Certificate under section 222 or 223 of the Income-tax Act, 1961

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..... ip;……………………... To ………………………………... ………………………………... (GIR/PAN) ………………………………... …&h .....

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..... ;………………………. [name of the place], for the recovery of the sum of Rs. ……………………………… details of which are given on the reverse [and the said Tax Recovery Officer has sent a certified copy of the said certificate to the undersigned under section 223(2) of th .....

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..... and other processes and all other proceedings taken for realising the arrears. SEAL . ………………………………... Tax Recovery Officer *Score out whichever paragraph is not applicable. DETAILS OF AMOUNT IN ARREARS Rupees Regular Advance Provisional Asst. year 1. Income-tax 2. Surcharge 3. Additional tax u/s 143 4 .....

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