(Kindly Print this letter on your letter head)

Date :
TO WHOMESOEVER IT MAY CONCERN
Undertaking pursuant to Section 206AB and Section 206CCA of the Income Tax Act, 1961
Dear Sir,
Subject : Declaration confirming filing of Income Tax Return for immediate two
preceding years.
I,__________________________________________ (Name of Authorised Signatory),
in capacity of Director/ owner/ partner of __________________________________
(Firm Name), having PAN _______________________, with registered office address
at ________ ____ __ _______ _________ ______________ _________ ____________
______ ________________________________________________________________
do hereby declare that we have filed Income Tax Returns for immediately last 2
preceding Financial Years for which the due date to file return of income has expired as
per sub-section (1) of section 139 of the Income Tax Act, 1961 and details of which are
as given under:

Financial Year for which Income

Tax Return was due as per Date of Filing ITR Acknowledgement No.
Section 139(1)

F.Y.2019-20 (A.Y. 2020-2021)

F.Y.2020-21 (A.Y. 2021-2022)

F.Y.2021-22 (A.Y. 2022-2023)

We hereby state that the information provided above is true and correct to the best of
our belief.
Signature
Name : _________________________
Place : _________________________