Printed from www.taxmann.com FORM NO. 10DB [See rule 20AB] Form for evidence of payment of securities transaction tax on transactions entered in a recognised stock exchange 1. Name of the assessee : 2. Address of the assessee : 3. Permanent Account Number (PAN) of the assessee : 4. MAPIN of the assessee : 5. Name of the Stock Exchange in which transaction entered into : 6. Financial year : 7. Name of the stock broker : 8. Address of the stock broker : 9. Stock broker code : 10. Details of value of securities transactions and securities transaction tax collected from the assessee: Client code number Code* of transaction Value of transactions entered into during the financial year Total securities transaction tax collected from the assessee during the financial year Value of transactions (included in value given in column 3) entered into in the course of business by the assessee Securities transaction tax collected on value of transactions given in column 5 1 2 3 4 5 6 01 02 03 04 05 Total Verification I, _____________________ (full name in block letters), son/daughter of __________________ solemnly declare that to the best of my knowledge and belief the information given in this Form is correct and complete and that the total amount of securities transaction tax shown therein is truly stated and is in accordance with the provisions of Chapter VII of the Finance (No. 2) Act, 2004 and Securities Transaction Tax Rules, 2004. Date _______________ Place _______________ (Name and Signature of the assessee) Printed from www.taxmann.com *CODES IN RESPECT OF TAXABLE SECURITIES TRANSACTION S.No. Nature of Transaction Code 1. Purchase of an equity share in a company or a unit of an equity oriented fund, where 01 (a) the transaction of such purchase is entered into in a recognised stock exchange; and (b) the contract for the purchase of such share or unit is settled by the actual delivery or transfer of such share or unit. 2. Sale of an equity share in a company or a unit of an equity oriented fund, where 02 (a) the transaction of such sale is entered into in a recognised stock exchange; and (b) the contract for the sale of such share or unit is settled by the actual delivery or transfer of such share or unit. 3. Sale of an equity share in a company or a unit of an equity oriented fund, where 03 (a) the transaction of such sale is entered into in a recognised stock exchange; and (b) the contract for the sale of such share or unit is settled otherwise than by the actual delivery or transfer of such share or unit. 4. Sale of a derivative being "option in securities", where the transaction of such sale is entered into in a recognised stock exchange. 04 5. Sale of a derivative being "futures", where the transaction of such sale is entered into in a recognised stock exchange. 05 Instructions : (i) Where an assessee has entered into transactions in a stock exchange under different client code through the same stock broker, details in this Form be filled separately for each such client code. (ii) Separate Form be furnished in respect of transactions entered into in different stock exchanges and also for the transactions entered in same stock exchange through different stock brokers. (iii) In column 4 of Table of item 10, fill the details of securities transaction tax collected by the stock broker from the assessee. (iv) Where the assessee entering into a transaction is a stock broker on which securities transaction tax has to be paid by him, item 1 and item 7 shall be same and such assessee shall, in column 4 of the Table of item 10, fill the details of securities transaction tax collected from him by the stock exchange.