DECLARATION UNDER FORM 15H
Declaration under section 197A(1C) of the Income-tax Act, 1961 by a resident individual of the age of sixty years or more claiming certain receipts without deduction of tax.
I, [Full Name], aged [Age] years, son/daughter of [Father's Name], resident of [Full Address], holding PAN [PAN Number], being a resident senior citizen, do hereby declare as under:
I hereby declare that the tax on my estimated total income for the previous year [Financial Year] relevant to the assessment year [Assessment Year], including the interest income of Rs. [Amount] arising from [Deposit/Account No.] held with [Bank/Institution Name], will be NIL. I accordingly request that no tax be deducted at source on such interest income.
I certify that I am a resident of India and that the particulars stated above are true and correct to the best of my knowledge and belief.
[Signature of Declarant]
[Name]
Place: [Place] Date: [DD/MM/YYYY]