Full Name of Association of Persons / Trusts / Body of Individuals / Local Authority / Artificial Juridical Persons

Date of Trust Deed / Formation of Body of Individuals / Association of Persons

Attach Certificate of Formation of Body of Individuals / Association of Persons / Trust Deed

Office Address

Flat / Room / Door / Block No.

Name of Premises / Building / Village

Road / Street / Lane/Post Office

Area / Locality / Taluka/ Sub- Division

Town / City / District

State / Union Territory

Pin Code

Attach Office Address Proof

[group residence]

Residence Address

Flat / Room / Door / Block No.

Name of Premises / Building / Village

Road / Street / Lane/Post Office

Area / Locality / Taluka/ Sub- Division

Town / City / District

State / Union Territory

Pin Code/Zip Code

Attach Residence Address Proof

[/group]

Source of Income
—Please choose an option—SalaryCapital GainsIncome from Business / ProfessionIncome from Other sourcesIncome from House propertyNo income

[group business-type]

Business/Profession Type
01 Medical Profession and Business02 Engineering03 Architecture04 Chartered Accountant/ Accountancy05 Interior Decoration06 Technical Consultancy07 Company Secretary08 Legal Practitioner and Solicitors09 Government Contractors10 Insurance Agency11 Films, TV and such other entertainment12 Information Technology13 Builders and Developers14 Members of Stock Exchange, Share Brokersand Sub-Brokers15 Performing Arts and Yatra16 Operation of Ships, Hovercraft, Aircrafts orHelicopters17 Plying Taxis, Lorries, Trucks, Buses or otherCommercial Vehicles18 Ownership of Horses or Jockeys19 Cinema Halls and Other Theaters20 Others
[/group]

Telephone / Landline Number

Email

Mobile Number

Representative Assessee

Title —Please choose an option—Shri.Smt.Kumari

Last Name

First Name

Middle Name

Proof of Name(Representative Assessee)

Address-

Flat / Room / Door / Block No.

Name of Premises / Building / Village

Road / Street / Lane/Post Office

Area / Locality / Taluka/ Sub- Division

Town / City / District

State / Union Territory

Pin-Code/ Zip-Code

Mobile Number

Proof of Address(Representative Assessee)

Attach Signature (2X4.5 cms)

Your Message

I hereby hereby declare that what is stated above is true to the best of my/our information and belief

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