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Name and address of the Acknowledgement Nos. of all Quarterly Name and address of the person to whom
person deducting tax Statements of TDS under sub-section (3) of payment made or in whose account it is
section 200 as provided by TIN Facilitation credited
Centre or NSDL web-site
Quarter Acknowledgement
No.
1
2
3
4
Place : Ahmedabad
Date : Signature of person responsible for deduction of tax
Full Name :
Designation :