TO : BHARAT PETROLEUM CORPORATION LIMITED

DECLARATION
I/we, the ______________ (Proprietor/Partner/Director) of M/s ____________________________
having Permanent Account Number (PAN) _____________________ hereby declare the
following:

a. I / We are aware of the provisions of TDS and TCS u/s 194Q, 206C(1H), 206AB and
206CCA.

b. My / Our total sales / gross receipts / turnover for the financial year 2020-21 at the PAN
level Exceeds Rs.10 crores. Please tick either “YES” or “NO”:
( YES / NO )
c. If answer to ‘b’ above is “YES”, I / we confirm to timely deposit TDS u/s 194Q with the
government and submit the TDS certificates to BPCL. My / Our TAN* is
_______________________ and copy / copies are attached herewith for verification. (No
need to give TAN if answer to ‘b’ above is “NO”)

d. I / We hereby agree to indemnify BPCL in case of failure on compliance of the provisions of

TDS u/s 194Q or non-issuance of TDS certificate or both, I / We shall be liable to pay BPCL
the TCS u/s 206C (1H), along with applicable interest and penalty incurred by BPCL for
delay in deposit of TCS u/s 206C(1H).

e. I / We give the below declaration with respect to section 206AB / 206CCA:

ITR filed for the financial year 2018-19 Yes/No :

If Yes, mention ITR acknowledgement number
ITR filed for the financial year 2019-20 Yes/No :
If Yes, mention ITR acknowledgement number
Whether total of TDS&TCS of FY 2018-19 was ₹50,000 or more Yes/No :
Whether total of TDS&TCS of FY 2019-20 was ₹50,000 or more Yes/No :

f. I / We also agree to indemnify BPCL in case of any liability which may arise consequent to
any error or non-adherence to any clause in this declaration.

g. I hereby declare that I am duly authorized to submit and sign this declaration.

Yours Faithfully
For Customer’s Name

NAME of Authorised Person

Designation
Sign and Seal
*In case of multiple TANs, please provide only the TAN(s) which you will use for BPCL.