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    15G PDF

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    Sudhendu Chauhan
    1. Virendrasinh Gohil is filing Form 15G to declare income of Rs. 2,56,950 from PF withdrawal without deduction of tax for the FY 2019-20. 2. He estimates his total income for FY 2019-20 at Rs. 2,40,000 including the income mentioned in the form. 3. The form provides details of the income and requires signatures of the declarant and the person responsible for paying the income.

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    15G PDF

    Uploaded by

    Sudhendu Chauhan
    407 views2 pages
    1. Virendrasinh Gohil is filing Form 15G to declare income of Rs. 2,56,950 from PF withdrawal without deduction of tax for the FY 2019-20. 2. He estimates his total income for FY 2019-20 at Rs. 2,40,000 including the income mentioned in the form. 3. The form provides details of the income and requires signatures of the declarant and the person responsible for paying the income.

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    1. Virendrasinh Gohil is filing Form 15G to declare income of Rs. 2,56,950 from PF withdrawal without deduction of tax for the FY 2019-20. 2. He estimates his total income for FY 2019-20 at Rs. 2,40,000 including the income mentioned in the form. 3. The form provides details of the income and requires signatures of the declarant and the person responsible for paying the income.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    407 views2 pages

    15G PDF

    Uploaded by

    Sudhendu Chauhan
    1. Virendrasinh Gohil is filing Form 15G to declare income of Rs. 2,56,950 from PF withdrawal without deduction of tax for the FY 2019-20. 2. He estimates his total income for FY 2019-20 at Rs. 2,40,000 including the income mentioned in the form. 3. The form provides details of the income and requires signatures of the declarant and the person responsible for paying the income.

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    © All Rights Reserved
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    of 2

    INCOME-TAX RULES, 1962

    FORM NO. 15G 1

    See section 197A(1), 197A(1A) and rule 29C]


    [

    Declaration under section 197A(1) and section 197A(1A) to be made by an


    individual or a person (not being a company or firm) claiming certain
    incomes without deduction of tax
    PART I
    1. Name of Assessee (Declarant) Virendrasinh Gohil 2. PAN of the Assessee1 ATKPG4313K
    3. Status2 4. Previous year(P.Y.)3 2019-20 5. Residential Status4
    Individual (for which declaration is being made) Residential
    6. Flat/Door/Block No.H-104 7. Name of Premises
    Shukan Eye 8. Road/Street/Lane 9. Area/Locality Kudasan
    DAIICT Road
    10. Town/City/District 11.
    GandhinagarState Gujarat 12. PIN 382421 13. Email gohilviral279@
    14. Telephone No. (with STD 15 (a) Whether assessed to tax under the Yes No yahoo.com
    Code) and Mobile No. Income-tax Act, 19615: No
    +91 9586612933 (b) If yes, latest assessment year for which assessed
    16. Estimated income for which this declaration 17. Estimated total income of the P.Y. in which
    is made 2,56,950/- income mentioned in column 16 to be included6
    2,40,000/-

    18. Details of Form No. 15G other than this form filed during the previous year, if any7
    Total No. of Form No. 15G filed Aggregate amount of income for which Form No.15G filed
    1 2,40,000/-
    19. Details of income for which the declaration is filed
    Sl. Identification number of relevant Nature of income Section under which tax Amount of income
    No. investment/account, etc.8 is deductible
    UAN : 100409650354 PF Withdrawal Section 192(A) 2,56,950/-
    PF No.: 356460000000007 ...............................................................

    Signature of the Declarant 9


    Declaration/Verification 10

    Virendrasinh N. Gohil
    *I/We............................................................... do hereby declare that to the best of *my/our knowl-
    edge and belief what is stated above is correct, complete and is truly stated. *I/We declare that
    the incomes referred to in this form are not includible in the total income of any other person
    under sections 60 to 64 of the Income-tax Act, 1961. *I/We further declare that the tax *on
    my/our estimated total income including *income/incomes referred to in column 16 *and
    aggregate amount of *income/incomes referred to in column 18 computed in accordance
    2019-20
    with the provisions of the Income-tax Act, 1961, for the previous year ending on ..............................
    2020-21
    relevant to the assessment year .............................. will be nil. *I/We also declare that *my/our
    *income/incomes referred to in column 16 *and the aggregate amount of *income/incomes
    2019-20
    referred to in column 18 for the previous year ending on .............................. relevant to the
    2020-21
    assessment year .............................. will not exceed the maximum amount which is not charge-
    able to income-tax.

