Form 15CB:Certificate of an Accountant

Company Name(s): 
Documents: 

Form No. 15CB
(See rule 37BB)
Certificate of an Accountant

I/We have examined the agreement (wherever applicable) between
Mr./Ms./M/s……………………...........……(Remitters) …………………………………
and Mr./Ms./M/s ……………………………… (Beneficiary)…..............................................................
requiring the above remittance as well as the relevant documents and books of account
required for ascertaining the nature of remittance and for determining the rate of deduction
of tax at source as per provisions of Charter- XVII-B.
We hereby certify the following :-
AName and address of the beneficiary of the
remittance
B 1. Country to which remittance is made Country:_________ Currency:
2. Amount payable
_______________________________
In foreign currency :
__________________
In Indian
Rs.
3. Name of the bank
_______________________________
Branch of the bank
__________________
4. BSR Code of the bank branch (7 digit)
5. Proposed date of remittance
(DD/MM/YYYY)
6. Nature of remittance as per agreement/
document
7. In case the remittance is net of taxes,
whether tax payable has been grossed up?
(Tick) Yes No
Taxability under the provisions of the
Income-tax Act (without considering
DTAA)
(a) the relevant section of the Act under
which the remittance is covered
(b) the amount of income chargeable to tax
(c) the tax liability
8.
(d) basis of determining taxable income and
tax liability
If any relief is claimed under DTAA -
(i) whether tax residency certificate is
obtained from the recipient of remittance (Tick) Yes No
(ii) please specify relevant DTAA
(iii) please specify relevant article of
DTAA
Nature of payment as
per DTAA
9.
(iv) taxable income as per DTAA In Indian Rs. ____________
(v) tax liability as per DTAA In Indian Rs. ____________
A. If the remittance is for royalties, fee for
technical services, interest, dividend, etc.
(not connected with permanent
establishment) please indicate:-
(Tick) Yes No
(a) Article of DTAA
(b) Rate of TDS required to be deducted in
terms of such article of the applicable
DTAA
As per DTAA(%) ________
B. In case the remittance is on account of
business income, please indicate
(Tick) Yes No
(a) The amount of income liable to tax in
India
(b) The basis of arriving at the rate of
deduction of tax
C. In case the remittance is on account of
capital gains, please indicate:-
(Tick) Yes No
(a) amount of long term capital gains
(b) amount of short-term capital gains
(c) basis of arriving at taxable income
D. In case of other remittance not covered
by sub-items A, B and C
(Tick) Yes No
(a) Please specific nature of remittance
(b) Whether taxable in India as per DTAA
(c) If yes, rate of TDS required to be
deducted in terms of such article of the
applicable DTAA
(d) if not, the please furnish brief reasons
thereof specifying relevant article of
DTAA
10. Amount of TDS In foreign currency ________
In Indian Rs. _____________
11.Rate of TDS As per Income-tax Act (%)__
or
As per DTAA (%) ________
12.Actual amount of remittance after TDS In foreign currency ________
13.Date of deduction of tax at source, if any
(DD/MM/YYYY)
Certificate No.2
Signature : ________________________
Name: ___________________________
Name of the proprietorship/ firm :
_________________________________
Address : _________________________
Registration No. : __________________
1. To be signed and verified by an accountant (other than an employee) as defined in the Explanation below sub-section (2) of section 288 of the Income-tax Act, 1961.
2 Certificate number is an internal number to be given by the Accountant.
Delete whichever is not applicable.