[see secon 197A}, 19714 andre 28¢) Dedratin unde section 178} and section 1978/1) f the ncame-ta Ae, 9611 be make by anni peso no bung # company eran recaps hou econ of fem) aiming aT emronas te onat aera bear aa cea oer =a Tapa eenoaeare fi Meamaa See face foe a 2. sims otis am Te ouren Terie ao ase herein bol Singers roma leredorh Seas] Invest on seus refered won Shea] ET Inert on sums referedoin Sees] CT Tree form uns refered ton Schedule 1 “Tasers of tiara taro Tom secon BOCA] Tom Ros au.ngs Scere refered a Sede | — ET 3. Emad lana lhe arevous eon whieh income mentioned in Col 7st bein 24, betas of vesteentsinrespet of whi the detaration ing made soHDULE! Det of shares, whch standin the ame fhe declan and ential owned by) ea aoe | Ton [oovaesrecs [2234] oyncenmier fess | onablonseh naw wes byte share tater _declarant(da/mm/yyyy) ona ota sets inl hee Sad eon in eaten |mturetartes| anometevaes | 2 pons oh scrterwe ‘ne matin then ae) (Betas one sums gen bythe cebrart on terest oreandadsssotie [mews] oasonahihsnesmeesienon | faiosarwhcrsimawere | seo senantowtontieansae |i pron imeem renonice | wen (oasis enema nd ntsned inte af decd bere owen) mutual fund units unit Dative number of units units (ota whoa nae oars Sg Sree reve one Po oe tree counter ates Snesebme | Oneonsiehthencune | steamourt et irene sorbet sesopeneiso|"e amet Pinta from wuw.incometaxindia.gov.in Page 1 of 2“sirature of he Decarant Decratin/Verteation spe. ta hereby care tat tthe bes of your knawge and bf what stated above correc, oles and itt. We eclr that the incomes refer to thor ar ot dude th total nore of any the pean Us 60 64 of the cometax At 195, Werther, felr that he ox “onmy/ourestmatd tl noms, nclung“incomelincores refered in Colum 2 abo, cmputeu naccoreaes we the prove ‘fee ncome tax Act 1961, fr the prevous yer endo reevaniothe assesment yer we i *YWe as, dedare tat our SSncre/ncmes rere an olen 2 or the pres yr ong on ratte sa yt ve not ec the mma amount schist chargeable to incone tax. [forue bythe persona whom he dean fund [Name af the person retpoleorpaingteineome fered ion Cla 7 oF ar 2 PAN ofthe pean ndeted Coun ova T 1 Comptes arene {TaN of a pon inated Car ToT PoR 5 Ena Js Teleshone We wi ST Cod) and Wabie No, : i Oat on whic Dedbratinisfurshed | Pesodim espe of which the didn hasbeen [10 Ameuntaincone pad i Oieon wit come (sare [dedsred othe income har ben pagers ese iz bate of elation, dtribvon o payment of dvaerdwarawalunder tne ]13 Account Numba of Naonal aur Sehr Fam whic whan ha ational Soins eters scene Frade tte chef Commision or Commissioner fname — sienture cf te person esponsblefor Eolonn 2 of Pat ‘Raraion canbe urban ini nde satin 257A a urn ata than comp iusto ABA) ‘Before signing the declration/verifeaton, the declarant should sais himself ha the information arsed in this fourn iste, covrect ad complete i al rerpet Ary prea natn ste aterint in the decraton shal te abi precaton under 27 fhe nce nt et 396] and on conn be 1 Ina case whore a sought tobe vadederoeds wont fel ups, with igorous imprisonment which sal nt bees than 6 months bu whieh ay exten ta seven eos and with ine 1) many ther ce, wth grous imprisonment wich nal ot be ls thn 3 monte bt whch ay extent two yeas an wth ne “Te peson espns or oan the income fered on conn 220 Pr hl ot cept the Gcaratin where he amount ol ncome ofthe nature eee toinaub ection (] or sub serion (0) oftetan 1978 or the agsegt fhe aout of such nome ceed or pd racy tbe reed pie ag he Previous ein whch such incomets tobe nuded exceeds the masimum amount which ot hagenle toto Pinta rom wuw.incometaxinda.gov.in Page 2 of 2