FORM NO.65 
[See rule 11P] 
 
 Application for *exercising/renewing option for the tonnage tax scheme under *sub- section 
(1) of section 115VP or sub - section (1) of section 115VR of the Income-tax Act, 1961. 
 
To, 
The Joint Commissioner, 
………………………… 
 
Sir,  
 
I, on behalf of                      , hereby apply for *exercising /renewing the option for the tonnage tax 
   [Nam e  of  t he  c om pany ]  
scheme in accordance with the provisions of *sub-section (1) of section 115VP or sub-section (1) 
of section 115VR of the Income-tax Act, 1961 with effect from the assessment year………..    
 
2.  A statement of particulars for the purpose of *exercising /renewing the option is 
enclosed as per Annexure to this Form. 
 
 Verification ** 
 
I, ………………………………(full name in block letters), do hereby declare that what is 
stated in this application and the Annexure hereto is true to the best of my information 
and belief. I further confirm that: 
 
 (1)            is an Indian company within the meaning of clause  
                   [Name of the company] 
(26) of section 2 of the Income-tax Act, 1961. 
 
(2)The place of effective management of the company within the meaning of section 
115VC of the Income-tax Act, 1961 is in India. 
 
(3) The company owns …… qualifying ship(s). 
 
(4) The main object of the company is operation of ships.  Copy of Memorandum of 
Association of the company is enclosed.  
 
2.  I further declare that I am making this application in my capacity as ……………… 
and I am also competent to make this application and verify it.  

 ……………………………… 
Name and Signature 
Place: ……….. 
 
Date : ……… 
 
Note: 

1.  This application should be filed with the Joint Commissioner of Income-tax 
having jurisdiction over the applicant company.  
2.  All the columns in the application must be filled in. Part A and Part B (if 
applicable) of  the Annexure must be filled in, failing which the application 
shall be treated as incomplete.  
3.  * Strike out whichever is not applicable. 
4.  ** Before signing the verification every person should satisfy himself that the 
application, the accompanying statements and documents are, to the best of 
his knowledge and belief, correct and complete in all respects. Any person 
making any false statement shall be liable to be prosecuted under section 
277 of the Income-tax Act, 1961. 
5.  The application shall be signed and verified on behalf of the company by the 
managing director of the company, or where for any unavoidable reason such 
managing director is not able to sign and verify this Form, or where there is 
no managing director, by any director: 
Provided that: 
(a)  where the  company is being wound up, whether under the orders of a 
court or otherwise, or where any person has been appointed as the 
receiver of any assets of the company, the statement shall be signed and 
verified by the liquidator referred to in sub-section (1) of section 178 of the 
Income-tax Act; 
(b)  where the management of the company has been taken over by the 
Central Government or any State Government under any law, the 
statement of the company shall be signed and verified by the principal 
officer thereof. 
 
 ANNEXURE 
Statement of particulars to be furnished for *exercising/renewing option for tonnage tax scheme  
 
 PART - A 
1.  Name of the company in full (in block letters)   
  
2.  Permanent Account Number 
  
3.  Address of the Registered Office 
  
4.  Address (es) of branch office (es) 
  
5.  Date of incorporation (enclose a copy of the certificate 
of incorporation) 

6.  Date on which the company became a qualifying 
company [to be given only in case of a company 
which becomes a qualifying company after the initial 
period] (enclose evidence in s upport of the claim) 
7.  Details of ships owned or chartered by the company 
(i)  Owned ships 

Sl.No.  Name of the 
 Net 
tonnage 
 Flag  Type of ship  Whether qualifying 
ship 
or not  
(1)  (2)  (3)  (4)  (5)  (6) 

(ii)  Ships chartered in on bareboat charter-cum -demise terms 
 
Sl.
No. 
 Name of the 
ship 
 Net 
tonnage 
 Flag   Type of 
 Date of 
commencement of 
charter 
 Period of 
charter  
 Reference     
No. of 
DG(Shipping) 
approval 
 Whether 
qualifying 
or not 
ship 
(1)  (2)  (3)  (4)   (5)  (6)  (7)   (8)  (9) 
                 
(iii)   Ships charte red in on bareboat charter terms for more than three years 
 
Sl.
No. 
 Name of the 
ship 
 Net 
tonnage 
 Flag   Type of 
 Date of 
commencement of 
charter 
 Period of 
charter  
 Reference     
No. of 
DG(Shipping) 
approval 
 Whether 
qualifying 
or not 
ship 
(1)  (2)  (3)  (4)   (5)  (6)  (7)   (8)  (9) 

