FORM NO. 27A
[See rule 37B]
Form for furnishing information with the return  or statement of deduction of tax at source filed on computer media
1. Details of the tax deductor
(a) Tax Deduction Account Number
(b) Permanent Account Number
(c)  Name of organisation
(d) Address : Flat / Door/ Block No.
    Name of Premises / Building
    Road / Street / Lane
    Area / Locality /
    Town / District / City
State
 PIN
Telephone No.
 Fax
2. Details of the person responsible for deduction of  tax at source
(a)  Name
(b) Address : Flat / Door/ Block No.
    Name of Premises / Building/
    Road / Street / Lane
    Area / Locality /
    Town / District / City
State
 PIN
Telephone No.
 Fax

3.  Control Totals 
 
Forms1  Total Amount Paid  Total Income Tax 
 Total No. of Persons  
from whom tax deducted  
deducted at Source 

 
(Column No.228 of form 24) 
24   
 
(Column No. 218 of form 24) 

 
(Column  No. 7 of form 26) 
26   
 
(Column No. 4 of form 26) 

(Column  No. 8 of form 27) 
  
27   
 
(Column No. 4 of form 27) 
 
4.      Other information 
 
Return 
Stateme
nt Form 
No. 
 Period 
Ending 
 Assessme
nt Year 
 Total No. of 
computer 
media 
enclosed 
 Whether 
existing TDS 
assessee (Y-
Yes  N-No) 
 Assessing 
Officer code 
 Periodicity2   Media used for 
the return of 
statement  

 

 Verification 
I,  ………………………………….. certify that all the particulars furnished above are correct and complete. 

Place  :              Name and signature of the person responsible   
Date   : 
           for deducting tax at source ………………………… 
              Designation   ……………………………. 
Notes : 
1.  Please use separate Form 27A for each return of TDS in Form No. 24 or Form No. 26 or Form No. 27, as the case may be. 
2.   0 for annual, 1 for 1s t  quarter of financial year, 2 for 2n d quarter of financial year, 3 for 3 rd  quarter of financial year, 4 for 4th 
quarter of financial year 
3.  Please give complete information.”.