Form No. 27A
Form for furnishing information with the statement of deduction/collection of tax at source (tick whichever is applicable) filed on computer media for the
period (From 01/07/2012 to 30/09/2012 )

1.		(a) Tax Deduction Account No.
(b) Permanent Account No.
(c) Form No.
2.	Particulars of the deductor/collector
(b) Type of deductor *
(a) Name
(d) Address
(c) Branch/division (if any)
Name of the premises/building
Flat No.
Area /Location
Road /Street /Lane
State
Town /City /District
Telephone No.
Pin Code
E-mail
(e) Assessment Year
(d) Financial year
(In case return/statement has been filed earlier)
(f) Previous receipt number
3.	Name of the person responsible for deduction/collection of tax
(a) Name
(b) Address
Name of the premises/building
Flat No.
Area /Location
Road /Street /Lane
State
Town /City /District
Telephone No.
Pin Code
E-mail
4.	Control totals
No. of deductee/party records
Sr. No.
Tax deducted/collection
Amount paid
Tax deposited (Total challan amount)
( Rs. )
( Rs. )
( Rs. )
1
5.	Total Number of Annexures enclosed
6.	Other Information
Verification
Place :
Date  :
Signature of person responsible for deducting/collecting tax at source
Name and designation of person responsible for deducting/collecting tax at source
Signature
* Mention type of deductor - Government or others
# dd/mm/yyyy :- date/month/year
I, MANOJ KUMAR GUPTA, hereby certify that all the particulars furnished above are correct and complete.
MUMN09518F
AABCN0161H
NYLON CARPET MFG CO (INDIA) PVT. LTD.
26Q
D-84
THANE BELAPUR ROAD
TURBHE
NAVI MUMBAI
 400705
Velvetcentre@hotmail.com
MANOJ KUMAR GUPTA
D-83

THANE BELAPUR ROAD
. ROAD
TURBHE
NAVI MUMBAI
 400705 
1986gupta@gmail.com
2012-2013
2013-2014
MANOJ KUMAR GUPTA
ACCOUNTANT
NAVI MUMBAI
11/10/2012
MAHARASHTRA
MAHARASHTRA
0
0
0
                      0
022 - 27614113
COMPANY
8149049867