Statement to be furnished to the Assessing Officer desiginated under rule 12B of the Income-tax Rules, 1962, in respect of Income distributed by Mutual Fund (Omitted)

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..... tatement to be furnished to the Assessing Officer designated under rule 12B of the Income-tax Rules, 1962, in respect of income distributed by a Mutual Fund (Separate forms to be filled up for each scheme) 1. Name of the Mutual Fund and the address of registered office 2. Permanent Account Number 3. Previous year ending 4. Names and addresses of the trustees of the fund 5. Object .....

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..... Date(s) Amount(s) 13. Tax payable on income distributed to the Unit holders Enclose audited accounts including balance sheet, annual repor .....

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..... Signature-------------------- Verification I/We ------------------------------- have examined the books of account and other documents showing the particulars of income earned and the income distribute .....

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