FORM NO. 39
[See rule 54]
Form of application for registration as authorised
income-tax practitioner
To
The Chief Commissioner or Commissioner of Income-tax,
………………………………………………………………..
I hereby apply for registration as an authorised income-tax practitioner under clause (v)/(vi)/ (vii)  of
section 288(2) of the Income-tax Act, 1961.
The following particulars are fumished herewith:-
1. Name in full [block letters]
2. Father’sname
3. Permanent residential address
4. Present residential address
5. Professional address(es) in India
6. Principal place of profession in India
7. If partner in a firm, names of the firm and other partners
*I certify that I have passed the accountancy examination of (a true copy of the certificate enclosed)
*I certify that I have acquired the educational qualifications of (a true copy of the certificate enclosed)
*I certify that I was an income-tax practitioner within the meaning of clause (iv) of sub-section (2) of
section 61 of the Indian Income- tax Act, 1922, and was actually practising immediately before 1st April
1962, as such and some of the cases in which I appeared in that capacity are as below:
Name and address of Assessment year Designation of the
assessee
 income-tax authority
before whom appeared
  1.
  2.
  3.

I certify that I have been practising as an authorised income-tax practitioner since .................... and that
I have not so far made any application for registration as an authorised income-tax practitioner to any
other Chief Commissioner or Commissioner of Income-tax.
 ………………………
Signature
Verification
I, ………………………………………………….., do declare that what is stated in the above application is
true to the best of my information and belief.
Date ....................
 ………………….
Signature
*Delete inappropriate words.