Certificate under section 222 or 223 of the Income-tax Act, 1961

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..... ... ... 1. * This is to certify that a sum of Rs. has become due from you on .. in the status of details of which are given on the reverse. Whereas a certificate bearing Serial Number .. dated .. had been forwarded by the Tax Recovery Officer, . [name of the place], for the recovery of the sum of Rs. .....

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..... tice; (b) all costs, charges and expenses incurred in respect of the services of this notice and of warrants and other processes and all other proceedings taken for realising the arrears. SEAL . ... Tax Recovery Officer *Score out whichever paragraph is not applicable. DETAILS OF AMOUNT IN ARREARS Rupees .....

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..... 7. Any other sum (give details) 8. Interest u/s 220(2) from the day when amount became due 9. Total - Forms T .....

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