Statement of income paid or credited by Venture Capital Company or Venture Capital Fund to be provided to the person who is liable to tax under section 222

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....vestor 1. Name: (refer Note 1) 2. Address: (refer Note 2) 3. Permanent Account Number (PAN):   4. E-mail Id:   ^1[5. Contact Number: Country Code Number   ] 6. Name of the Venture Capital Company or Venture Capital Fund:   7. PAN of the Venture C....

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....                2. (Repeat, if required, for each name and capital gains code as well               Declaration I,_____________, hereby declare that the information provided in this application is true and correct to the best of my knowledge. I have not concealed any rel....

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.... 2 3. Long term capital gain chargeable at 20% 3 4. Short term capital gain chargeable at 20% under section 198 4 5. Short term capital gain chargeable at 30% 5 6. Short term capital gain chargeable at applicable rates 6 4. Some of the information in the form would be pre-filled to the extent possible. 5. The amount mentioned in this form is to be filled....