FORM NO.

15CA [See rule 37BB]

Information to be furnished for payments to a non-resident not being
a company, or to a foreign company
Acknowledgement Number -934893390150425

Part C
To be filled up if the remittance is chargeable to tax under the provisions of the Income-tax Act,
1961 and the remittance or the aggregate of such remittances, as the case may be, exceeds five
lakh rupees during the financial year and a certificate in Form No. 15CB from an accountant as
defined in the Explanation below subsection (2) of section 288 has been obtained.
Section A - GENERAL INFORMATION
Remitter

Name of the remitter MADURA COATS PVT LIMITED

PAN of the remitter AABCM8279K

TAN of the remitter -

Area Code -

AO Type -

Range Code -

AO No -

Principal Place of Business BANGALORE,

Complete Address of the remitter 35, New Jail Road, Madurai

South, Keerathurai S.O,
MADURAI, Tamil Nadu, INDIA -
625001

Email of the remitter corptax.mcpl@coats.com

Phone Number of the remitter 9845136707

Status Company

Residential status of remitter Domestic company

Remittee

Name of recipient of remittance AUTOMATIC DATA

PROCESSING LTD

PAN of the recipient of remittance -

Status Company
 Address 6, Nexus court, Mulgrave, VIC,
AUSTRALIA, Foreign,
AUSTRALIA - 3170

Email address -

Phone Number -

Country to which remittance is made Australia

Principal Place of Business Australia

Accountant

a. Name of the Accountant signing the certificate MAHADEV DAMBAL

b. Name of the proprietorship/firm of the accountant DAMBAL AND CO

c. Address NO.7/1, 2NDFLOOR, , WEST

OF CHORD ROAD ,,
MAHALAKSHMIPURAM,
BANGALORE, , Karnataka,
INDIA - 560086

d. Registration no. of the accountant 203853

e. Date of certificate 12-Apr-2025

f. Certificate No. 933162011120425

Section B - PARTICULARS OF REMITTANCE AND TDS (as per certificate of the accountant)
Remittance

1. Country to which remittance is made Australia

Currency AUD

2. Amount Payable

In foreign currency 12,215.08

In Indian (₹) ₹ 6,45,811

3. IFSC Code

Name of Bank DBS Bank Ltd

Branch of the bank ULSOOR ROAD

4. BSR Code of the bank branch (7 digit) 8400009

5. Name of Authorized Dealer -

Branch Address of the authorized dealer -

 6 Proposed date of remittance 20-Apr-2025

7. Nature of remittance as per agreement/document Processing Charges

8. Relevant purpose code as per RBI Telecommunication, Computer

& Information Services
S0803 - Data base, data
processing charges

9. In case the remittance is net of taxes, whether tax payable has been No
grossed up

I.T. Act

10. Taxability under the provisions of the Income-tax Act (without

considering DTAA)

a. The relevant section of the Act under which the remittance is covered 195

b. The amount of income chargeable to tax ₹ 6,45,811

c. The tax Liability ₹ 1,41,045

d. Basis of determining taxable income and tax liability TDS IS MADE ON THE
AMOUNT PAID/PAYABLE

DTAA

11. If any relief is claimed under DTAA

i. Whether tax residency certificate is obtained from the recipient of No

remittance

ii. Please specify relevant DTAA NA

iii. Please specify relevant article of DTAA (Nature of payment as per NA

DTAA)

iv. Taxable income as per DTAA ₹0

v. Tax liability as per DTAA ₹0

A. If the remittance is for royalties, fee for technical services, interest, Yes
dividend, etc,(not connected with permanent establishment), please
indicate

a. Article of DTAA ARTICLE 12

b. Rate of TDS required to be deducted in terms of such article of the 15

applicable DTAA (%)

B. In case the remittance is on account of business income, please No

indicate

a. The amount of income liable to tax in India ₹0

 b. The basis of arriving at the rate of deduction of tax -

C. In case the remittance is on account of capital gains, please indicate No

a. Amount of long term capital gains ₹0

b. Amount of short-term capital gains ₹0

c. basis of arriving at taxable income -

D. In case of other remittance not covered by sub-items A, B and C No

a. Please specify nature of remittance -

b. Whether taxable in India as per DTAA No

c. If yes, rate of TDS required to be deducted in terms of such article of 0

the applicable DTAA (%)

d. If not, please furnish brief reasons thereof specifying relevant article ARTICLE XII
of DTAA

TDS

12. Amount of tax deducted at source

In foreign currency 2,667.77

In Indian (₹) ₹ 1,41,045

13. Rate of TDS as per Income-tax Act (%) or As per DTAA (%) As per Income-tax Act
21.84

14. Actual amount of remittance after TDS (In foreign currency) 9,547.31

15. TDS Date of deduction of tax at source, if any 20-Mar-2025

Verification
I, SURESH KOTHAKOTA, son/daughter of Gopinadha Rao in the capacity of Assistant Manager (designation)
solemnly declare that the information given above is true to the best of my knowledge and belief and no relevant
information has been concealed.
I, certify that a certificate has been obtained from an accountant, particulars of which are given in this Form,
certifying the amount, nature and correctness of deduction of tax at source.
In case where it is found that the tax actually deductible on the amount of remittance has not been deducted or
after deduction has not been paid or not paid in full, I undertake to pay the amount of tax not deducted or not
paid, as the case may be, along with interest due. I shall also be subject to the provisions of penalty for the said
default as per the provisions of the Income-tax Act, 1961.
I, further undertake to submit the requisite documents for enabling the Income-tax authorities to determine the
nature and amount of income of the recipient of the above remittance as well as documents required for
determining my liability under the Income-tax Act, 1961 as a person responsible for deduction of tax at source.

Name of the person responsible for paying to non-resident SURESH KOTHAKOTA

Designation of the person responsible for paying to non-resident Assistant Manager

IP Address 182.78.46.34

Date 15-Apr-2025

Place BANGALORE

Acknowledgement Number - 934893390150425

This form has been digitally signed by SURESH KOTHAKOTA having PAN EVAPK8821C from IP Address
182.78.46.34 on 15-Apr-2025 01:24:53 PM
Dsc Sl No and issuer 24397656CN=e-Mudhra Sub CA for Class 3 Individual 2022,C=IN,O=eMudhra
Limited,OU=Certifying Authority