 
(iv) Ships chartered in on bareboat charter terms for less than three years  
 
Sl.
No. 
 Name of the 
ship 
 Net 
tonnage 
 Flag   Type of 
 Date of 
commencement of 
charter 
 Period of 
charter  
 Reference     
No. of 
DG(Shipping) 
approval 
 Whether 
qualifying 
or not 
ship 
(1)  (2)  (3)  (4)   (5)  (6)  (7)   (8)  (9) 

 
(v)  Ships chartered out on bareboat charter-cum-demise terms 
 
Sl.No.   Name of ship  Net tonnage  Date of commencement 
 Period of 
charter   
 Whether 
of charter 
qualifying 
or not 
(1)  (2)  (3)  (4)  (5)  (6) 

 
 
(vi)  Ships chartered out on bareboat charter terms for more than three years 
 
Sl.No.  Name of 
 Net tonnage  Date of 
 Whether 
qualifying 
or not 
 Period of 
charter   
ship 
commencement of 
charter 
(1)  (2)  (3)  (4)  (5)  (6) 

 

(vii)  Ships c hartered out on bareboat charter terms for less than three years 
 
Sl.No.  Name of 
 Net tonnage  Date of 
 Whether 
qualifying 
or not 
 Period of 
charter   
ship 
commencement of 
charter 
(1)  (2)  (3)  (4)  (5)  (6) 

 

 
 
(viii)  Other ships chartered in [other tha n those referred to at (ii), (iii) and (iv) above] 
 
Sl.
No. 
 Name of the 
ship 
 Net 
tonnage 
 Flag   Type of 
 Date of 
commencement of 
charter 
 Period of 
charter  
 Reference     
No. of 
DG(Shipping) 
approval 
 Whether 
qualifying 
or not 
ship 
(1)  (2)  (3)  (4)   (5)  (6)  (7)   (8)  (9) 

8. Name(s) and address(es) of directors of the 
applicant company 
 
PART-B 
(Statement of particulars to be furnished only in case of renewing of option for tonnage tax scheme)   
  
1.  Date(s) of exercising earlier option(s) alongwith date(s ) of 
order approving the option [enclose a copy of the order(s)].  
  
2.  Details regarding earlier options: 
(i)  Whether the company ceased to be a  qualifying 
company at any time during earlier option(s) 
(ii )  Whether any default was made in complying with 
the provisions of section 115VT or section 115VU 
or section 115VV (if yes, give details) 
(iii)   Whether the company was excluded from the 
scheme under section 115VZC (if yes, give 
details) 
(iv )  Whether the company voluntarily opted out of the 
tonnage tax scheme (if yes, give de tails) 
(v)  Whether there was an amalgamation of the 
company with a company, which was a qualifying 
company on 1st  October, 2004 and had not 
exercised the option within the initial period. 
Place :     
  
Date :     
  
                                                                                                                    **Signed 

Note:  
1.  * Strike out whichever is not applicable. 
2.  ** This Annexure has to be signed by the person competent to sign the application. 
3.  “Initial period” means the period after the 30th  day of September, 2004 but before the 1s t day 
of January, 2005. 
4.  Part-A is to be filled up both in case of exercising the option and while renewing the option. 
However, Part-B is to be filled up only in cases where an application is being filed for 
renewing the option. 
5.  In respect of each of the ships, details of which are being given in item 7, a copy of the 
following certificates, as may be relevant, in case of each qualifying ship should be 
enclosed: 
 
 (i)  Certificate of registration under the Merchant Shipping Act, 1958 and certificate 
under Merchant Shipping (Tonnage Measurement of Ship) Rules, 1987 made under 
the Merchant Shipping Act, 1958; 
(ii )  Certificate of registration under the Merchant Shipping Act, 1958 and international 
tonnage certificate issued under the provisions of the Convention on Tonnage 
Measurement of Ships, 1969 as specified in the Merchant Shipping (Tonnage 
Measurement of Ship) Rules, 1987 made under the Merchant Shipping Act, 1958; 
(iii)    Permission obtained from the Director-General of Shipping to charter in a ship in    
case of ships registered outside India.