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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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..... ction (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 (1A) of section 115BAC : 4. Assessment year for which the form is being furnished : yyyy - yy 5. Whether opting out of or re-entering the regime .....

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..... g I ……………(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 ca .....

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..... lip;………… Designation…………………………. Address…………………….………… *Signature of the person competent to verify the return of income of the Individual/ HUF / association of persons (other than a co-operative society)/body of in .....

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