FORM

INDIAN INCOME TAX RETURN ITR-2

[For Individuals & HUFs not having Income from Business or Profession]
(Please see Rule 12 of Income-tax Rules, 1962) (Also see attached instructions)

Assessment Year

2 0 1 3 -1 4
PAN Status (tick)
Individual HUF

Part A-GEN
First Name Flat/Door/Block No.

GENERAL
Middle name Last name Name of Premises/Building/Village Area/Locality

PERSONAL INFORMATION

Road/Street/Post Office

Date of Birth (DD/MM/YYYY)

(in case of Individual)

Town/City/District

State Country

Pin code

Sex (In case of Individuals) (Tick)

Male
Female

Residential/Office Phone Number with STD code / Mobile No. 1

Mobile No. 2

Employer Category
(If in employment) (Tick) Govt PSU Other

Email Address - 1 Self Email Address - 2 Return filed (Tick) [Please see instruction number-7] OR In response to notice
FILING STATUS

Income Tax Ward/Circle

Before due date -139(1)

139(9)
142 (1)

After due date -139(4)

148

Revised Return- 139(5)

153A / 153C

If revised, then enter Receipt No. and Date of filing original return (DD/MM/YYYY)
Resident Residential Status (Tick) Are you governed by Portuguese Civil Code? (Tick) Whether this return is being filed by a representative of assessee? (Tick) If yes, please furnish following information (a) Name of the representative (b) Address of the representative (c) Permanent Account Number (PAN) of the representative

Non-Resident Yes

Resident but Not Ordinarily Resident No

(If YES please fill Schedule 5A)

Yes No

PART -B

Part B-TI
1 2 3
TOTAL INCOME

Computation of total income

Salaries (7 of Schedule S) Income from house property (3c of schedule HP) (enter nil if loss) Capital gains a Short term Short-term (u/s 111A) (enter nil, if loss) (A1a+A 2e of i Schedule CG) Short-term (others) (enter nil if loss) ((A5 A1a-A 2e) of ii Schedule CG) iii Total short-term (3ai + 3aii) (A5 of Schedule CG) b i 1 2 NIL NIL

3ai 3aii 3aiii

NIL NIL NIL NIL NIL NIL 3c For Office Use Only
Receipt No. Date Seal and signature of receiving official

Long-term (B6 - B3e B4 of Schedule CG) (enter nil if loss) 3bi 3bii 3biii

Long-term without indexation (B3e + B4 of Schedule CG) ii (enter nil if loss) iii Total Long-Term (3bi +3bii) c Total capital gains (3aiii + 3biii) (enter nil if 3c is a loss) Do not write or stamp in this area (space for bar code)

NIL

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5 6 7 8 9 10 11 12 13 14 15 16

Income from other sources from sources other than from owning race horses and winnings from Lottery etc. a (1g of Schedule OS) winnings from lotteries, crossword puzzles, races, games, gambling, betting etc. b (2 of Schedule OS) c from owning and maintaining race horses (4c of Schedule OS) (enter nil if loss) d Total (4a + 4b + 4c) (enter nil if 4d is a loss) Total (1 + 2 + 3c + 4d) Losses of current year set off against 5 (total of 2vii and 3vii of Schedule CYLA) Balance after set off of current year losses (5 - 6) (also total of column 4 of Schedule CYLA) Brought forward losses set off against 7 (2vii of Schedule BFLA) Gross Total income (7-8) (also 3viii of Schedule BFLA +4b ) Income chargeable to tax at special rate under section 111A, 112 etc. included in 9 Deductions under Chapter VI-A [q of Schedule VIA and limited to (9-10)] Total income (9-11) Income which is included in 12 and chargeable to tax at special rates (total of (i) of schedule SI) Net Agricultural Income/any other income for rate purpose (4 of Schedule EI) Aggregate income (12-13+14) [applicable if (12-13) exceeds maximum amount not chargeable to tax] Losses of current year to be carried forward (total of row xi of Schedule CFL)

