Form 27E:Annual return of collection of tax under section 206C of I.T. Act,1961 in respect of collections

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FORM NO. 27E
[See section 206C and rule 37E]
Annual return of collection of tax under section 206C of I.T. Act, 1961 in respect of collections for the period ending_____________

1. Particulars of seller
(a) Name of Seller
(b) Address
Flat/Door/Block No.
Name of Premises/Building
Road/Street/Lane
Area/Locality
Town/City/District
State
PIN
(c) TAN
(d) PAN
2. Has address of the seller changed1 Tick b as applicable Yes No
3. (a) Please tick the boxes below indicating the collection made during the year from which tax was required to be collected at source by you under the Income-tax Act, 1961.
(i) Alcoholic liquor for human consumption
(ii) Timber obtained under a forest lease
(iii) Timber obtained by any mode other than under a forest lease
(iv) Any other forest produce not being timber or tendu leaves
(v) Scrap
(vi) Parking lot
(vii) Toll plaza
(viii) Mining and quarrying
(ix) For Tendu leaves
(b) Please furnish information in separate Annexures as per the enclosed proforma for each type of collection indicated in item (a) above
4. Details of tax collected and paid to the credit of the Central Government