FORM NO.26QAA

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Printed From Taxmann's Income Tax Rules on CD Page 1 of 3 Form No. 26QAA [See section 206A and rule 31AC] Quarterly return under section 206A for the quarter ended June/September/December/March (tick whichever applicable) of the Financial Year . PART - A (i) Name of the Person (ii) Permanent Account Number (iii) Address of the Person (iv) Total number of term deposits on the last day of the quarter VERIFICATION I, , hereby certify that all the particulars furnished in Part-A and Part-B are correct and complete. Place : Signature of the principle officer of the banking company/co-operative society/public company Date : Name and designation of the principle officer (FOR OFFICE USE) Receipt No. Date Name and signature of the person receiving the quarterly return (with stamp) PART - B (on computer media) Quarterly return for the quarter ended of the Financial Year under section 206A. (i) Name of the Person (ii) Permanent Account Number (iii) Address of the Person (iv) Total number of term deposits on the last day of the quarter (v) Break-up of number of time deposits (Please furnish the details for each branch separately Printed From Taxmann's Income Tax Rules on CD Page 2 of 3 Sl. No. Particulars of the Branch No. of time deposits on the first day of the Quarter of value below Rs. 25,000 Rs. 25,000-Rs. 50,000 Rs. 50,000 - Rs. 1,00,000 Rs. 1,00,000-Rs. 5,00,000 above Rs. 5,00,000 (501) (504) (505) (506) (507) (508) 1. TAN (502) Address BSR Code (503) if any 2. Sl. No. Particulars of the Branch Details of time deposits made during the Quarter of value below Rs. 25,000 Rs. 25,000-Rs. 50,000 Rs. 50,000 - Rs. 1,00,000 Rs. 1,00,000-Rs. 5,00,000 above Rs. 5,00,000 (501) (509) (510) (511) (512) (513) 1. TAN (502) Address BSR Code (503) if any 2. Printed From Taxmann's Income Tax Rules on CD Page 3 of 3 Sl. No. Particulars of the Branch Details of time deposits not to be included in Form No. 26QAA for next Quarter of value below Rs. 25,000 Rs. 25,000-Rs. 50,000 Rs. 50,000 - Rs. 1,00,000 Rs. 1,00,000-Rs. 5,00,000 above Rs. 5,00,000 (501) (514) (515) (516) (517) (518) 1. TAN (502) Address BSR Code (503) if any 2.