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Statement to be furnished to the Assessing OFficer desiginated under rule 12B of the Income-tax Rules, 1962, in respect of income distributed by Mutual Fund (Omitted)

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....cer designated under rule 12B of the Income-tax Rules, 1962, in respect of income distributed by the Unit Trust of India (Separate forms to be filled up for each scheme) 1. Address of Registered Office 2. Permanent Account Number 3. Previous year ending 4. Names and addresses of the office bearers 5. Name of Scheme 6. Face Value of Unit 7. Total No. of Units 8. Details of Income distribut....

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....lare that I am furnishing such statement in my capacity as -------------------------------------------(designation) and that I am competent to furnish this statement and verify it. Verified today the -------------------------- day of ---------------------- Place----------------- Signature-------------------- Verification I/We ------------------------------- have examined the books of account a....