TaxTMI 
TaxTMI 
FORM OF DECLARATION UNDER SECTION 183 OF THE FINANCE ACT, 2016, IN RESPECT OF THE INCOME DECLARATION SCHEME, 2016
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....lip;……………………………………………………………………… E-mail…………………………….Telephone No……………………… Residence…………………………………………………………………………………………………………… ………………………………………………………………………………………………………………………… Mobile No. …………………….Telephon....
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....;………………….. (Full name in block letters) son/daughter/wife of Shri…………………………………………….. (name of father/husband) hereby solemnly declare that- (a) the information given in this declaration is correct and complete to the best of my knowledge and belief; (b) in addition to my own income in respect of the assessment year(s) for which the declaration is made, income of other persons in respect of which I am chargeable to tax and income accruing or arising from the assets held by me through any other person for which I had failed to furnish a return under section 139 of the Income-tax Act, 1961/which I had failed to disclose in a return of income furnished by me before the commencement of the Scheme/which has otherwise escaped assessment, has also been disclosed in this declaration; (c) the income of any other person in respect of which I am not chargeable to tax has not been included in this declaration; (d) the provisions of clause (a) of section 196 of the Finance Act, 2016 in respect of Conservation of Foreign Exchan....
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....p;…. Date………………….. *Score out whichever is not applicable. Annexure to Form 1 STATEMENT OF UNDISCLOSED INCOME Description of undisclosed income and income declared in the form of investment in assets (use separate sheet in case of multiple assets in the same category) I. Total undisclosed income S.No. Assessment year to which the undisclosed income pertains Amount of undisclosed income (in Rs.) Nature of undisclosed income Total (to be taken to item 7 of the Form) II. Whether any part of income referred in (I) above is in form of investment in asset Yes No III. If reply to (II) above is Yes, furnish description of undisclosed income declared in the form of investment in assets (Use separate sheet in case of multiple assets in the same category) 3[1. Immovable property (attach valuation report) (i) Nature of property (land/building/flat etc.) ________________ (ii) Address of the property ________________ (iii) Name(s) under which held ________________ (iv) Date of acquisition ________________ (v) Cost of acquisition as per rule 3(1)(d)(I) ________________ (vi) Value as estimated by the registered v....
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.... Unquoted shares and securities other than equity shares in a company [Rule 3(1)(c)(III)] (attach valuation report) (i) Description of share/security (A) Name of issuer __________________ (B) Number of securities/shares __________________ (C) Type of security/share __________________ (ii) Name(s) under which held __________________ (iii) Cost of acquisition __________________ (iv) Date(s) of acquisition __________________ (v) Value as determined under Rule 3(1)(c)(III)(ii) __________________ (vi) Fair Market value as per Rule 3 __________________ 5. Any other asset (i) Description of asset __________________ (ii) Name(s) under which held __________________ (iii) Cost of acquisition/ investment __________________ (iv) Date of acquisition/ investment __________________ (v) Value as determined under Rule 3(1)(g)(II) __________________ (vi) Fair market value as per Rule 3 __________________ 6. Total value of all the assets declared __________________ 7. Deduction as per rule 4 of the Income Declaration Scheme Rules, 2016 __________________ (where part of asset acquired from income already assessed under the Income-tax Act) (to be provided in....