Application by a person specified in rule 209 for a certificate under section 395(1), for receipt of certain sums without deduction of tax

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.... Country of Incorporation (drop down) 8. Address of Head Office (outside India) (refer Note 3) 9. Email id   10. Contact Number Country code Number Part B (to be filled where applicant is banking company/insurer) Declaration and Request I, .... (name of declarant) having Permanent Account Number ..... being the principal officer of ........ (name of the applicant), hereby declare: 1. That ....... (name of the applicant) is a *banking company/insurer which is not a domestic company and which is operating in India through above branch(es). 2. That the said *company/insurer is entitled to receive interest, not being interest on securities (other than interest payable on securi....

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....irst, middle and last name shall be provided in full without any abbreviations. In any other case also, name shall be provided in full. 2. Fill 'person' status as (i) Individual (ii) Hindu undivided family (iii) Company (iv) Firm (v) Association of persons, whether incorporated or not (vi)Body of individuals, whether incorporated or not (vii) Local Authority (viii)Artificial Juridical Person (ix) Government (x) Trust 3. The address shall contain i. Country/Region, ii. Flat/Door/Building, iii. Road/Street/ Block/Sector, iv. PIN/ZIP Code, v. Post Office, vi. Area/locality, vii. District, viii. State. 4. Some of the information in the form would be pre-filled to the extent possible. Part C (to be filled where applicant is a person ....

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....is made. (d) ........ (name of the applicant) is not in default or deemed to be in default in respect of any tax (including advance tax and tax payable under section 266), interest, penalty, fine, or any other sum payable under the Act. (e) interest or other sum is receivable by the branches on their own account and not on behalf of its head office or any branch situated outside India, or any other person; Therefore, a certificate may kindly be issued authorising ..... (name of the applicant) to receive such sum (other than interest or dividends) without deduction of tax under section 393(2) (Table: Sl. No. 17), during the tax year.... I hereby declare that what is stated in this application is true and correct. P....