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

FORM NO. 10FA for Certificate of residence under section 90 and 90A. FORM NO. 10FA is used by assessee for getting certificate under section 90 and 90A of the Income-tax Act, 1961. Certificate is issued of residence in Form No. 10FB be granted in the case of person other than individual.

(1) The certificate referred to in sub-section (4) of section 90 and sub-section (4) of section 90A to be obtained by an assessee, not being a resident in India, from the Government of the country or the specified territory shall contain the following particulars, namely:—

 (i)  Name of the assessee;

(ii)  Status (individual, company, firm etc.) of the assessee;

(iii) Nationality (in case of individual);

(iv) Country or specified territory of incorporation or registration (in case of others);

(v)  Assessee’s tax identification number in the country or specified territory of residence or in case no such number, then, a unique number on the basis of which the person is identified by the Government of the country or the specified territory;

(vi)  Residential status for the purposes of tax;

(vii) Period for which the certificate is applicable; and

(viii)  Address of the applicant for the period for which the certificate is applicable.

(2) The certificate referred to in sub-rule (1) shall be duly verified by the Government of the country or the specified territory of which the assessee, referred to in sub-rule (1), claims to be a resident for the purposes of tax.

(3) An assessee, being a resident in India, shall, for obtaining a certificate of residence for the purposes of an agreement referred to in section 90 and section 90A, make an application in Form No. 10FA to the Assessing Officer.

(4) The Assessing Officer on receipt of an application referred to in sub-rule (3) and being satisfied in this behalf, shall issue a certificate of residence in respect of the assessee in Form No. 10FB.

 

FORM NO. 10FA

[See rule 21AB (3)]

Application for Certificate of residence for the purposes of an agreement under section 90 and 90A of the Income-tax Act, 1961

To

The Assessing Officer,

_________________,

_________________,

_________________.

Sir,

I request that a certificate of residence in Form No. 10FB be granted in my case/in the case of ________________________ [for person other than individual]

2. The relevant details in this regard are as under: –
(i)

Full Name and address of the applicant

 

 

(ii)

Status (State whether individual, Hindu undivided family, firm, body of individuals, company etc.)

 

 

(iii)

Nationality (in case of individual)

 

 

(iv)

Country of incorporation/registration (in case of others).

 

 

(v)

Address of the applicant during the period for which TRC is desired

 

 

(vi)

Email ID

 

 

(vii)

PAN/ TAN (if applicable)

 

 

(viii)

Basis on which the status of being resident in India is claimed

 

 

(ix)

Period for which the residence certificate is applicable

 

 

(x)

Purpose of obtaining Tax Residency Certificate (must be specified)

 

 

(xi)

Any other detail

 

 

3. The following document in support are enclosed: –
(1)

 

(2)

 

(3)

I,_______________________________ [full name in block letters] _________________________________son / daughter of ____________________________________, in the capacity of ____________________________________ [designation for person other than individual], verify that to the best of my knowledge and belief, the information given in this form is correct and complete and that the other particulars shown therein are truly stated.

Verified today the_____________________________________ day of ____________________________________

Place ________

Signature of the Applicant ____________________
Name____________________________________

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