Indemnity Bond Format for IT Refund

INDEMNITY BOND

Name of the Assessee :

PAN No. :

Assessment Year :

I…………………………..Son/Wife/Daughter of…………………….. resident of India do hereby agree to Indemnify the Government of India for any loss that may occur on issuing refund of Rs………………(Rupees……………….) for its year ending………………

I have not received the original Refund order and I declare that no refund has been claimed by me or any other person in respect of the aforesaid refund order.

Date:………………….. Signature………………

Place………………….. Name………………………

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