Form No. 121  ·  Declaration u/s 393(6) | Fill Online, Download, Print, and Submit

[See rule 211] — Income without deduction of tax

TAX DECLARATION

1

Personal

2

Income

3

ITR

4

Sign

5

Review

6

Download

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Declarant Details — Part A

Fields 1–7 · Personal information of the declarant

1. Full Name *

0 / 40

Full name is required

2. Address *

0 / 100

Include all address components as per Note 2

Address is required

3. Permanent Account Number *

Valid 10-character PAN required

4. Status * — Select —IndividualHUFAOP / BOITrustOther

Status is required

5. Residential Status * — Select —ResidentNon-residentResident but not ordinarily resident

Refer Note 4

Residential status is required

5(a). Age 60+ at any time during the tax year? — N/A —YesNo

Applicable only for resident individuals

6. Email ID

Enter a valid email address

7. Contact Number *

Country code + number

Contact number is required

Step 1 of 5

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Income Details — Part A

Fields 8–13 · Tax year, nature and estimated amounts

8. Tax Year *

Format: YYYY-YY

Tax year is required

9. Nature of Income * — Select — Accumulated balance from recognised provident fund Insurance commission Rent from specified person Units of mutual fund / specified company Interest on securities / bank / post office Life insurance policy payment Dividend from domestic company

Refer Note 5

Nature of income is required

10. Estimated Income for this Declaration (₹) *

Income amount is required

13. Estimated Total Income of Tax Year (₹) *

Total income including col. 12. Refer Note 7

Estimated total income is required

Prior Form No. 121 Filings — Fields 11 & 12

11. Other Form No. 121 Filed This Year? NoYes

11(a). Total Number of Forms Filed Earlier

Required when “Yes” is selected above

11(b). Aggregate Income in Prior Forms (₹)

Refer Note 6

Required when “Yes” is selected above

12. Aggregate Income This Year (₹) — Auto

Sum of columns 10 and 11(b)

Step 2 of 5

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ITR Filing History — Part A, Field 14

Details of ITR filed for the previous two tax years (optional)

Sl.Tax YearAcknowledgment No.Return Income (₹)

1.

2.

NoteProvide ITR details for the two tax years immediately preceding the current declaration year. Leave blank if ITR was not filed.

Step 3 of 5

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Place & Date of Signing

Verification and signing details for the declaration

Place *

0 / 30

Place is required

Date *

Enter date as DD/MM/YYYY

Valid date in DD/MM/YYYY format required

Declaration Statement (Section 393(6))By proceeding you declare that: (i) all information is correct and complete; (ii) incomes are not includible in total income of any other person under sections 96–99; (iii) tax on estimated total income for the tax year will be nil; (iv) income does not exceed maximum amount not chargeable to tax; (v) if found false, you shall be liable to prosecution or penalty under the Act.

Step 4 of 5

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Step 5 of 5

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[See rule 211]  ·  Declaration under section 393(6) for receipt of certain incomes without deduction of tax