Form 15CB - Filed Form

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FORM NO.

15CB[See rule 37BB]


Certificate of an accountant
Acknowledgement Number -161119170030823

I, have examined the agreement (wherever applicable) between M/s. RED PIXELS VENTURES LIMITED with PAN
AAHCR4327D (Remitters) and M/s. CLEVER GEST LDA (Beneficiary) requiring the above remittance as well as
the relevant documents and books of account required for ascertaining the nature of remittance and for
determining the rate of deduction of tax at source as per provisions of Chapter- XVII-B.
We hereby certify the following :-

A. Name and address of the beneficiary of the remittance CLEVER GEST LDA
Rua Dr. Eduardo Santos,
Silva,261,Foreign,Portugal -
4200283

B. 1. Country to which remittance is made Portugal

Currency USD

2. Amount payable

In foreign currency 1,000

In Indian (₹) ₹ 82,000

3. IFSC Code INDB0000005

Name of Bank INDUSIND BANK LTD

Branch of the bank BARAKHAMBA

4. BSR code of the bank branch (7 digit) 6380006

5. Name of the Authorized Dealer IndusInd Bank Ltd.

Branch Address of the Authorized dealer International Division,


IndusInd House, 4th Floor,
425, Dr. Dadasaheb
Bhadkamkar Marg, Mumbai
400 004

6. Proposed date of remittance 17-Aug-2023

7. Nature of remittance as per agreement/document Other Income / Other (Not In


The Nature Of Income)
REFUND OF ADVANCE
PAYMENT RECEIVED

8. Please furnish the relevant purpose code as per RBI Others


S1502 - Reversal of wrong
entries, refunds of amount
remitted for non-Exports
9. In case the remittance is net of taxes, whether tax payable has No
been grossed up

10. Taxability under the provisions of the Income-tax Act (without


considering DTAA)

i. Is remittance chargeable to tax in India No

ii. If not reasons thereof REFUND OF ADVANCE


PAYMENT RECEIVED

iii. If yes, (a) the relevant section of the Act under which the -
remittance is covered

(b) The amount of income chargeable to tax -

(c) The tax Liability -

(d) Basis of determining taxable income and tax liability -

11. If income is chargeable to tax in India and any relief is claimed


under DTAA

i. Whether tax residency certificate is obtained from the No


recipient of remittance

ii. Please specify relevant DTAA

iii. Please specify relevant article of DTAA

iv. Taxable income as per DTAA -

v. Tax liability as per DTAA -

11.A If the remittance is for royalties, fee for technical services, No


interest, dividend, etc,(not connected with permanent
establishment) please indicate:-

a. Article of DTAA -

b. Rate of TDS required to be deducted in terms of such article -


of the applicable DTAA (%)

11.B In case the remittance is on account of business income,please No


indicate:-

a. Whether such income is liable to tax in India -

b. If so, the basis of arriving at the rate of deduction of tax -

c. If not, then please furnish brief reasons thereof. specifying -


relevant article of DTAA

11.C In case the remittance is on account of capital gains, please No


indicate :-

a. Amount of long term capital gains -


b. Amount of short-term capital gains -

c. basis of arriving at taxable income -

11.D In case of other remittance not covered by sub-items A, B and C Yes

a. Please specify nature of remittance REFUND OF ADVANCE


PAYMENT RECEIVED

b. Whether taxable in India as per DTAA No

c. If yes, rate of TDS required to be deducted in terms of such -


article of the applicable DTAA (%)

d. If not, please furnish brief reasons thereof, specifying relevant N.A.


article of DTAA

12. Amount of TDS

In foreign currency -

In Indian (₹) -

13. Rate of TDS (%) -


-

14. Actual amount of remittance after TDS (In foreign currency) 1,000

15. Date of deduction of tax at source, if any 03-Aug-2023

Accountant Name RAHUL KAPOOR

Name of the proprietorship/firm RKACA & ASSOCIATES LLP

Membership Number 083760

Address E-186, Greater Kailash I,


Greater Kailash, SOUTH DELHI,
Delhi, INDIA, 110048

Registration Number 00014372

IP Address 182.69.176.155

Date of Certificate 03-Aug-2023

Place New Delhi

Acknowledgement Number - 161119170030823

This form has been digitally signed by RAHUL KAPOOR having PAN AALPK9964G from IP Address
182.69.176.155 on 03-Aug-2023 03:16:55 PM
Dsc Sl No and issuer 179296960871841CN=SafeScrypt sub-CA for Class 3 Individual 2022,C=IN,O=Sify
Technologies Limited,OU=Sub-CA

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