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    Form 15G Word

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    Asif Nadeem
    1) Asif Nadeem has filed a Form 15G to declare income of Rs. 1,00,000 from PF withdrawal without tax deduction under Section 192A of the Income Tax Act. 2) He has estimated total income of Rs. 2,50,000 for the previous year 2021-22. 3) The form provides details of his PAN, residential status, income sources, and a declaration that the income and total income do not exceed taxable limits.

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    Form 15G Word

    Uploaded by

    Asif Nadeem
    343 views2 pages
    1) Asif Nadeem has filed a Form 15G to declare income of Rs. 1,00,000 from PF withdrawal without tax deduction under Section 192A of the Income Tax Act. 2) He has estimated total income of Rs. 2,50,000 for the previous year 2021-22. 3) The form provides details of his PAN, residential status, income sources, and a declaration that the income and total income do not exceed taxable limits.

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    1) Asif Nadeem has filed a Form 15G to declare income of Rs. 1,00,000 from PF withdrawal without tax deduction under Section 192A of the Income Tax Act. 2) He has estimated total income of Rs. 2,50,000 for the previous year 2021-22. 3) The form provides details of his PAN, residential status, income sources, and a declaration that the income and total income do not exceed taxable limits.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    343 views2 pages

    Form 15G Word

    Uploaded by

    Asif Nadeem
    1) Asif Nadeem has filed a Form 15G to declare income of Rs. 1,00,000 from PF withdrawal without tax deduction under Section 192A of the Income Tax Act. 2) He has estimated total income of Rs. 2,50,000 for the previous year 2021-22. 3) The form provides details of his PAN, residential status, income sources, and a declaration that the income and total income do not exceed taxable limits.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    of 2

    INCOME-TAX RULES, 1962

    FORM NO.15G
    [See section 197 A(1), 197 A (1A ) and rule 29C]

    Declaration under section 197A(1) and section 197A (1A) to be made by an


    individual or person (not being a company or firm) claiming certain incomes
    without deduction of tax.

    PART I

    1. Name of Assessee (Declarant): Asif Nadeem 2. PAN of the Assessee: AELPN4481M


    3. Status: Individual 4. Previous Year (P.Y.) : 2021-22 5. Residential Status: Indian
    (for which declaration is being made)
    6.Flat/Door/ Block No: 12-5/16 7. Name of premises : 8. Road/Street/Lane: 9. Area/Locality:
    Ganesh Nagar Kommadhi Madhurawada

    10. Town/City/District: 11. State: 12. PIN: 530048 13. Email:


    Visakhapatnam Andhra Pradesh [email protected]
    14. Telephone No. (with STD 15 (a) Whether assessed to tax under the Yes No
    Code) and Mobile No. Income-tax act, 1961: ✔️
    9123XXX456
    (b) If yes, latest assessment year for which assessed

    16. Estimated income for which this declaration 17. Estimated total income of the. P.Y. in which
    Is made. Income mentioned in column 16 to be included.
    1,00,000 2,50,000
    18. Details of Form No. 15G other than this form filed during the previous year, if any : NA
    Total No. of Form 15G filed Aggregate amount of income for which Form No. 15G filed

    19. Details of the income for which this declaration is filed.


    Sl. Identification number for Nature of income Section under which Amount of income
    No relevant tax is deductible.
    Investment/account, etc.
    1 UAN: 1009043XXX78 PF withdrawal Section 192 A 1,00,000
    PF No:
    GRVSP0078089000678

    Signature of the declarant

    Declaration / Verification

    *I/We Vinay Konuru do here by declare that to the best of *my/our knowledge And believe what is stated
    above is correct, complete and is truly stated. *I/We declare that the incomes referred to in this form are not
    includible in the total income of any other person under sections 60 to 64 of the Income-tax act, 1961. *I/We
    further declare that the tax *on aggregate amount of *income/incomes referred to in column 18 computed in
    accordance with the provisions of Income-tax, Act 1961. For the previous year ending on
    March 2022, relevant to the assessment year 2022-23, will be nil. *I/We also declare that *my/our
    *income/incomes referred to in column 16 *and the aggregate amount of *income/incomes referred to in
    column 18 for the previous year ending on Mar 2022 relevant to the assessment year 2022-23 will not exceed
    the maximum amount which is not chargeable to income tax.

    Place: Visakhapatnam
    Date: Signature of the declarant
    PART II

    [ To be filled by the person responsible for paying the income


    Referred to in column 16 of of Part I ]
    1. Name of the person responsible for paying 2. Unique Identification No.
    3. PAN of the person 4. Complete Address 5. TAN of the person responsible for paying
    responsible for paying
    6.Email 7. Telephone No. (with STD Code) and Mobile No. 8. Amount of income paid
    9. Date on which Declaration is received 10. Date on which the income has been paid / credited.
    (DD/MM/YYYY) (DD/MM/YYYY)

    Place:
    Date:
    Signature of the person responsible for paying
    the income referred to in column 16 of part I

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