Tax Remission Form
Annexure II
(See Rule 28(2-A)(e))
Please fill in Capital letters where applicable and sign the declaration.
Date --/--/20--
Period From --/--/20-- To --/--/20--
DECLARATION FOR TAX REMISSION CLAIM
I ............................................... Proprietor /Partner / Director of M/s ....................................... located at ........................... having TIN ........................................... do hereby certify that the total number of employers working in my industrial unit is ................................, I, certify that I have provided employment to ............................ number of locals (constituting .................. of the work force) in my industrial unit as per list attached in terms of Govt. Order no. 265-IND of 2005 dated 27-10-2005
CERTIFICATE
It is hereby certified that the Declaration made herein above by the industrial unit is true and correct.