Vehicle Reg. Number:*		TIN:*
Telephone:*		Email*
Seating Capacity:*		NIN/BRN:
Taxpayer Name:*		Vehicle Type:*	Select Vehicle TypeBUSTAXI   Select Vehicle Type BUS TAXI
Start district:*	Select One   Select One	Arrival district:*	Select One   Select One
Start urban Centre :*	Select One   Select One	End urban Centre :*	Select One   Select One
Route Name:*		Add Stop Over(s):	ABIMADJUMANIAGAGOALEBTONGAMOLATARAMUDATAMURIAAMURUAPACARUABUDAKABUDUDABUGIRIBUGWERIBUHWEJUBUIKWEBUKEDEABUKOMANSIMBIBUKWOBULAMBULIBULIISABUNDIBUGYOBUNYANGABUBUSHENYIBUSIABUTALEJABUTAMBALABUTEBOBUVUMABUYENDEDOKOLOFORT PORTALGOMBAGULUHOIMAIBANDAIGANGAISINGIROJINJAKAABONGKABALEKABAROLEKABERAMAIDOKAGADIKAKUMIROKALANGALAKALIROKALUNGUKAMPALA CAPITAL CITYKAMULIKAMWENGEKANUNGUKAPCHORWAKAPELEBYONGKASANDAKASESEKATAKWIKAYUNGAKAZOKIBAALEKIBOGAKIBUKUKIKUUBEKIRUHURAKIRYANDONGOKISOROKITGUMKOBOKOKOLEKOTIDOKUMIKWEENKYANKWANZIKYEGEGWAKYENJOJOKYOTERALAMWOLIRALUUKALUWEEROLWENGOLYANTONDEMANAFWAMARACHAMASAKAMASINDIMAYUGEMBALEMBARARAMITOOMAMITYANAMOROTOMOYOMPIGIMUBENDEMUKONONABILATUKNAKAPIRIPIRITNAKASEKENAKASONGOLANAMAYINGONAMISINDWANAMUTUMBANAPAKNEBBINGORANTOROKONTUNGAMONWOYAOMOROOTUKEOYAMPADERPAKWACHPALLISARAKAIRUBANDARUBIRIZIRUKIGARUKUNGIRIRWAMPARASERERESHEEMASIRONKOSOROTISSEMBABULETOROROWAKISOYUMBEZOMBO
Total Amount:*		Installment Amount:*
Assessment Start Date:*		Assessment End Date:*

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