PAYMENT VOUCHER
Issued under Rule 52 of the CGST Rules, 2017 for supplies liable to tax under Reverse Charge (Section 9(3)/9(4))
| Recipient (issuing) Name / GSTIN | [Business Name] / [Recipient GSTIN] |
| Payment Voucher No. | [Serial No.] |
| Date | [DD/MM/YYYY] |
| Supplier (Party) Name / GSTIN | [Party Name] / [Supplier GSTIN or Unregistered] |
| Description of Goods/Services | [Nature of supply] |
| Place of Supply | [State & State Code] |
| Taxable Value ₹ | Rate | CGST | SGST | IGST | Tax Paid under RCM ₹ |
|---|---|---|---|---|---|
| [₹ Value] | [Rate %] | [₹] | [₹] | [₹] | [₹] |
Amount Paid to Supplier (in words): [Rupees ... Only]
For [Business Name]
Authorised Signatory: ____________________
Legal note: Under reverse charge the recipient pays the tax in cash and issues this payment voucher. A self-invoice under Section 31(3)(f) is additionally required where the supplier is unregistered.