8/12/2019 form15aa
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5[FORM No. 15AA :
Certificate under section 197(1) 6[*** of t!e "nco#e$ta%
Act& 1961& re'atin to deduction of
ta%
[See rule 28AA]
Certificate No. _______________ Income-tax Officer,
*To________________ __________________
_______________ _________________
Date ___________
1. I hereby authorise you to pay without euction of income-tax,
the !"sa#ary$% interest on
securities$ interest other than interest on securities$insurance
commission &'"commission (notbein) insurance commission or
bro+era)e% "$ rent% "$ income in respect of units% (stri+e out
whicheer is not app#icab#e payab#e by you on the unermentione
securities$sums creite in
the name of ____________.
&. I hereby authorise you to pay the !"sa#ary$% interest on
securities$interest other than interest on
securities$ insurance commission "$ rent% "$ income in respect
of units% payab#e by you on the
unermentione securities$ sums creite in the name of __________
after euctin) income-taxat the rate of ________________ per cent an
surchar)e at the rate of __________________ per
cent of the amount of the interest on securities$ interest other
than interest on securities$
insurance commission "$ rent% "$ income in respect of
units%.1/"&0. I hereby authorise you to pay the unermentione
sum bein) in the nature of
compensation or the enhance compensation or the consieration or
the enhance consieration
on account of compu#sory acuisition of the capita# asset without
euction of income-tax$ aftereuctin) income-tax at the rate of
_______________ per cent an surchar)e at the rate of
________ per cent of such sum (stri+e out whicheer is not
app#icab#e%.
2. This certificate sha## remain in force up to
_________________ un#ess it is cance##e by me
uner intimation to you before that ate.
C+,-+ "
,escri/tion of
securities
Nu#0er of securities ,ate of securities A#ount of securities
(1) () (2) (3)
C+,-+ ""
'.
No.
Na#e and address
of t!e /erson to
4!o# t!e su#s are
ien on interest
A#ount of
suc! su#s
!e date on
4!ic! suc!
su#s 4ere
ien on
interest
eriod for
4!ic! suc!
su#s 4ere
ien on
interest
Rate of interest
(1) () (2) (3) (5) (6)
C+,-+ """
8/12/2019 form15aa
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'. No. Na#e and address of /erson res/onsi0'e for
/a8in insurance co##ission
A#ount of insurance
co##ission
(1) () (2)
7[C+,-+ "
'.No. Na#e and address of
/erson res/onsi0'e for
/a8in sa'ar8
eriod of e#/'o8#ent A#ount of sa'ar8
(1) () (2) (3)
[C+,-+
'. No. Na#e and address of /ersons res/onsi0'e
for /a8in rent
A#ount of rent
(1) () (2)
9[C+,-+ "
'. No. Na#e and
address of
t!e #utua'
fund
Nu#0
er of
units
C'ass of units and
face a'ue of eac!
unit
ota' face
a'ue of
units
,istinctie
Nos. of
units
(1) () (2) (3) (5) (6)
1;[C+,-+ ""
'. No. Na#e and address of t!e /erson res/onsi0'e for
/a8in co#/ensation or t!e en!anced
co#/ensation or t!e consideration or t!e
en!anced consideration on account of co#/u'sor8
ac
