FORM NO. 24G
[See section 30 and rule 37CA]
TDS/TCS Book Adjustment Statement
Details of transfer voucher for the month ending (month) mm (year) yyyy

1. Accounts Officer details
Accounts Officer Identification PAO registration Number (provided by Central
Number (AIN) Record Keeping Agency)
Account office name
Accounts Office Address
Address 1 Address 2
Address 3 Address 4
City State
PIN code Email ID
STD code-Phone No.
2. Responsible persons details (see note 1)
Responsible persons name
Responsible persons designation
Responsible persons Address
Address 1 Address 2
Address 3 Address 4
City State
PIN code Email ID
STD code – Phone No Mobile No. of the responsible person
3. Type of statement
Has the statement been filed earlier for this month (Yes/No)
If answer to above is “Yes”, then provisional receipt No.