Quarterly statement of deduction of tax under section 397(3)(b) in respect of payments made other than salary for the quarter ended…(June/September/December/March) … … … … … …. (Tax Year)]

Part A

Row

No..

Particulars of the Deductor

1.

Type of deductor

● Government

● Non-Government

2.

Name

(refer Note 1)

3.

Address

(refer Note 2)

4.

Permanent Account Number

(refer Note 3)

5.

Tax Deduction and Collection Account Number

6.

E-mail id

7.

Contact Number

Country Code

Number

8.

Tax year

9.

Has the statement been filed earlier for this quarter

(Yes/No)

10.

If answer to Row No. (9) is “Yes”, then Return Receipt Number of original statement

11.

If Government Deductor, please mention AIN of PAO/DTO/CDDO

Particulars of the person responsible for deduction of tax (applicable in case of non-individual deductor)

12.

Name

(refer Note 1)

13.

Address

(refer Note 2)

14.

Permanent Account Number

15.

Email id

16.

Contact number

Country Code

Number

Part B

1.

Details of the tax deducted and paid to the credit of the Central Government:

Sl.

No.

Total

tax

(refer

Note

4)

Total

interest

Total

fee

(refer

Note

5)

Total

penalty/others

Total

amount

deposited as

per challan /

Total

amount

adjusted

through

Mode of

payment

of tax

(by way of

challan/by

way of

book

BSR

code/

Receipt

Number

of

Form

No.

137

Date on

which amount

deposited

through

challan/ Date

of transfer

voucher

(dd/mm/yyyy)

Challan

Serial

No. /

DDO

Serial

No. of

Form

No. 137

Minor

Head

of

Challan

(refer

Note 9)

Book

Adjustment

(B+C+D+E)

(refer Note

6)

adjustment

(refer Note

7)

(refer

Note 8)

(refer Note 8)

(refer

Note 8)

(A)

(B)

(C)

(D)

(E)

(F)

(G)

(H)

(I)

(J)

(K)

2.

Details of amount paid and tax deducted thereon from the deductees and amount paid without deduction (see Annexure)

Sl.

No.

Challan

Reference

No.

[Column A

of Table

(Sl. No. 1)

in Part B]

Permanent

Account

Number of

the deductee

Name of

the

deductee

Section

code

(refer

Note 15)

Date of

payment

or credit

(dd/mm/

yyyy)

Amount

paid

or

credited

Amount of

cash

withdrawal

where the

aggregate

amount of

withdrawal

exceeds Rs. 1

Crore as

referred to in

section 393(3)

[Table: Sl. No.

5] (in case of

person other

than

cooperative

society)

Amount of

cash

withdrawal

where the

aggregate

amount of

withdrawal

exceeds Rs.

3 Crore for

cases

covered by

section

393(3)

[Table: Sl.

No. 5] (in

case of co-

operative

societies)

(A)

(B)

(C)

(D)

(E)

(F)

(G)

(H)

(I)

Total tax

deducted

(refer

Note 14)

Whether

total

amount of

tax

deducted as

mentioned

in column

(J) has

been

deposited

(Yes/No)

Total tax

deposited

Rate at

which

tax

deducted

Date of

deduction

(dd/mm/

yyyy)

Reason for non-

deduction

/ Lower

deduction /

H igher

deduction /

Threshold /

Transporter etc.

(refer Notes 1 to

13)

Certificate

number of

certificate issued

under section

395 for non-

deduction

/lower

deduction

Unique

Identification

Number of

Form No. 121

submitted by

the deductee

(J)

(K)

(L)

(M)

(N)

(O)

(P)

(Q)

For payments covered in section 393(1) [Table Sl. No. 8

(iv), Note 6]

For payments covered in section 393(1) [Table Sl. No. 8

(vi), Note 6]

Amount of

tax deposited

BSR Code

of bank

Date of

payment

Challan

serial

number

Amount of

tax deposited

BSR Code

of bank

Date of

payment

Challan

serial

number

(R)

(S)

(T)

(U)

(V)

(W)

(X)

(Y)

For payments covered in section 393(3) [Table Sl. No. 1,

Note 2]

For payments covered in section 393(3) [Table Sl. No. 2,

Note 2]

Amount of

tax deposited

BSR Code

of bank

Date of

payment

Challan

serial

number

Amount of

tax deposited

BSR Code

of bank

Date of

payment

Challan

serial

number

(Z)

(AA)

(AB)

