FORM 60 [See third provision to of Rule 114B] Form of Declaration to be filled by a person who does no have either permanent account number of general index Register Number and who makes payment in respect of transaction specified in clauses(c) to (f) of rule 114B of the income Tax Act. 1962. 1. Full Name and Address of the relevant _____________________________________________________ _____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ 2. Particulars of transaction Account Type _____________________ Number __________________ 3. Amount of the transaction Rs. _____________________________ 4. Are you assessed to tax ? Yes / No 5. if yes, i) Details of Ward / Circle / Range where the last return of income was filed. ii) Reasons for not having permanent account number / General Index Register Number 6. Details of document being produced in support of address in column (1) _______________________________________________________________________________________ Verification 1. I, _______________________________________ do hereby declare that what is stated above is true to the best of my knowledge and belief. Date____________________ Place___________________ ______________________________ Signature of the declarant Instruction: Documents which can be produced in support of the address are: (a) Ration Card (b) Passport (c) Driving License (d) Identity Card issued issued by any institution (e) Copy of Electricity bill or Telephone bill showing residential address. (f) Any document of communication issued by authority of Central Government or local bodies showing residential address. (g) Any other documentary evidence in support of his address given in the declaration. Note: Amendment with effect from 1st November, 1998 as per Income Tax Act, 1962 Rule 114 B: para (c) A time deposit exceeding Rs. 50,000/- with a banking company : para (f) opening an account with a Banking Company
