Declaration under section 393(6) for receipt of certain incomes without deduction of tax

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....ax Year (for which declaration is made)   Details of income 9. Nature of income (refer Note 5) 10. Estimated income for which declaration is made   11. Details of Form No. 121 other than this form filed during the tax year, if any (refer Note 6) 11(a). Total number of Form No. 121 filed earlier   11(b). Aggregate amount of income for which Form No. 121 were filed   12. Aggregate amount of income for which declaration is made during the tax year [sum of column 10 and 11(b)]   13. Estimated total income of the tax year including the income mentioned in column 12 (refer Note 7) 14. Details of the ITR filed for previous two tax years Sl. No. ....

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.... and Collection Account Number   4. Permanent Account Number   5. Email id   6. Contact number Country Code Number 7. Tax Year   Details of the declarant and the declarations received 8. Name of the declarant (refer Note 1) 9. Permanent Account Number   10. Unique Identification Number   11. Date of Birth/Incorporation (dd/mm/yyyy) 12. Address (refer Note 2) 13. Email id   14. Contact number Country Code Number   15. Estimated income for which declaration is made (as per column 10 of Part A) 16. Estimated total income of the tax year of the declarant (as per column 13 of ....

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....ss including business related to continuance, renewal, or revival of the insurance policies. (c) rent from a specified person (d) income in respect of (i) units of a mutual fund, or (ii) units from the Administrator of the specified undertaking, or (iii) units from the specified company (e) interest on securities, interest other than interest on securities by a banking company or a co-operative society carrying on the business of banking or interest by a post office for a deposit made under a scheme notified by the Central Government or by Specified person (f) payment in respect of life insurance policy including the sum allocated as bonus on such policy (g) dividend (including dividend on prefer....