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

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..... 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 ( .....

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..... tails of income distributed, tax and interest payable Income distributed Tax payable under section 115TA Interest chargeable under section 115TB, if any Payment towards 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** .....

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..... ________________ ___________________ Place Signature Verification I/We ________________________________________________ have examined the books of account and other documents showing the particulars of income earned and the income distributed to the investors by the ________________________________________ (name of the securitisation tr .....

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