FORM NO. 15J
[See sub-rule (3) of rule 29D]
Particulars to be furnished by the Contractor under the third proviso to clause (i) of sub-section (3) of section 194C for the Financial Year________(Assessment Year_________)

1. Name of the person (contractor) :
2. Tax Deduction and Collection Account Number
(TAN)
:
3. Permanent Account Number (PAN) :
4. Address :
5. Details of the declaration furnished under the second proviso to clause (i) of sub-section (3)
of section 194C by the heavy goods carriage/truck owners:
S.
No.
Name of the
individual (heavy
goods
carriages/trucks
owner)
PAN
(wherever
the subcontractor
has quoted)
Address of the
subcontractor
Amount
paid or
credited
during the
year
Heavy goods
carriage/truck
Registration
Number
Date of
Registration
Verification
I,______________________________________________, hereby certify that all the particulars furnished above are correct and complete.
Place______________
Date______________
Signature of the person responsible for crediting/paying any sum to the subcontractor_____________