FORM NO. 133 [See Rule 215 - Certificate of tax deducted or collected at source to be furnished under section 395(4)[Table: Sl. No. 4]] Certificate under section 395(4) for tax collected at source PART A

Certificate No.Last updated on
Row
No.
Details of the collector
1.Name(refer Note 1)
2.Address(refer Note2)
3.Permanent Account Number
4.Tax Deduction and Collection Account Number
5.Email id
6.Contact numberCountry CodeNumber
7.Tax year
8.Quarter of tax year
Details of the collectee
9.Name(refer Note 1)
10.Address(refer Note2)
11.Permanent Account Number

PART B

Summary of receipt
Sl. No.Amount received/debitedNature of receiptDate of receipt/debit
(dd/mm/yyyy)
Total
Summary of tax collected at source in respect of the collectee
QuarterReceipt Numbers of original
quarterly statements of TCS under
Section 397 - Compliance and Reporting section 397(3)(b)
Amount of tax
collected
Rate at which tax
is collected at
source
Amount of tax
deposited/adjusted
PART C
I. Details of tax collected and deposited in the central government account through book adjustment
(The Collector to provide payment wise details of tax collected and deposited with respect to the collectee)
Sl. No.Tax deposited
(refer Note 5)
Book Identification Number (BIN)
Receipt numbers
of Form No. 137
DDO serial
number in Form
No. 137
Date of Transfer
voucher
(dd/mm/yyyy)
Status of Matching
with Form No. 137
Total
II. Details of tax collected and deposited in the central government account through challan
(The Collector to provide payment wise details of tax collected and deposited with respect to the collectee)
Sl. No.Tax deposited
(refer Note 5)
Challan Identification Number (CIN)
BSR Code of the
Bank Branch
Date on which
tax deposited
(dd/mm/yyyy)
Challan Serial
Number
Status of matching
with TIN 2.0
Total

DECLARATION I, …………….., (name of person responsible for collection of tax)…………. having Permanent Account Number
…… working in the capacity as ……. (designation) of ………. (name of the collector) do hereby certify that a sum of ₹ ………….. [₹…………(in words)] has been collected and deposited to the credit of the Central Government.
I further certify that the information given above is true, complete and correct and is based on the books of account, documents, TCS statements, TCS deposited and other available records.

Place: Signature of person responsible for collection of tax
Date: Name:
Designation:
Notes:

  1. In case of individual, the first, middle and last name shall be provided in full without any abbreviations. In any other case also, name shall be provided in full.
  2. 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.
  3. Government collectors to fill information in item I of Part C if tax is paid without production of an income-tax challan and in item II of Part C if tax is paid accompanied by an income-tax challan.
  4. Non-Government collectors to fill information in item II of Part C.
  5. In Part B, items I and II, in column for tax deposited, sum of tax collected, surcharge and health & education cess shall be provided.
  6. Some of the information in the Form would be pre-filled to the extent possible.
  7. Amounts to be filled in ₹ unless otherwise provided.