4a 4b 4c 4d 5 6 7 8 9 10 11 12 13 14 15 16

NIL NIL NIL NIL NIL NIL NIL NIL NIL NIL NIL NIL NIL NIL NIL NIL

Part B-TTI
1

Computation of tax liability on total income

NIL NIL NIL 1d 2 3 NIL NIL NIL

Tax payable on total income a Tax at normal rates on 15 of Part B-TI 1a b Tax at special rates (total of (ii) of Schedule SI) 1b Rebate on agricultural income [applicable if (12-13) c 1c of Part B-TI exceeds maximum amount not chargeable to tax] d Tax Payable on Total Income (1a + 1b 1c) Education cess, including secondary and higher education cess, on 1d 2 Gross tax liability (1d+ 2) 3 Tax Relief 4 a Section 89 4a b Section 90/90A ( 3 of Schedule TR) 4b c Section 91 ( 4 of Schedule TR) 4c d Total (4a + 4b + 4c) Net tax liability (3 - 4d) 5 Interest payable 6 a For default in furnishing the return (section 234A) 6a b For default in payment of advance tax (section 234B) 6b c For deferment of advance tax (section 234C) 6c d Total Interest payable (6a + 6b + 6c) Aggregate liability (5 + 6d) 7 Taxes Paid 8 a Advance Tax (from Schedule-IT) 8a TDS (total of column 5 of Schedule-TDS1 and column 7 of b 8b Schedule-TDS2) c Self Assessment Tax (from Schedule-IT) 8c d Total Taxes Paid (8a + 8b + 8c) Amount payable (Enter if 7 is greater than 8d, else enter 0) 9 10 Refund (If 8d is greater than 7) Enter your bank account number (mandatory and for direct deposit of 11 refund into bank, the number should be 11 digits or more) cheque, or deposited directly into your bank account? 12 Do you want refund by 13 Give additional details of your bank account IFSC Code Type of Account (tick as applicable)

COMPUTATION OF TAX LIABILITY

NIL NIL 4d 5 NIL NIL

6d 7 NIL NIL NIL 8d

9

NIL NIL

TAXES PAID

10

NIL NIL NIL

REFUND

( tick as applicable)
Savings Current

14

Do you have,(i) any asset (including financial interest in any entity) located outside India or (ii) signing authority in any account located outside India? [applicable only in case of a resident] [Ensure Schedule FA is filled up if the answer is Yes ]
VERIFICATION son/daughter of

Yes

No

I,

, holding permanent account number

solemnly declare that to the best of my knowledge and belief, the information given in the return and

schedules thereto is correct and complete and that the amount of total income and other particulars shown therein are truly stated and are in accordance with the provisions of the Income-tax Act, 1961, in respect of income chargeable to Income Tax for the previous year relevant to the Assessment Year 2013-14.

Place

Date

9/18/2013

Sign here

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15 If the return has been prepared by a Tax Return Preparer (TRP) give further details as below: Identification No. of TRP Name of TRP Counter Signature of TRP If TRP is entitled for any reimbursement from the Government, amount thereof

16

Schedule S
Name of Employer Address of Employer

Details of Income from Salary

PAN of Employer (Optional) Town /City State Pin Code

SALARIES

1 2 3 4 5 6 7

Salary (Excluding all exempt/ non-exempt allowances, perquisites & profit in lieu of salary as they are shown separately below) Allowances exempt under section 10 2 (Not to be included in 7 below) Allowances not exempt (refer Form 16 from employer) Value of perquisites (refer Form 16 from employer) Profits in lieu of Salary (refer Form 16 from employer) Deduction u/s 16 (Entertainment allowance by Government and tax on employment) Income chargeable under the Head Salaries (1 + 3 + 4 + 5 - 6)

3 4 5 6 7

NIL

Schedule HP
1

Details of Income from House Property (Please refer to instructions)

Town/City
Yes No

Address of property 1

State

Pin Code

Is the property co-owned? Your percentage of share in the property. S.No. Name of Co-owner(s) I II (Tick) If let out a

(if YES please enter following details) Percentage Share in Property

PAN of Co-owner (s) (optional )

Name of Tenant

PAN of Tenant (Optional)

HOUSE PROPERTY

Annual Letable value/ rent received or receivable 1a (higher of the two, if let out for whole of the year, lower of the two if let out for part of the year) b The amount of rent which cannot be realized 1b c Tax paid to local authorities 1c NIL d Total (1b + 1c) 1d e Annual value (1a 1d) (nil, if self -occupied etc. as per section 23(2)of the Act) 1e NIL f 30% of 1e 1f g Interest payable on borrowed capital 1g h Total (1f + 1g) 1h i Income from house property 1 (1e - 1h) 1i Address of property 2 Town/City State
Yes No

NIL

NIL NIL Pin Code

Is the property co-owned? Your percentage of share in the property. S.No. Name of Co-owner(s) I II (Tick) If let out

