FORM NO. 27A
[See rule 37B]
Form for furnishing information with the return or statement of deduction of tax at source filed on computer media
1. Details of the tax deductor
(a) Tax Deduction Account Number
(b) Permanent Account Number
(c) Name of organisation
(d) Address : Flat / Door/ Block No.
Name of Premises / Building
Road / Street / Lane
Area / Locality /
Town / District / City
State
PIN
Telephone No.
Fax
2. Details of the person responsible for deduction of tax at source
(a) Name
(b) Address : Flat / Door/ Block No.
Name of Premises / Building/
Road / Street / Lane
Area / Locality /
Town / District / City
State
PIN
Telephone No.
Fax
3. Control Totals
Forms1 Total Amount Paid Total Income Tax
Total No. of Persons
from whom tax deducted
deducted at Source
(Column No.228 of form 24)
24
(Column No. 218 of form 24)
(Column No. 7 of form 26)
26
(Column No. 4 of form 26)
(Column No. 8 of form 27)
27
(Column No. 4 of form 27)
4. Other information
Return
Stateme
nt Form
No.
Period
Ending
Assessme
nt Year
Total No. of
computer
media
enclosed
Whether
existing TDS
assessee (Y-
Yes N-No)
Assessing
Officer code
Periodicity2 Media used for
the return of
statement
Verification
I, ………………………………….. certify that all the particulars furnished above are correct and complete.
Place : Name and signature of the person responsible
Date :
for deducting tax at source …………………………
Designation …………………………….
Notes :
1. Please use separate Form 27A for each return of TDS in Form No. 24 or Form No. 26 or Form No. 27, as the case may be.
2. 0 for annual, 1 for 1s t quarter of financial year, 2 for 2n d quarter of financial year, 3 for 3 rd quarter of financial year, 4 for 4th
quarter of financial year
3. Please give complete information.”.