FORM NO.34A

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Printed from www.taxmann.com FORM NO. 34A [See rule 44A] Application for a certificate under section 230A(1) of the Income-tax Act, 1961 To The Assessing Officer, Sir, I request that a certificate under sub-section (1) of section 230A of the Income-tax Act, 1961, be granted to me. I give below the necessary particulars : 1. Full name and address of applicant [in block letters] 2. Status (whether individual, HUF, etc.) 3. Name of father (or husband) [To be filled in if the applicant is an individual] 4. (i) In case any assessment has been made on the applicant under the Indian Income-tax Act, 1922/Income-tax Act, 1961/Wealth-tax Act, 1957/Expenditure Tax Act, 1987/Gift- tax Act, 1958, name of the Income-tax Circle/Ward/District in which such assessment in respect of the latest year was made (ii) If no assessment has been made as stated above, whether a return has been submitted under any of the said Acts for any year, and if so, the amount of income/wealth/expenditure/gift returned for each such year and the Circle/Ward/District where such return has been filed 5. (i) Names and addresses of all firms or associations of persons or bodies of individuals in which applicant is a partner or member and the Income-tax Circle/Ward/District in which each such firm or association of persons or body of individuals is assessed to tax (ii) Names and addresses of all private limited companies in which applicant is or has been a director at any time after 1st April, 1962, and the Circle/Ward/District in which each such company is assessed to tax 6. Particulars of existing tax liability as on the date of the application under- C.A.P. /Asst. Year Amount Rs. (i) the Excess Profits Tax Act, 1940 (ii) the Business Profits Tax Act, 1947 (iii) the Indian Income-tax Act, 1922 (iv) the Income-tax Act, 1961 (v) the Wealth-tax Act, 1957 (vi) the Expenditure-tax Act, 1987 (vii) the Gift-tax Act, 1958 [If there is no existing liability against the applicant on the date of the application under any one of the aforesaid Acts, this should be indicated by writing 'Nil' against the name of the relevant Act ] 7. (i) Nature of the document, i.e., whether a deed of sale, gift, settlement, lease, etc., proposed to be registered (ii) Nature of applicant's right, title or interest to or in the property purported to be transferred, assigned, limited or extinguished Printed from www.taxmann.com 8. (i) In case the transferor is not the beneficial owner of or has no beneficial right or interest in the property proposed to be transferred, the name(s) and address(es) of the beneficial owner/owners (ii) In case the property is held by the applicant as a trustee, agent, guardian or in any other capacity on behalf of any person or persons, the name(s) and address(es) of such other person/persons C.A.P. /Asst. Year Amount Rs. 9. In a case where the applicant is a trustee, the particulars of all existing tax liabilities, if any, of the beneficiary(ies) of the trust as on the date of application, under- [To be filled in only if the beneficiary(ies) is/are chargeable to tax] (i) the Excess Profits Tax Act, 1940 (ii) the Business Profits Tax Act, 1947 (iii) the Indian Income-tax Act, 1922 (iv) the Income-tax Act, 1961 (v) the Wealth-tax Act, 1957 (vi) the Expenditure Tax Act, 1987 (vii) the Gift-tax Act, 1958 [Particulars should be given in a separate sheet if there is more than one such beneficiary] 10. Date on which the right, title or interest to or in the property concerned was acquired 11. Cost of acquisition of the property. If the property was constructed by the applicant, cost of acquisition of the land and the cost of construction 12. Particulars of the source or sources from which the cost of acquisition or construction was met 13. If the property or part thereof was acquired under any of the following modes of acquisition, the particular mode of acquisition applicable to the applicant should be indicated : (i) on any distribution of assets on the total or partial partition of a Hindu undivided family (ii) under a gift or will (iii) (a) by succession, inheritance or devolution, or (b) on any distribution of assets on the dissolution of a firm, body of individuals or other association of persons, or (c) on any distribution of assets on the liquidation of a company, or (d) under a transfer to a revocable or an irrevocable trust, or (e) any other mode not covered by the above 14. Name and address of the transferee, assignee, etc. 15. (i) Full value of the consideration for which the property or the right, title or interest to or in the property is purported to be transferred (ii) If the trans