(AC)

(AD)

(AE)

(AF)

(AG)

Section

Nature of Payment

Payer

Section

Code

392(7)

Any payment of accumulated balance due to an employee

Trustees of the Employees‘ Provident

Fund Scheme, 1952 or any person

authorized under the scheme to make

payment of accumulated balance due

to employees

1004

393(1) [Table:

Sl. No. 1 (i)]

Commission or brokerage - insurance

Any person

1005

393(1) [Table:

Sl. No. 1 (ii)]

Commission or brokerage - others

specified person

1006

393(1) [Table:

Sl. No. 2

(ii).D(a)]

Rent on machinery etc.- specified person

Specified person

1008

393(1) [Table:

Sl. No. 2

(ii).D(b)]

Rent other than machinery etc.- specified person

Specified person

1009

393(1) [Table:

Sl. No. 3(ii)]

Payment on any consideration, not being consideration in kind, under the agreement referred to in section 67(14).

Any person

1011

393(1) [Table:

Sl. No. 3 (iii)]

Payment of compensation on acquisition of certain immovable property

Any person

1012

393(1) [Table:

Sl. No. 4 (i)]

Income payable to a resident assessee in respect of Units of a specified Mutual Fund specified under Schedule VII [Table: Sl. No. 20 or 21] or units from the Administrator of the specified undertaking or units from specified company

Any person

1013

393(1) [Table:

Sl. No. 4 (ii)]

Certain income in the form of interest from units of a business trust to a resident unit holder

Any Business Trust

1014

393(1) [Table:

Sl. No. 4 (ii)]

Certain income in the form of dividend from units ofa business trust to a resident unit holder

Any Business Trust

1015

393(1) [Table:

Sl. No. 4 (ii)]

Certain income in the form of Renting from units of a business trust being a real estate investment trust to a resident unit holder

Any Business Trust

1016

393(1) [Table:

Sl. No. 4 (iii)]

Any income, other than that proportion of income which is exempt under Schedule V [Table: Sl. No. 2], in respect of units of an investment fund specified in section 224, payable to its unitholder.

Any Investment fund specified in

section 224

1017

393(1) [Table:

Sl. No. 4 (iv)]

Any income, in respect of an investment in a securitisation trust specified in section 221 to an investor.

Any securitisation trust specified in

section 221

1018

393(1) [Table:

Sl. No. 5 (i)]

Any income by way of Interest on securities

Any person

1019

393(1) [Table:

Sl. No. 5

(ii).D(a)]

Any income by way of interest other than interest on securities, in case of deductee/payee is a senior citizen

(a) Abanking company; or (b) a

cooperative society carrying on the

business of banking; or (c) a post

office for a deposit made under a

scheme notified by the Central

Government

1020

393(1) [Table:

Sl. No. 5

(ii).D(b)]

Any income by way of interest other than interest on securities, in case of deductee/payee is other than senior citizen

(a) Abanking company; or (b) a

cooperative society carrying on the

business of banking; or (c) a post

office for a deposit made under a

scheme notified by the Central

Government

1021

393(1) [Table:

Sl. No. 5 (iii)]

Any income being interest other than interest on securities

Specified person [other than person in

Sl. No. 5(ii).C]

1022

393(1) [Table:

Sl. No. 6

(i).D(a)]

Any sum for carrying out any work (including supply of labour for carrying out any work) in pursuance of a contract between the contractor

Any designate

1023

Section

Nature of Payment

Payer

Section

Code

and a designated person – if contractor is individual or Hindu undivided family

393(1) [Table:

Sl. No. 6

(i).D(b)]

Any sum for carrying out any work (including supply of labour for carrying out any work) in pursuance of a contract between the contractor and a designated person – if contractor is a person other than individual or Hindu undivided family

Any designate

1024

393(1) [Table:

Sl. No. 6

(iii).D(a)]

Any sum by way of–– (a) fees for technical services (not being a professional services); or (b) royalty in the nature of consideration for sale, distribution or exhibition of cinematographic films; or (c) payee, engaged only in the business of operation of call centre

Specified person

1026

393(1) [Table:

Sl. No. 6

(iii).D(b)]

Any sum by way of–– (a) fees for professional services; or (b) any sum referred to in section 26(2)(h)

Specified person

1027

393(1) [Table:

Sl. No. 6

(iii).D(b)]

Any sum by way of remuneration or fees or commission by whatever name called, other than those on which tax is deductible under section 392, to a director of a company

Specified person

1028

393(1) [Table:

Sl. No. 7]

Any dividends (including on preference shares) declared.

