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Form for furnishing accountant certificate under first proviso to sub-section (6A) of section 206C of the Income-tax Act, 1961

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..... on 206C in the case of (name of the seller/licensor/lessor) ________________________________ with 2[Permanent Account Number or Aadhaar Number] # (2[Permanent Account Number or Aadhaar Number] of the seller/licensor/lessor) ___________________ and TAN (TAN of the seller licensor/lessor) ____________________ located at (address of the seller/licensor/lessor) _______________ I do hereby state that .....

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..... ve digits of BIN) Date of deposit through challan/* *date of transfer voucher or *has not yet been paid by me. Place: Signature: Date: Designation: # In case of Government deductors, "2[Permanent Account Number or Aadhaar Number] NOT REQD" should be mentioned. *Delete whichever is not applicable. ** For payment made without the production of challan by the Government deductor. .....

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..... Date of Receipt or debit Section under which tax was Collectible Amount received or debited Amount tax collectible Details of amount collected, if any Amount collected Date of collection (ii) The buyer/licensee/lessee, has furnished his return of income for the assessment year _________________ relevant to the receipt referred to in (i) above. The details of return of income filed by t .....

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..... ounted for (iv) It has been ensured that the information furnished is true and correct in all respects and no relevant information has been concealed or withheld (v) Neither I, nor any of my partners, is a director, partner or an employee of the above mentioned entities or its associated concerns I/we* fully understand that any statement made in this certificate, if proved incorrect or false, w .....

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