FORM NO. 143 [See Rule 219 - Statement of deduction or collection of tax at source under section 397(3)(b)[Table: Sl. No. 4]] Quarterly statement of collection of tax at source under section 397(3)(b) for the quarter ended………………………….. (June/September/December/March) ……………………….. (Tax Year)

Row No.Part A: Particulars of the Collector
1.Type of Collector Government
 Non-Government
2.Name(refer Note 1)
3.Address(refer Note 2)
4.Permanent Account Number(refer Note 3)
5.Tax Deduction and Collection Account Number
6.E-mail id
7.Contact NumberCountry CodeNumber
8.Tax year
9.Has the statement been filed earlier for this quarterYes/No
10.If answer to Row No. (9) is ―Yes‖, then Return Receipt Number
of original statement
11.If collector is Government Collector, please mention AIN of
PAO/DTO/CDDO code
Particulars of the person responsible for collection of tax
12.Name(refer Note 1)
13.Address(refer Note 2)
14.Permanent Account Number
15.E-mail id
16.Contact NumberCountry CodeNumber
Part B
1.Details of the tax collected and paid to the credit of the Central Government:
Sl.
No.
Total
Tax
(refer
Note
4)
Total
interest
Total
fee
(refer
Note
5)
Total
Penalty
/ Others
Total amount
deposited as
per challan /
Total amount
adjusted
through
Book
Adjustment
(B+C+D+E)
(refer Note
6)
Mode of
payment of
tax
(by way of
challan/by
way of
book
adjustment
(refer Note
7)
BSR
code/
Receipt
Number
of Form
No. 137
(refer
Note 8)
Date on which
amount
deposited
through
challan/ Date
of transfer
voucher
(dd/mm/yyyy)
(refer Note 8)
Challan
Serial
No. /
DDO
Serial
No. of
Form
No. 137
(refer
Note 8)
Minor
Head of
Challan
(refer
Note 9)
ABCDEFGHIJK
2.Details of amount received and tax collected thereon from the collectees (see Annexure)

DECLARATION I, ….. (name of the person responsible for collecting tax at source), having Permanent Account Number ……., am the person responsible for collecting tax at source in the case of …….. (name of the collector). I certify that all the particulars furnished above are correct and complete. Place: Signature of the person responsible for collecting tax at source: Date: Name:
Designation:
Notes:

  1. (a) 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. (b) ln case of Central Government, please mention name of Ministry/Department. In case of State Government, please mention name of the State.

  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. It is mandatory for non-Government collectors to quote Permanent Account Number. In case of Government col- lectors, Permanent Account Number should be mentioned as ―PANNOTREQD”.

  4. In column (B), total tax shall be sum of amount of tax collected, surcharge and health & education cess.

  5. Fee paid under section 427 for late filling of TCS statement to be mentioned in separate column of ‘Total Fee’ [col- umn (D)].

  6. In column (F), Government DDOs to mention the amount remitted by the PAO/CDDO/DTO. Other collectors to write the exact amount deposited through challan.

  7. In column (G), Government collectors to write “B” where TDS is remitted to the credit of Central Government through book adjustment. Other collectors to write ―C‖.

  8. Challan/Transfer Voucher (CIN/BIN) particulars, i.e. (H), (I) and (J) should be exactly the same as available at TIN 2.0/TRACES portal.

  9. In column (K), mention minor head as marked on the challan.

  10. Amounts to be filled in ₹ unless otherwise provided

ANNEXURE: COLLECTEES WISE BREAKUP OF TCS Details of amount received/debited during the quarter ended _____(dd/mm/yyyy) and of tax collected at source

Sl. N o.Challan Referen ce No. (Colum n A of Sl. No. I of Part B)Perman ent account numberNa meWheth er non- reside nt (Y/N)Collecte e code (applica ble where collectee is non- resident) (refer Note 8)Whether collectee has a permanent establishm ent in India (applicabl e where collectee is non- resident) (yes/No)Wheth er collect ee opting out of taxatio n regim e under sectio n 202(1) ?Amou nt receiv ed / Debite dDate on which amount received/ debited (dd/mm/yy yy)Collecti on Code (refer Note 9)Total tax collect ed (refer Note 10)
(A)(B)(C)(D)(E)(F)(G)(H)(I)(J)(K)(L)
Whether total amount of tax collected as mentioned in column (L) has been deposited (Yes/No)Total tax depositedDate of collection (dd/mm/yyyy)Rate at which tax collectedReason for lower collection/ collection at higher rate (refer Note 1 to 7)Certificate number of certificate issued under Section 395 - Certificates section 395(3) for lower collection of taxWhether the payment by collectee is liable to TDS as per Section 394 - Collection of Tax at Source section 394(5) and whether TDS has been deducted from such payment [if ―F‖ is selected in column (Q)] (Yes/No)If answer to (S) is yes, then
Challan
number
Date of
payment of
TDS to
Central
Government
(M)(N)(O)(P)(Q)(R)(S)(T)(U)

DECLARATION I, ….. (name of the person responsible for collecting tax at source), having Permanent Account Number ……., am the person responsible for collecting tax at source in the case of …….. (name of the collector). I certify that all the particulars furnished above are correct and complete.

