Form 15CA - Filed Form

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FORM NO.

15CA [See rule 37BB]


Information for payment to Non-Resident

Information to be furnished for payments to a non-resident not


being a company, or to a foreign company

Part D
To be filled up if the remittance is not chargeable to tax under the provisions of the Income-tax Act,
1961 {other than payments referred to in rule 37BB(3)} by the person referred to in rule 37BB(2)
Remitter (Sender) Details

Name of the remitter NSL TEXTILES LIMITED

PAN of the remitter, if available AABCJ1299A

Status of remitter Company

Residential status of remitter Domestic company

TAN of the Remitter -

Address EMGEE HOUSE,3RD FLOOR,


4TH LINE, GUNTUR, Guntur,
Chandramoulinagar S.O, Andhra
Pradesh, INDIA - 522007

Email ID [email protected]

Phone Number 9581412111

Remittee (recipient) Details

Name of recipient of remittance MRS. GAYATRI RATHO JINDEL

PAN of the recipient of remittance, if available -

Address 2, SIMS CLOSE, # 2-14,


SINGAPORE, SINGAPORE,
SINGAPORE, SINGAPORE,
Singapore - 387298

Email ID -

Phone Number -

Country to which remittance is made Country Singapore

Currency US Dollar

Country of which the recipient of remittance is resident, if available Singapore


Remittance (Fund transfer) Details

Amount payable in foreign currency 3,488.64

Amount payable in Indian Currency ₹ 2,56,947

Name of the Bank CANARA BANK

Name of the branch of the bank BANGALORE CORPORATE


SERVICE BR

BSR code of the bank branch (7 digit) 5600151

Name of the authorized dealer Canara Bank

Branch Address of the authorized dealer International Division, Maker


Chambers III, 7th Floor, Nariman
Point, Mumbai 400 021

Proposed date of remittance 17-Sep-2021

Nature of remittance Commission

Please furnish the relevant purpose code as per RBI Other Business Services
S1020 - Commission agent
services

2. I certify that I have reason to believe that the remittance as above is not chargeable under the provision of
Income-tax Act 1961 and is not liable for deduction of tax at source.
Verification
I, MANDAVA CHOWDARY, son/daughter of PRABHAKAR RAO in the capacity of MANAGING DIRECTOR solemnly
declare that the information given above is true to the best of my knowledge and belief and no relevant information
has been concealed. In a case where it is found that the tax actually deductible on the amount of remittance has
not been deducted or after deduction has not been paid or not paid in full, I undertake to pay the amount of tax not
deducted or not paid, as the case may be, along with interest due. I shall also be subject to the provisions of
penalty for the said default as per the provisions of the Income-tax Act, 1961. I further undertake to submit the
requisite documents for enabling the income-tax authorities to determine the nature and amount of income of the
recipient of the above remittance as well as documents required for determining my liability under the income-tax
Act as a person responsible for deduction of tax at source.

Place 182.72.150.14

Date 16-Sep-2021

Name of the person responsible for paying to non-resident MANDAVA CHOWDARY

Designation MANAGING DIRECTOR

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