Particulars to be furnished by the contractor under the third proviso to clause (i) of sub-section (3) of section 194C for the Financial Year_________ (Assessment Year) ______ (Omitted)

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..... [See sub-rule (3) of rule 29D] PARTICULARS TO BE FURNISHED BY THE CONTRACTOR UNDER THE THIRD PROVISO TO CLAUSE (i) OF SUB-SECTION (3) OF SECTION 194C FOR THE FINANCIAL YEAR . (ASSESSMENT YEAR . ) 1. Name of the person (contractor) : 2. Tax Deduction and Collection Account Number (TAN) : 3. Permanent Account Number (PAN) : .....

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..... 3. VERIFICATION I, , hereby certify that all the particulars furnished above are correct and complete. Place .. Date .....

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