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Statement of income paid or credited by investment fund to be furnished under section 115UB of the Income-tax Act, 1961

Income Tax - 64D - FORM NO.64D [See Rule 12CB (1)(ii)] 1. Name of the Investment Fund: 2. Address of the registered office: 3. Legal status: [company/trust/limited liability partnership; body corporate] 4. Permanent Account Number: 5. Previous year e .....

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tive Investment Funds) Regulations, 2012: (ii) If Yes, furnish following details: (a) Whether registered as Category I/II (b) Registration number (c) Date of registration 8. Total Income of Investment Fund: 9. (i) Details of losses of the previous ye .....

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ired to be set off against the income of the previous year in accordance with clause (i) of sub-section (2) of section 115UB: S.No. Head of Income Amount of loss Amount set off in current year Amount to be carried forward (1) (2) (3) (4) (5) (iii) Ag .....

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ncome under head 'Capital Gain': S.No. Category Amount Proportion (Column 3/Amount at 9(iii) above] (1) (2) (3) (4) 1 Long Term Capital Gain referred to in Section 10(38) 2 Long Term Capital Gain [Others] 3 Short Term Capital Gain [To which S .....

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ails of person being a unit holder, referred to in sub-section (1) or section 115UB by whom the income is received or in whose name it has been credited: S. No. Name of Unit Holder Address PAN Total amount paid/ credited/ Deemed to be credited Income .....

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Referred to in Section 10(38) [Column 5 x Column 4(1) of Table at s.no.9(v)] Others [Column 5 x Column 4(2) of Table at s.no. 9(v)] To which Section 111A applies [Column 5 x Column 4(3) of Table at s.no.9(v)] Others [Columns 5 x Column 4(4) of Table .....

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ate of registration under Securities and Exchange Board of India (Alternative Investment Funds) Regulations, 2012. Attach audited accounts including balance sheet, annual report, if any, with certified copies of income and appropriation towards payme .....

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________________ do hereby solemnly declare that to the best of my knowledge and belief what is stated above and in the Annexure(s), including the documents accompanying such Annexure(s), is correct and complete. I further declare that I am furnishin .....

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