Schedule – 2
(Relating to Sub-rule (3) of Rule 3)
To,
The Tax Office,
………………..Zone.
I have, hereby, furnished the following statement of the rent received with in the fiscal year…………. within the time-limit as referred to in the House and Land Rent Tax Act. The following statement is true and correct. If the
statement is held to be false, I shall bear and pay according to the prevailing Nepal law.

Tax payer’s name: –
Signature:-
Address: –
Name of signature maker –
Address –
Date –