_ | eset con 7 Fata TRS [earartancae a FORM NO. 15G [Swe Sacon IPA 19004 ard Pe 20] ean Soe WKS ATA recat eee ry Se man ag Caren i me ome wi ine PARTI 2. PAN of the Assoss00 3. Status | | |4. Previous Year ?.¥ {for wien deciaraton is being made) 5. Residential Status | j Toma a. Telephone No. (with STO Godel & Mobile No, 1: (a) Whether assessed to tax under the Income-Tax Act, 7953] Ves Nol (b) tyes, latest assessment year for which assossed 76. Estimated income for which this decieration is made 7 Evid il nave 0s PY. wh cra road ann | tebe ned: 18. Dotils of Form No. 156 other then this Form fled during the provious year, any Total No of Form No. 166 fied ‘Aggregate amount of income for which Form No, 750 fled, 18, Detalls of income for which the declarations i fied ISL.No] - Idenfication number ofralevant | Nature cfincame [Section under which “Arnount of income investmenVaccount, tc ‘axis deauetbla i Interest on Securties| - Section 123 Declaration /Vertention 0 i i tags aia ‘in sinowtwSoe Singin aid Sy sed “We” Gein a ei yn al ng i es a a ea dis Bt ta Tram ucngaomaares ered to Gunn 16 ed apeopetneraurt of “ncana/ncones aka toh Soe saoyn somautog Pr ucocane wn he Povaane te team: Alt OH Tt he paves Yee yo SADE tte Ste cence at [RBWodt wat lino, dear tet Seyieat“ncopatectgran tore Cohene 1 "and vgrgamn aa of rca cenes cour V6 a rete art ‘ing on Su0siiz4 mevant tio nsurnon’ ye 252015 no exand ha mauinom amuses Nel Sargent neon oon Oxmmmeamer PARTI i {Tobe tea te person responsible fox paying th Income rere to In column 1 of Part] a aN oe ae Ye rt poor resin ‘oa ttt "AARCHT95H “Romp rear TOG Gk Tony, Sins Ka Corin Mob SO 1 Ta ofa pean vesporate or oaoa MUMI10102B 7 Dao wich Dede Ras Wawra) TEs an oh ie ans has ben plaid ari? Farancas aha Chel Commision x Commision’ name tat For ICICI BANK LIMITED "Incr rtrved toe Coram Rot Pe [8 {Dole wrchve ao apeato 2 per pros tanion B6AN2.e cnt rd eon 17M] 197A a ia dara as otk Perenrt At Nabe PAN 3 Dscaraton canbe ribs y anu wer scion 187A} er pron (et Wah eo arshn) unde cen ITAA) 4 Thetnansal you oui neon pre 5 Plans rerton eran sana pr poo cf scton fe ect et 181 Please renton “Yor I anented tx nde provson Reames A tye neuen ya sauna yar roaig ha year wie ‘Sectrton od. 1 Pluae meron beaut ete some oh raves yr whch’ saranda tw anoit tneam rwach con mac. 1 Irene ary decaraiona a Fom No Tes adel gt ete dna th rave ya aren ln uh Pay No 18 9 ‘fonts amount hen osc si deca) hae ec. 9 lero ha datree ast’ tbc, sent abet a Goel mein aoa, Neral Grogs Steen lene ply unt arokye coe, {a eden ie expiyn win bw dcrlonunahedonbaat ate HU AO oe 1 ern sing th Scartcovwrtnon, he caw abs sty nme al Pe oman aed om ta, cael acl ak eect, ry So0n ‘rang ale stoma carat al baba 9 poacitin ini acon 27 ob rear es 196 an conc open 1 nse wt 0. 1 tm wuaesexcode tere les, wh rps Inbar wich shal bla an Hm et Wh ay od 1 ey ater eave ipa iar wich a ee ns ao neo bu wih ay nla oo yes re wth 12 The paren arpa png eae rare eco 180 asa ae uu eben a! al Fa No, eye ate ta the tances ar nt repo i lrecn nurse ao We paul rae Pa@icici Bank ICICI BANK LIMITED CIN : L65190GJ1994PLC021012 Corporate Olfice : ICICI Bank Towers, Bandra Kurla Complex, Mumbai 400 051 realtor aintecn ee centers een ane Toor #6 oor, Relay Staton Conte Vs Nas Mero A070 Taino tooo For the kind attention of Investors Dear Customer, ‘We value your relationship with ICICI Bank. In accordance with and subject to the provisions of the Income tax Act, (the “Act”) 1961, tax is deducted at source if the annual interest on Bonds paid/credited exceeds Rs.5,000/- during the financial year. In caso ‘your total income for the financial year 2023-2024 is below the taxable limit of Rs.3,00,000, tax will not be deducted if the necessary declaration in the prescribed form i.e. Form 18G, printed on the reverse of this letter, is submitted as indicated below by bondholders other than companies, firms and Co-operative Societies. Form 18G is a solf-declaration form, which does not require any special attestation, except your signature. Further Form15G can be submitted by those bondholders whose total income for the financial year 2023 -2024is below the taxable limit, Form 15Gis valid for one financial year only and hence this form will not be considered beyond the current financial year. Form 15G has to be submitted for each financial year separately. Tax will be deducted at the prevailing rates if Form 15G is not furnished within the stipulated period. Any claim for refund'of tax will not be considered. Further please note, with respect to the new provision of 206AB and 206CCA of Income Tax Act 1961 effective from 1st July 2021, if the PAN is appearing as that of “Specified Person” inthe utility provided by the Income Tax Authorities, taxis required to be deducted/collected at the higher rate. Further also note Section 139AA of Income Tax Act, 1961 (the Act) require linkage of PAN and AADHAR of a Person. If any person has failed to link AADHAR with PAN, then after March 31, 2023 or such other date as ‘may be specified by Central Board of Direct Taxes PAN of such person will become inoperative. In absence of valid/operative PAN, tax will be deducted at higher of the prescribed rate or 20% . Also Form 15G/15H will be treated as invalid in absence of valid /opers before date of deduction or payment whichever i Also as per prevailing provisions of Income Tax Act, 1961, (” the Act"), TDS certificate is to be ‘generated through TRACES website and PAN of the deductee is mandatory and hence in absence of PAN, TDS. certificate cannot be generated. TDS certificates will be sont to enable the investors to claim credit for tax deducted at source from the Income-tax authorities. We request you to furnish us your PAN immediately, if not submitted earlier, to enable us to incorporate the same on the TDS certificate to be issued to you in future, Certain details in the form have been filed in by us. Please verity these details before proceeding. In ease of discrepancies, please make necessary corrections and sign against every correction. Complete all the details ‘Such as estimated income, estimated total income of P.Y. and aggregate amount of income (Column 16,17,18) ‘te. Please signin the place marked () and return the form at our Registrars address mentioned above. Please ensure that this form is complete in all respects and returned to us, on or before the record date. Incomplete forms will not be taken cognizance of as they are not accepted by the Income-tax authoritios and would resultin the deduction of tax a source by us. Before returning the form. please check thatthe signature in original has been affixed at both the places. We request your co-operation in the matter. Please help us to serve you better. Yours faithfully, ae