FORM NO. 27D [See rule 37D] Certificate under section 206C of the Income-tax Act, 1961 for Tax collected at source Name and address of the Collector Name and address of the Collectee PAN of the Collector TAN of the Collector PAN of the Collectee Assessment year Period From To CIT (TDS) Address.................. ...................... City........ Pin Code.......... Summary of receipt Amount received/debited Nature of receipt Date of receipt/debit Summary of tax collected at source Quarter Receipt Number of original quarterly statements of TCS under proviso to sub-section (3) of section 206C Amount of tax collected in respect of the collectee Amount of tax deposited/remitted in respect of the collectee I. DETAILS OF TAX COLLECTED AND DEPOSITED IN THE CENTRAL GOVERNMENT ACCOUNT THROUGH BOOK ENTRY (The Collector to provide payment wise details of tax collected and deposited with respect to the collectee) S. No. Tax Deposited in respect of the collectee (Rs.) Book identification number (BIN) BAMS number given by PAO/CDDO/TO DDO sequence Number in the Book Adjustment Mini Statement Date on which tax deposited (dd/mm/yyyy) Total II. DETAILS OF TAX COLLECTED AND DEPOSITED IN THE CENTRAL GOVERNMENT ACCOUNT THROUGH CHALLAN (The Collector to provide payment wise details of tax collected and deposited with respect to the collectee) S. No. Tax Deposited in respect of the collectee (Rs.) Challan identification number (CIN) BSR Code of the Bank Branch Date on which tax deposited (dd/mm/yyyy) Challan Serial Number Total Verification I,.........., son/daughter of .......... working in the capacity of ......... (designation) do hereby certify that a sum of Rs .......... [Rs. .......... (in words)] has been collected at source and deposited to the credit of the Central Government. I further certify that the information given above is true, complete and correct and is based on the books of account, documents, TCS statements, TCS deposited and other available records. Place Date Signature of person responsible for collection of tax Designation: Full Name : Notes: 1. Government collectors to fill information in item I if tax is paid without production of an income-tax challan and in item II if tax is paid accompanied by an income-tax challan. 2. Non-Government collectors to fill information in item II. 3. In item I and II, in the column for TCS, give total amount for TCS, Surcharge (if applicable) and education cess. 4. The collector shall furnish the address of the Commissioner of Income-tax (TDS) having jurisdiction as regards TCS statements of the assessee. 5. This Form shall be applicable only in respect of tax collected on or after 1st day of April, 2010.
