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..... ber of the Unit: ...................................... 3. Tax deduction/collection account number of the Unit: . 4. Status of the Unit: .. 5. Residential status of the Unit: 6. Complete address, email and phone number of the Unit: ... 7. Details of remittances made: .....

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..... Purpose Code as per RBI $ Country Currency In foreign Currency In Indian Rs. Verification I, ____________ (full name in block letters), son/daughter of . solemnly de .....

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..... enalty for the said default as per the provisions of the Income-tax Act, 1961. I/We* further undertake to submit the requisite documents for enabling the income-tax authorities to determine the nature and amount of income of the recipient of the above remittance as well as documents required for determining my/our* liability under the Income-tax Act as a person responsible for deduction of tax .....

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