Specified accounts maintained by the specified person

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..... S.No. Account number Name of Retirement Fund Name of notified Country select from drop down Balance as on last day of the financial year prior to the previous year for whic .....

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..... t of Income from the specified account which was not taxable in India due to reasons referred in clause (b) of sub-rule (2) of rule 21AAA (in Rs) Specify the previous year or years in which amount referred to in column (xii) is exempt on account of the specified person being non-resident or not ordinarily resident (yyyy-yyyy) Whether return of income for the previous year referred to in column (xii) was furnished in India? Yes/No (If yes, please quote acknowledgement numer) .....

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..... ress . Note : - (i) Option once exercised in respect of a previous year, as specified in paragraph 4, shall be applicable to all subsequent years, under sub-rule (6) of rule 21AAA. (ii) ($) For column (vii) in paragraph 5, select the following codes:- Code 1 Accrual basis 2 Receipt basis 3 Any other basis, specify (iii) ($$) For column (ix) in paragraph 5 select the following codes: Code 1 Salary 2 Interest .....

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