Application by a person for a certificate under section 197 and/or 206C(9) of the Income-tax Act, 1961, for no deduction/collection of tax or deduction of tax at a lower rate
Printed from www.taxmann.com FORM NO. 13 [See rules 28 and 37G] Application by a person for a certificate under section 197 and/or 206C(9) of the Income-tax Act, 1961, for no *deduction/collection of tax or *deduction/ collection of tax at a lower rate To The Assessing Officer, 1. *I,_________________________________________________of__________________do, hereby, request that a certificate may be issued to the person responsible for paying to me the incomes/sum by way of salary/interest on securities/interest other than "interest on securities"/insurance commission/commission (not being insurance commission) or brokerage/commission, etc., on the sale of lottery tickets/fees for professional or technical services/any sum by way of payment to contractors and sub-contractors/dividends/rent/income in respect of units/sum by way of payment of compensation on acquisition of immovable property (strike out whichever is not applicable) authorising him not to deduct income-tax/to deduct income-tax at the rate of____________per cent at the time of payment to me of such income/sum. The particulars of my income are as per para 2. and/or *I,____________________________________________of__________________________________do, hereby, request that a certificate may be issued to the seller, being the person responsible for collecting the tax from me in respect of the amount payable by me as the buyer of_____________________________[specify the nature of goods referred to in the Table in sub-section (1) of section 206C]/lessee or licensee of_______________________________________________________[specify the nature of contract or licence or lease referred to in the Table in sub-section (1C) of section 206C] (Strike out whichever is not applicable) authorizing him to collect income-tax at the rate of____________________per cent at the time of debit of such amount to my account or receipt thereof from me, as the case may be. The particulars of my income are as per para 2. 2. The particulars of my income/other relevant details are as under : (i.) Status (State whether individual, Hindu undivided family, firm, body of individuals, etc.) (ii.) Residential status (Whether resident / resident but not ordinarily resident / non-resident) (iii.) Permanent Account No. (iv.) Assessment year to which the payments relate. (v.) Estimated total income of the previous year relevant to the assessment year referred to in (iv) above (give the computation and basis thereof) (vi.) Total tax payable on the income at (v) (vii.) Average rate of tax [Col. (vi) × 100] [Col. (v) ] (viii.) How the liability determined in col. (vi) is proposed to b di h d ? Printed from www.taxmann.com be discharged ? (Specify the amount to be paid by way of advance tax, TDS and TCS) (ix.) Total income assessed in the last three assessment years and the total tax paid for each such year : Assessment year Total income Total tax (i) (ii) (iii) (x.) Date and amount of advance tax, tax deducted at source and tax collected at source, if any, already paid so far. (xi.) Details of income claimed to be exempt and not included in the total income (Please append a note giving reason for claiming such exemption). (xii.) Please furnish the particulars in Annexure-I in respect of no deduction of tax or deduction of tax at a lower rate under section 197 and/or in Annexure-II for collection of tax at lower rate under section 206C(9) of the Income-tax Act, as the case may be. *I,___________________________________the trustee/co-trustee of_______________________do hereby declare that the securities/sums/shares, particulars of which are given in the Annexure, are properly held under trust wholly for charitable or religious purposes and that the income therefrom qualifies for exemption under sections 11 and 13 of the Income-tax Act, 1961. *I declare that the securities/sums/shares, particulars of which are given in the Schedules above, stand in my name and are beneficially owned by me, and the income therefrom is not includible in the total income of any other person under sections 60 to 64 of the Income-tax Act, 1961. I further declare that what is stated in this application is correct. Date________________ ______________________ Signature Place________________ _______________________ Address *Strike out whichever is not applicable. ANNEXURE I [For the purpose of tax deduction at source] Please furnish the particulars with the Schedules below in respect of the payments for which the certificate is sought. SCHEDULE I Description of securities Number of securities Date of securities Amount of securities Estimated amount of interest to be received (1) (2) (3) (4) (5) Printed from www.taxmann.com SCHEDULE II Sl. No. Name and address of the person to whom the sums are given on Interest Amount of such sums The date on which such sums were given on interest Period for which such
