Income-tax Rules, 1962

FORM NO. 60
[See second provision to rule 114B]
Form for declaration to be filed by an individual or a person (not being a company or firm) who does not
have a permanent account number and who enters into any transaction specified in rule 114B

First Name SHESHADRI

1 Middle Name G
Surname N
Date of Birth/ Incorporation of
2 07/24/1999
declarant
Father's Name (in case of individual)
First Name MR NARASIMHAIAH
3
Middle Name
Surname N
Flat/ Room No. Floor No.
4 5
GUNDUR
Name of premises Block Name/No.
6 7
BANGALORE
Road/ Street/ Lane Area/ Locality
8 9
KARNATAKA GUNDUR
Town/ City District State
10 11 12
BANGALORE KARNATAKA
Telephone Number (with
Pin code Mobile Number
13 14 STD code) 15
560049 7348868160
16 Amount of transaction (Rs.) 81699
17 Date of transaction 06/22/2025
In case of transaction in joint names,
18 number of persons involved in the
transaction
 Mode of transaction
19 Cash, Cheque, Card, Draft/Banker's Cheque, Online transfer Other

Aadhaar Number issued by UIDAI (if

20
available)
If applied for PAN and it is not yet
21 generated enter date of application and
acknowledgement number
If PAN not applied, fill estimated total income (including income of spouse, minor child etc. as
22 per section 64 of Income-tax Act, 1961) for the financial year in which the above transaction is
held
a. Agricultural income (Rs.)
b. Other than agricultural income (Rs.) Rs 15000-25000
Name and
Document
Details of document being produced in address of the
Document code identification
23 support of identify in Column 1 (Refer authority issuing
number
Instruction overleaf) the document
Aadhaar 0143
Name and
Document
Details of document being produced in address of the
Document code identification
24 support of address in Columns 4 to 13 authority issuing
number
(Refer Instruction overleaf) the document
Aadhaar 0143

Verification
I, SHESHADRIG N do hereby declare that what is stated above is true to the best of my knowledge and
belief. I further declare that I do not have a Permanent Account Number and my/ our estimated total income
(including income of spouse, minor child etc. as per section 64 of Income-tax Act, 1961) computed in
accordance with the provisions of Income-tax Act, 1961 for the financial year in which the above transaction
is held will be less than maximum amount not chargeable totax.
Verified today, the 23 rd day of June 2025

Place: BENGALURU (Signature of declarant)

Note:

1. Before signing the declaration, the declarant should satisfy himself that the information furnished in this
form is true, correct and complete in all respects. Any person making a false statement in the declaration shall
be liable to prosecution under section 277 of the Income-tax Act, 1961 and on conviction be punishable,
(i) in a case where tax sought to be evaded exceeds twenty-five lakh rupees, with rigorous imprisonment
which shall not be less than six months but which may extend to seven years and withfine;
(ii) in any other case, with rigorous imprisonment which shall not be less than three months but which may
extend to two years and withfine.
2. The person accepting the declaration shall not accept the declaration where the amount of income of the
nature referred to in item 22b exceeds the maximum amount which is not chargeable to tax, unless PAN is
applied for and column 21 is dulyfilled.
 First Name SHESHADRI
1 Middle Name G
Surname N
Date of Birth/ Incorporation of
2 07/24/1999
declarant
Father's Name (in case of individual)
First Name MR NARASIMHAIAH
3
Middle Name
Surname N
Flat/ Room No. Floor No.
4 5
GUNDUR
Name of premises Block Name/No.
6 7
BANGALORE
Road/ Street/ Lane Area/ Locality
8 9
KARNATAKA GUNDUR
Town/ City District State
10 11 12
BANGALORE KARNATAKA
Telephone Number (with
Pin code Mobile Number
13 14 STD code) 15
560049 7348868160
16 Amount of transaction (Rs.) 81699
17 Date of transaction 06/22/2025
In case of transaction in joint names,
18 number of persons involved in the
transaction
Mode of transaction
19 Cash, Cheque, Card, Draft/Banker's Cheque, Online transfer Other

Aadhaar Number issued by UIDAI (if

20
available)
If applied for PAN and it is not yet
21 generated enter date of application and
acknowledgement number
If PAN not applied, fill estimated total income (including income of spouse, minor child etc. as
22 per section 64 of Income-tax Act, 1961) for the financial year in which the above transaction is
held
 a. Agricultural income (Rs.)
b. Other than agricultural income (Rs.) Rs 15000-25000
Name and
Document
Details of document being produced in address of the
Document code identification
23 support of identify in Column 1 (Refer authority issuing
number
Instruction overleaf) the document
Aadhaar 0143
Name and
Document
Details of document being produced in address of the
Document code identification
24 support of address in Columns 4 to 13 authority issuing
number
(Refer Instruction overleaf) the document
Aadhaar 0143

Verification
I, SHESHADRIG N do hereby declare that what is stated above is true to the best of my knowledge and
belief. I further declare that I do not have a Permanent Account Number and my/ our estimated total income
(including income of spouse, minor child etc. as per section 64 of Income-tax Act, 1961) computed in
accordance with the provisions of Income-tax Act, 1961 for the financial year in which the above transaction
is held will be less than maximum amount not chargeable totax.
Verified today, the 23 rd day of June 2025

Place: BENGALURU (Signature of declarant)

Note:

1. Before signing the declaration, the declarant should satisfy himself that the information furnished in this
form is true, correct and complete in all respects. Any person making a false statement in the declaration shall
be liable to prosecution under section 277 of the Income-tax Act, 1961 and on conviction be punishable,
(i) in a case where tax sought to be evaded exceeds twenty-five lakh rupees, with rigorous imprisonment
which shall not be less than six months but which may extend to seven years and withfine;
(ii) in any other case, with rigorous imprisonment which shall not be less than three months but which may
extend to two years and withfine.
2. The person accepting the declaration shall not accept the declaration where the amount of income of the
nature referred to in item 22b exceeds the maximum amount which is not chargeable to tax, unless PAN is
applied for and column 21 is dulyfilled.