FORM No. 49C
[See rule 114DA]
Annual Statement under section 285 of the Income-tax Act, 1961
Sl No.
1. Financial Year for which the Statement is being submitted
2. Name and Principal Address of the non-resident person in India
3. Head Office Address of the non-resident person
4. Permanent Account Number (if Allotted)
5. Tax Identification No., if any, of country of Incorporation or residence
6. Liaison Office (L.O.) Registration No. granted by RBI
7. Nature of activities undertaken by L.O.
8. Date of opening of L.O. in India
9. Date of RBI approval for L.O. opening
10. Address of L.O./L.O.s in India
11. Date of submitting Annual Activity Certificate (AAC) for the Financial Year to RBI
12. Name, address and Membership No. of the Chartered Accountant signing the Annual Activity Certificate (AAC) as prescribed by RBI
13. India specific financial details for the financial year i.e., receipts, income and expenses of the non-resident person from or in India (not only of the L.O.)
14. Details of all purchases, sales of material, and services from/to Indian parties during the year by the non-resident person (not limited to transactions made by L.O.)
15. Name & Designation of Officer In charge for each Office of the non-resident person in India
16. Details of any salary or compensation of any sort payable outside India to any employee working in India or for services rendered in India
17. Total Number of employees working in the LO/L.O.s during the year. Particulars of employees drawing salary of Rs. 50,000 or above per month specifying their Name Designation and sitting location
18. Details (with complete addresses Including PAN) of agents/representative/distributors of the non-resident person in India.
19. Names & addresses of the top five parties in India with whom the L.O. has been doing the liaisoning
20. Details of Products or services for which liaisoning activity is done by the L.O.
21. Details of any other entity (including PAN, if any) for which liaisoning activity is done by the L.O.
22. Details of Group entities (with addresses and PAN, if any) present in India as Branch Office/Companies/LLPs etc., incorporated in India and nature their business activities.
23. Details (with addresses) of other L.O.s of the Group entities in Idi
24. Other Group entities operating from the same premises as the office of the L.O.
VERIFICATION
I, ……… [full name in block letters] …………………… son/daughter of …………………………………… holding Permanent Account Number ……………………………………… solemnly declare that to the best of my knowledge and belief, the information given in the form is correct and complete and that the other particulars shown therein are truly stated. I further declare that I am submitting this form in my capacity as ………………….…… and I am also competent to make this submission and verify it.
Verified today the ………………………… day of ……………………….…
Place
Signature of Authorised Signatory
Name …………………………..…
[ITR62;49C,1] Printed from