Form of application for an assessee, resident in India, seeking to invoke mutual agreement procedure provided for in agreements with other countries or specified territories

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..... tory) for the reasons given hereunder. The matter may kindly be taken up with the Competent Authority of ----------------------------------------- (name of the country or specified territory) under Article --------------- of the ----------------------------------------------------------------------- (specify the agreement) between India and ---------------------------------------- (name of the country or specified territory). The relevant details in this regard are as under: (a) Name of the Applicant - (b) Permanent Account No. /Aadhar - (c) Circle /Ward - (d) Assessment Year(s) - (e) Previous Year(s) - (f) Office Address Telephone No. - (g) Residential Address Telephone No. (If applicable) - (h) Status - (i) .....

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..... ------ Place ------------------ (Signature) ] ************* NOTES:- 1. Substituted vide Notification No. 95/2019 dated 06-11-2019 w.e.f. 01-09-2019 before it was read as Permanent Account No. 2. Substituted vide NOTIFICATION NO. 23/2020 dated 06-05-2020 before it was read as FORM NO. 34F [See rule 44G] Form of application for giving effect to the terms of any agreement under clause (h) of sub-section (2) of section 295 of the Income-tax Act, 1961 To The Competent Authority in India, Foreign Tax and Tax Research, Department of Revenue, Ministry of Finance and Company affairs, New Delhi. Sir, Whereas the applicant is aggrieved by the action of the tax auth .....

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..... / daughter / wife of Shri solemnly declare that to the best of my knowledge and belief, the information given in this application and the annexures and statements accompanying it is correct and complete and particulars shown therein are truly stated and relate to the previous year(s) relevant to the assessment year 2. I also declare that to the best of my knowledge, I have not concealed any fact or information which could be relevant for deciding my application. 3. I further declare that I am making this application in my capacity as ..(designation) and that I am competent to make this application and verify it. Date Place .. .....

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