FORM NO. 27B
[See rule 37EA]
Form for furnishing information with the return of collection of tax at source filed on computer media

DETAILS OF THE PERSON BEING A SELLER, COLLECTING THE TAX

Tax Deduction Account Number

Permanent Account Number

Name of the seller

Address of seller

Telephone No.

Fax No.

DETAILS OF THE PERSON RESPONSIBLE FOR COLLECTION OF TAX AT SOURCE

Name

Designation

Address

Telephone No.

Fax No.

OTHER INFORMATION [Please give the complete information]

* Return Form No.

Period ending

Assessment year

Periodicity

Media used for the return

Total number of computer media enclosed

Whether existing tax deducted at source/tax collected at source assessee (Y -Yes N-No)

A.O. Code

CONTROL TOTALS

S. No.

Control Total required for Form Nos. 27EA, 27EB, 27EC and 27ED

TOTAL

1.

Gross amount debited to/received from companies

2.

Gross amount debited to/received from non-companies

3.

Total amount of tax collected from companies at prescribed rates

4.

Total amount of tax collected from non-companies at prescribed rates

5.

Total number of persons from whom tax was collected

Place :

Name and signature of the person responsible for collecting tax at source

Date :

Verification
I,              , certify that all the particulars furnished above and in the enclosed computer media are correct and complete. 

Place
	Name and signature of the person responsible for collecting tax at source
Date	Designation

Note : *Indicate the appropriate Form No.