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Quarterly statement of deduction of tax under sub-section (3) of section 200 of the Income-Tax Act, 1961 in respect of Payments other than Salary for the quarter ended June/September/December/March (tick whichever applicable) ....... (year)

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..... (d) Has the statement been filed earlier for this quarter (Yes/No) (e) If answer to (d) is Yes , then Token No. of original statement (f) Type of [Deductor/Payer] (See Note 2) 2. Particulars of the [Deductor/Payer] (a) Name (b) If Central/State Government Name (See Note 3) AIN Code of PAO/TO/CDDO (c) TAN Registration No. (d) Address Flat No. Name of the premises/building Road/Street/Lane Area/Location Town/City/District State PIN Code Telephone No. Alternate telephone No. (See .....

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..... 5. Details of amount paid and tax deducted thereon from the deductees and amount paid without deduction (see Annexure) Verification I,.........................................................................., hereby certify that all the particulars furnished above are correct and complete. ............................................................................................ Signature of the person responsible for deducting tax at source .............. .....

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..... Total tax to be allocated among deductees/payees as in the vertical total of Col. 421 Total interest to be allocated among the deductees/payees mentioned below Sl. No. Deductee /payee reference number provided by the deductor/ payer, if available Deduct ee/ payee code (01- Company 02- Other than comp any) PAN of the deductee / payee Name of the deduct ee/ payee Section code (See Note 16) Date of payme nt or credit (dd/mm/ yyyy) Amount paid or credite d Amount of cash withdrawal in excess of Rs. 1 crore as referred to in section 194N (in cases not covered by the first proviso or third proviso to section 194N) Amount of cash withdrawal which is in excess of Rs. 20 l .....

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..... [421] [422] [423] [424] [425] 1 2 3 .....

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..... .....

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..... deduction or lower deduction is on account of payment made to a person referred to in the fourth proviso to section 194 N or on account of notification issued under fifth proviso to section 194N. 11. Write O if no deduction is as per the provisions of sub-section (2A) of section 194LBA. 12. Write P if no deduction is on account of payment of dividend made to a business trust referred to in clause (d) of second proviso to section 194 or in view of any notification issued under clause (e) of the second proviso to section 194. 13. Write Q if no deduction in view of payment made to an entity referred to in clause (x) of sub-section (3) of section 194A. 14. Write S if no deduction is in view of the provisions of sub-section (5) of section 194Q. 15. Write U if the deduction is on higher rate in view of section 206AB for non-filing of return of income. 16. List of section codes is as under: Section Nature of Payment Section Code 192A Payment of accumulated balance due to an employee 192A 193 .....

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..... for professional service or royalty etc (@10%) 94J-B 194K Income in respect of units 94K 194LA Payment of Compensation on acquisition of certain immovable property 4LA 194LBA(a) Certain income in the form of interest from units of a business trust to a resident unit holder 4BA1 194LBA(b) Certain income in the form of dividend from units of a business trust to a resident unit holder 4BA2 194LB Income in respect of units of investment fund LBB 194LBC Income in respect of investment in securitization trust LBC 194N Payment of certain amounts in cash other than cases covered by first proviso or third proviso 94N 194N First Proviso Payment of certain amounts in cash to non-filers except in case of c .....

