FORM No.27C
[See rule 37C]
Declaration under subsection (1A) of section 206C of the Incometax Act, 1961 to
be made by a buyer for obtaining goods without collection of tax
PART I

2. PAN of the Buyer

(h) for Form No.27C, the following Form shall be substituted, namely :—
Place:
Date:
Place:
Date:
Notes:
1.
2.
3.
4.
5.
i)
ii)
Before signing the verification , the declarant should satisfy himself that the information furnished in the declaration is true, correct and complete in all respects.
Any person making a false statement in the declaration shall be liable to prosecution under 277 of the Incometax Act, 1961 and on conviction be punishable
[For use by the person to whom the declaration is furnished]
1=Company; 2=Firm; 3=AOP/BOI; 4=HUF; 5=Individual; 6=Others
Indicate the capacity in which the declaration is furnished on behalf of a HUF, AOP, firm, company, etc.
Delete whichever is not applicable.
The declaration should be furnished in duplicate.
In a case where tax sought to be evaded exceeds twentyfive lakh rupees, with rigorous imprisonment which shall not be less than 6 months but
which may extend to seven years and with fine;
In any other case, with rigorous imprisonment which shall not be less than 3 months but which may extend to two years and with fine.";
PART II
2. PAN of the Seller
4. TAN of the Seller
5. Email
Area Code
6. Telephone No. (with STD Code) and
Mobile No.
7. Status (choose among 1 to 6)
8. Date on which declaration is furnished (dd/mm/yyyy)
9. Date of debiting of the amount payable by the buyer to the account of the buyer or receipt of the amount payable from the buyer in cash or by issue of a
cheque or draft or by any other mode (dd/mm/yyyy)
Forwarded to the Chief Commissioner or Commissioner of Incometax…………………………………………………………
………………………………………………..

Declaration/Verification
I/We……………………………….do hereby declare that to the best of my /our knowledge and belief what is stated above is correct, complete and is truly stated. I
/we declare that the goods referred to in Column No. 21 shall not be used for trading purposes. I/We also, declare that I/we am/are resident in India within
the meaning of section 6 of the Incometax Act, 1961.
Signature of the Declarant
AO Type Range Code
……………………………………………….
Signatuer of the person responsible for
collecting tax at the time of the sale of the
goods referred to in column no. 21 of Part I.
……………………………………………………………
…………………………………………………………….
…………………………………………………………….
14. Email 15. Telephone No. (with STD Code) and
Mobile No.
7. Area/Locality
INFORMATION: BUYER
Manufacturing, processing , production of
articles or things
19. Nature of Business/Occupation
18. Jurisdictional Chief Commissioner of Incometax or Commissioner of Incometax (if
not assessed to Incometax earlier)
1. Name of the Seller
Generation of power
3. Complete address
Signature of the Declarant
………………………………………………..
………………………………………………..
AO No.
5.Status(choose among 1 to 6)
1. Name of Buyer (applicant)
6. Road/Street/Lane 9. AO Code (under whom assessed last time)
10. Town/City/District 11. State
12. PIN
"FORM No.27C
[See rule 37C]
PART I
8. Assessed in which Ward/Circle
2. PAN of the Buyer
Declaration under subsection (1A) of section 206C of the Incometax Act, 1961 to be made by a buyer for obtaining goods without collection of tax
3. Flat/Door/Block No. 4. Name of Premises
INFORMATION: GOODS
13. Last Assessment year in which assessed
16. Present Ward/Circle
17. Present AO Code(if not same as above)
Area Code AO Type Range Code AO No.
21. Nature of goods [refered to in the table in subsection(1) of section 206C]
20. Purpose of utilization of goods (tick the relevant box)