Statement to be furnished in respect of income distributed by a securitization trust (Omitted)

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..... istributed by a securitisation trust 1. Name of the securitisation trust 2. Address of the principal place from where the activities of the securitisation trust are being carried out 3. Permanent Account Number 4. Previous year ending 5. Date of setting up of the securitisation trust (DD/MM/YYYY) 6. Objects of the securitisation trust (Enclose a copy of the trust deed) 7. Whether the sec .....

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..... ards tax and interest under section 115TB (Attach a copy of challans) Sl. No. Date Of distribution Amount Date of payment Amount Exempt investors* Individuals/ HUFs** Any other person*** Total Enclose audited accounts including balance sheet, annual report, if any, with certified copies of income and appropriation towards distribution of income. I, __________________________ .....

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..... e distributed to the investors by the ________________________________________ (name of the securitisation trust) for the previous year ending ________________________. 2. I/We declare that the above particulars are true and correct to the best of my/our knowledge and belief. _________________ ________________________________ Place (Signature with name of the Accountant) Date ____________ Not .....

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