Form No. 15G: Signature of The Declarant
Form No. 15G: Signature of The Declarant
Form No. 15G: Signature of The Declarant
15G
[See rule 29C(2)]
Declaration under section 197A(1) of the Income-tax Act, 1961, to be made
by an individual claiming receipt of dividend
without deduction of tax
No. of shares Class of shares Total face value Distinctive Date(s) on which
and face of shares numbers of the shares were
value of the shares acquired by
each share the declarant
……………………………
Signature of the declarant
Verification
I, ...............… … … … … … … … … … … … … … … do hereby declare that to the best of my knowledge and
belief what is stated above is correct, complete and is truly stated.
Verified today, the ...................day of..............,
Place ...................... … … … … … … … … … … …
Date ...................... Signature of the principal
officer of the company