Annexure-1
FORM NO. 15G"
[See section 197A(1), 197A(1A) and rule 29C]
Declaration under section 197A (1) and section 197A (1A) to be made by an individual or a person
(not being a company or firm) claiming certain incomes without deduction of tax.
PART I
1. Name of Assessee (Declarant) 2. PAN of the Assessee 1
3. Status2 4. Previous year(P.Y.) 3 (for which 5. Residential Status4
declaration is being made) : 2025-26
6. Flat/ Door/ Block No. 7. Name of Premises 8. Road/Street/Lane 9. Area/ Locality
10. Town/City/ District 11. State 12. PIN 13. Email
14. Telephone No. (with STD 15 (a) Whether assessed to tax under the Income-tax Act, 19615 :
Code) and Mobile No. Yes No
Kindly fill
(b) If yes, latest assessment year for which assessed estimated total
income for FY
16. Estimated income for 17. Estimated total income of the P.Y. in which income mentioned 2025-26
which this declaration is in column 16 to be included6
made
18. Details of Form No. 15G other than this form filed during the previous year, if any'
Total No. of Form No. 15G filed Aggregate amount of income for which Form No.15G filed
19. Details of income for which the declaration is filed
SI. Identification number of relevant Nature of income Section under Amount of income
No. investment/account, etc." which tax
is deductible
1
Please
sign here
…………………………..
Signature of the Declarant9
Declaration/Verification10
*I/We.................................... do hereby declare that to the best of *my/our knowledge and belief what
is stated above is correct, complete and is truly stated. *I/We declare that the incomes referred to in
this form are not includible in the total income of any other person under sections 60 to 64 of the Income-
tax Act, 1961. *I/We further declare that the tax *on my/our estimated total income including *income/
incomes referred to in column 16 *and aggregate amount of *income/ incomes referred to in column 18
computed in accordance with the provisions of the Income-tax Act, 1961, for the previous year ending on
March 31, 2026 relevant to the assessment year 2026-27 will be nil. *I/We also declare that *my/our
*income/ incomes referred to in column 16 *and the aggregate amount of *income/ incomes referred to in
column 18 for the previous year ending on March 31, 2026 relevant to the assessment year 2026-27 will
not exceed the maximum amount which is not chargeable to income-tax.
Please
sign here
Place: ..................................................... …………………………..
Signature of the Declarant9
Date: ...................................................... ..
PART ll
[To be filled by the person responsible for paying the income referred to in
column 16 of Part I]
1. Name of the person responsible for paying : 2. Unique Identification No.11
3. PAN of the person 4. Complete Address : 5. TAN of the person
responsible for paying responsible for paying
6. Email 7. Telephone No. (with STD 8. Amount of income paid12
Code) and Mobile No.
9. Date on which Declaration is 10. Date on which the income has been paid/
received (DD/ MM/YYYY) credited (DD/ MM/YYYY)
Place: ......................................................
Signature of the person responsible for paying the
Date: ...................................................... income referred to in column 16 of Part I
*Delete whichever is not applicable.
1As per provisions of section 206AA(2), the declaration under section 197A(1) or 197A(1A) shall be invalid if the
declarant fails to furnish his valid Permanent Account Number (PAN).
2 Declaration can be furnished by an individual under section 197A(1) and a person (other than a company or a
firm) under section 197A(1A).
3The financial year to which the income pertains.
4Please mention the residential status as per the provisions of section 6 of the Income-tax Act, 1961.
5 Please mention "Yes" if assessed to tax under the provisions of Income-tax Act, 1961 for any of the assessment year
out of six assessment years preceding the year in which the declaration is filed.
6Please mention the amount of estimated total income of the previous year for which the declaration is filed
including the amount of income for which this declaration is made.
7 1 n case any declaration(s) in Form No. 15G is filed before filing this declaration during the previous year, mention
the total number of such Form No. 15G filed along with the aggregate amount of income for which said declaration(s)
have been filed.
8Mention the distinctive number of shares, account number of term deposit, recurring deposit, National Savings
Schemes, life insurance policy number, employee code, etc.
9 lndicate the capacity in which the declaration is furnished on behalf of a HUF, AOP, etc.
