FORM NO. 39
[See rule 54]
Form of application for registration as authorised income-tax practitioner

To
The Chief Commissioner or Commissioner of Income-tax,
…………………………
I hereby apply for registration as an authorised income-tax practitioner under clause (v)/(vi)/(vii) of section 288(2) of the Income-tax Act, 1961.
The following particulars are furnished herewith :-
1. Name in full [block letters]   
2. Father's name          
3. Permanent residential address          
4. Present residential address   
5. Professional address(es) in India      
6. Principal place of profession in India
7. If partner in a firm, name of the firm and other partners         
* I certify that I have passed the accountancy examination of (a true copy of the certificate enclosed)
* I certify that I have acquired the educational qualifications of (a true copy of the certificate enclosed)
* I certify that I was an income-tax practitioner within the meaning of clause (iv) of sub-section (2) of section 61 of the Indian Income-tax Act, 1922, and was actually practising immediately before 1st April, 1962, as such and some of the cases in which I appeared in that capacity are as below :

Name and address of assessee	Assessment year	Designation of the income-tax authority before whom appeared

I certify that I have been practising as an authorised income-tax practitioner since and that I have not so far made any application for registration as an authorised income-tax practitioner to any other Chief Commissioner or Commissioner of Income-tax.
 Signature
Verification
I, , do declare that what is stated in the above application is true to the best of my information and belief
Date                                                                                                                             Signature
*Delete inappropriate words.