| แบบง.404 | รายงานเงินรายได้แผ่นดิน | ส่วนภูมิภาค | ||||||
| ประจำเดือน..............พ.ศ..................... | ปีงบประมาณ................ | |||||||
| กระทรวง............................................. | กรม.............................. | |||||||
| รายได้แผ่นดินที่จัดเก็บได้ | รายได้แผ่นดินนำส่งคลัง | |||||||
| ลำดับ | รหัส | ประเภทรายได้ | เดือนนี้ | รวมแต่ต้นปี | เดือนนี้ | รวมแต่ต้นปี | รายได้ค้างนำส่ง | หมายเหตุ |
| (1) | (2) | (3) | (4) | (5) | (6) | (7) | (8) | |
| xxxxx | xxxxx | xxxxxxxxxxxxxxxxxxxxxx | 999,999,990.00 | 999,999,990.00 | 999,999,990.00 | 999,999,990.00 | 999,999,990.00 | xxxxxxxxxxxxxx |
| xxxxx | xxxxx | xxxxxxxxxxxxxxxxxxxxxx | 999,999,990.00 | 999,999,990.00 | 999,999,990.00 | 999,999,990.00 | 999,999,990.00 | xxxxxxxxxxxxxx |
| xxxxx | xxxxx | xxxxxxxxxxxxxxxxxxxxxx | 999,999,990.00 | 999,999,990.00 | 999,999,990.00 | 999,999,990.00 | 999,999,990.00 | xxxxxxxxxxxxxx |
| xxxxx | xxxxx | xxxxxxxxxxxxxxxxxxxxxx | 999,999,990.00 | 999,999,990.00 | 999,999,990.00 | 999,999,990.00 | 999,999,990.00 | xxxxxxxxxxxxxx |
| xxxxx | xxxxx | xxxxxxxxxxxxxxxxxxxxxx | 999,999,990.00 | 999,999,990.00 | 999,999,990.00 | 999,999,990.00 | 999,999,990.00 | xxxxxxxxxxxxxx |
| xxxxx | xxxxx | xxxxxxxxxxxxxxxxxxxxxx | 999,999,990.00 | 999,999,990.00 | 999,999,990.00 | 999,999,990.00 | 999,999,990.00 | xxxxxxxxxxxxxx |
| xxxxx | xxxxx | xxxxxxxxxxxxxxxxxxxxxx | 999,999,990.00 | 999,999,990.00 | 999,999,990.00 | 999,999,990.00 | 999,999,990.00 | xxxxxxxxxxxxxx |
| xxxxx | xxxxx | xxxxxxxxxxxxxxxxxxxxxx | 999,999,990.00 | 999,999,990.00 | 999,999,990.00 | 999,999,990.00 | 999,999,990.00 | xxxxxxxxxxxxxx |
| xxxxx | xxxxx | xxxxxxxxxxxxxxxxxxxxxx | 999,999,990.00 | 999,999,990.00 | 999,999,990.00 | 999,999,990.00 | 999,999,990.00 | xxxxxxxxxxxxxx |
| xxxxx | xxxxx | xxxxxxxxxxxxxxxxxxxxxx | 999,999,990.00 | 999,999,990.00 | 999,999,990.00 | 999,999,990.00 | 999,999,990.00 | xxxxxxxxxxxxxx |
| xxxxx | xxxxx | xxxxxxxxxxxxxxxxxxxxxx | 999,999,990.00 | 999,999,990.00 | 999,999,990.00 | 999,999,990.00 | 999,999,990.00 | xxxxxxxxxxxxxx |
| xxxxx | xxxxx | xxxxxxxxxxxxxxxxxxxxxx | 999,999,990.00 | 999,999,990.00 | 999,999,990.00 | 999,999,990.00 | 999,999,990.00 | xxxxxxxxxxxxxx |
| xxxxx | xxxxx | xxxxxxxxxxxxxxxxxxxxxx | 999,999,990.00 | 999,999,990.00 | 999,999,990.00 | 999,999,990.00 | 999,999,990.00 | xxxxxxxxxxxxxx |
| xxxxx | xxxxx | xxxxxxxxxxxxxxxxxxxxxx | 999,999,990.00 | 999,999,990.00 | 999,999,990.00 | 999,999,990.00 | 999,999,990.00 | xxxxxxxxxxxxxx |
| รวม | 999,999,990.00 | 999,999,990.00 | 999,999,990.00 | 999,999,990.00 | 999,999,990.00 | xxxxxxxxxxxxxx | ||