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  • Form 10IA

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    manickam.ramlaksh
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    This medical certificate certifies that an individual named Shri/Smt./Ms. [Name] is a person with disability/severe disability suffering from autism/cerebral palsy/multiple disability. The condition is described as progressive, non-progressive, likely to improve, or not likely to improve. The certificate recommends or does not recommend reassessment of the individual's condition after a specified number of months or years. The certificate is signed and stamped by a neurologist, pediatric neurologist, civil surgeon, or chief medical officer.

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    Form 10A for Investment proof submission

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    This medical certificate certifies that an individual named Shri/Smt./Ms. [Name] is a person with disability/severe disability suffering from autism/cerebral palsy/multiple disability. The condition is described as progressive, non-progressive, likely to improve, or not likely to improve. The certificate recommends or does not recommend reassessment of the individual's condition after a specified number of months or years. The certificate is signed and stamped by a neurologist, pediatric neurologist, civil surgeon, or chief medical officer.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    231 views1 page

    Form 10IA

    Uploaded by

    manickam.ramlaksh
    This medical certificate certifies that an individual named Shri/Smt./Ms. [Name] is a person with disability/severe disability suffering from autism/cerebral palsy/multiple disability. The condition is described as progressive, non-progressive, likely to improve, or not likely to improve. The certificate recommends or does not recommend reassessment of the individual's condition after a specified number of months or years. The certificate is signed and stamped by a neurologist, pediatric neurologist, civil surgeon, or chief medical officer.

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    © All Rights Reserved
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    of 1

    FORM NO.

    10-IA
    [See sub-rule (2) of rule 11A]

    Certificate of the medical authority for certifying ‘person with disability’, ‘severe
    disability’, ‘autism’, ‘cerebral palsy’ and ‘multiple disability’ for purposes of section
    80DD and section 80U
    Certificate No.
    Date :

    This is to certify that Shri/Smt./Ms son/daughter of Shri , age


    years male/female* residing at , Registration No. is a person
    with disability/severe disability* suffering from autism/cerebral palsy/multiple disability*.
    2. This condition is progressive/non-progressive/likely to improve/not likely to improve*.
    3. Reassessment is recommended/not recommended after a period of
    months/years*.

    Sd/-
    (Neurologist/Pediatric Neurologist/Civil Surgeon/
    Chief Medical Officer*)
    Name :
    Address of Institution/Government hospital :

    Qualification/designation of specialist :

    SEAL

    Signature/Thumb impression* of the patient


    Note : *Strike out whichever is not applicable.

    Printed from www.incometaxindia.gov.in Page 1 of 1

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