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FORM NO. 33

[See Rule 3]

CLEARANCE CERTIFICATE UNDER SECTION 230(1) OF THE INCOME-TAX ACT, 1961

Folio No.

Government of India

1.	Full Name (in block letters)
2.	Name of father (or husband)
3.	Passport No./Emergency Certificate No.

	This is to certify that the abovementioned applicant has :
	*(a)	no liabilities outstanding
	*(b)	made satisfactory arrangements for the payment of taxes which are or may become payable under the Income-tax Act, 1961 (43 of 1961), the Indian Income-tax Act, 1922 (11 of 1922), the Excess Profits Tax Act, 1940 (15 0f 1940), the Business Profits Tax Act, 1947 (21 of 1947), the Wealth-tax Act, 1957 (27 of 1957), the Expenditure Tax Act, 1957 (29 of 1957) or the Gift-tax Act, 1958 (18 of 1958).
	This certificate is valid for a journey or journeys to be commenced on or after and before


Place:
Date:		(Assessing Officer, Foreign Section)

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* Strike out the paragraph which is not applicable.