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 furnished herewith :-
1. Name in full [block letters]
2. Father's name
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, name 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 assessee Assessment year Designation of the income -tax authority before whom appeared
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.
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