Certificate under section 395(4) for tax deducted at source
Certificate No. | Last updated on | |||
PART A | ||||
Row No. | Particulars of the deductor and nature of transaction | |||
1. | Name | (refer Note 1) | ||
2. | Address | (refer Note 2) | ||
3. | Permanent Account Number | |||
4. | Email id | |||
5. | Contact number | Country Code | Number | |
6. | Tax year | |||
7. | Nature of Transaction (select one) | □ Payment of rent □ Transfer of immovable property □ Payment by way of commission/brokerage □ Fee for technical services □ Payment in pursuance of a contract □ Transfer of virtual digital asset | ||
Particulars of the deductee | ||||
8. | Name | (refer Note 1) | ||
9. | Address | (refer Note 2) | ||
10. | Permanent Account Number | |||
PART B | ||||||||
Summary of Transaction(s) (as per Form No. 132) | ||||||||
Row No. | Acknowledgement Number | Amount Paid / Credited | Rate at which tax is deducted at source | Date of payment /credit (dd/mm/yyyy) | Amount of tax deducted and deposited | |||
1. | ||||||||
2. | ||||||||
.. | ||||||||
Total: | Total: | |||||||
Details of tax deposited to the credit of the central government for which credit is to be given to the deductee | ||||||||
Amount of tax deposited | Challan Identification number (CIN) | |||||||
BSR Code | Date of tax deposit (dd/mm/yyyy) | Challan Serial Number | ||||||
PART C
DECLARATION
□ I, … … … … . . . … . having Permanent Account Number ………… in the capacity of ……………… (designation)
do hereby certify that a sum of (₹) ………… [₹ ………… (in words)] has been deducted and deposited to the credit of the Central Government.
□ I further certify that the information given above is true, complete and correct and is based on the books of ac-
count, documents, challan-cum-statement of deduction of tax, TDS deposited and other available records.
Place: Signature of person responsible for deduction of tax:
Date: Name:
Notes:
1. In case of individual, the first, middle and last name shall be provided in full without any abbreviations. In any other case also, name shall be provided in full.
2. The address shall contain i. Country/Region, ii. Flat/Door/Building, iii. Road/Street/ Block/Sector, iv. PIN/ZIP Code, v. Post Office, vi. Area/locality, vii. District, viii. State.
3. Some of the information in the form would be pre-filled to the extent possible.
4. Amounts to be filled in ₹ unless otherwise provided.