Application under section 288(1) [Table: Sl. No. 11] for credit of tax deduction at source
Row No. | Part A: Particulars of assessee | ||
1. | Name | (refer Note 1) | |
2. | Address | (refer Note 2) | |
3. | Permanent Account Number | ||
4. | Residential Status | (refer Note 3) | |
5. | Email id | ||
6. | Contact Number | Country Code | Number |
7. | Tax year in which specified in- come* has been included in the return of income | ||
8. | Date on which return of income for relevant tax year was filed | ||
Part B: Details with reference to specified income and tax deduction at source
Row No. | Total income/ deemed total in- come / loss ofas- sessee as per return of income for the tax year specified in column 7 of Part A (refer Note 4) | Amount of Specified in- come* included in return of in- come (refer Note 5) | Nature of speci- fied income (refer Note 5) | Rate at which the specified income was subject to tax | Amount of tax deducted on spec- ified income in subsequent tax year (refer Note 5) | Date of deduc- tion of tax (dd/mm/ yyyy) |
A | B | C | D | E | F | G |
Total |
Rate at which tax deducted | Date of payment of tax deducted to the Central Government (dd/mm/ yyyy) | section of the Act under which tax deducted | Amount of tax out of (F) claimed for tax year | Name of deductor | Tax deduc- tion and collection account number of deductor | Permanent Account Number of deductor |
H | I | J | K | L | M | N |
*Specified income means any income referred to in section 288(1)[Table: Sl. No.11] which has been included in the return of income of a tax year and tax on such income is deducted at source and paid to the credit of the Central Government under the provisions of Chapter XIX-B of the Act in a subsequent tax year.
DECLARATION
I … … … … … … … … . … having Permanent Account Number … … … . … … … in my capacity as … … … … . of ……………. (name of assessee) do hereby declare that: -
□ To the best of my knowledge and belief what is stated above is correct, complete and truly stated.
□ I have furnished the return of income in which such specified income was included, for the relevant tax year
under section 263.
□ I have not claimed credit for the tax deducted at source on the specified income claimed in Form No. 102 in any other tax year and will not claim the same.
Place: ………… Signature
Date: Name:
Designation:
Notes:
1. In case of individual, the first, middle and last name shall be provided in full without any abbreviations. In any oth- er case also, name shall be provided in full.
2. The address shall contain Flat/Door/Block number, Name of the premises, Road/Street/Lane, Area/locality, Town/City/District, State, Pin/ZIP Code.
3. Fill ‘residential status‘ as (i) Resident (ii) Non-resident (iii) Resident but not ordinarily resident.
4. Total income/deemed total income/loss should be reported as per latest intimation/assessment/re-assessment/ rec- tification / re-computation order, as the case may be.
5. For more than one entry, separate rows may be filled.
6. Amounts to be filled in ₹ unless otherwise provided