Application for information under section 258(2)(a) of the Act

To

The Principal Chief Commissioner/Chief Commissioner/Principal Commissioner/Commissioner of Income- tax,

Sir,

I, applicant, request you to furnish information relating to the following assessee (details as per Part-B).

Part A: Personal Information of the applicant

1.

Name

(Refer Note 1)

2.

Father’s/ Husband’s name

3.

Designation

4.

Address

(Refer Note 2)

5.

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: Personal Information of the assesse whose information has been sought

6.

Name

(Refer Note 1)

7.

Permanent Account Number

8.

Aadhar Number (applicable for individuals), if available

9.

Status

(Refer Note 3)

10.

Address

(Refer Note 2)

Part C: Details about information sought

11.

Tax Year

12.

Specific information sought

(i)

(Free text up to 200 words) (upload)

(Refer Note 4)

(ii)

(Repeat if required)

13.

Reason for seeking information

(i)

(Free text up to 200 words) (upload)

(Refer Note 4)

(ii)

(Repeat if required)

Date:

Signature of the applicant

(Name: …..………………….)

Designation: … … … … … … ..