Form No. 55

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FORM NO. 55
[See rule 2C]
[Now redundant]
Application for approval of an association or institution for purposes of exemption under
section 10(23), or continuance thereof for the year

1. Name and address of the association/institution


2. Legal status, whether registered society/others. Please enclose a
copy of certificate of registration
3. Date of inception or setting up of the association
4. Activities encouraged in India as reflected in the memorandum
(please specify each game/activity).
5. Activities, if any, encouraged outside India (give details)
6. Name and address of the office bearers
7. Total income of the association including voluntary contributions
for the previous year relevant to the assessment year for or from
which the exemption is sought
8. Amount of income referred to above that has been or deemed to
have been utilised wholly and exclusively for the objects of the
association [income deemed to have been utilised shall have the
same meaning as assigned to it in sub-sections (1) and (1A) of
section 11]
9. Amount accumulated for the purpose mentioned in Column (8)
above
10. (i) Details of modes in which the funds of the association are
invested or deposited showing the nature, value and income from
the investment.
(ii) Details of funds not invested in the modes specified in section
11(5):

Sl. No. Name and address of the In the case of a company, Nominal value of the Income from the investment
concern number and class of shares investment
held
1 2 3 4 5

11. (i) Is the association carrying on any business (give details) ?


(ii) Is the business incidental to the attainment of its objectives ?
12. Details of nature, quantity and value of contributions (other than
cash) and the manner in which such contribution has been
utilised.
13. Details of shares, security or other property purchased by or on
behalf of the association from any interested person as specified
in sub-section (2) of section 13

Printed from incometaxindia.gov.in


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14. Whether any part of the income or any property of the association
was used or applied, in a manner which results directly or
indirectly in conferring any benefit, amenity or perquisite
(whether converted into money or not), or any interested person
as specified in sub-section (3) of section 13. If so, details thereof
15. Amount deemed to be income of the association by virtue of
sub-section (3) of section 11, as made applicable by the third
proviso to section 10(23)
16. (i) State the assessment particulars including permanent account
number/GIR number, name of the ward/circle
(ii) Last assessed and returned income
17. Has the association/institution distributed its income in the last
three years among its members?. If so, please indicate
reasons/purposes, i.e., whether as a loan, grant, subsidy or income

18. Enclose audited accounts including balance sheet, annual report,


if any, with certified copies of income appropriation towards the
object of the association.

Certified that the above information is true and to the best of my knowledge and belief.
Place
Date Signature

Designation

Full address

Notes :
1. The application form should be sent to the Director General Income-tax (Exemptions) through the
Commissioner of Income-tax having jurisdiction over the trust or institution. Four copies of the application
form along with the enclosures should be sent.
2. The applicant shall furnish any other documents or information as required by the DG Income-tax (Exemptions)
or any authority authorised by the DG Income-tax (Exemptions).

Printed from incometaxindia.gov.in

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