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CDBBATW2504080021_Form

This document is Form No. 60, which is a declaration for individuals without a Permanent Account Number (PAN) who engage in specified transactions. It includes personal details of the declarant, transaction information, and a verification statement confirming the accuracy of the provided information. The form also outlines the legal implications of providing false information and the conditions under which the declaration can be accepted.

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Vikas Pandey
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23 views1 page

CDBBATW2504080021_Form

This document is Form No. 60, which is a declaration for individuals without a Permanent Account Number (PAN) who engage in specified transactions. It includes personal details of the declarant, transaction information, and a verification statement confirming the accuracy of the provided information. The form also outlines the legal implications of providing false information and the conditions under which the declaration can be accepted.

Uploaded by

Vikas Pandey
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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“FORM NO.

60[See second proviso to rule 114B}


Form for declaration to be filed by an individual or a person (not being a company or firm) who does not have a permanent
account number and who enters into any transaction specified in rule 114B

1 First Name Amit Date of Birth/ Incorporation of declarant


Middle Name kumar 2
1 0 1 0 1 9 9 8
Surname singh

3 First
Father’s Name (in case of individual) S/O Anil
Name
Middle Name Kumar
Surname Singh
4 Flat/ Room No. 5 Floor No.
0
6 Name of premises 7 Block Name/No.

8 Road/ Street/ Lane 9 Area/ Locality


bishunpur tedhi,bishunpur tedhi Bahraich Huzoorpur
10 Town/ City 11 District 12 State
KAISERGANJ BAHRAICH Uttar Pradesh
13 Pin code 14 Telephone Number (with STD code) 15 Mobile Number
271872 6394196120
16 Amount of transaction (Rs.) 4 5 0 0 0 In case of transaction in joint names.
18 number of persons involved in the 1
17 Date of transaction 0 8 0 4 2 0 2 5 transaction

19 Mode of transaction: ü Cash, ü Cheque, ü Card, ü Draft/Banker’s Cheque, ü Online transfer, ü Other

Aadhaar Number issued by UIDAI


20 Yes
(if available)

If applied for PAN and it is not yet generated enter


21
date of application and acknowledgement number

If PAN not applied, fill estimated total income (including income of spouse, minor child etc. as per section 64 of Income­tax Act, 1961) for
22
the financial year in which the above transaction is held

a Agricultural income (Rs.) 0

b Other than agricultural income (Rs.) 0

Details of document being produced in Document Code Document identification Name and address of the authority issuing
23 support of identify in Column 1 (Refer 1 number the Document
Instruction overleaf)
Details of document being produced in Document Code Document identification Name and address of the authority issuing
24 support of address in Columns 4 to 13 1 number the Document
(Refer Instruction overleaf)
Verification

I, Amit kumar singh do hereby declare that what is stated above is true to the best of my knowledge and belief. I further declare that I do not have a
Permanent Account Number and my/ our estimated total income (including income of spouse, minor child etc. as per section 64 of Income­tax Act, 1961) computed in
accordance with the provisions of Income­tax Act, 1961 for the financial year in which the above transaction is held will be less than maximum amount not chargeable to
tax.
Verified today, the 8 day of April 20 2 5

Place: ____________ (Signature of declarant)

Note:
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 277 of the Income­tax Act, 1961
and on conviction be punishable,­
(i) in a case where tax sought to be evaded exceeds twenty­five 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.
2. The person accepting the declaration shall not accept the declaration where the amount of income of the nature referred to in item 22b exceeds
the maximum amount which is not chargeable to tax, unless PAN is applied for and column 21 is duly filled.

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