Form 15H "Declaration Under Section 197a (1a) of the Income Tax Act, 1961 to Be Made by a Persons [not Being a Company or a Firm] Claiming Receipt of Interest Other Than '"interest on Securities'" or Income in Respect of Units Without Deduction of Tax" - India

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Form 15H "Declaration Under Section 197a (1a) of the Income Tax Act, 1961 to Be Made by a Persons [not Being a Company or a Firm] Claiming Receipt of Interest Other Than '"interest on Securities'" or Income in Respect of Units Without Deduction of Tax" - India

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Form 15H "Declaration Under Section 197a (1a) of the Income Tax Act, 1961 to Be Made by a Persons [not Being a Company or a Firm] Claiming Receipt of Interest Other Than '"interest on Securities'" or Income in Respect of Units Without Deduction of Tax" - India, Page 2

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FORM 15H

[(See Rules 29C(3)]

Declaration under Section 197A (1A) of the Income Tax Act, 1961 to be made by

a persons [Not being a company or a firm] claiming receipt of interest other than

“Interest on Securities” or income in respect of units without deduction of Tax

PART – 1

I/We ________________________________________ son / daughter / wife of

to ______________________________ resident of ___________________

________________________________________________________________

______ @ do hereby declares:-

1.

That the sums particulars of which are given below, stand inmy/our namd

and beneficially belong to me/us and the interest re respect of such sums

and / or income in respect of units is/are not includible in the total income

of any other person under section 60 to 64 of the income tax, 1961.

2.

That my /our present occupation is _______________________________

3.

That the tax on my/our estimated total income including the interest other

than ‘Interest on Securities’ and/or income in respect of units referred to in

paragraph 1 computed in accordance with the provisions of the income tax

Act, 1961 for the previous year ending _____________________ relevant

to the assessment year _______________ to ______________ will be nil.

4.

*That I/We have been assessed to income tax at any time in the past byt

I/WE fall within the Jurisdiction of the Chief Commissioner or

Commissioner of Income Tax __________________________________

That I was/We were last assessed to income tax for the assessment year

______- __________ by the Assessing Officer _______________________

Circle / ward / District and the permanent account number allotted to me/us is

______________________________________________________

_______________________

Signature of the declarant

VERIFICATION

I/We

_________________________________________________________

hereby declare that the contents of paragraphs 1 to 4 are true to the best of

my/our knowledge and belief and nothing has been concealed therein.

Verified today the _________________ day of _________ 200

Signature of the declarant

Part – II

(FOR USE BY THE PERSON TO WHOM THE DECLARATION IS FURNISHED)

1.

Name and address of the person responsible for paying interest on sums

or income in respect or units, as the case may be, mentioned in

Paragraph 1 of declaration.

___________________________________________________________

___________________________________________________________

___________________________________________________________

___________________________________________________________

___________________________________________________________

___________________________________________________________

FORM 15H

[(See Rules 29C(3)]

Declaration under Section 197A (1A) of the Income Tax Act, 1961 to be made by

a persons [Not being a company or a firm] claiming receipt of interest other than

“Interest on Securities” or income in respect of units without deduction of Tax

PART – 1

I/We ________________________________________ son / daughter / wife of

to ______________________________ resident of ___________________

________________________________________________________________

______ @ do hereby declares:-

1.

That the sums particulars of which are given below, stand inmy/our namd

and beneficially belong to me/us and the interest re respect of such sums

and / or income in respect of units is/are not includible in the total income

of any other person under section 60 to 64 of the income tax, 1961.

2.

That my /our present occupation is _______________________________

3.

That the tax on my/our estimated total income including the interest other

than ‘Interest on Securities’ and/or income in respect of units referred to in

paragraph 1 computed in accordance with the provisions of the income tax

Act, 1961 for the previous year ending _____________________ relevant

to the assessment year _______________ to ______________ will be nil.

4.

*That I/We have been assessed to income tax at any time in the past byt

I/WE fall within the Jurisdiction of the Chief Commissioner or

Commissioner of Income Tax __________________________________

That I was/We were last assessed to income tax for the assessment year

______- __________ by the Assessing Officer _______________________

Circle / ward / District and the permanent account number allotted to me/us is

______________________________________________________

_______________________

Signature of the declarant

VERIFICATION

I/We

_________________________________________________________

hereby declare that the contents of paragraphs 1 to 4 are true to the best of

my/our knowledge and belief and nothing has been concealed therein.

Verified today the _________________ day of _________ 200

Signature of the declarant

Part – II

(FOR USE BY THE PERSON TO WHOM THE DECLARATION IS FURNISHED)

1.

Name and address of the person responsible for paying interest on sums

or income in respect or units, as the case may be, mentioned in

Paragraph 1 of declaration.

___________________________________________________________

___________________________________________________________

___________________________________________________________

___________________________________________________________

___________________________________________________________

___________________________________________________________

2.

Date on which the declaration was furnished by the declarant.

3.

Period for which interest or income in respect of units as the case may be

credited / paid __________________________________________

4.

Amount of interest or income in respect of units, as the case may be

__________________________________________

5.

Rate on which interest or income in respect of units, as the case may be is

credited / paid __________________________________________

Forwarded to the Chief Commissioner or Commissioner of Income Tax _______

____________________________

Signature of the person responsible

For Paying interest other than interest on Securities

/ income in respect of units

Place :

Date:

NOTES

1.

@Give complete postal address

2.

The declaration should be furnished in duplicate

3.

*Delete whichever is not applicable

4.

**Indicate the capacity in which the declaration is furnished on behalf of

Hindu undivided family, association of persons etc.

5.

Before signing the verification the declarant should satisfy himself that the

information furnished in the declaration is true correct and complete in all

respects.

6.

Any persons making a false statement in the declaration shall be liable to

be prosecuted under section 227 of the income tax Act, 1961 and on

conviction be punishable.

i.

in a case where the amount of tax which would have been evaded

if the statement or account had been accepted as true, exceed one

hundred thousand rupees with vigorous imprisonment for a term

which shall not be less than six months but which may extend to

seven years and with fine.

ii.

In any other case, with rigorous imprisonment for a term which shall

not be less than three months but which may extend to three years

and with fine.

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