FORM NO. 34

[See rule 43]

Exemption certificate under proviso to section 230(1) of the Income-tax Act, 1961

                                              Certificate 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 who intends to travel abords is exempted from producing a Clearance Certificate under section 230(1) of the Income-tax Act, 1961 (43 of 1961), in respect of the  journey or journeys to be undertaken on or  after                        and before

Pace .                                                                                             

Date .                                                                                                              Assessing Officer

(SEAL)                                                                                                           .              Foreign Section