Application for Certificate of residence for the purposes of an agreement under section 90 and 90A of the Income Tax Act, 1961

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..... ____, Sir, I request that a certificate of residence in Form No. 10FB be granted in my case/in the case of ________________________ [for person other than individual] 2. The relevant details in this regard are as under: - (i) Full Name and address of the applicant (ii) Status (State whether individual, Hindu undivided family, firm, body of individuals, company etc.) (iii) Nationality (in .....

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..... belief, the information given in this form is correct and complete and that the other particulars shown therein are truly stated. Verified today the ____________________ day of ____________ Place Signature of the Applicant ____________________ Name____________________________________] -------------------- Notes:- 1. Inserted vide Notification No.39/2012, dated 17/09/2012 2. Substituted v .....

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