FORM NO. 5B
[See rule 8B]

Application for notification of a zero coupon bond under clause (48) of section 2 of the Income-tax Act, 1961

1. Name of the applicant
2. Category (Please tick one): Infrastructure capital
company/Infrastructure capital fund/Public
sector company
3. Address of the applicant
4. Permanent Account Number of the applicant
5. Assessing Officer under whose jurisdiction
the applicant is assessed/assessable to
income-tax
6. Date of incorporation/registration (Please
enclose copy of certificate of
incorporation/registration)
7. Objects of the applicant (Please enclose copy
of Memorandum/Trust deed, etc.)
(a) main objects
(b) ancillary objects
8. The total number of bonds proposed to be
issued
9. Amount for which the bond is proposed to be
issued
10. Amount payable on maturity/redemption of
the bond
11. Discount [(10) - (9)]
12. Period of life of the bond
13. The period during which the bonds are to be
issued.
14. The objects of issue of the bonds
15. In case of infrastructure capital company or
infrastructure capital fund—
(a) the name of enterprise or enterprises or
undertaking or undertakings in which
investment is proposed to be made;
(b) nature of business carried on by the
enterprise or enterprises or undertaking or
undertakings referred to in (a);
(c) whether the enterprise or enterprises or
undertaking or undertakings referred to in (a)
is, for the time being, approved under clause
(23G) of section 10, if yes, please attach copy
of the approval;
(d) whether approval referred to in (c) is for
any particular amount of investment/cost of
project, if yes, furnish the details thereof.
16. In case of public sector company—
(a) the nature of business;
(b) in case investment is proposed to be made
in the business of the company, please furnish
details thereof;
(c) in case investment is proposed to be made
with another public sector company or public
sector companies or enterprise or enterprises
or undertaking or undertakings, please furnish
the details thereof;
(d) nature of business carried on by the public
sector company or public sector companies or
the enterprise or enterprises or undertaking or
undertakings referred to in (c);
(e) whether the enterprise or enterprises or
undertaking or undertakings referred to in (c)
is, for the time being, approved under clause
(23G) of section 10, if yes, please attach copy
of the approval;
(f) whether approval referred to in (e) is for
any particular amount of investment/cost of
project, if yes, furnish the details thereof.
17. Location of project/projects in which
investment is proposed to be made.
18. Approximate year-wise investment required
to be made.
19. Sources of investment (other than the bonds),
if any.
20. Schedule of development of project/projects :
(a) planned date of commencement
(b) planned date of commencement of
operations of the project.
21. Details of management responsible for
execution of project:
(a) name of directors, trustees, etc., with their
experience, qualifications and performance.
(b) name of other key personnel with their
qualification and experience.
(c) organisational structure.
(d) particulars of Asset Management
Company in case of a fund.
22. Copy of the project report, if any
(Write “not applicable” against the column or columns which are not relevant to the applicant.)
I certify that the information furnished above is true to the best of my knowledge and belief. I undertake on behalf of (write the name of the applicant) that the
money realised on issue of such bond shall be invested in accordance with clause (iv) or clause
(v) of sub-rule (3) of rule 8B of the Income-tax Rules, 1962.
Signature of the authorised signatory
Note : The application form (in duplicate) should be sent to the Board by the applicant alongwith
the documents as required in the application form.