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Form 49b - Form Of Application For Allotment Of Tax Deduction And Collection Account Number Under Section 203a Of The Income Tax Act, 1961 Page 3

(g) Firm / Association of Persons / Association of Persons (Trusts) / Body of Individuals / Artificial

Juridical Person (See Note 3) :

Name

(h) Branch of Firm / Association of Persons / Association of Persons (Trusts) / Body of Individuals /

Artificial Juridical Person:

Name of Firm / Association of Persons / Association of Persons (Trusts) / Body of Individuals / Artificial

Juridical Person:

Name/Location of branch

2 Address

Flat / Door / Block No.

Name of Premises / Building / Village

Area / Locality / Taluka / Sub-Division

Town / City / District

State / Union Territory

PIN code

Telephone No.

STD Code

e-mail IDs

3 Nationality of Deductor (Tick the appropriate entry)

Indian

Foreign

4 Permanent Account Number (PAN) - (specify wherever applicable)

5 Existing Tax Deduction Account Number (if any)

6 Existing Tax Collection Account Number (if any)

7 Date (DD-MM-YYYY)

Signed (Applicant)

*I/We,

in my/our capacity as

do hereby declare that what is stated above is true to the best of my/our knowledge and belief.

Verified today the

d d

m m

y y y y

(Signature/Left Thumb Impression of Applicant)

Notes :

1 This column is applicable only if a single TAN is applied for the whole company. If separate TANs are applied for

different divisions / branches, please fill details in (d).

2 For branch of Individual business/Hindu Undivided Family, please fill details in (f).

3 For branch of firm/Association Of Persons/Association Of Persons (Trust)/Body Of Individuals / Artificial

Juridical Person, please fill details in (h).

4* Delete whichever is inapplicable.

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Form 49b - Form Of Application For Allotment Of Tax Deduction And Collection Account Number Under Section 203a Of The Income Tax Act, 1961 Page 3