CONSENT FORM FOR COMPANIES OPTING TO FUNCTION AS A LARGE TAXPAYER

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..... __________ (Bangalore/Chennai/Delhi/Kolkata/Mumbai). Following information regarding the company is furnished. PAN : Address as in last income-tax return filed : Jurisdiction of Assessing Officer before whom income-tax return is filed : Details of registration (under Central Excise Rules, 2002, and Service Tax Rules, 1994) : Name and address of the Unit Excise Registration No. and pa .....

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..... form. (i) Financial year (ii) Excise duty through cash (account current) (iii) Service tax through cash (account current) (iv) Advance tax (income tax/corporation tax) Name, designation, phone and fax numbers and e-mail address of the contact person(s) of the company (to be authorized by the company). (Signature) (Name and Designation of the person authorized u/s 140 of the IT .....

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