FORM NO. 10DC
[See rule 20AB]
Form for evidence of payment of securities transaction tax on transactions of sale of unit of equity oriented fund to the Mutual Fund

1. Name of the assessee :
2. Address of the assessee :
3. Permanent Account Number (PAN) of the assessee :
4. MAPIN of the assessee :
5. Name of the Mutual Fund having the equity
oriented fund of which units sold by the assessee to
that Fund
:
6. Address of the Mutual Fund referred to in item 5 :
7. Details of value of securities transactions and securities transaction tax collected from the person:
Name of
equity
oriented
fund
Unique
client code
of the fund
Folio
number of
assessee
Value of
transactions
entered into
during the
financial
year
Total
securities
transaction
tax collected
from the
assessee
during the
financial
year
Value of
transactions
(included in value
given in column
5) entered into in
the course of
business by the
assessee
Securities
transaction tax
collected on
value of
transactions
given in column
7
1 2 3 4 5 6 7
Total
Verification
I,__________________________________________________(full name in block letters), son/daughter of__________________________________________solemnly declare that to the best of my knowledge and belief the information given in this Form is correct and complete and that the total amount of securities transaction tax shown therein is truly stated and is in accordance with the provisions of Chapter VII of the Finance (No. 2) Act, 2004 and Securities Transaction Tax Rules, 2004.
Date _______________
Place _______________ (Name and Signature of the assessee)
Instructions :
(i) This Form be furnished separately for the transactions with each Mutual Fund.
(ii) Details of securities transaction tax paid on sale of units of various equity oriented fund under a Mutual Fund be given separately.