Form 10CCBD, Download Income Tax Form 10CCBD in PDF Format

FORM NO. 10CCBD for Report on Business of Operating and Maintaining a Hospital. FORM NO. 10CCBD is relevant to an assessee, in respect of profits and gains derived from the business of operating and maintaining a hospital anywhere in India. The amount of deduction in the case of an undertaking deriving profits from the business of operating and maintaining a hospital located anywhere in India, other than the excluded area, shall be hundred per cent of the profits and gains derived from such business for a period of five consecutive assessment years, beginning with the initial assessment year. But Hospital in following area is excluded from this scheme—

  1. Greater Mumbai urban agglomeration;
  2. Delhi urban agglomeration;
  3. Kolkata urban agglomeration;
  4. Chennai urban agglomeration;
  5. Hyderabad urban agglomeration;
  6. Bangalore urban agglomeration;
  7. Ahmedabad urban agglomeration;
  8. District of Faridabad;
  9. District of Gurgaon;
  10. District of Gautam Budh Nagar;
  11. District of Ghaziabad;
  12. District of Gandhinagar; and
  13. City of Secunderabad;

FORM NO. 10CCBD

(See rule 18DDA)

1.

Name of the assessee

:

2.

PAN

:

3.

Status

:

4.

Ownership of the hospital

:

(a) Whether the hospital is owned by the assessee

Yes

No

(b) (i) if no, name of the owner

:

(ii) whether the owner is a person referred to in

:

Yes

No

section 40A(2)(b)

5.

Name and address of the hospital

:

6.

Date of commencement of medical services

:

7.

Initial assessment year

:

8.

Approval from the local authority under the local regulation (attach a copy of the approval in the initial assessment year)

:

 

Approval

Issuing authority

Approval date and number

(a) Permission for construction of the hospital

(b) Completion or occupation certificate

 

9.

Location of the hospital :

(i) Name of the locality/area in which the hospital

:

is located

(ii) Whether the said locality/area is within the

:

Yes

No

jurisdiction of any of the excluded area

10.

Technical specifications of the hospital :

(a) Number of beds for the patients

:

(b) Whether an operation theatre is provided

:

Yes

No

(c) Whether a labour room is provided

:

Yes

No

(d) Whether a pathological laboratory is

Yes

No

maintained in the hospital

(e) Number of qualified doctors available in the

hospital (round the clock)

(f) Number of qualified nurses available in the hospital (round the clock)

(g) Whether hospital is equipped to handle

Yes

No

emergency cases

(h) Whether facilities in the nature of Magnetic

Yes

No

Resonance Imaging (MRI)/Electrocardiogram (ECG) are available

11.

Details relating to computation of deduction :

(a) Total receipts from the business of operating

:

Rs.

and maintaining a hospital

(b) Other receipts of the undertaking

:

Rs.

(c) Profits derived from the business of operating

:

Rs.

and maintaining a ***hospital not located in excluded area

(d) Deduction under section 80-IB(11C)

:

Rs.

Declaration

*I/We have examined the balance sheet of the above undertaking styled**
and belonging to the assessee M/s
(Permanent Account No.
) as at
and the profit and loss account of the said undertaking for the year ended on that date which are in agreement with the books of account maintained at the head office at
and branches at

*I/We have obtained all the information and explanations which to the best of **my/our knowledge and belief were necessary for the purposes of the audit. In *my/our opinion, proper books of account have been kept by the head office and the branches of the undertaking aforesaid visited by *me/us so far as appears from *my/our examination of books, and proper returns adequate for the purposes of audit have been received from branches not visited by *me/us, subject to the comments given below:—

*In my/our opinion, the undertaking satisfies the conditions stipulated in sub-section (11C) of section 80-IB and the amount of deduction claimed under this section is as per the provisions of the Income-tax Act, and

In *my/our opinion and to the best of *my/our information and according to explanations given to *me/us, the said accounts given a true and fair view—

    (i)    In the case of the balance sheet, of the state of affairs of the above named undertaking as at
, and

    (ii)    In the case of the profit and loss account, of the profit or loss of the undertaking for the accounting year ending on

Place


Date

Signed

Chartered Accountant

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