FORM NO. 13E
[See rule 28(5)]
Application for a certificate under section 194J(2) of the Income-tax Act, 1961, relating to deduction of income-tax from payments of fees for professional or technical services
To,
The Assessing Officer,
Sir,
I,,
[name]
of do hereby declare that
[address]
my total income (including income comprised in payments of the nature referred to in section 194J of the income-tax Act, 1961) computed in accordance with the provisions of that Act for the previous year relevant to the assessment year 19 19 *was less than the minimum liable to income-tax/amounted to Rs…………… and I have no reason to expect that my total income (computed as aforesaid) for three assessment years next following will increase substantially.
2. I, therefor, request that a certificate may be issued to the person(s) responsible for paying any sum by way of fees for *professional/technical services. Particulars of which are given in the Schedule hereto, authorising *him/them not to deduct income-tax/to deduct income-tax at the rate of ………………………..per cent at the time of credit of such income to my account or, as the case may be, payment thereof to me.
3. I hereby declare that what is stated in this application is correct.
Date
Signature
Address
Permanent Account Number
SCHEDULE
Sr. No.|Name and address of person(s) responsible for paying fees for *professional/technical services|Amount of *professional/technical services|
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Date ………………………… ……………………………………………………
Signature
*Score out whichever is not applicable.