FORM A
[See sub-paragraph (1) of paragraph 5]
(To be submitted in duplicate)
[Name of the Deposit Office]
Serial No.
Application for opening an account under the Capital Gains Accounts Scheme, 1988
To
The Manager
[Name and address of the Deposit Office]
I, [Name and address of the Applicant/ Depositor] aged years hereby apply for opening account-A and/ or account-B, under the Capital Gains Accounts Scheme, 1988 (in terms of section 54/ 54B/ 54D/ 54F/ 54G/ 54GB of the Act) in my name/ in the name of [Name of the depositor] of whom I am the guardian/ karta / authorised officer, and tender herewith the amount of Rs. in cash /by way of Crossed cheque/ Demand draft, towards deposit as per details below.
1. (a) Amount deposited
Rs. [in figures]
Rs. [in words]
in cash/by crossed cheque/Demand Draft No. dated drawn on
(b) Address of the depositor :
2. I wish to make a nomination in respect of the amount to my credit in the said account/
I do not wish to make a nomination in respect of the amount to my credit in the said account, at present.
3. (a) Applicant's relationship with the depositor [in case the depositor
is minor]:
(b) Whether applicant is natural guardian/ guardian appointed by
court, for the minor depositor
(c) Date of birth of minor:
4. Depositor's permanent I.T. Account No./ District/ Ward/ Circle/
Range where assessed
5. Previous year : From to month
[as applicable in case of the depositor]
6. Assessment year in respect of which deposit is to be made
7. (a) Whether deposit is to be made under account-A or account-B or
under account-A and account-B
(b) In case the deposit is to be made under account-A and account-B
(i) Amount to be deposited under account-A Rs. [in figures]
Rs. [in words]
(ii) Amount to be deposited under account-B Rs. [in figures]
Rs. [in words]
(c) In case of account-B
(i) period for which deposit is to be made
(ii) whether the deposit is made as cumulative/Non-cumulative :
[CGNS88;A,1]
Printed From Taxmann
FORM A - Page No
Signature/Thumb impression of the Depositor/of the
Guardian/Karta/Authorised Officer of the Depositor
Date :
Place : Additional specimen
Signature/Thumb impression of the eligible assessee as referred to in
section 54GB of the Act [applicable in case of section 54GB only]
FOR THE USE OF DEPOSIT OFFICE
1. (a) Account-A No. has been opened on with Rs. in the name of [Name of the depositor]
(b) Pass book No. has been issued to the applicant/ depositor.
2. (a) Account-B No. has been opened on with Rs. in the name of [Name of the depositor] as cumulative/ non-cumulative deposit.
(b) Deposit Receipt No. for Rs. dated has been delivered on to the applicant/ depositor.
3. Cheque No. dated for Rs. drawn on tendered by the applicant/depositor, has not been realised, hence account has not been opened.
Date :
Officer-in-charge
Notes :
1.Delete what is not applicable.
2. Option with respect to type of account/ accounts intended to be opened and amount to be deposited and other details (in case two accounts, i.e., account-A and account-B are to be opened) must be mentioned under the respective columns.
3.Nomination Form E must be submitted along with this application in case of individual depositor intending to make nomination otherwise, the applicant should delete the portion under column 2 of the form, whichever is not applicable.
4. Column 3 is for deposits made on behalf of a minor.
5. If space provided under the columns is not sufficient to furnish any detail, the same may be furnished by way of using separate enclosure and making reference of the same in respective columns.
[CGNS88;A,1]
Printed From Taxmann