Form No. 33
[See rule 43]
Clearance certificate under the first proviso to subsection (1A) of section 230 of
the Income-tax Act, 1961

Folio No.____________________
GOVERNMENT OF INDIA
1. Full name (in block letters)
2. Name of father (or husband)
3. Permanent Account Number
4. Passport No./Emergency Certificate No.
This is to certify that the above mentioned applicant has —
(a) no liabilities outstanding;
(b) made satisfactory arrangements for the payment of taxes which are or may become payable under the Wealth-tax Act, 1957 (27 of 1957), the Gift-tax Act, 1958 (18 of 1958), the Income-tax Act, 1961 (43 of 1961) or the Expenditure-tax Act, 1987 (35 of 1987).
This certificate is valid for a journey or journeys to be commenced on or after_____________and
before_________________
Place __________________
Date ___________________ (Assessing Officer)
(Seal)
Strike out the paragraph which is not applicable.