10Before signing the declaration/verification, the declarant should satisfy himself that the information furnished in
this form is true, correct and complete in all respects. Any person making a false statement in the declaration shall
be liable to prosecution under section 277 of the Income-tax Act, 1961 and on conviction be punishable-
(i) in a case where tax sought to be evaded exceeds twenty-five lakh rupees, with rigorous imprisonment which shall
not be less than six months but which may extend to seven years and with fine;
(ii) in any other case, with rigorous imprisonment which shall not be less than three months but which may extend to two
years and with fine.
11The person responsible for paying the income referred to in column 16 of Part I shall allot a unique identification
number to all the Form No. 15G received by him during a quarter of the financial year and report this reference
number along with the particulars prescribed in rule 31A(4)(vii) of the Income-tax R ules, 1962 in the TDS statement
furnished for the same quarter. In case the person has also received Form No.15H during the same quarter, please allot
separate series of serial number for Form No.15G and Form No.15H.
12The person responsible for paying the income referred to in column 16 of Part I shall not accept the declaration
where the amount of income of the nature referred to in sub-section (1) or sub-section (1A) of section 197A or the
aggregate of the amounts of such income credited or paid or likely to be credited or paid during the previous year in
which such income is to be included exceeds the maximum amount which is not chargeable to tax. For deciding the
eligibility, he is required to verify income or the aggregate amount of incomes, as the case may be, reported by the
declarant in columns 16 and 18.
Annexure-2
FORM NO. 15H
[See section 197A(1C) and rule 29C]
Declaration under section 197A(1C) to be made by an individual who is of the age of sixty years
or more claiming certain incomes without deduction of tax.
PART I
1. Name of Assessee (Declarant) 2. Permanent Account 3. Date of
Number or Aadhaar Birth2(DD/MM/YYYY)
Number of the Assessee 1
4. Previous year(P.Y.)3 (for which 5. Flat/Door/Block No. 6. Name of Premises
declaration is being made)
2025-2026
7. Road/Street/Lane 8. Area/Locality 9. Town/City/District 10. State
11. PIN 12. Email 13. Telephone No. (with STD Code) and Mobile No.
Yes No Please fill
14 (a) Whether assessed to tax4: estimated
total
(b) If yes, latest assessment year for which assessed income
for FY
15. Estimated income for which this declaration is made 2025-26
16. Estimated total income of the P.Y. in which income
mentioned in column 15 to be included 5
17. Details of Form No.15H other than this form filed for the previous year, if any6
Total No. of Form No.15H filed Aggregate amount of income for which Form No.15H filed
18. Details of income for which the declaration is filed
Sl No. Identification number of Nature of income Section under Amount of
relevant which tax is income
investment/account, etc.7 deductible
Please
sign here
Signature of the Declarant
1. Substituted by the IT (Fourteenth Arndt.) Rules, 2015, w.e.f. 1-10-2015. Earlier Form No. 15H was amended by the IT (Fifth
Arndt.) Rules, 1982, w.e.f. 21-6-1982, IT (Fifth Arndt.) Rules, 1989, w.r.e.f. 1-4-1988, IT (Fourteenth Arndt.) Rules, 1990,
w.e.f. 20-11-1990 , IT (Twelfth Arndt.) Rules, 1992, w.e.f. 1-6-1992, IT (Seventh Arndt.) Rules, 1995, w.e.f. 1-7-1995, IT
(Thirty-second Arndt.) Rules, 1999, w.e.f. 19-11-1999, IT (Twelfth Arndt.) Rules, 2002, w.e.f. 21-6-2002 , IT (Eighth
Arndt.) Rules, 2003, w.e.f. 9-6-2003, IT (Fourteenth Arndt.) Rules, 2003, w.e.f. 1-8-2003 and IT (Second Arndt.) Rules,
2013, w.e.f. 19-2-2013.
