FORM NO. 27EA
[See section 206C and rule 37E]
Half-yearly return of collection of tax under section 206C from buyers of alcoholic liquor for human consumption (other than Indian made foreign liquor) and tendu leaves for the period ending		.

1.	(a)   Tax Deduction Account Number											
											
        (b)   Permanent Account Number											
2. Details of the seller	
        (a)   Name																										
																										
        (b)   Address																										
																										
                  Flat/Door/Block No.																										
																										
                Name of premises/Building																										
																										
                  Road/Street/Lane																										
																										
                Area/Locality																										
																										
                  Town/City/District																										
																										
                 State																										
																										
                Pin Code							

©	Has address of the seller since submitting the last return Tick	 as applicable Yes           No	

3.	Details of gross amount debited/received under section 206C(1) and tax collected thereon :
Buyer 	Gross amount debited/received during the half-yearly period  (Rs.)	Total amount of tax collected	
		Income-tax (Rs.)	Surcharge (Rs.)	Total 
(Rs.)	
	(1)	(5)	(6)	(7)	
1. Companies					
2. person other than companies					
    Total					

3.	Details of tax collected and paid  to the  Central Government :
(a)	By or on behalf of Central Government:
Sl. No.	Amount of tax deducted (Rs.)	Transfer Voucher Number	Date of Transfer Voucher	
(1)	(2)	(3)	(4)	

				
				
		Total		

(b)	By person responsible for collecting other than Central Government
Sl. No.	Challan Number	Date of payment	Amount of tax paid (Rs.)	Name and address of the bank	
(1)	(2)	(3)	(4)	(5)	

					
					
Total			

3.	Details of payments debited/received from buyers and of tax collected at source under section 206C :  :
(a)	In the case of buyers, being companies:
Sl. No.	Permanent Account Number (PAN)	Name of company	Address of the company	Total value of the purchase(s)	Amount  debited/ received  (Rs.)	Amount of tax collected
	Date on which tax collected
	Date on which tax collected at source was paid to the credit of the Central Government 	Tax deduction Certificate Number
	Date of furnishing of tax Deduction Certificate to the company
	
(1)		(1)		(1)		(1)		(1)		(1)		(1)		(1)		(1)		(1)		(1)		

											
											
Total				
       
(b)	In the case of buyers, other than companies:
Sl. No.	Permanent Account Number (PAN)	Name of buyer	Address of the buyer	Total value of the purchase(s)	Amount  debited/ received  (Rs.)	Amount of tax collected
	Date on which tax collected
	Date on which tax collected at source was paid to the credit of the Central Government 	Tax deduction Certificate Number
	Date of furnishing of tax Deduction Certificate to the company
	
(1)		(1)		(1)		(1)		(1)		(1)		(1)		(1)		(1)		(1)		(1)		

											
											
Total				

Verification
I, 							, certify that all the particulars furnished above are correct and complete.
Place:				Name and signature of the responsible for deducting tax at source
Date:												Designation: