Income tax refund and affidavit

This query is : Resolved

Querist : Anonymous

Querist : Anonymous (Querist)

26 January 2013 Dear Sir,
Any one having Indemnity form for claim of income tax refund with affidavit,
Sir, Please send me rameshmba001@rediff.com
Thanking You.

Bhaskaran Chackrapani Warrier

Bhaskaran Chackrapani Warrier (Expert)
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26 January 2013
INDEMNITY BOND

I, B. Chakrapani Warrier,aged about 40 years, holder of PANo, ACPPC7018G, resident of XX/104, WARRIER NAGAR,KOCHI-682016 do hereby undertake to indemnify the President of India in respect of any loss which the Income Tax Department may incur, due to allowing me credit for Rs. 50,000/- being the amount of tax deduction at source as per the following details, on the basis of a duplicate certificate submitted by me before the Assessing Officer Circle / Ward 1, Cochin.

Deductor Date of TDS Amt.of TDS
..... ........ ......
..... ........ ......

I hereby affirm and declare that I have not made any other claim on the basis of the original TDS Certificate in respect of the above amount, nor shall I make any separate claim for the same in future. In case of Original TDS Certificate is found or traced in future, I undertake to surrender the same before my Assessing Officer.

Signature

Dated this the 26th day of January,2013

In the presence of Witnesses
1) ................ signature 2) ................ signature

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