{AJAXCONTENT}
Form No 27
(See rule 37A)
  Statement of deduction of tax from interest, dividends or any other sum payable to (i) persons, not being companies, who are non-residents or residents but not ordinarily residents, and (ii) companies which are neither Indian companies nor companies which have made the prescribed arrangements for the declaration and payment of dividends within India, for the period ending
1. Particulars of the person making deduction of tax
    (a) Name
    (d) Address.
       Name of Premises / Building
        Road / Street / Lane
        Area / Locality
        Town/City/District.
        PIN
        State.
   (c) Tax Deduction Account Number
   (d) Permanent Account Number
Form No 27
2. Has address of the person making deduction of tax changed 1                      Tick as applicable         Yes checked >         No checked >
3. Status as defined within the meaning of section 204 read with rule 30          Tick as applicable         Central Govt.  checked >         Others checked >
    (a) Please tick the boxes below indicating the section and type of payment (other than "Salaries") made during the year from which tax
          was required to be deducted at source by you under the Income-tax Act, 1961
194E checked > 195 checked > 196A checked "> 196B checked > 196C checked > 196D checked >
    (b) Please furnish information in separate Annexures as per the enclosed proforma for each type of payment indicated above. viz, interest, dividends etc. including the payments on which no tax has been deducted on the basis of certificate issued by a chartered accountant.
4. Details of tax deducted and paid to the credit of the Central Government
S. No. Section Code TDS Rs. Surcharge Rs. Education Cess Rs. Interest Rs. Others Rs. Total Tax deposited Rs. (3+4+5+6+7) Cheque /DD No.(if any) BSR Code Date on which Tax deposited Transfer voucher/ Challan serial Number2 Whether TDS deposited by book entry? Yes/No 3
(551) (552) (553) (554) (555) (556) (557) (558) (559) (560) (561) (562) (563)
(1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13)
 
Form No 27
(See rule 37A)
  

VERIFICATION
I       , hereby certify that all the particulars furnished above are correct and complete.
Place :                      Signature of person responsible for deducting tax at source



                           Name and designation of person responsible for deducting tax at source

Date :

Notes - 1. If address has changed give changed address in column 1(b).
             2. Where deduction is made by or on behalf of the Government, to give particulars of transfer vouchers; other deductors to give particulars of                 challan no. regarding deposit into bank.
             3. Column is relevant only for Government deductors.
  

Annexure
Details of , paid / credited during the financial year and of tax deducted at source under section      of Income Tax Act 1961 :-
Deductee Code3 Permanent Account Number (PAN) of deductee Name and Address of Deductee (Address need not be given if PAN is mentioned) Amount payable before deduction of tax Rs. Date on which amount paid/credited Rate at which tax deducted Whether grossing up is required4 Amount of tax deducted (Rs.) Date on which tax deducted Bank Branch Code5 Date on which tax paid to the credit of Central Government Challan number given by bank Date of furnishing Tax Deduction Certificate Reason for nondeduction / lower deduction if any6
(564) (565) (566) (567) (568) (569) (570) (571) (572) (573) (574) (575) (576) (577)
(1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) (14)
 
Form No 27
(See rule 37A)
  

Notes : -
1 Please state the nature of payment viz. interest, dividends.
2 Please use separate Annexures for deductions made under different sections.
3 Please enter Deductee Code 01 for companies, 02 for 'other than companies'.
4 Write Y for Yes and N for No.
5 Where deduction is made by or on behalf of the Government, transfer voucher number may be entered in column (10).
6 Write 'A' if deduction is made at a lower rate or no tax deducted is on account of a certificate under section 197 or 195 or write 'B' if on account of certificate issued by a chartered accountant.
7 If necessary, please use additional sheets to give full details of payment in the above format. Please also give running serial number to all pages.
Signature of person responsible for deducting tax at source
Name and designation of person responsible for deducting tax at source