Form for declaration to be filed by any person (other than a company or firm) or a foreign company covered by sub-rule (2) to rule 159, who does not have a permanent account number and who enters into any transaction specified in rule 159 (Refer Note 1)
Part-A: Nature of Transaction | ||
1. | Nature of Transaction | (Refer note 2 and 3) |
Part-B: Declaration |
I declare that I/applicant do/does not have a Permanent Account Number(PAN). Further, I also declare that,– (i) my status is Individual or Hindu Undivided Family or Association of Persons or Body of Individuals or Artificial Juridical person or Government or Trust or Local Authority or Foreign Company (please select appropriate status); and (ii) my or our or applicant‘s estimated total income (including income of spouse, minor child etc. as per sec- tion 99 of the Act, 2025 (30 of 2025)) computed in accordance with the provisions of Income-tax Act, 2025 (30 of 2025) for the financial year in which the above transaction is held will be less than maxi- mum amount not chargeable to tax; or the applicant is a foreign company covered by sub-rule (2) to rule 159 and does not have any income chargeable to tax in India. Place: Date: (Signature of declarant) |
Part-C: Identity and Address details | ||||
1. | Name | (Refer Note 4) | ||
2. | Date ofBirth or Incorporation | dd/mm/yyyy (Refer Note 5) | ||
3. | Father‘s Name | (Refer Note 6) | ||
4. | If PAN is applied for but it is not yet generated, enter both details below: (Refer Note 7) | |||
(i) | Date of application | dd/mm/yyyy | ||
(ii) | Acknowledgement number | |||
5. | Aadhaar Number | |||
6. | Residence Address | (Refer Note 8) | ||
7. | Office Address | (Refer Note 8) | ||
8. | Address for Communication (select one) | (i) Residence (ii) Office | ||
9. | Contact Details | |||
(i) | Mobile Number | Country Code | Number | |
(drop down) (for digital form) | ||||
(ii) | Telephone Number | Country Code | Number | |
(drop down) (for digital form) | ||||
(ii) | Email ID | |||
10. | Taxpayer Identification Number (TIN) in the Country of Residence (in case of foreign company) | |||
11. | Details of income chargeable to tax in India in case of foreign company (Refer Note 9) | |||
(i) | Quantum of income chargeable to tax (in Rs) | |||
(ii) | Quantum of income not chargeable to tax (in Rs) | |||
Part-D Details of the Transaction | |||
1. | Date of Transaction | dd/mm/yyyy | |
2. | Total Amount of transaction (Rs) | (Refer Note 10) | |
3. | Amount of cash transaction, out of total amount mentioned in item number 2 above. | (Refer Note 11) | |
4. | Mode of transaction | (Refer Note 12) | |
5. | In case of the transaction is in joint names (Refer Note 9) | ||
(i) | Number of persons involved in the transaction | ||
(ii) | Share of the declarant (in percentage terms) | ||
Part-E: Documents submitted as proof | |||||
I have enclosed [Refer Note 13] as the documents for proof of Identity, Address and Date of Birth or Date of in- corporation | |||||
1. | Proof of Identity (POI) | ||||
Document Identification Number | |||||
Name of the authority issuing document | (Refer Note 4) | ||||
Address of the authority issuing document | (Refer Note 8) | ||||
2. | Proof of Address (POA) | ||||
Document Identification Number | |||||
Name of the authority issuing document | (Refer Note 4) | ||||
Address of the authority issuing document | (Refer Note 8) | ||||
3. | Proof of Date ofBirth (DoB)/Date of Incorporation (DoI) | ||||
Document Identification Number | |||||
Name of the authority issuing document | (Refer Note 4) | ||||
Address of the authority issuing document | (Refer Note 8) | ||||
Part-F: Verification |
1. I, , son or daughter or wife of Shri , solemnly declare that to the best of my knowledge and belief, the information given in this application and documents, if any, accompanying it are correct and complete, and particulars shown therein are truly stated. 2. I also declare that I am making this application for …………in my capacity as ………..(self or Repre- sentative Assessee ) and I am competent to make this application and verify it. 3. I understand that if any part of this declaration is found to be false, I may face legal consequences under the relevant provisions of the Act. Date: Place: (Signature of declarant) Name: Designation |
Notes:
1. Before signing the declaration, the declarant should satisfy himself that the information furnished in this form is true, correct and complete in all respects. Any person making a false statement in the declaration shall be liable to prosecution under section 482 of the Act.
