Printed from www.taxmann.com FORM NO. 10HA [See rule 29AA] Form of certificate under second proviso to section 80-O of the Income-tax Act, 1961 PART A (CERTIFICATE OF FOREIGN INWARD REMITTANCE TO BE GIVEN BY BANK) _______________________________Bank No.______________ Ref. No_____________ Date_______________ 1. We certify that we have received the following remittance and proceeds thereof were paid : (a) to beneficiary M/s_____________________________________________(Name and address) on____________________________________________________________ By Cash___________________By Pay-Order________________ By Credit to Current/ Saving/ Cash Credit Account with us/ with our____________________office for beneficiary's account, or (b) to_________________________Bank_______________________on_____________________ for credit of beneficiary of M/s.__________________________________________(Name and address) Account 2. Name and address of remmiter__________________________________________________________ 3. Name and address of remitting bank______________________________________________________ 4. Demand Draft/ Telegraphic Transfer/ Money Transfer No.____________Dated_________Foreign currency amount_________________Rupee equivalent_______________(Rupees_________________________) Favouring_________________________ 5. Exchange rate applied_________________________________ 6. Purpose of remittance as stated by remitter * / beneficiary________________________________ We also certify that the payment thereof has/ has * not been received in non-convertible rupees or under any special trade or payments agreement. We confirm that we have obtained reimbursement in any manner approved by the Reserve Bank of India and according to the laws. For ______________ Bank *Strike out whichever is inapplicable. To Manager Countersigned (name and designation) (Address) PART B (CERTIFICATE TO BE GIVEN BY ELIGIBLE ASSESSEE) 1. Inward remittance received during the previous year 2. (i) Whether the convertible foreign exchange in (1) was brought into India * Yes /No within a period of six months from the end of the previous year (ii) If not, whether it was brought into India within such further period in the * Yes /No previous year as allowed by the Competent Authority (iii) Specify the amount and the relevant previous year in case such amount is brought into India in convertible foreign exchange beyond the period of six months from the end of relevant previous year and with the approval of the competent authority, where such amount relates to any other previous year. (Specify the authority and the period upto which the approval has been accorded.) I certify that the total deduction of Rs.____________________claimed under section 80-O in respect of Printed from www.taxmann.com assessment year_______________is correctly claimed in accordance with the provisions of the section. I hereby certify that the above particulars contained in Part A and Part B of this certificate are true and correct to the best of my knowledge and belief and nothing has been concealed therein. Place _______________ Date ________________ (Signature) *Strike out whichever is inapplicable.
