FORM NO. 52A
[See rule 121A].
Statement to be furnished to the Assessing Officer under 285B
of the Income-tax Act, 1961, in respect of production
of a cinematograph film
1. Name and address of the producer
2. Permanent Account Number
3. Name of the film
4. Date on which the production of the film was started
5. If the production of the film has been completed, the date
of completion
6. Financial year to which the statement relates
7. Details of payments of over Rs. 25,000 in the aggregate
made by the producer or due from him to each person
engaged in the production of the film as employee or
otherwise:
Name and address of Nature of payment Date on which Amount of payment
the person to whom
 payment was made
payment has been
 or became due
made or is due
 Verification
I, ....................................…………………………, do hereby declare that what is stated above is true to the
best of my knowledge and belief.
Verified today the..........................day of.............................  ........
 ……………………………..
Signature of the producer
Notes:
1. The statement should be in respect of the financial year during which the production of a cinematograph
film is carried on and should be furnished within thirty days from the end of the financial year or within
thirty days from the date of the completion of the production of the film, whichever is earlier.
2. If the space provided in item 7 for the details of payments is insufficient, separate enclosures may be used
for the purpose.