Any domestic company

1029

393(1) [Table:

Sl. No. 8 (i)]

Any sum under a life insurance policy, including the sum allocated as bonus on such policy, other than the amount not includible in the total income under Schedule II [Table: Sl. No. 2]

Any person

1030

393(1) [Table:

Sl. No. 8 (ii)]

Any sum for purchase of any goods

Any person, being a buyer

1031

393(1) [Table:

Sl. No. 8 (iv)]

Any benefit or perquisite, whether convertible into money or not, arising from business or the exercise of a profession of any resident.

Any specified person

1033

393(1) [Table:

Sl. No. 8 (iv)

Note 6]

Any benefit or perquisite, whether in cash or in kind or partly in cash and partly in kind, whether convertible into money or not, arising from business or the exercise of a profession of any resident.

Any specified person

1034

393(1) [Table:

Sl. No. 8 (v)]

Sale of goods or provision of services by an e- commerce participant, facilitated by an e- commerce operator through its digital or electronic facility or platform. - any e commerce operator

Any e-commerce operator

1035

393(1) [Table:

Sl. No. 8 (vi)]

Any sum by way of consideration for transfer of a virtual digital asset by other than Individual or Hindu Undivided Family.

Any person

1037

393(1) [Table:

Sl. No. 8 (vi)

Note 6]

Any sum by way of consideration, whether in cash or in kind or partly in cash and partly in kind, for transfer of a virtual digital asset.

Any person

1038

393(3) [Table:

Sl. No. 1]

Any income by way of winnings (other than winnings from Sl. No. 2 of the table at section 393(3)) from–– (a) any lottery; or (b) crossword puzzle; or (c) card game and other game of any sort; or (d) gambling or betting of any form or nature whatsoever

Any person

1058

393(3) [Table:

Sl. No. 1 Note

2]

Any income by way of winnings (other than winnings from Sl. No. 2 of the table at section 393(3)) from–– (a) any lottery; or (b) crossword puzzle; or (c) card game and other game of any sort; or (d) gambling or betting of any form or

Any person

1059

Section

Nature of Payment

Payer

Section

Code

nature whatsoever where consideration, is made in kind or cash is not sufficient to meet the tax liability and tax has been paid before such winnings are released

393(3) [Table:

Sl. No. 2]

Any income by way of winnings from online game.

Any person

1060

393(3) [Table:

Sl. No. 2 Note

2]

Any income by way of winnings from online games, is made in kind or cash is not sufficient to meet the tax liability and tax has been paid before such winnings are released

Any person

1061

393(3) [Table:

Sl. No. 3]

Any income by way of winnings from any horse race.

Any person, being a bookmaker or a

person to whom a license has been

granted by the Government under any

law for the time being in force for

horse racing in any race course or for

arranging for wagering or betting in

any race course

1062

393(3) [Table:

Sl. No. 4]

Any income, credited or paid to a person, who is or has been stocking, distributing, purchasing or selling lottery tickets, by way of commission, remuneration or prize (by whatever name called) on such tickets

Any person

1063

393(3) [Table:

Sl. No. 5.D(a)]

Payment of certain amounts in cash by bank/ post office / co-operative society to a deductee being a co-operative society

Every person, being,— (a) a banking

company to which the Banking

Regulation Act, 1949 (10 of 1949)

applies (including any bank or banking

institution referred to in section 51 of

that Act); (b) a cooperative society

engaged in carrying on the business of

banking; or (c) a post office

1064

393(3) [Table:

Sl. No. 5.D(b)]

Payment of certain amounts in cash by bank/ post office / co-operative society to a deductee being a person other than co-operative society

Every person, being,— (a) a banking

company to which the Banking

Regulation Act, 1949 (10 of 1949)

applies (including any bank or banking

institution referred to in section 51 of

that Act); (b) a cooperative society

engaged in carrying on the business of

banking; or (c) a post office

1065

393(3) [Table:

Sl. No. 6]

Any amount referred to in section 80CCA(2)(a) of the Income-tax Act, 1961 (43 of 1961) (as it existed prior to its repeal).

Any person

1066

393(3) [Table:

Sl. No. 7]

Any sum in the nature of salary, remuneration, commission, bonus or interest paid to a partner of the firm or credited to his account (including capital account).

Any person, being a firm

1067