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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 |
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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
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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