FORM NO. 34
[See rule 43]
Exemption certificate under proviso to section 230(1) of the Income-tax Act, 1961
Certificate No..
GOVERNMENT OF INDIA
1. Full name (in block letters)
2. Name of father (or husband)
3. Passport No./Emergency Certificate No.
This is to certify that the abovementioned applicant who intends to travel abroad is exempted from producing a Clearance Certificate under section 230(1) of the Income-tax Act, 1961 (43 of 1961), in respect of the journey/journeys to be undertaken on or after and before
Place………………..
Date………………… Assessing Officer
Foreign Section
(SEAL)