Declaration/Verification 8
I ....................................................... do hereby declare that I am resident in India within the meaning of
section 6 of the Income-tax Act, 1961. I also hereby declare that to the best of my knowledge and belief what
is stated above is correct, complete and is truly stated and that the incomes referred to in this form are not
includible in the total income of any other person under sections 60 to 64 of the Income-tax Act, 1961. I
further declare that the tax on my estimated total income including *income/incomes referred to in
column 15 * and aggregate amount of *income/incomes referred to in column 17 computed in accordance
with the provisions of the Income-tax Act, 1961, for the previous year ending on 31-03-2026relevant to
the assessment year 2026-2027 will be nil.
Please
sign here
Place: .....................................
Date: ...................................... Signature of the Declarant
PART II
[To be filled by the person responsible for paying the income
referred to in column 15 of Part I]
1. Name of the person responsible for paying 2. Unique Identification No.9
3. Permanent Account 4. Complete Address 5. TAN of the person
Number or Aadhaar responsible for paying
Number of the person
responsible for paying
6. Email 7. Telephone No. (with STD Code) 8. Amount of income paid 10
and Mobile No.
9. Date on which Declaration is received 10. Date on which the income has been
(DD/MM/YYYY) paid/credited (DD/MM/YYYY)
Place: ...................................... .
Date: ...................................... . Signature of the person responsible for paying the
income referred to in column 15 of Part I
*Delete whichever is not applicable.
1. As per provisions of section 206AA(2), the declaration under section 197A(1C) shall be invalid if the declarant
fails to furnish his valid Permanent Account Number or Aadhaar Number.
2. Declaration can be furnished by a resident individual who is of the age of 60 years or more at any time during the
previous year.
3. The financial year to which the income pertains.
4. Please mention "Yes" if assessed to tax under the provisions of lncome-tax Act, 1961 for any of the assessment
year out of six assessment years preceding the year in which the declaration is filed.
5. Please mention the amount of estimated total income of the previous year for which the declaration is filed
including the amount of income for which this declaration is made.
6. In case any declaration(s) in Form No. 15H is filed before filing this declaration during the previous year, mention
the total number of such Form No. 15H filed along with the aggregate amount of income for which said declaration(
s) have been filed.
7. Mention the distinctive number of shares, account number of term deposit, recurring deposit, National Savings
Schemes, life insurance policy number, employee code, etc.
8. Before signing the declaration/verification, the declarant should satisfy himself that the information furnished in
this form is true, correct and complete in all respects. Any person making a false statement in the declaration shall
be liable to prosecution under section 277 of the Income-tax Act, 1961 and on conviction be punishable-
(i) in a case where tax sought to be evaded exceeds twenty-five lakh rupees, with rigorous imprisonment which shall
not be less than six months but which may extend to seven years and with fine;
(ii) in any other case, with rigorous imprisonment which shall not be less than three months but which may extend to
two years and with fine.
9. The person responsible for paying the income referred to in column 15 of Part I shall allot a unique identification
number to all the Form No. 15H received by him during a quarter of the financial year and report this reference number
along with the particulars prescribed in rule 31A(4)(vii) of the Income-tax Rules, 1962 in the TDS statement furnished
for the same quarter. In case the person has also received Form No.15G during the same quarter, please allot separate
series of serial number for Form No.15H and Form No.15G.
10. The person responsible for paying the income referred to in column 15 of Part I shall not accept the declaration
where the amount of income of the nature referred to in section 197A(1C) or the aggregate of the amounts of such income
credited or paid or likely to be credited or paid during the previous year in which such income is to be included exceeds
the maximum amount which is not chargeable to tax after allowing for deduction(s) under Chapter VI-A, if any, or set
off of loss, if any, under the head "income from house property" for which the declarant is eligible. For deciding the
eligibility, he is required to verify income or the aggregate amount of incomes, as the case may be, reported by the
declarant in columns 15 and 17.
1[Provided that such person shall accept the declaration in a case where income of the assessee, who is eligible for
rebate of income-tax under section 87A, is higher than the income for which declaration can be accepted as per this
note, but his tax liability shall be nil after taking into account the rebate available to him under the said section 87A.]
1. Inserted by Income-tax (4th Amendment) Rules, 2019, w.e.f. 22-5-2019.
Annexure – 3
Declaration by shareholder qualifying as Insurer as per section 2(7A) of the Insurance Act,
1938
<on letterhead of the shareholder>
Date: << >>
TO WHOMSOEVER IT MAY CONCERN
Dear Sir,
Sub: Declaration with regards to dividend income.
