FORM NO. 125 [See Rule 208 - Furnishing of declaration and evidence of claims by specified senior citizen under section 393(1) Table Sl. No. 8(iii)] Declaration to be furnished by Specified Senior Citizen for deduction of tax under Section 393(1) [Table: Sl. No. 8(iii)]
| Details of the specified senior citizen | ||||
|---|---|---|---|---|
| 1. | Name | (refer Note 1) | ||
| 2. | Address | (refer Note 2) | ||
| 3. | Permanent Account Number | |||
| 4. | Date of birth | |||
| 5. | Tax year | (refer Note 3) | ||
| 6. | Email id | |||
| 7. | Contact number | Country Code | Number | |
| 8. | Name of the Specified Bank | |||
| 9. | Name of Employer from which pension is drawn | |||
| 10. | Pension Payment Order (PPO) Number | |||
| 11. | Details of the Accounts maintained with the Bank: | |||
| Sl. No. | Account Number | Individual Account / Joint Account | ||
| 12. | Whether opting out of New Tax Regime under section 202? | (Yes/No) (refer Note 4) |
DECLARATION
I, … having Permanent Account Number ……. do hereby certify that the information given above is
complete and correct and that I do not have any income other than the income of the nature of pension and/or interest
which is received or receivable only in the account(s) of the specified bank stated above.
Date ………………………………. Signature of person
Place ……………………………… Name: ………………………………
Notes:
- In case of individual, the first, middle and last name shall be provided in full without any abbreviations.
- The address shall contain i. Country/Region, ii. Flat/Door/Block number iii. Road/Street/Block/Sector, iv. PIN/ZIP Code, v. Post Office, vi. Area/locality, vii. District, viii. State.
- Tax year means the tax year in respect of whose income, declaration is being made
- The deduction allowable and rebate allowable shall be in accordance with the new tax regime, unless the individual opts out of the said regime.