Application by a person under section 434 for refund of tax deducted

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....Part-A: Details of the Applicant 1. Name (Refer Note 1) 2. Address (Refer Note 2) 3. Status (Refer Note 3) 4. Name of Father/Husband* (Refer Note 1) 5. Residential status (Select One) (vii) Resident (viii) Resident but not ordinarily resident (ix) Non-resident 6. Permanent Account Number   7. Contact details   Mob....

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....nt is effective   17. Proof of Agreement (Refer Note 5) Part-D: Details of transaction on which tax not deductible has been deducted 18. Amount of transaction   19. Date of transaction dd/mm/yyyy 20. Date of payment made dd/mm/yyyy 21. (i) Mode of payment   (ii) Attach proof of payment of row 21(i) (Refer Note 5) 22. ....

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....rior to the relevant tax year? (Select One) (i) Yes (ii) No (B) If the answer to row 28(A) is yes, then provide following:   (i) Tax year   (ii) Date of transaction dd/mm/yyyy (iii) Amount of tax deducted   (iv) Amount of tax refunded   (v) Date of order of Commissioner (Appeals) or the Assessing Officer, as the case m....

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....t. *Delete whichever is not applicable Place: Date: ____________________ (Signature) Name: __________ Designation: __________ Address: _________ Notes: 1. In case of individual, the first, middle and last name shall be provided in full without any abbreviations. In any other case also, the name shall be provided in full. 2. The address shall contain (i) Country/Reg....