For the purpose of determination of Income-tax TDS liability under Income Tax Act 1961, we hereby certify
as follows:
Nature of information Details
Name of the Shareholder
Status Insurance Company
Contact number
PAN
Registration number of the certificate
obtained from IRDA
Nature of Insurance business
Further, we declare that we qualify as Insurer as per section 2(7A) of the Insurance Act, 1938 and << name of
the shareholder >> is the beneficial owner of dividend income and is eligible for exemption from withholding
taxes as per section 194 Income-tax Act, 1961 for the Financial Year 2025-26.
In this regard, we have enclosed certificate of registration with IRDA / LIC / GIC, as applicable.
In this connection, we also certify that the above made declarations applies to all DP ID & client ID linked the
PAN << PAN of the shareholder >>.
For ………….
Authorized Signatory
Name and Designation:
Annexure – 4
Declaration by Mutual Fund shareholder eligible for exemption u/s 10(23D) of the Income-tax
Act, 1961
<on letterhead of the shareholder>
Date: << >>
TO WHOMSOEVER IT MAY CONCERN
Dear Sir,
Sub: Declaration with regards to dividend income.
For the purpose of determination of Income-tax TDS liability under Income Tax Act 1961, we hereby certify as
follows:
Nature of information Details
Name of the Shareholder
Status Mutual Fund (MF)
Contact number
PAN
The notification number in which the MF is
notified to be exempt under Section 10(23D)
MF SEBI Registration number (if the MF is
registered with SEBI)
or
If the MF is set up by public sector bank /
public financial institution (PFI) / authorized
by RBI.
Further, we also declare that << Name of the Shareholder >> is the beneficial owner of dividend income and is
eligible for exemption u/s 10(23D) of the Income-tax Act, 1961 and therefore eligible for exemption from
withholding taxes as per section 196 of Income-tax Act, 1961 for the FY 2025-26.
In this regard, we have enclosed certificate of registration of Mutual Fund with SEBI or a certificate indicating a
Mutual Fund is set up by public sector bank / PFI / authorized by RBI being notified by Central Government, as
the case may be.
In this connection, we also certify that the above made declarations applies to all DP ID & client ID linked the
PAN << PAN of the shareholder >>.
For …………
Authorized Signatory
Name and Designation
Annexure - 5
Declaration by Category I/II Alternate Investment Fund (AIF) registered with SEBI holding
registration and declaring dividend income is not chargeable under the head 'Profit and Gains
of Business or Profession' and qualifies for exemption u/s 10(23FBA)
<on letterhead of the shareholder>
Date: << >>
TO WHOMSOEVER IT MAY CONCERN
Dear Sir,
Sub: Declaration with regards to dividend income.
For the purpose of determination of Income-tax TDS liability under Income Tax Act 1961, we hereby certify
as follows:
Nature of information Details
Name of the Shareholder
Status
Contact number
PAN
We declare the that we are a Category I/II Alternate Investment Fund (AIF) registered with SEBI holding
registration no << >> and our dividend income is not chargeable under the head 'Profit and Gains of Business
or Profession' for the FY 2025-26 and qualifies for exemption u/s 10(23FBA). Therefore, we are eligible for
exemption from withholding taxes under the Income Tax Act, 1961 (the Act) as specified in CBDT Notification
No. 51/2015 of the Act.
Further, we have attached the certificate of registration of the AIF with SEBI.
In this connection, we also certify that the above made declarations applies to all DP ID & client ID linked the
PAN << PAN of the shareholder >>.
For ………….
Authorized Signatory
Name and Designation:
Annexure -6
Declaration for exemption under Circular 18/2017 of the Income Tax Act, 1961
<on letterhead of the Shareholder>
Date: << >>
TO WHOMSOEVER IT MAY CONCERN
Dear Sir,
Sub: Declaration with regards to dividend income.
