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Form for filing declaration under sub-section (1) and undertaking under sub-section (4) of section 91 of the finance (no. 2) act, 2024

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....ase both assessee and deptt are in appeal against the same order, provide both the ARNs](Add one row)   Assessment Year   Financial Year (to be furnished only if TAN based appeal)       INFORMATION RELATING TO ELIGIBILITY Whether the applicant is appellant in terms of section 89 of the DTVSV and is not ineligible to apply in terms of section 96 of DTVSV? Yes No Option exercised by the Appellant Whether opting to pay tax on reduction of losses or depreciation or MAT credit If Yes, go to relevant schedule under Part A; If No, fill up Schedule XXVII under Part D PART B - INFORMATION RELATING TO DISPUTE: (SEPARATE FORM-1 DECLARATION FOR EACH DISPUTE) Nature of tax arrear Disputed tax/Disputed Interest/Disputed Penalty/Disputed Fee Details of pending appeal / writ / SLP / DRP Objections / Revision application as on 22.07.2024.- (1) Whether Appeal /objection/revision/Writ / SLP? (2) Appellate Forum - JCIT(A)/CIT(A) / DRP/CIT/PCIT/ITAT / HC / SC (3) Filed by - (Tick the relevant option) - Assessee / Department / Both (4) Date of filing ....

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.....(name in block letters) son/daughter of Shri/Smt. ................................................... solemnly declare that to the best of my knowledge and belief the information given in this declaration is correct and complete and is in accordance with the provisions of the Direct Tax Vivad se Vishwas Scheme, 2024. I further declare that I am making this declaration in my capacity as (drop down to be provided) ............................ and that I am competent to make this declaration and verify it. I am holding permanent account number _______ (if allotted) Place ................... Date ..................... Name and signature of the declarant UNDERTAKING To, The Designated Authority ............................................ ............................................ Sir/Madam, *I, ................................................................(name in block letters) son/daughter of Shri/Smt ............................................ having PAN .............................................having decided to avail the benefit of the Direct Tax Vivad se Vishwas Scheme, 2024 prov....

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....inst which objections filed  A B Disputed income out of A -   (i) relating to issues, which have been decided in favour of assessee in his case for any assessment year by ITAT (and such order has not been subsequently reversed by the High Court) or High Court (and such order has not been subsequently reversed by the Supreme Court) B(i) (ii) relating to issues other than B(i)  B(ii) C Disputed tax in relation to disputed income at B(i) C D Disputed tax in relation to disputed income at B(ii) D E Total disputed tax (C+D) E F Interest charged on disputed tax F G Penalty levied on disputed tax G H Tax arrears (E+F+G) H X Amount payable under DTVSV on or before 31.12.2024 New appellant case 0.5*C + D Old appellant case 0.55*C +1.1*D X Y Amount payable under DTVSV on or after 01.01.2025 New appellant case 0.55*C + 1.1D Old appellant case 0.6*C +1.2*D Y Combination: Disputed tax + DRP direction + Assessee Schedule III. To be filled in case DRP has issued directions under section 144C of the Income-tax Act in response to objections filed by the assesse....

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....ncome as per order against which appeal filed OR to be filed A   B Disputed income out of A  B   C Disputed tax in relation to disputed income at B C   D Interest charged on disputed tax D   E Penalty levied on disputed tax E   F Tax arrears (C+D+E) F   X Amount payable under DTVSV on or before 31.12.2024 New appellant case 0.5*C Old appellant case 0.55*C X   Y Amount payable under DTVSV on or after 01.01.2025 New appellant case 0.55*C Old appellant case 0.6*C Y     Combination: Disputed tax + HC + Assessee Schedule VI. To be filled in case appeal or writ of assessee is pending before the High Court as on 22.07.2024 A Total income as per order against which appeal / writ filed  A   B Disputed income out of A  B   C Disputed tax in relation to disputed income at B C   D Interest charged on disputed tax D   E Penalty levied on disputed tax E   F Tax arrears (C+D+E) F   X Amount payable under DTVSV on or....

