FormNumber I FormSection FormLaw Income Tax Direct Tax FormTitle by keithmurray

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									FormNumber 10-I FormSection 80DDB FormLaw Income Tax & Direct Tax                    FORM No.10-I
FormTitle Certificate of prescribed authority for the purposes of section 80DDB

                                                   FormParentAct IncomeTax Act, 1961
               Certificate of prescribed authority for the purposes of section 80DDB
                                          [See rule 11DD]


1    Name of the Patient                                                   xx

2    Address                                                               xx

3    Name      and     details    of    the                                xx
     disease/ailment (please see rule 11D)
4    The date of commencement of                                            x
     treatment
5    Name, address, registration No. of                                    xx
     the prescribed Authority [See rule
     11DD (2)]

                                            Verification
I certify that the information furnished above is true to the best of my knowledge and the patient is
suffering from above mentioned chronic and protected disease as defined in section 80DDB of
income-tax Act, 1961 read with rule 11DD of the Income-tax Rules, 1962.



                                                                        Signature
                                                                           xx

                                                                  Name and Address

								
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