted line with




                                                                                                                                                                                                                           ROBINSON ROAD P.O. BOX 231
                the mailing details
                exposed.




                                                                                                                                       PRIVATE AND CONFIDENTIAL




                                                                                                                                                                                                                                                        SINGAPORE 900431
                                                                                                                                                                  BUSINESS REPLY SERVICE
                                                                                        Fold along the dotted line




                                                                                                                                                                    PERMIT NO. 01934
           2)   Fold your Giro
                application form
                into smaller piece
                and insert within
                the envelope.
           3)   Seal all 3 sides
                with glue.
                                                                  Glue on all 3 sides

								
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