INCOME-TAX RULES, 1962 FORM NO. 15H [See section 197A(10) 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. Pane Meee cee (ba eres ae TAY PRE KASH puerrissig | BEAN PRS Ti caoMETP TG ae eee Chart roSS de Being made) qo2e-2\ [sem lb4 hS avd Mom | PEE ect 25 TRoad/Strect/lane pyy3 | SArca/Loally [9 Town/Cay/Dmirict | (State Tava TPN Woo PS 7 Email Rah Wa Whetherasse 15, Telephone No [withSTD Codejand Mobile No. Dat Yeu No fj] Bette serteies\aesevsmecnt year fo 15. Esimaied income for whick this declaration Tb. Esimate ‘ome of the PY. in whichincome mad ie mentioned in column IS to be included TT, Deals of Form Na. ISH the previows year fan W\® Toial No.of Form No. ISH regate amount of income for which Form Ne ex _Yseo |= WP uctible aU seal — Jryrenresy | deae- ap sy Roth