fixed deposits application - vallibel financefixed deposits application author: vallibel finance...
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Finance PLC (PQ 526) No. 310, Galle Road, Colombo-03, Sri Lanka.
Tel: 2370990 Fax: 2375851 E-mail: [email protected]
vallibel
Financevallibel
Certificate No:
Branch
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Yes
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No
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Tax Rate
Hold
Cheque to bank Bank slip
Special Approved :...........................................
Vallibel Finance PLC.
Finance (PQ 526)vallibel
No. 310, Galle Road, Colombo-03, Sri Lanka.
Tel: 2370990 Fax: 2375851
E-mail: [email protected]
1 Name With Initials (1 Depositor)
2 Name With Initials (2 Depositor)
3 Name With Initials (3 Depositor)
4 Name With Initials (Nominee)
5 Name With Initials (Correspondance)
6 Name With Initials (Payee)
Previous Deposit Certificate Declaration Receipt No:
Receipt Copy Cheque No: & Amount
KYC Form Realization Date
NIC/BR Copy
Billing
Allocated By Cheque Realization Confirmed By
Input By Activated By
Verified By Manager’s Signature(Approved)
BSP Code
BSP Code
BSP Code
BSP Code
BSP Code
BSP Code
............................................. .............................................
............................................. .............................................
............................................. .............................................
Account Operating Instructions
Anyone of Us* Withdrawal Either or Survivor Without Reference to Nominee/s
All Signatories Renewal
Vallibel Finance PLC
*Applies only for withdrawal at maturity & payment of interest/
Financevallibel
DEPARTMENT OF' INLA}{D REVENUE
To: Vallibel Finance PLC
No.310,
Galle Road,
Colombo 03.
Account No'.: .........
Year of Assessment:
DECLARATION (BY SENIOR CITIZENS)
hereby declare that;
I am a citizenand resident of Sri Lanka and asenior cilizen(as per the provisions of the Inland Revenue
Act, No. 24 of 2017) and,
1. The aggregate interest receivable by me for the above year of assessment on the monies deposited
in this account or any other account of this financial institution or any other accounts in any otherbank or any other financial institution does not exceed Rs. 1,500,000/:. Therefore, please refrainfrom deducting withholding tax on the interest payable on this account.
2.T1te aggregate of the interest receivable by me for the above year of assessment on the monies
deposited in this account or any other account of this financial institution or any other accounts inany other bank or any other financial institution rnay exceed the tax relief of Rs. 1,500,000/:.Therefore, please withhold tax on any interest in excess of Rs ........ which is thebalance ofthe tax relief.
@alance of the tax relief = Rs. 115001000/= - interest due up-to-date from all accounts otherthan this account for the above year of assessment)
3. The tax relief on interest income of Rs. 1,500,000i: which is available to senior citizen has been
availed by me in respect of the interest recsivable by me on the monies deposited in the otheraccounts of this financial institution or other banks or other financial institutions. Therefore, please
withhold tax on the total interest receivable by me from this account.
I certiff that the above declaration made by me is true and correct:
Any changes to my r?sidence status witl be notified to thefinancial institurion at the time of sueh change.
Date
(*pleas e s trike-off the s tatem ents not t rel evant)
Signature of the Declarant
I,....................
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