FORM NO. 27G
[See rule 37H]
Certificate under sub-section (9) of section 206C of the
Income-tax Act, 1961, relating to collection
Of tax at source
Certificate No.________________
*To Income-tax office,
________________________ _____________________________
________________________ _____________________________
Date _________________________
I hereby authorise you to debit the amount payable by M/s. _____________________________________
____________________________________________________________________________to his
(name of the buyer)
account or to receive, as the case may be, such amount from the said buyer on account of sale _________
______________________________________________
[specify the nature of goods referred to in the table in sub-section (1) of section 206C]
the particulars of which are given in the schedule below, after collecting income-tax at the rate of _______
_______________ percent of such amount.
2. The certificate shall remain in force for the assessment year ___________________ unless it is cancelled by me under intimation to you before the said period.
SCHEDULE
Serial number | Full name & Address of the seller | Date of sale with reference Number of such sale | Nature and description of the goods sold and details of sale | Amount expected to be Debited/received in pursuance of the sale during the current financial year |
1 | 2 | 3 | 4 | 5 |
(SEAL) _________________________
Assessing Officer
*Name and Address of person responsible for collecting tax.
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