2. The nature of transaction in Part A may be filled as per the following codes:
S.no | Nature of Transaction | Code |
1 | Purchase or sale or gift or joint development agreement of any immovable property | 01 |
2 | Opening an account (other than basic savings and time deposit) | 02 |
3 | Investment in Time deposit | 03 |
4 | Commencement of account based relationship with an insurer | 04 |
5 | Payment to a hotel or restaurant or convention centre or banquet hall or any person engaged in event management | 05 |
6 | Sale or purchase of goods and services of any nature not classi- fied above | 06 |
3. Part A to F of the form are to be filled for all 6 transactions.
4. In case of individuals, the first, middle and last name shall be provided in full without any abbreviations. In other cases, the name of the entity should be provided as mentioned in the registration document issued un- der the relevant law, in which the entity has been constituted.
5. In case of individuals the date of birth shall be provided and in other cases the date of incorporation of the entity shall be provided.
6. In case of individuals father‘s name shall be provided.
7. In case the estimated total income exceeds maximum amount not chargeable to tax, the person should ap- ply for PAN, fill out item 4 in Part C and furnish proof of submission of application.
8. The address shall contain (i) Country or Region, (ii) Flat or Door or Building, (iii) Road or Street or Block or Sector, (iv) PIN or ZIP Code, (v) Post Office, (vi) Area or locality, (vii) District and (viii) State.
9. The person accepting the declaration shall not accept the declaration where income chargeable to tax is shown in item 11(i) in Part C.
10. The total amount of transaction should be filled in item 2 of part D. In case the transaction is undertaken in names of more than one-person, total number of persons involved in the transaction should be mentioned in item 5(i) of Part D and share of the person in percentage terms in item 5(ii) of Part D. e.g. for purchase of immovable property worth Rs 100/- in the name of 5 persons, with the share of declarant being 10 percent, the declarant should fill ‘100‘ in item 3, ‘5‘ in item 5(i) and ‘10‘ in item 5(ii).
11. The amount of cash involved in the transaction, whose value is given in item 2 of part D should be filled in item 3 of Part D.
12. The mode of transaction in item 4 of Part D may be filled as per the following codes:
S.no | Mode of Transaction | Code |
1 | Cash | 01 |
2 | Cheque | 02 |
3 | Card | 03 |
4 | Draft/Bankers Cheque | 04 |
5 | Online transfers | 05 |
6 | Mixed (cash and other mode) | 06 |
7 | UPI transactions | 07 |
8 | Others | 08 |
13. Documents which can be produced in support of identity, address and date of birth (not required if applied for PAN and item 4 in Part C is filled):
Sl. No. | Nature of Document | Document | Proof of | Proof of | Date of |
Code | Identity | Address | Birth/Incorporation* | ||
A. For Individuals and HUF | |||||
1. | AADHAARcard | 01 | Yes | Yes | No |
2. | Bank/Post office passbook bearing pho- tograph of the person | 02 | Yes | Yes | No |
3. | Elector‘s photo identity card | 03 | Yes | Yes | Yes |
4. | Ration/Public Distribution System card bearing photograph of the person | 04 | Yes | Yes | No |
5. | Driving License | 05 | Yes | Yes | Yes |
6. | Passport | 06 | Yes | Yes | Yes |
7. | Pensioner Photo card | 07 | Yes | Yes | No |
8. | National Rural Employment Guarantee Scheme (NREGS) Job card | 08 | Yes | Yes | No |
9. | Caste certificate bearing photo of the person | 09 | Yes | Yes | No . |
10. | Certificate of identity/address signed by a Member of Parliament or Member of Legislative Assembly or Municipal Councillor or a Gazetted Officer as per annexure A prescribed in Form 093 | 10 | Yes | Yes | No |
