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    Signed - Declaration Form

    Uploaded by

    himanshu chhabra
    The document is a merchant declaration form for SE Finance Private Limited. It contains the specimen signature of Akshay Mittal, Director of SE Finance Private Limited, authorizing him as the sole signatory for the merchant's relationship with PhonePe. It also contains declarations that the merchant is registered under the Income Tax Act with TAN number DELS67084D and GSTIN number AJBPM0725E. Akshay Mittal declares that the facts and information provided are true and correct to the best of his knowledge.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Signed - Declaration Form

    Uploaded by

    himanshu chhabra
    47 views1 page
    The document is a merchant declaration form for SE Finance Private Limited. It contains the specimen signature of Akshay Mittal, Director of SE Finance Private Limited, authorizing him as the sole signatory for the merchant's relationship with PhonePe. It also contains declarations that the merchant is registered under the Income Tax Act with TAN number DELS67084D and GSTIN number AJBPM0725E. Akshay Mittal declares that the facts and information provided are true and correct to the best of his knowledge.

    Original Title

    Signed_declaration Form (19) (1)

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    The document is a merchant declaration form for SE Finance Private Limited. It contains the specimen signature of Akshay Mittal, Director of SE Finance Private Limited, authorizing him as the sole signatory for the merchant's relationship with PhonePe. It also contains declarations that the merchant is registered under the Income Tax Act with TAN number DELS67084D and GSTIN number AJBPM0725E. Akshay Mittal declares that the facts and information provided are true and correct to the best of his knowledge.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    47 views1 page

    Signed - Declaration Form

    Uploaded by

    himanshu chhabra
    The document is a merchant declaration form for SE Finance Private Limited. It contains the specimen signature of Akshay Mittal, Director of SE Finance Private Limited, authorizing him as the sole signatory for the merchant's relationship with PhonePe. It also contains declarations that the merchant is registered under the Income Tax Act with TAN number DELS67084D and GSTIN number AJBPM0725E. Akshay Mittal declares that the facts and information provided are true and correct to the best of his knowledge.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    You are on page 1of 1

    v.

    1 – 08/2022

    Merchant Declaration

    To,
    PhonePe Private Limited (“PhonePe”)
    Unit No.001, Ground Floor, Boston House,
    Suren Road, Off. Andheri-Kurla Road,
    Andheri (East), Mumbai 400093
    Maharashtra, India

    Subject Merchant Declaration

    Akshay Mittal
    I,____________________________________(director), of_________________
    _____________________________________________________________________________
    SE Finance Private Limited (hereinafter referred to as Merchant”) do hereby
    declare that below signed specimen signature be considered my authenticated signatures and that I will be the sole
    authorized signatory of the Merchant with respect to the Merchant’s engagement/relationship with PhonePe (including,
    but not limited to, registration/execution/renewal/amendment of the business related
    association(s)/partnership(s)/contract(s)/terms and conditions with PhonePe).

    Specimen Signature
    with seal:
    Name: Akshay Mittal

    I, on behalf of the Merchant, further declare that:

    1. The Merchant is registered under Income Tax Act, 1961 (as may be amended from time to
    DELS67084D
    time) and have obtained TAN Number _________________________ against the registration. R

    The Merchant does not hold TAN as it is not liable to deduct tax at source or collect tax at source as per Tick (if
    the provisions of Income Tax Act, 1961. applicable)

    2. The Merchant is registered and GSTIN certificate/acknowledgement having provisional


    number ___________________________ is issued by GST authorities. OR

    The Merchant does not have any registration with GST authorities. Tick (if
    applicable)

    AJBPM0725E hereby declare that the above facts and information are true, complete and correct
    I, having PAN number ___________________,
    to the best of my knowledge. I understand and agree that in case it is found that the above-mentioned facts and information
    are incorrect, I will be personally held liable for the same.

    Yours faithfully,
    For and behalf of the Merchant

    ___________________
    (Signature with Seal)
    Designation: Director
    Date: 21 Jun 2023
    Place: Bhopal

    Page 1 of 1

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