FORM NO. 27B 
 
[See rule 37EA ] 
             Form for furnishing information with the return or statement of deduction of tax at source filed on computer media.  
 
 DETAILS   OF  THE  PERSON  BEING  A  SELLER,  COLLECTING  THE  TAX 
Tax Deduction Account Number   
Permanent Account Number 
  
Name and Address of Seller 
   
Telephone No. 
 Fax No. 

 
 
OTHER  INFORMATION 
[Please give the complete information] 
Return 
Form 
No. 
 Whether existing 
TDS/tax collected 
at source assessee 
(Y - Yes, N - No) 
 A.O. Code 
 Period ending  Assessment Yr.  Periodicity  Media used 
computer media 
enclosed 
for the  return  Total number of 

CONTROL  TOTALS  
S. No.  Control Total required for Form Nos.27EA, 27EB, 27EC and 27ED  Total 
1.  Gross Amount debited to/received from companies     
2.  Gross amount debited to/received from non-companies     
3.  Total amount of tax collected from companies at prescrib ed rates     
4.  Total amount of tax collected from non-companies at prescribed rates     
5.  Total number of persons from whom tax was collected    

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

  
................................................................... 
 
Place : .....................................    
 Name and signature of the person responsible for            
deducting tax at source 

  
  
Designation : ...............................................................……  
Date     : ……...………….