(if YES please enter following details) Percentage Share in Property (optional)

PAN of Co-owner (s) (optional )

Name of Tenant

PAN of Tenant (Optional)

Annual Letable value/ rent received or receivable 2a (higher of the two, if let out for whole of the year, lower of the two, if let out for part of the year) The amount of rent which cannot be realized b 2b c Tax paid to local authorities 2c NIL d Total (2b + 2c) 2d e Annual value (2a 2d) 2e NIL f 30% of 2e 2f g Interest payable on borrowed capital 2g h Total (2f + 2g) 2h i Income from house property 2 (2e - 2h) 2i Income under the head "Income from house property" a Rent of earlier years realized under section 25A/AA 3a b Arrears of rent received during the year under section 25B after deducting 30% 3b c Total ( 3a + 3b +1i + 2i ) 3c a
Please include the income of the specified person referred to in Schedule SPI while computing the income under this head

NIL

NIL NIL

NIL

NOTE

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Schedule CG
A

Capital Gains

Short-term capital gain 1 In case of NON-RESIDENT to which first proviso to section 48 is applicable From assets (shares/units) where section 111A is applicable (STT paid) From assets where section 111A is not applicable 2 From assets (shares/ units) in the case of others where section 111A is applicable (STT paid) a Full value of consideration 2a b Deduction under section 48 i Cost of acquisition bi ii Cost of Improvement bii iii Expenditure on transfer biii NIL iv Total (i + ii + iii) biv NIL c Balance (2a 2biv) 2c Loss, if any, to be ignored under section 94(7) or 94(8) d 2d (enter positive values only) e Short-term capital gain (2c +2d) 3 From assets in case of others where section 111A is not applicable a Full value of consideration 3a b Deductions under section 48 i Cost of acquisition bi ii Cost of Improvement bii iii Expenditure on transfer biii NIL iv Total (i + ii + iii) biv NIL c Balance (3a 3biv) 3c Loss, if any, to be ignored under section d 3d 94(7) or 94(8) (Enter positive value only) e Deduction under section 54B/ 54D 3e f Short-term capital gain (3c + 3d 3e) 4 Amount deemed to be short term capital gains under sections 54B/54D/54G/ 54GA 5 Total short term capital gain (1a + 1b + 2e + 3f + A4) Long term capital gain 1 From asset in case of non-resident to which first proviso to section 48 is applicable 2 From asset in the case of others where proviso under section 112(1) is not applicable a Full value of consideration 2a b Deductions under section 48 i Cost of acquisition after indexation bi ii Cost of improvement after indexation bii iii Expenditure on transfer biii NIL iv Total (bi + bii + biii) biv NIL c Balance (2a - biv) 2c Deduction under sections d 2d 54/54B/54D/54EC/54F/ 54G/54GA/54GB Net balance (2c 2d) e 3 From asset where proviso under section 112(1) is applicable (without indexation) a Full value of consideration 3a b Deduction under section 48 i Cost of acquisition without indexation bi ii Cost of improvement without indexation bii iii Expenditure on transfer biii NIL iv Total (bi + bii + biii) biv NIL c Balance (3a - biv) 3c d Deduction under section 54/54B/54D/54EC/54F/54GB 3d e Net balance (3c - 3d) 4 From unlisted securities in case of non-resident as per section 112(1)(c)(iii) 5 Amount deemed to be long term capital gains under sections 54/54B/54D/54EC/54ED/54F/54GB 6 Total long term capital gain [1 + 2e + B3e + B4 + B5] 7 In case of deduction u/s 54GB, furnish PAN of the company Income chargeable under the head CAPITAL GAINS (A5 + B6) (enter B6 as nil, if loss)

1a 1b

2e

NIL

CAPITAL GAINS

3f A4 A5 1

NIL NIL

2e

NIL

B3e B4 B5 B6 C

NIL

NIL NIL

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Information about accrual/receipt of capital gain

Upto 15/9 Date (i) (ii) (iii) (Iv) 16/9 to 15/12 16/12 to 15/3 16/3 to 31/3

Long- term [where proviso under section 112(1) is applicable (Without Indexation) + non-residents as per section 112(1)(c)(iii)]Tax Rate is 10% ; Enter only positive value from Item B3e + B4 of Schedule CG AFTER loss adjustment under this category in Schedule CYLA and BFLA, if any. Long- term where proviso under section 112(1) is not applicable (With Indexation)Tax Rate is 20%; Enter only positive value from Item (B6 -B3e- B4) of Schedule CG AFTER loss adjustment under this category in Schedule CYLA and BFLA, if any. Short-term under 111ATax Rate is 15% ; Enter only positive value from Item A1a+A 2e of Schedule CG AFTER loss adjustment under this category in Schedule CYLA and BFLA, if any. Short-term OTHERSTaxed at normal rates; Enter only positive value from Item (A5 A 2e-A1a) of Schedule CG AFTER loss adjustment under this category in Schedule CYLA and BFLA, if any.