Place: ….. Signa ture of the person responsible for collecting tax at source Date: ….. Name:
Designation:

Notes:

  1. Write “A” if “lower collection” is on account of a certificate under section 395(3).
  2. Write “B” if “non-collection” is on account of furnishing of declaration under section 394(2).
  3. Write “C” if collection is at higher rate under section 397(2) on account of non-furnishing of PAN.
  4. Write “F” if no collection is on account of section 394(5) or section 402(6) [Table: Sl. No. 4 and 5, Column D].
  5. Write ―K‖ if no collection as per the provisions of section 394(4).
  6. Write ―Y‖ if no collection is on account of receipt equal to or below threshold limit as specified in section 394(1) [Table: Sl. No. 7].
  7. Write ―Z‖ if no collection or lower collection is in view of notification issued under section 400(1).
  8. List of Collectee Codes:
Sl. No.StatusDescription
101Company
202Individual
303Hindu undivided family
404Association of Persons (AOP) except in case of AOP consisting of only companies as its
members
505Association of Persons (AOP) consisting of only companies as its members
606Co-operative society
707Firm
808Body of individuals
909Artificial juridical person referred to in clause (g) of sub-section (77) of section 2
1010Others
  1. Write collection code as mentioned below:
SectionNature of ReceiptPerson responsible for collectionSection code
394(1) [Table:
Sl. No. 1]
Sale of alcoholic liquor for human consumption.Seller1068
394(1) [Table:
Sl. No. 2]
Sale of tendu leavesSeller1069
394(1) [Table:
Sl. No. 3]
Sale of timber obtained under a forest leaseSeller1070
394(1) [Table:
Sl. No. 3]
Sale of timber obtained by any mode other than a forest leaseSeller1071
394(1) [Table:
Sl. No. 3]
Sale of any other forest produce (not being timber or tendu leaves)
obtained under a forest lease.
Seller1072
394(1) [Table:
Sl. No. 4]
Sale of scrap.Seller1073
394(1) [Table:
Sl. No. 5]
Sale of minerals, being coal or lignite or iron ore.Seller1074
394(1) [Table:
Sl. No. 6.D(a)]
Sale consideration exceeding threshold limit in case of sale of motor
vehicle
Seller1075
394(1) [Table:
Sl. No. 6.D(b)]
Sale consideration exceeding threshold limit in case of sale of wrist
watch
Seller1076
394(1) [Table:
Sl. No. 6.D(b)]
Sale consideration exceeding threshold limit in case of sale of art
piece such as antiques, painting, sculpture
Seller1077
394(1) [Table:
Sl. No. 6.D(b)]
Sale consideration exceeding threshold limit in case of sale of
collectibles such as coin, stamp
Seller1078
394(1) [Table: Sl. No. 6.D(b)]Sale consideration exceeding threshold limit in case of sale of yacht, rowing boat, canoe, helicopterSeller1079
394(1) [Table:
Sl. No. 6.D(b)]
Sale consideration exceeding threshold limit in case of sale of pair
of sunglasses
Seller1080
394(1) [Table:
Sl. No. 6.D(b)]
Sale consideration exceeding threshold limit in case of sale of bag
such as handbag, purse
Seller1081
394(1) [Table:
Sl. No. 6.D(b)]
Sale consideration exceeding threshold limit in case of sale of pair
of shoes
Seller1082
394(1) [Table:
Sl. No. 6.D(b)]
Sale consideration exceeding threshold limit in case of sale of
sportswear and equipment such as golf kit, ski-wear
Seller1083
394(1) [Table:
Sl. No. 6.D(b)]
Sale consideration exceeding threshold limit in case of sale of home
theatre system
Seller1084
394(1) [Table:
Sl. No. 6.D(b)]
Sale consideration exceeding threshold limit in case of sale of horse
for horse racing in race clubs and horse for polo
Seller1085
394(1) [Table:
Sl. No. 7.D(a)]
Remittance under the Liberalised Remittance Scheme of an amount
or aggregate of the amounts exceeding threshold limit for purposes
of education or medical treatment
Authorised
dealer
1086
394(1) [Table:
Sl. No. 7.D(b)]
Remittance under the Liberalised Remittance Scheme of an amount
or aggregate of the amounts exceeding threshold limit for purposes
other than education or medical treatment
Authorised
dealer
1087
394(1) [Table:
Sl. No. 8.D(a)]
Sale of ―overseas tour programme package‖ including expenses for
travel or hotel stay or boarding or lodging or any such similar or
related expenditure with amount or aggregate of amounts up to
threshold limit.
Seller1088
394(1) [Table:
Sl. No. 8.D(b)]
Sale of ―overseas tour programme package‖ including expenses for
travel or hotel stay or boarding or lodging or any such similar or
related expenditure with amount or aggregate of amounts above
threshold limit.
Seller1089
394(1) [Table:
Sl. No. 9]
Use of parking lot for the purpose of business, excluding mining and
quarrying of mineral oil (including petroleum and natural gas).
Seller1090
394(1) [Table:
Sl. No. 9]
Use of toll plaza for the purpose of business, excluding mining and
quarrying of mineral oil (including petroleum and natural gas).
Seller1091
394(1) [Table:
Sl. No. 9]
Use of mine or quarry for the purpose of business, excluding mining
and quarrying of mineral oil (including petroleum and natural gas).
Seller1092
  1. In column (L), total tax deducted shall be sum of amount of tax collected, surcharge and health & education cess.
  2.   Amounts to be filled in ₹ unless otherwise provided.