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..... f section 200 of the Income-Tax Act, 1961 in respect of Payments other than Salary for the quarter ended June/September/December/March (tick whichever applicable) ....... (year) ************ NOTES:- 1. For further amendment See Notification No. 95/2019 dated 06-11-2019 w.e.f. 01-09-2019 2. For further amendment See Notification No. G.S.R.858(E) dated 18-11-2019 3. For further amendment See NOTIFICATION NO. 43/2020 dated 03-07-2020 4. Substituted vide NOTIFICATION NO. 71/2021 dated 08-06-2021 5. Substituted vide NOTIFICATION NO. 67/2022 dated 21-06-2022 w.e.f. 01-07-2022 before it was read as, 4 [ See sections 192A, 193, 194, 194A, 194B, 194BB, 194C, 194D, 194DA, 194EE, 194F, 194G, 194H, 194-I, 194J, 194K, 194LA, 194LBA, 194LBB, 194LBC, 194N, 194-O, 194Q, 197A, 206AA, 206AB and rule 31A ] 6. Substituted vide NOTIFICATION NO. 67/2022 dated 21-06-2022 w.e.f. 01-07-2022 before it was read as, ANNEXURE: DEDUCTEE/PAYEE WISE BREAK UP OF TDS (Please use separate Annexure for each line-item in Table at Sl. No. 4 of main Form 26Q) Details of amount paid/credited during the quarter ended .. (dd/mm/yy .....

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..... 2] [423] [424] [425] 1 2 3 .....

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..... b-section (2A) of section 194LBA. 12. Write P if no deduction is on account of payment of dividend made to a business trust referred to in clause (d) of second proviso to section 194 or in view of any notification issued under clause (e) of the second proviso to section 194. 13. Write Q if no deduction in view of payment made to an entity referred to in clause (x) of sub-section (3) of section 194A. 14. Write S if no deduction is in view of the provisions of sub-section (5) of section 194Q.* 15. Write U if the deduction is on higher rate in view of section 206AB for non-filing of return of income*. 16. List of section codes is asunder: Section Nature of Payment Section Code 192A Payment of accumulated balance due to an employee 192A 193 Interest on securities 193 194 dividend 194 194A Interest other than interest on securities 94A 194B Winnings from lotteries and c .....

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..... Payment of certain sums by e-commerce operator to e-commerce participant 94O 194Q* Payment of certain sums for purchase of goods 94Q * Note:- In relation to section 194Q and section 206AB, the changes shall come into effect from 1st July, 2021. 7. Substituted vide NOTIFICATION NO. 28/2023 dated 22-05-2023 w.e.f. 01-07-2023 before it was read as, 5 [ [See sections 192A, 193, 194, 194A, 194B, 194BB, 194C, 194D, 194DA, 194EE, 194F, 194G, 194H, 194 -I, 194J, 194K, 194LA, 194LBA, 194LBB, 194LBC, 194N, 194-O, 194P, 194Q, 194R, 194S, 197A, 206AA, 206AB and rule 31A] ] 8. Substituted vide NOTIFICATION NO. 28/2023 dated 22-05-2023 w.e.f. 01-07-2023 before it was read as, 6 [ ANNEXURE: DEDUCTEE/PAYEE WISE BREAK UP OF TDS ( Please use separate Annexure for each line-item in Table at Sl. No. 4 of main Form 26Q ) Details of amount paid/credited during the quarter ended (dd/mm/yyyy) and of tax deducted at source BSR Code of branch/Receipt Number of Form No. 24G Date on which challan deposited/Transfe .....

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..... 3 Total .....

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..... Verification I, ........................................................................... , hereby certify that all the particulars furnished above are correct and complete. Place: .. .. Signature of the person responsible for deducting tax at source Date: .. . .. Name and designation of the person responsible for deducting tax at source Notes: 1. Write A if lower deduction or no deduction is on account of a certificate under section 197. 2. Write B if no deduction is on account of de .....

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..... 194 dividend 194 194A Interest other than interest on securities 94A 194B Winnings from lotteries and crossword puzzles 94B Proviso to section 194B Winnings from lotteries and crossword puzzles where consideration is made in kind or cash is not sufficient to meet the tax liability and tax has been paid before such winnings are released 94B-P 194BB Winnings from horse race 4BB 194C Payment of contractors and sub-contractors 94C 194D Insurance Commission 94D 194DA Payment in respect of life insurance policy 4DA 194EE Payments in respect of deposits under National Savings Schemes 4EE 194F Payments on account of repurchase of Units by Mutual Funds or UTIs 94F .....

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