NOTE

Please include the income of the specified persons referred to in Schedule SPI while computing the income under this head.

Schedule OS
1

Income from other sources

2 3 4

5 NOTE

Income a Dividends, Gross 1a b Interest, Gross 1b c Rental income from machinery, plants, buildings, 1c Others, Gross (excluding income from owning race horses) Mention the source 1di i d 1dii ii 1diii iii 1d iv Total (1di + 1dii + 1diii) e Total (1a + 1b + 1c + 1d) f Deductions under section 57:i Expenses / Deductions fi ii Depreciation fii iii Total fiii g Balance (1e - fiii) Winnings from lotteries, crossword puzzles, races, games, gambling, betting etc. (Gross) Income from other sources (other than from owning race horses ) (1g + 2) (enter 1g as nil if loss) Income from owning and maintaining race horses a Receipts 4a b Deductions under section 57 in relation to (4) 4b c Balance (4a - 4b) Income chargeable under the head "Income from other sources" (3 + 4c) (enter 4c as nil if loss and take 4c loss figure to Schedule CFL)

OTHER SOURCES

0 1e 0

0 1g 2 3 0 0

4c 5

0 0

Please include the income of the specified persons referred to in Schedule SPI while computing the income under this head.

Schedule CYLA
Sl. No.

Details of income after Set Off of current year losses

Income of current year (Fill this column only if income is zero or positive) 1 House property loss of the current year set off Total loss (3c of Schedule-HP) 2 Other sources loss (other than loss from race horses) of the current year set off Total loss (3 of Schedule -OS) 3 4=1-2-3 Current year's income remaining after set off

Head/ Source of Income

CURRENT YEAR LOSS ADJUSTMENT

Loss to be adjusted i ii iii iv Salaries House property Short-term capital gain Long term capital gain Other sources (excluding profit from owning race horses and winnings from lottery) Profit from owning and maintaining race horses Total loss set off Loss remaining after set off out of 2 & 3

NIL NIL NIL NIL NIL NIL

NIL NIL NIL NIL NIL NIL

vi vii viii

NIL NIL NIL NIL NIL

NIL

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Schedule BFLA
BROUGHT FORWARD LOSS ADJUSTMENT Sl. No.

Details of income after Set Off of Brought Forward Losses of earlier years
Head/Source of Income Income after set off, if any, of current year's losses as per 4 of Schedule-CYLA 1 Brought forward loss set off Current year's income remaining after set off 3

i ii iii iv v

Salaries House property Short-term capital gain Long term capital gain Other sources (excluding profit from owning race horses and winnings from lottery) Profit from owning and maintaining race horses Total of brought forward loss set off Current year's income remaining after set off Total (i3+ii3+iii3+iv3+v3+vi3)

NIL NIL NIL NIL NIL NIL NIL

NIL NIL NIL NIL NIL NIL NIL

vi vii viii

Schedule CFL

Details of Losses to be carried forward to future years

Assessment Year Date of Filing House property (DD/MM/YYYY) loss Short-term capital loss Long-term Capital loss Other sources loss (from owning race horses)

CARRY FORWARD OF LOSS

i ii iii iv v vi vii viii ix x xi xii

2005-06 2006-07 2007-08 2008-09 2009-10 2010-11 2011-12 2012-13 Total of earlier year losses Adjustment of above losses in Schedule BFLA 2013-14 (Current year losses) Total loss carried forward to future years

NIL NIL NIL NIL

NIL NIL NIL NIL

NIL NIL NIL NIL

NIL NIL NIL NIL

Schedule VIA
TOTAL DEDUCTIONS

Deductions under Chapter VI-A (Section)

g h i j k l m 80DDB 80E 80G 80GG 80GGA 80GGC 80QQB q NIL n o p 80RRB 80TTA 80U

80C 80CCC 80CCD(1) (assessees c(i) contribution) 80CCD(2) (employers c(ii) contribution) 80CCG d 80D e 80DD f q a b

