Form No. 42

Application for Certificate of residence for the purposes of an agreement under section 159(1) and 159(2)

Prescribed under rule 75(3) · Rule 75

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Part A: Particulars ofthe Applicant
1.		Name:				(refer Note 1)
2.		Address:				(refer Note 2)
3.		Communication Address in India:				(refer Note 3)
4.		Permanent Account Number (PAN):
5.		E-mail Id:
6.		Contact Number:				Country Code		Number

Part B: Details for Tax Residency Certificate (TRC)
7.	Status:				(refer Note 4)
8.	Nationality (in case of individuals):
9.	Country/Region of incorporation/ registration (in case of others):				(refer Note 5)
10.	Address of the applicant during the period for which Tax Residency Certificate (TRC) is desired (refer Note 2):
	Sl. No.		Address	Period of Stay (From ______ to _______)			Number of days
	1.
	2.		Repeat, if required
11.	Basis on which the status of being resident in India is claimed:
12.	Period for which the residence certificate is applicable:
13.	Purpose of obtaining TRC (must be specified):
14.	Other details to be provided as separate enclosure:				(Attach as per Note 6)

Verification

I _________________________ hereby affirm that the information provided above is true and correct to the best of my knowledge. I have not concealed any relevant fact. I am submitting this form in my capacity as (designation), holding PAN and I am competent to verify and submit this form.

Place: Signature:

Date: Name:

Designation:

Notes:

1. The name shall include the first name, middle name and last name, in the case of an individuals and full name of

the entity for other cases.

2. The address shall include flat/door/building, road/street/block/sector, area/locality, post office, town/city/district, state, country/region and pin code/zip code.

3. The communication address in India shall include flat/door/building, road/street/block/sector, area/locality, post of- fice, town/city/district, state and pin code.

4. Fill person status as below: —

(I)	Individual
(II)	Hindu undivided family
(III)	Company
(IV)	Firm
(V)	Association of Persons or Body of individuals, whether incorporated or not
(VI)	Local authority
(VII)	Artificial Juridical Person
(VIII)	Government
(IX)	Trust
(X)	Limited Liability Partnership

5. Where the region is a specified territory, the same may be mentioned.

6. With respect to Part B (Sl. No. 14), following details shall be provided as annexures, namely: —

Annexu re	Particulars
A-1	Passport copies
A-2	Documents of incorporation/ registration
A-3	Proof of stay in India
A-4	Any other relevant information

7. Some of the information in the form would be pre-filled to the extent possible.

← PreviousForm No. 41 – Information to be provided under section 159(8)Next →Form No. 43 – Certificate of residence for the purposes of section 159

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.