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Return of taxable securities transactions

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..... Receipt No. Date 2. Address of the stock exchange ………….. ……….. Seal and Signature of Receiving Official .....

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..... Total 7. Total securities transaction tax collectible CODE (Schedule) Amount (In Rs.) 01. (A[10]) 02. (A[11]) 03. .....

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..... Verification I, .............(full name in block letters), son/ daughter of .............. solemnly declare that to the best of my knowl edge and belief the information given in this return and schedules accompanying it is correct and complete and that the total value of taxable securities transactions and other particulars shown therein are truly stated and are in accordance with provisions of Chapter VII of the Finance (No. 2) Act, 2004 and Securities Transaction Tax Rules, 2004. I further declare that I am making this return in my capacity as ....................and I am also competent to make this return and verify it. Date .................. Place .................. .....

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..... being "futures", where the transaction of such sale is entered into in a recognised stock exchange. 05 Schedules-A Sl. No. Stock Under Code Trading Client Code Client Name PAN of Client MAPIN of Client Value of taxable securities transactions (In Rs.) Securities transaction tax collectible (In Rs.) Code 01 Code 02 Code 03 Code 01 Code 02 Code 03 1 2 3 4 5 6 7 8 9 10 11 12 Total .....

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..... (In Rs.) 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 Total Notes: 1. This Form must be used by a recognised stock exchange only. 2. Details required in Schedules A, B C may be furnished on computer media as specified in rule 7. 3. Details required in Schedules A B may be given sepa rately for each stock Broker Code and Clearing Member Code as the case may be. Particulars of Client Name, PAN and MAPIN of client should b .....

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