In case of loss of TDS certificate, a draft of Indemnity bond claiming credit based on duplicate certificates to be submitted to IT department

THIS INDEMNITY BOND is made on this .......... day of .................... 19..... by Shri .................... son of Shri .............................. resident of ..............................

WHEREAS I am working as government contractor and receive payments from government/DDA. etc. after deduction of tax at source.

WHEREAS during the financial year 19.....-19..... (relevant to assessment year 19.....-19.....) a sum of Rs...........was deducted by Government/DDA, etc. toward tax deduction at source which cerlificates were tendered to the Income-tax Department for adjustment/refunds.

WHEREAS the said certificates included the following certificates which have been misplaced/lost or are otherwise not traceable:

TDS Certificate No. and date

Issuing Authority

Gross work done

TDS Amount

Remarks

1

2

3

4

5

1

2

3

4

Total Rs.

WHEREAS I have approached the Income-tax Department for adjustment of the above said certificates.

AND WHEREAS it is declared that I have not claimed or received benefit or deduction in respect of the said tax deduction...