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....ayable under DTVSV on or before 31.12.2024 New appellant case 0.5*C Old appellant case 0.55*C X   Y Amount payable under DTVSV on or after 01.01.2025 New appellant case 0.55*C Old appellant case 0.6*C Y    Combination: Disputed tax + 264 + Assessee Schedule X. To be filled in case revision application of assessee under section 264 is pending before the PCIT/CIT as on 22.07.2024  A Total income as per order against which revision application filed A   B Disputed income out of A  B    C Disputed tax in relation to disputed income at B C   D Interest charged on disputed tax D   E Penalty levied on disputed tax E   F Tax arrears (C+D+E) F   X Amount payable under DTVSV on or before 31.12.2024 New appellant case C Old appellant case 1.1*C X   Y Amount payable under DTVSV on or after 01.01.2025 New appellant case 1.1*C Old appellant case 1.2*C Y     B. Schedules applicable where declaration relates to disputed TDS/TCS (applicable for TAN) Combination: Dispute....

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....be filled in case appeal of Department is pending before the ITAT as on 22.07.2024    Amount of TDS / TCS disputed in appeal     A TDS/TCS default for which appeal is filed  A    B Interest charged on disputed TDS / TCS B   C Penalty levied on disputed TDS / TCS C   D TDS / TCS arrears (A+B+C) D   X Amount payable under DTVSV on or before 31.12.2024 New appellant case 0.5*A Old appellant case 0.55*A X   Y Amount payable under DTVSV on or after 01.01.2025 New appellant case 0.55*A Old appellant case 0.6*A Y   Combination: Disputed TDS/TCS + HC + Deductor/Collector Schedule XIV. To be filled in case appeal or writ of assessee is pending before the High Court as on 22.07.2024  Amount of TDS / TCS disputed in appeal     A TDS/TCS default for which writ or appeal is filed  A    B Interest charged on disputed TDS / TCS B   C Penalty levied on disputed TDS / TCS C   D TDS / TCS arrears (A+B+C) D ....

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....B+C) D   X Amount payable under DTVSV on or before 31.12.2024 New appellant case 0.5*A Old appellant case 0.55*A X   Y Amount payable under DTVSV on or after 01.01.2025 New appellant case 0.55*A Old appellant case 0.6*A Y     Combination: Disputed TDS/TCS + 264 + Deductor/Collector Schedule XVIII. To be filled in case revision application of assessee under section 264 is pending before the PCIT/CIT as on 22.07.2024    Amount of TDS / TCS disputed in appeal     A TDS/TCS default for which revision application filed A    B Interest charged on disputed TDS / TCS B   C Penalty levied on disputed TDS / TCS C   D TDS / TCS arrears (A+B+C) D   X Amount payable under DTVSV on or before 31.12.2024 New appellant case A Old appellant case 1.1*A X   Y Amount payable under DTVSV on or after 01.01.2025 New appellant case 1.1*A Old appellant case 1.2*A Y     C. Schedule applicable where declaration relates to disputed penalty, interest or f....

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....+ 0.35*B(ii) + 0.35*C Y    Combination: Disputed penalty/interest/fee + ITAT + Department Schedule XXI. To be filled in case appeal of Department is pending before the ITAT as on 22.07.2024 A Total amount of penalty/interest/fee as per order against which appeal filed  A   B Disputed penalty / interest / fee relating to issues on which appeal has been filed  B    C Tax arrears (B) C   X Amount payable under DTVSV on or before 31.12.2024 New appellant case 0.125*B + 0.125*C      Old appellant case 0.15*B + 0.15*C      X   Y Amount payable under DTVSV on or after 01.01.2025 New appellant case 0.15*B + 0.15*C  Old appellant case 0.175*B + 0.175*C Y   Combination: Disputed penalty/interest/fee + HC + Assessee Schedule XXII. To be filled in case appeal or writ of assessee is pending before the High Court as on 22.07.2024   A Total amount of penalty / interest / fee as per order against which appeal or writ has been filed  A    B Disputed penal....

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....penalty / interest / fee as per order against which appeal or writ or SLP has been filed  A   B Disputed penalty / interest / fee on issues raised in appeal B    C Tax arrears (B) C   X Amount payable under DTVSV on or before 31.12.2024 New appellant case 0.125*B + 0.125*C      Old appellant case 0.15*B + 0.15*C      X   Y Amount payable under DTVSV on or after 01.01.2025 New appellant case 0.15*B + 0.15*C  Old appellant case 0.175*B + 0.175*C Y   Combination: Disputed penalty/interest/fee + 264 + Assessee Schedule XXVI. To be filled in case revision application of assessee under section 264 is pending before the PCIT/CIT as on 22.07.2024    Amount of TDS / TCS disputed in appeal     A Total amount of penalty / interest / fee as per order against which revision application filed A    B Disputed penalty / interest / fee on issues raised in revision application B   D Tax arrears (B) D   X Amount payable under DTVSV....