Printed from www.taxmann.com Form No. 10CCD [See rule 19AC] Certificate under sub-section (3) of section 80QQB for Authors of certain books in receipt of Royalty income, etc. 1. Details of the book: (i) Title (ii) Language (iii) Whether Scientific/Literary/Artistic (Please indicate) (iv) Whether the book is in the nature of a brochure, commentary, guide, diary, journal, magazine, text- book for schools, tracts, etc. (Yes/No) 2. Name and address of the author of the book: 3. Books sold during the previous year ending on 31st day of March: In India outside India (i) No. of books published (ii) Value of books sold in Indian rupees 4. Details of agreement with the author: (a) Whether any lump-sum payment made during the year in lieu of all rights in the book? (i) Yes/No (Please indicate) (ii) If yes, state the amount paid (in Indian rupees) (iii) If no, the nature of payment (mark " where applicable) (a) assignment or grant of any of the interest of author in the copyright of the books (b) Royalty or copyright fee 5. Details of payment: (i) Payment received in Indian rupees (ii) Payment received in foreign currency (value in Indian rupees) (iii) Total Payment received (iv) If in foreign currency, details of payment in the following proforma : Total amount payable during the year Amount actually paid Date of payment Mode of payment 6. Verification: This is to verify that I/We,__________________S/o_______________is/are the publisher of the book titled_______________________authored by Shri/Smt./Ms._____________________in the capacity of proprietor/partner/director of the publishing house named__________________having PAN No._____________, and have during the previous year, made the payment equivalent of Rs._______________, as Printed from www.taxmann.com copyright fee/royalty or as payment in lieu of all rights in the said book to him/her. Signature and name of the person responsible for making payment Date : _______________ Place : _______________ Address
