DECLARATION UNDER FORM 15G
Declaration under section 197A(1) and 197A(1A) of the Income-tax Act, 1961 by an individual (not being a senior citizen) claiming certain receipts without deduction of tax.
I, [Full Name], son/daughter of [Father's Name], resident of [Full Address], holding PAN [PAN Number] and being a resident of India, do hereby declare as under:
I hereby declare that my estimated total income for the previous year [Financial Year] relevant to the assessment year [Assessment Year], including the interest income of Rs. [Amount] on account of [Deposit/Account No.] with [Bank/Institution Name], will be NIL / below the maximum amount not chargeable to tax. I therefore request that no tax be deducted at source on the said interest income under the provisions of the Income-tax Act, 1961.
I further declare that the information furnished above is true, complete and correct.
[Signature of Declarant]
[Name]
Place: [Place] Date: [DD/MM/YYYY]