11. | Certificate from employer | 11 | Yes | Yes | No |
12. | Kisan passbook bearing photo | 12 | Yes | No | No |
13. | Arm‘s license | 13 | Yes | No | No |
14. | Central Government Health Scheme /Ex-servicemen Contributory Health Scheme card | 14 | Yes | No | Yes |
15. | Photo identity card issued by the gov- ernment/ Public Sector Undertaking | 15 | Yes | No | Yes |
16. | Electricity bill (Not more than 3 months old) | 16 | No | Yes | No |
17. | Landline Telephone bill (Not more than 3 months old) | 17 | No | Yes | No |
18. | Water bill (Not more than 3 months old) | 18 | No | Yes | No |
19. | Consumer gas card/book or piped gas bill (Not more than 3 months old) | 19 | No | Yes | No |
20. | Bank Account Statement (Not more than 3 months old) | 20 | No | Yes | No |
21. | Credit Card statement (Not more than 3 months old) | 21 | No | Yes | No |
22. | Depository Account Statement (Not more than 3 months old) | 22 | No | Yes | No |
23. | Property registration document | 23 | No | Yes | No |
24. | Allotment letter of accommodation from Government | 24 | No | Yes | No |
25. | Passport of spouse bearing name of the person | 25 | No | Yes | No |
26. | Property tax payment receipt (Not more than one year old) | 26 | No | Yes | No |
27. | Domicile certificate bearing photo of the person | 27 | Yes | Yes | Yes |
28. | Birth certificate issued by the municipal authority or any office authorised to issue birth and death certificate by the Registrar of Birth and Deaths or the Indian Consulate as defined in clause (d) of sub-section (1) of section 2 of the Citizenship Act, 1955 (57 of 1955); | 28 | No | No | Yes |
29. | Pension payment order | 29 | No | No | Yes |
30. | Marriage certificate issued by the Reg- istrar of Marriages | 30 | No | No | Yes |
31. | Matriculation certificate or mark sheet of recognised board | 31 | No | No | Yes |
B. For Association of Persons (Trust) | |||||
Copy of trust deed or copy of certificate of registration issued by Charity Com- missioner. | 32 | Yes | Yes | Yes | |
C. | For Association of Persons (other than Trusts) or Body of Individuals or Local Authority or Artificial Ju- ridical Person | ||||
Copy of Agreement or copy of certifi- cate of registration issued by Charity commissioner or Registrar of Cooper- ative society or any other competent authority or any other document origi- nating from any Central or State Gov- ernment Department establishing iden- tity, address and date of incorporation of such person. | 33 | Yes | Yes | Yes | |
D. For a foreign company | |||||
1. | Copy of Certificate of Registration or incorporation issued in the country where the applicant is located, duly attested by authorized officials of IFSC banking unit | 34 | Yes | Yes | Yes |
2. | Copy of tax identification number is- sued in the country where the applicant is located, duly attested by authorized officials ofIFSC banking unit | 35 | Yes | Yes (if address mentioned in the same) | Yes |
* The document shall be accepted only if it bears the name, date, month and year of birth or incorporation of the de- clarant.
(i) In case of a transaction in the name of a Minor, any of the above-mentioned documents as proof of Identity and Address of any of parents or guardians of such minor shall be deemed to be the proof of identity and ad- dress for the minor declarant, and the declaration should be signed by the parent or guardian.
(ii) For HUF any document in the name ofKarta of HUF is required.
(iii) In case of Government, only document required is certificate from the Head of the Department or Pay and Accounts Officer or Zonal Accounts Officer or District Treasury Officer or Cheque Drawing and Disbursing Officer.