Application for exercise of option under clause (i) of sub-section (6) of section 115BAC or withdrawal of option under the proviso to sub-section (6) of section 115BAC of the Income-tax Act, 1961

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..... to sub-section (6) of section 115BAC of the Income-tax Act, 1961 To, The Assessing Officer .. ......... Sl.No. 1. Name : 2. PAN : 3. Status of the person referred to in sub-section .....

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..... d/mm/yyyy 20 . 7. Whether having any Unit in International Financial Services Centre (IFSC), as referred to in sub-section (1A) of section 80LA ( if re-entering as per row 5) : Yes/No 8. If yes in 7, provide details regarding Units in IFSC: (Add number of .....

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..... Name in full and in block letters) having PAN ..son/daughter/wife of .(in case of individual) do hereby declare that to the best of my knowledge and belief what is stated in the Form above is correct and complete. I further declare that I am furnishing such statement in my capacity as (designation) and that I am competent to make this declaration and furnish this Form. I further d .....

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..... al person referred to in sub-clause (vii) of clause (31) of section 2 in accordance with the provisions of section 140 of the Act. Note : For status of the person one of the following codes to be selected: Sl. No. Code (i) Individual 1 (ii) Hindu Un .....

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