FormDownload Logo

Free Form 15H Income Tax India Form

Forms in Tax

Form 15H is for senior citizens who have not paid tax in the current year to save their TDS.

 Advertisements

Form 15H Income Tax India Form

Text version of this Form

———————– Page 1———————–

FORM NO. 15H
[See rule 29C (3)]
Declaration under section 197A (1A) of the Income-tax Act, 1961, to be made by a person (not
being a company or a firm) claiming receipt of interest on securities or interest other than “interest
on securities” or income in respect of units without deduction of tax.

Part I

I/We* ………………………………………………………………………………………………………………………………………………
*son/daughter/wife of ………………………………………………………………………………………………………………………..
resident of ……………………………………………………………………………………………………. ………………………………….
………………………………………………………………………………………………………………….. @do hereby declare –
1. that the securities/sums, particulars of which are given below, stand in* my/our name and beneficially belong
to *me/us, and *the 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 section 60 to 64 of the Income tax Act, 1961 :

*Table I
Date on which Period for which
Name and address of the person to whom Amount of sums were given such sums were Rate of
the sums are given on interest such sums on interest given on interest Interest

*Table II
Class of units Distinctive Income
Name and address of the Number of
and face value numbers in respect
Mutual Fund units
of each unit of units of units

*Table III

Description of Number Date(s) of Amount of Date(s) on which the securities
securities of securities securities securities were acquired by the declarant

2. that *my/our present occupation is …………………………………………………………………………………………………….. ;

3. that the tax on *my/our estimated total income including the interest on securities, interest other than “interest
on securities” *and/or income in respect of units, referred to in paragraph 1 computed in accordance with the

provisions of the Income-tax Act, 1961, for the previous year ending on ………………………………………………. …….

relevant to the assessment year 200……………. – 200……………. will be nil;

3A.that *my/our income from *dividend/interest on securities/interest other than “interest on securities”/units/
amounts referred to in clause (a) of sub-section (2) of section 80CCA or the aggregate of such incomes, computed
in accordance with the provisions of the Income-tax Act, 1961, for the previous year ending on ……………………….
relevant to the assessment year 200……………. – 200……………. will not exceed the maximum amount which is
not chargeable to income-tax.
(P.T.O.)

———————– Page 2———————–

4. *that *I/We have not been assessed to income-tax at any time in the past but *I/we fall within the jurisdiction of

the Chief Commissioner or Commissioner of Income-tax ……………………………………………………………….. …….;
OR
that *I was/We were last assessed to income-tax for the assessment year 200……………………. – 200…………………….

by the Assessing Officer …………………………………………………. Circle / Ward / District and the permanent Account

number allotted to *me/us is …………………………………………………………..

**Signature of the declarant

Verification

*I/We, ………………………………………………………………………………………………………………………………………………….,
hereby declare that the contents of paragraphs 1 to 4 are true to the best of *my/our knowledge and belief and
nothing has been concealed therein.

Verified today, the …………………………….. day of …………………………….. 200…………………

Place : …………………………….

Signature of the declarant

Part II
[FOR USE BY THE PERSON TO WHOM THE DECLARATION IS FURNISHED]

1. Name and address of the person responsible for
paying interest on sums or income in respect of
units, as the case may be, mentioned in paragraph
1 of the declaration
2. Date on which the declaration was furnished by
the declarant ………………………………………………………………………………..
3. Period for which interest or income in respect of
units, as the case may be, is credited/paid ………………………………………………………………………… ……..
4. Amount of interest or income in respect of units,
as the case may be ………………………………………………………………………………..
5. 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, ………………………………………………………..

Place : ………………………………….

Date : ………………………………….
Signature of the person responsible for paying *interest on securities /
interest other than “interest on securities” / income in respect of units

Notes : 1. @ Give complete postal address.
2. The declaration should be furnished in duplicate
3. * Delete whichever is not applicable.
4. ** Indicate the capacity in which the declaration is furnished on behalf of a Hindu undivided family, association of persons, etc.
5. Before signing the verification, the declarant should satisfy himself that the information furnished in the declaration is true, correct
and complete in all respects.
6. Any person making a false statement in the declaration shall be liable to be prosecuted under section 277 of the Income-tax Act,
1961, and on conviction be punishable :-
(i) in a case where the amount of tax, which would have been evaded if the statement or account had been accepted as true,
exceeds one hundred thousand rupees, with rigorous imprisonment for a term which shall not be less than six months but
which may extend, to seven years and with fine;
(ii) in any other case, with rigorous imprisonment for a term which shall not be less than three months but which may extend to
three years and with fine.

 Advertisements

Review Form 15H Income Tax India Form

Name
Email
Review Title
Rating
Review Content

Form 15H Income Tax India Form Reviews

 Advertisements