FORM NO. 15H for Declaration Be Made By Senior Citizen Claiming Certain Receipts without Deduction of Tax. FORM NO. 15H is exclusively meant for senior citizens and not for other categories of persons. The form must be used revised w.e.f 1-8-2003, for making self deceleration in order to receive payment without deduction of tax at source.
(1) A declaration under sub-section (1) by an individual or under sub-section (1A) of section 197A by a person (not being a company or firm) shall be in Form No. 15G and shall be verified in the manner indicated therein.
(1A) A declaration under sub-section (1C) of section 197A by an individual resident in India, who is of the age of sixty-five years or more at any time during the previous year and is entitled to a deduction from the amount of income-tax on his total income referred to in section 88B shall be in Form No. 15H and shall be verified in the manner indicated therein.]
(2) The declaration referred to in sub-rule (1) or sub-rule (1A) shall be furnished in duplicate to the person responsible for paying the “interest on securities” or dividend or interest other than “interest on securities” or, income in respect of units or, as the case may be, any amount referred to in clause (a) of sub-section (2) of section 80CCA.
(3) The person referred to in sub-rule (2) shall deliver or cause to be delivered to the Chief Commissioner or Commissioner, one copy of the declaration referred to in sub-rule (1) or sub-rule (1A) on or before the seventh day of the month next following the month in which the declaration is furnished to him.
Explanation.—For the purposes of sub-rule (3), the Chief Commissioner or the Commissioner means the Chief Commissioner or Commissioner to whom the Assessing Officer having jurisdiction to assess the person referred to in sub-rule (2) is subordinate.
FORM NO. 15H
[See rule 29C (1A)]
Declaration under sub-section (1C) of section 197A of the Income-tax Act, 1961, to be made by an individual who is of the age of sixty-five years or more claiming certain receipts without deduction of tax
@ do hereby declare-
1. that the shares/securities/sums, particulars of which are given in the Schedule below, stand in my name and are beneficially owned by me, and the dividend/interest in respect of such securities/sums and/or income in respect of units is/are not includible in the total income of any other person under sections 60 to 64 of the Income-tax Act, 1961;
That the particulars of my account under the National Savings Scheme and the amount of withdrawal are as per the Schedule below:
Description and details of investment
Date of investment/opening of account
Estimated income to be received
2. That my present occupation is ;
3. That I am of the age of
years and am entitled to a deduction from the amount of income-tax on my total income referred to in section 88B;
4. that the tax on my estimated total income, including *income/incomes referred to in the Schedule below computed in accordance with the provisions of the Income-tax Act, 1961, for the previous year ending on
relevant to the assessment year
will be nil;
5. That I have not been assessed to income-tax at any time in the past but
I fall within the jurisdiction of the Chief Commissioner of Income-tax
or Commissioner of Income-tax
That I was last assessed to income-tax for the assessment year
by the Assessing Officer
. Circle/Ward and the Permanent Account Number allotted to me are
6. That I am/am not resident in India within the meaning of section 6 of the Income-tax Act, 1961;
Signature of the declaring
do hereby declare that to the best of my knowledge and belief what is stated above is correct, complete and is truly stated.
Verified today, the
Signature of the declarant
[FOR USE BY THE PERSON TO WHOM THE DECLARATION IS FURNISHED]
|1. Name and address of the person responsible for paying the income, mentioned in paragraph 1 of the declaration|
|2. Date on which the declaration was furnished by the declarant|
|3. Date of declaration, distribution or payment of dividend/withdrawal from account number |
under the National Savings Scheme.
|4. Period in respect of which *dividend has been declared/interest is being credited or paid/income in respect of units is being credited or paid|
|5. Amount of dividend/interest or income in respect of units/withdrawal from National Saving Scheme Account|
|6. Rate at which interest or income in respect of units, as the case may be, is credited/paid|
Forwarded to the Chief Commissioner or Commissioner of Income-tax,
Signature of the person responsible for paying the income referred to in Paragraph 1