form 15g

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“FORM NO. 15G See section 197A(1), 197A(1A) and rule 29C Declaration under section 197A (1) and section 197A(1A) to be made by an individual or a person (not being a company or firm) claiming certain
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. Year 12. Yearly Income 12A (for which declaration is being made) 13. Previous year (N.Y.T.) 14. Residential Status2 16. Name of Assessee (Declarant) 16A. Name of Assessee1 or the Assessee has not established a PAN at this time. 2. The PAN is not established because there is no PAN assigned to the company (or firm) with the income for which the declaration is being made. 3. The income for which the declaration is being made is declared as income for which the PAN is required (see paragraph 5). 4. The PAN is not established because if the Assessee had established a PAN at this time, only one PAN would be established for the Assessee. 5. The Income For Which the Declarations Need to be Made is that for which an equivalent PAN would be established (see paragraph 6). 6. The Income for Which the Declarations Need to be Made is that for which: (i) a PAN would be established; or (ii) a separate income tax return (ITR) is to be filed; or (iii) the income is not subject to any tax or duty; or (iv) the income received by the Assessee during the year from any source is subject to non-refundable taxes (refer to paragraph 9) 7. The Income For Which the Declarations Need to be Made is that for which an equivalent PAN would be established (see paragraph 6). 8. The Income for Which the Declarations Need to be Made is the income for which the PAN is established (see paragraph 6) 9. The Assessee has already established a PAN. 10. The Income For Which the Declarations Need to be Made is that for which a separate ITR (if required) would be filed. 11. The income for which the declarations are being made is not subject to any tax or duty. 12. The Income For Which the Declarations Need to be Made is the income for which a separate ITR (if required) would be filed. 11. Income for which declaration has not been established because an equivalent PAN is not established (see paragraph 5). 13. Income for which PAN is not established at this time (see paragraph 6). 14. Income for which PAN is not established at this time (see paragraph 6). 15. Income for which PAN is established, but not at this time (see paragraph 6). 16. Income for which PAN is established, but not at this time (see paragraph 6).

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