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Form No. 117

Declaration under section 375(1) of the Act tobe made by an assessee claiming that identical question of law is pending before the High Court or the Supreme Court

Prescribed under rule 194 · Rule 194

1.

Name

(Refer Note 1)

2.

Permanent Account Number

3.

Address

(Refer Note 2)

4.

Contact Details

(i)

Landline No. with STD code

STD code

Number

(Dropdown)

(Repeat if required)

(ii)

Mobile Number

Country Code

Number

(Dropdown)

(Repeat if required)

(iii)

Email ID

(Repeat if

required)

Part B: Details of the relevant case before the Assessing Officer or Appellate Authority

5.

Authority before which it is pending

(Dropdown)

6.

Tax Year

7.

Question(s) of laws

(Upload)

Part C: Details of pendency of other case at High Court/Supreme Court

8.

Questions of Law are pending before

(Dropdown)

9.

Tax Year of the pending case

10.

Question(s) of laws

(Refer Note 3)

Part D: Declaration that pending question(s) of law in relevant case are identical to other case

11.

I do hereby declare that the question(s) of law arising in the ‘relevant case‘ as referred in Part-B is identical to the question(s) of law in other case as referred in Part-C. Further, if authority*** agrees to apply the final decision on question(s) of law in the other case as referred to in Part-C to the relevant case as referred to in Part-B above, I , the assessee, Permanent Account Number shall not raise the question(s) of law of my relevant case referred in Part-B in appeal before any appellate authority or in a subse- quent appeal before a higher forum.

Signature of Declarant

(Name: ………………) Designation (if applicable): … … … … … … ..

Form of verification

I, Permanent Account Number , do hereby declare that to the

best of my knowledge and belief, what is stated above is correct, complete and is truly stated.

I further declare that I am making the declaration in my capacity as and that I am competent to make this declaration and verify it. Verified today the day of 20 .

Place

Date

Signature of Declar-

ant

(Name:………………) Designation (if applicable): … … … … … … ..

Note:

1. The first, middle and last name of the declarant shall be provided in full without any abbreviations.

2. The address shall contain (i) Flat or Door or Block number, (ii) Name of the premises, (iii) Road or Street or Lane, (iv) Area or locality, (v) Town or City or District, (vi) State and (vii) PIN or ZIP Code of the de- clarant.

3. With respect to row 10, the following details shall be provided as annexures, namely:

Annexure

Particulars

A-1

Copy of the statement of the case, and

A-2

the question(s) of law referred to the High Court/Supreme Court,

A-3

Copy of the judgement of the High Court and

A-4

the grounds of appeal to the Supreme Court

Either Annexure A-1, A-2 or A-3, A-4 shall be provided as attachment.

4. Some of the Information in the form would be pre-filled to the extent possible.

5. For the purposes of this form and rule 194 the words “relevant case” and “other case” shall have the same meaning as assigned to them in section 375 of the Act.

6. *** Mention the designation of the authority.

Notes for the Systems:

(A) For point No.5, Drop-downs shall be provided containing the following options:

(i) Assessing Officer

(ii) Joint Commissioner (Appeals)

(iii) Commissioner (Appeals)

(iv) Income-tax Appellate Tribunal

(B) For point No. 8, Drop-downs shall be provided containing the following options:

(i) the High Court on a reference under section 256 or on an appeal under section 260A of the Income - tax Act, 1961 (43 of 1961)( as it existed prior to its repeal); or

(ii) the Supreme Court on a reference under section 257 or on an appeal under section 261 of the Income-tax Act, 1961 (43 of 1961)( as it existed prior to its repeal); or

(iii) the High Court on an appeal made under section 365 of the Act; or

(iv) the Supreme Court on appeal made under section 367 of the Act; or in a Special Leave Petition under ar- ticle 136 of the Constitution, against the order of the Appellate Tribunal or the jurisdictional High Court.

Source: Income-tax Rules, 2026, Appendix III – notified by the CBDT vide G.S.R. 198(E) dated 20 March 2026. Reproduced for reference; the layout of the official Gazette form may differ slightly. Please verify with the official notification.

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