For the purpose of determination of Income-tax TDS liability under Income Tax Act 1961, we hereby certify
as follows:
Nature of information Details
Name of the Shareholder
Status
Contact number
PAN
We declare the that we are an institution covered by clause << >> of paragraph 4 of Circular 18/2017 of the
Income Tax Act, 1961 and our income is unconditionally exempt and also, we are not statutorily required to
file an Income tax return for the FY 2025-26. Therefore, we are eligible or exemption from withholding taxes
under the Income Tax Act, 1961.
In this connection, we also certify that the above made declarations applies to all DP ID & client ID linked
the PAN << PAN of the shareholder >>.
For ………….
Authorized Signatory
Name and Designation:
Declaration by Joint Shareholders under Rule 37BA (2) of the Income tax Rules, 1962*
I the primary shareholder (Joint Shareholder 1) of
shares of Infosys Limited as on May 30, 2025 (the record date for Final dividend
payout for F.Y.2024-25) against (DPID & Folio No) do hereby request the
company to provide the credit of Tax Deducted at source on the dividend payouts by the Company, separately
to the joint shareholders (beneficiary shareholder) of the said shares as per the following information given in
this regard.
The reason for such request is that the beneficial ownership of shares that are held by below-mentioned Joint
shareholders (Total number of shares). The details are provided as under:
No. Particulars Joint Shareholder Joint Shareholder
1 2
1. Name of the Joint shareholder (beneficiary
shareholder):
2. PAN of Joint shareholder
3. Percentage of shares held by the Joint Shareholder
(beneficiary shareholder)
4. Residential Status of Joint shareholder in India for
F.Y. 2025-26
5. Country of Tax Residence of Joint Shareholder for
F.Y. 2025-26 in case residential status as mentioned in
(4) above is other than India
6. Address of the joint shareholder
7. Email ID of Joint Shareholder
8. Telephone Number of Joint Shareholder
We hereby validate the above-mentioned information, and we do hereby declare that to the best of my
knowledge and belief what is stated above is correct complete and is truly stated. We undertake to indemnify
for any tax liability (including but not limited to interest and penalty) that may arise on you in future on account
of non-deduction of tax at source on the basis of the above declaration furnished by us.
Signature of Joint Shareholder 1 Signature of Joint Shareholder 2
Notes:
- In case of additional Joint shareholder, necessary columns can be added and signed.
- The company will consider the information as available with the depositories (NSDL/CDSL) or by the
Registrar and Share Transfer Agent (KFin Technologies Limited) as on the record date. We request you to
kindly verify the correctness of the records and for any changes to update the same with your depository
participant (if you hold shares in dematerialized mode) or the Registrar and Share Transfer Agent (if you
hold shares in physical mode). In case of mismatch of any data as declared above with the
Depositories/Registrar & Share Transfer Agent, the company will not consider the above declaration for
further processing.
*For the purpose of credit for tax deducted at source on dividends paid by Infosys Ltd. to its joint
shareholders, a declaration duly signed by all of them, stating the below facts needs to be obtained
by the Company for every dividend payout as per Income Tax Rules, 19621.
1
Rule 37BA: Credit for tax deducted at source for the purposes of section 199. (1) Credit for tax deducted at source
and paid to the Central Government in accordance with the provisions of Chapter XVII, shall be given to the person to
whom payment has been made or credit has been given (hereinafter referred to as deductee) on the basis of
information relating to deduction of tax furnished by the deductor to the income-tax authority or the person authorized
by such authority.
(2)(i) Where under any provisions of the Act, the whole or any part of the income on which tax has been deducted at
source is assessable in the hands of a person other than the deductee, credit for the whole or any part of the tax
deducted at source shall be given to the other person and not to the deductee:
Provided that the deductee files a declaration with the deductor and the deductor reports the tax deduction in the
name of the other person in the information relating to deduction of tax referred to in sub-rule (1).
(ii) The declaration filed by the deductee under clause (i) shall contain the name, address, permanent account number
of the person to whom credit is to be given, payment or credit in relation to which credit is to be given and reasons for
giving credit to such person.
(iii) The deductor shall issue the certificate for deduction of tax at source in the name of the person in whose name
credit is shown in the information relating to deduction of tax referred to in sub-rule (1) and shall keep the declaration
in his safe custody.