    Place: Gandhinagar ...............................................................


    Date: 12/08/2020 Signature of the Declarant 9

    1. Substituted by IT (Fourteenth Amdt.) Rules 2015, w.e.f. 1-10-2015. Earlier Form No. 15G was
    inserted by the IT (Fifth Amdt.) Rules, 1982, w.e.f. 21-6-1982 and later on amended by the
    IT (Fifth Amdt.) Rules, 1989, w.r.e.f. 1-4-1988, IT (Fourteenth Amdt.) Rules, 1990, w.e.f.
    20-11-1990 and IT (Twelfth Amdt.) Rules, 2002, w.e.f. 21-6-2002 and substituted by the IT
    (Eighth Amdt.) Rules, 2003, w.e.f. 9-6-2003 and IT (Second Amdt.) Rules, 2013, w.e.f. 19-2-2013.
    PART II
    [To be filled by the person responsible for paying the income
    referred to in column 16 of Part I]
    1. Name of the person responsible for paying 2. Unique Identification No.11
    3. PAN of the person 4. Complete Address 5. TAN of the person responsible for paying
    responsible for paying
    6. Email 7. Telephone No. (with STD Code) and Mobile No. 8. Amount of income paid12
    9. Date on which Declaration is received 10. Date on which the income has been paid/credited
    (DD/MM/YYYY) (DD/MM/YYYY)

    Place: .......................................... .................................................................................................


    Date: .......................................... Signature of the person responsible for paying
    the income referred to in column 16 of Part I

    *Delete whichever is not applicable.


    1
    As per provisions of section 206AA(2), the declaration under section 197A(1) or 197A(1A) shall
    be invalid if the declarant fails to furnish his valid Permanent Account Number (PAN).
    2
    Declaration can be furnished by an individual under section 197A(1) and a person (other than
    a company or a firm) under section 197A(1A).
    3
    The financial year to which the income pertains.
    4
    Please mention the residential status as per the provisions of section 6 of the Income-tax Act,
    1961.
    5
    Please mention “Yes” if assessed to tax under the provisions of Income-tax Act, 1961 for any
    of the assessment year out of six assessment years preceding the year in which the declaration
    is filed.
    6
    Please mention the amount of estimated total income of the previous year for which the
    declaration is filed including the amount of income for which this declaration is made.
    7
    In case any declaration(s) in Form No. 15G is filed before filing this declaration during the
    previous year, mention the total number of such Form No. 15G filed along with the aggregate
    amount of income for which said declaration(s) have been filed.
    8
    Mention the distinctive number of shares, account number of term deposit, recurring
    deposit, National Savings Schemes, life insurance policy number, employee code, etc.
    9
    Indicate the capacity in which the declaration is furnished on behalf of a HUF, AOP, etc.
    10
    Before signing the declaration/verification, the declarant should satisfy himself that the
    information furnished in this form is true, correct and complete in all respects. Any person
    making a false statement in the declaration shall be liable to prosecution under section 277
    of the Income-tax Act, 1961 and on conviction be punishable-

    i
    ( ) in a case where tax sought to be evaded exceeds twenty-five lakh rupees, with rigorous
    imprisonment which shall not be less than six months but which may extend to seven
    years and with fine;

    ii
    ( ) in any other case, with rigorous imprisonment which shall not be less than three months
    but which may extend to two years and with fine.
    11
    The person responsible for paying the income referred to in column 16 of Part I shall allot
    a unique identification number to all the Form No. 15G received by him during a quarter of
    the financial year and report this reference number along with the particulars prescribed in

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