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    Form 15g

    Uploaded by

    contactus kannan
    This document is an Indian income tax form for individuals to declare income that should be exempt from tax withholding. It contains details such as the declarant's name, address, income sources, and a declaration that their estimated total income and income reported on the form will not be taxable. The person paying the income must provide their details and certify receipt of the form. In no more than 3 sentences.

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    © All Rights Reserved
    Download as XLS, PDF, TXT or read online from Scribd

    Form 15g

    Uploaded by

    contactus kannan
    20 views4 pages
    This document is an Indian income tax form for individuals to declare income that should be exempt from tax withholding. It contains details such as the declarant's name, address, income sources, and a declaration that their estimated total income and income reported on the form will not be taxable. The person paying the income must provide their details and certify receipt of the form. In no more than 3 sentences.

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    This document is an Indian income tax form for individuals to declare income that should be exempt from tax withholding. It contains details such as the declarant's name, address, income sources, and a declaration that their estimated total income and income reported on the form will not be taxable. The person paying the income must provide their details and certify receipt of the form. In no more than 3 sentences.

    Copyright:

    © All Rights Reserved
    Download as XLS, PDF, TXT or read online from Scribd
    Download as xls, pdf, or txt
    20 views4 pages

    Form 15g

    Uploaded by

    contactus kannan
    This document is an Indian income tax form for individuals to declare income that should be exempt from tax withholding. It contains details such as the declarant's name, address, income sources, and a declaration that their estimated total income and income reported on the form will not be taxable. The person paying the income must provide their details and certify receipt of the form. In no more than 3 sentences.

    Copyright:

    © All Rights Reserved
    Download as XLS, PDF, TXT or read online from Scribd
    Download as xls, pdf, or txt
    of 4

    FORM NO.

    15G

    [See section 197A(1), 197A(1A) and rule 29C]

    Declaration under section 197A (1) and section 197A(1A) to be made by an individual or a person (not being

    a company or firm) claiming certain incomes without deduction of tax.

    PART I

    1. Name of Assessee (Declarant) 2. PAN of the Assessee1


    4. Previous year(P.Y.) 3 (for
    3. Status2 which declaration is being made) 5. Residential Status 4

    CESSATION (SHORT SERVICE) – other reason 0

    6. Flat/Door/Block No. 7. Name of Premises 8. Road/Street/Lane 9. Area/Locality

    10. Town/City/District 11. State 12. PIN 13. Email

    14. Telephone No. (with STDCode) and 15 (a) Whether assessed to tax under
    Yes No
    Mobile No. the Income-tax Act, 1961 5:
    (b) If yes, latest assessment year for
    □ ☑
    which assessed
    16. Estimated income for which this declaration is made
    17. Estimated total income of the P.Y. in which income mentioned in
    column 16 to be included 6

    18. Details of Form No. 15G other than this form filed during the previous year, if any 7

    Total No. of Form No. 15G filed Aggregate amount of income for which Form No.15G filed

    19. Details of income for which the declaration is filed

    Sl. Identification number of


    relevant investment/account, Nature of income Section under which tax is deductible Amount of income
    No. etc.8

    0 0 NIL NIL

    ……………………………………….
    Signature of the Declarant9

    Declaration/Verification10

    *I/We do hereby declare that to The best of *my/our knowledge and belief what is

    stated above is correct, complete and is truly stated. *I/We declare that the incomes referred to in this form are not

    includible in the total income of any other person under sections 60 to 64 of the Income-tax Act, 1961. *I/We further

    declare that the tax *on my/our estimated total income including *income/incomes referred to in column 16 *and

    aggregate amount of *income/incomes referred to in column 18 computed in accordance with the provisions of the

    Income-tax Act, 1961, for the previous year ending on .................... relevant to the assessment year ..................will

    be nil. *I/We also declare that *my/our *income/incomes referred to in column 16 *and the aggregate amount of

    *income/incomes referred to in column 18 for the previous year ending on .................... relevant to the assessment

    year .................. will not exceed the maximum amount which is not chargeable to income-tax.

    Place: …………………………………………………………….
    Signature of the Declarant 9
    Date:
    PART II

    [To be filled by the person responsible for paying the income referred to in column 16 of Part I]

    1. Name of the person responsible for paying 2. Unique Identification No. 11

    3. PAN of the person responsible


    for paying 4. Complete Address 5. TAN of the person responsible for paying

    6. Email 7. Telephone No. (with STD Code) and Mobile No. 8. Amount of income paid12

    9. Date on which Declaration is received (DD/MM/YYYY) 10. Date on which the income has been paid/credited (DD/MM/YYYY)

    Place: ……………………………………………….. ………………………………………………

    Signature of the person responsible for paying

    Date: ………………………………………………. the income referred to in column 16 of Part I

    *Delete whichever is not applicable.


    1As per provisions of section 206AA(2), the declaration under section 197A(1) or 197A(1A) shall be invalid if the
    declarant fails to furnish his valid Permanent Account Number (PAN).
    2Declaration can be furnished by an individual under section 197A(1) and a person (other than a company or a firm)
    under section 197A(1A).
    3The financial year to which the income pertains.
    4Please mention the residential status as per the provisions of section 6 of the Income-tax Act, 1961.
    5 Please mention “Yes” if assessed to tax under the provisions of Income-tax Act, 1961 for any of the assessment
    year out of six assessment years preceding the year in which the declaration is filed.
    6Please mention the amount of estimated total income of the previous year for which the declaration is filed
    including the amount of income for which this declaration is made.
    7In case any declaration(s) in Form No. 15G is filed before filing this declaration during the previous year, mention
    the total number of such Form No. 15G filed along with the aggregate amount of income for which said
    declaration(s) have been filed.
    8Mention the distinctive number of shares, account number of term deposit, recurring deposit, National Savings
    Schemes, life insurance policy number, employee code, etc.
    9Indicate the capacity in which the declaration is furnished on behalf of a HUF, AOP, etc.
    10Before signing the declaration/verification, 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 277 of the Income-tax Act, 1961 and on conviction be punishable-
    (i) in a case where tax sought to be evaded exceeds twenty-five lakh rupees, with rigorous imprisonment
    which shall not be less than six months but which may extend to seven years and with fine;
    (ii) in any other case, with rigorous imprisonment which shall not be less than three months but which may
    extend to two years and with fine.
    11The person responsible for paying the income referred to in column 16 of Part I shall allot a unique identification
    number to all the Form No. 15G received by him during a quarter of the financial year and report this reference
    number along with the particulars prescribed in rule 31A(4)(vii) of the Income-tax Rules, 1962 in the TDS statement
    furnished for the same quarter. In case the person has also received Form No.15H during the same quarter, please
    allot separate series of serial number for Form No.15G and Form No.15H.
    12The person responsible for paying the income referred to in column 16 of Part I shall not accept the declaration
    where the amount of income of the nature referred to in sub-section (1) or sub-section (1A) of section 197A or the
    aggregate of the amounts of such income credited or paid or likely to be credited or paid during the previous year in
    which such income is to be included exceeds the maximum amount which is not chargeable to tax. For deciding the
    eligibility, he is required to verify income or the aggregate amount of incomes, as the case may be, reported by the
    declarant in columns 16 and 18.;

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