Income Tax Department Form No.15G

Income Tax Form No.15G

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Download Income Tax Form No.15G

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Income Tax Form No.15G Format

INCOME-TAX RULES, 1962
FORM NO. 15G
[See section 197A(1), 197A(1A) and rule 29C]
Declaration under section 197A(1) and section 197A(1A) to be made by an individual or a person (not being a company or firm) claiming certainincomes without deduction of tax

PART I
1. Name of Assessee (Declarant)
2. PAN of the Assessee
3. Status
4. Previous year(P.Y.)
5. Residential Status(for which declaration is being made)
6. Flat/Door/Block No.
7. Name of Premises
8. Road/Street/Lane
9. Area/Locality
10. Town/City/District
11. State
12. PIN
13. Email
14. Telephone No. (with STD)
15 (a) Whether assessed to tax under theYesNoCode) and Mobile No.Income-tax Act, 19615:
(b) If yes, latest assessment year for which assessed
16. Estimated income for which this declaration
17. Estimated total income of the P.Y. in whichis madeincome mentioned in column 16 to be included
18. Details of Form No. 15G other than this form filed during the previous year, if any Total No. of Form No. 15G filed Aggregate amount of income for which Form No.15G filed
19. Details of income for which the declaration is filed

Declaration/Verification
I/We……………………………………………………… do hereby declare that to the best of *my/our knowl-edge and belief what is stated above is correct, complete and is truly stated. *I/We declare thatthe incomes referred to in this form are not includible in the total income of any other personunder sections 60 to 64 of the Income-tax Act, 1961. *I/We further declare that the tax *onmy/our estimated total income including *income/incomes referred to in column 16 *andaggregate amount of *income/incomes referred to in column 18 computed in accordancewith the provisions of the Income-tax Act, 1961, for the previous year ending on …………………………relevant to the assessment year ………………………… will be nil. *I/We also declare that *my/our*income/incomes referred to in column 16 *and the aggregate amount of *income/incomesreferred to in column 18 for the previous year ending on ………………………… relevant to theassessment year ………………………… will not exceed the maximum amount which is not charge-able to income-tax.

Place: ………………………………………………………………………………………….
Date: ………………………………….

Signature of the Declaration

PART II:
[To be filled by the person responsible for paying the incomereferred to in column 16 of Part I]

1. Name of the person responsible for paying
2. Unique Identification No.
3. PAN of the person responsible for paying
4. Complete Address
5. TAN of the person responsible for paying
6. Email
7. Telephone No. (with STD Code) and Mobile No.
8. Amount of income paid
9. Date on which Declaration is received
10. Date on which the income has been paid/credited(DD/MM/YYYY)(DD/MM/YYYY)

Place: ………………………………………………………………………………………………………………………….
Date: ……………………………………

Signature of the person responsible for payingthe income referred to in column 16 of Part I

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