(Print this on your letter head)

No Permanent Establishment in India Declaration

I_________________CEO/Director/Partner of __________________________having it’s national office

at:

(Mention your companies registered address below)

Hereby State that:

a. ________________(You company Name)is a valid and subsisting company incorporated under

the laws of _________________( Country Name)
b. ________________ (You company Name) is the legal beneficial owner of the payment towards
advertising services and do not involve any transmission of technical knowledge.
c. We do not, wholly or partly carry on business in the Republic of India through a permanent
establishment situated there in, as defined under the DTAA entered into between India and
____________________(Your country Name)
d. We do not have a Business connection in the Republic of India, as defined in Explanation (a) of
Section 9(1)(i) of the Indian Income Tax Act, 1961
Reference to the legal provisions of the Indian Income Tax Act 1961, Section 9(1)(i), Explanation
(a) and __________________________________(Legal provision of your country).

For ____________(Your company)

(Authorized Person signature with Seal)

Name :

Designation:

Date :