FORM NO. 40C
[See rule 77]
Application for recognition
1. Name of the Fund for which recognition under Part A of the Fourth Schedule to the Income-tax Act, 1961 is sought:
2. Permanent Account Number of the Fund:
3. Date of creation of the fund:
4. Name of the employer:
5. Address of the employer:
6. Business/Profession of the employer:
7. Principal place of business of the employer:
8. Total number of employees:
9. Number of employees employed in India:
10. Number of employees subscribing to the fund:
(i) In India -
(ii) Outside India -
11. Place where the accounts of the funds are/will be maintained:
12. The number of trustees of the fund:
13. The name and address of the trustees:
14. (a) Whether it is an irrevocable trust:
Yes
No
(b) If not, the reasons thereof:
15. Please indicate the contribution by the employee as a percentage of his salary:
16. Please indicate the contribution by the employer as a percentage of employee’s salary:
17. The contribution being made/proposed to be made by the employer:
18. Whether the establishment is covered under
Yes
No
Employees’ Provident Fund and Miscellaneous Provisions Act, 1952 (EPF and MP Act):
If yes,
(a) whether covered under section 1(3) of EPF and MP Act:
(b) whether covered under section 1(4) of EPF and MP Act:
19.
(a) Whether the establishment is exempt under
Yes
No
section 17 of the EPF and MP Act:
(b) If yes, please indicate the exemption number/date and enclose documentary proof:
(c) If no, please indicate the date of application and attach proof of receipt from Employees Provident Fund Organization:
20. (a) Whether the fund was recognized under the
Yes
No
Income-tax Act, 1961 before 31-3-2006:
(b) If yes, please indicate the date of approval and attach a copy of letter of approval:
21. If the fund is already in existence, please furnish the following details relevant to the financial year ending prior to the date of application:
(a) the total corpus of the fund:
(b) investment pattern being followed [give breakup in accordance with the investment pattern prescribed in rule 67(2)]:
(c) a copy of the balance-sheet of the fund:
22. Whether the establishment has an approved superannuation fund. If yes, please indicate the approval number and date and indicate the authority which has granted the approval:
23. Whether the establishment has an approved gratuity fund. If yes, please indicate the approval number and date and indicate the authority which has granted the approval:
VERIFICATION
I/We , the trustees of the above named fund, solemnly declare that the information given in the application is true and correct to the best of my/our information and belief and that the documents sent herewith are the original or true copies thereof.