Schedule 80G

Details of donations entitled for deduction under section 80G

PAN of Donee Amount of donation Eligible Amount of donation

A Donations entitled for 100% deduction without qualifying limit Name and address of donee i ii DETAILS OF DONATIONS iii iv v B

Total vi Donations entitled for 50% deduction without qualifying limit Name and address of donee
i ii iii iv v vi

NIL
PAN of Donee Amount of donation

NIL
Eligible Amount of donation

Total

NIL

NIL

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Donations entitled for 100% deduction subject to qualifying limit Name and address of donee i ii iii iv v PAN of Donee Amount of donation Eligible Amount of donation

Total vi Donations entitled for 50% deduction subject to qualifying limit

Name and address of donee PAN of Donee

NIL
Amount of donation

NIL
Eligible Amount of donation

i ii iii iv v vi
E

Total Total donations (Avi + Bvi + Cvi + Dvi)

NIL NIL

NIL NIL

Schedule SPI
Sl. No. 1 2 3

Income of specified persons (spouse, minor child etc) includable in income of the assessee (income of the minor child, in excess of Rs. 1,500 per child, to be included) Name of person PAN of person (optional) Relationship Nature of Income

Amount (Rs.)

Schedule SI Income chargeable to Income tax at special rates (Please see instruction No. 9(iii) for section code and rate of tax) Special rate Income Tax thereon Sl Section (%) i ii No. 111A (STCG on shares where STT paid) 15.00% NIL 1 2 SPECIAL RATE 3 4 5 6 7 8 9 10 11 Schedule EI 1 2 3 4 Details of Exempt Income (Income not to be included in Total Income) Interest Income Dividend Income Long-term capital gains from transactions on which Securities Transaction Tax is paid Gross Agricultural income (other than income to be excluded i i
under rule 7A, 7B or 8 of I.T. Rules)

112 proviso (LTCG on listed securities/ units without indexation) 112 (LTCG on others) 112(1)(c)(iii) (LTCG on unlisted securities in case of non-residents) 115BB (Winnings from lotteries, puzzles, races, games etc.)

10.00% 20.00% 10.00% 30.00%

NIL NIL NIL NIL NIL NIL NIL NIL NIL NIL

Total

INCOME

1 2 3

EXEMPT

ii iii 5 6

Expenses relating to above Agricultural income Brought forward loss as per part IV of Schedule I of the
Finance Act

ii iii 4 5 6 NIL NIL

Net Agricultural income (i-ii-iii) Others, including exempt income of minor children Total (1 + 2 + 3 + 4 + 5)

Schedule IT
Sl. No. (1) i ii iii iv v NOTE TAX PAYMENTS

Details of payments of Advance Tax and Self-Assessment Tax

BSR Code (2) Date of Deposit (DD/MM/YYYY) (3) Serial Number of Challan (4) Amount (Rs.) (5)

Enter the total of Advance Tax and Self Assessment tax in Sl. No. 8a and 8c of Part B-TTI

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Schedule TDS1
TDS ON SALARY Sl No. (1) i ii NOTE

Details of Tax Deducted at Source from Salary [As per Form 16 issued by Employer(s)]
Name of the Employer Income chargeable under Salaries (4) Total tax deducted

Tax Deduction Account Number (TAN) of the Employer (2)

(3)

(5)

Please enter the total of column 5 of Schedule TDS1 and column 7 of schedule-TDS2 in 8(b) Part B-TTI

Schedule TDS2
TDS ON OTHER INCOME Sl No. (1) i ii NOTE

Details of Tax Deducted at Source on Income [As per Form 16 A issued by Deductor(s)]
Name of the Deductor Unique TDS Financial Year in Certificate Number which TDS is Deducted (4) (5) Total Tax Deducted (6) Amount out of (6) claimed this Year (7)

Tax Deduction Account Number (TAN) of the Deductor (2)

(3)

Please enter the total of column 5 of Schedule TDS1 and column 7 of schedule-TDS2 in 8(b) Part B-TTI

Schedule FSI
1 INCOME ACCRUING OR ARISING OUTSIDE INDIA

Details of Income accruing or arising outside India

Business Income (included in PART B-TI) (C) Capital Gain Income
(included in PART B-TI) (D)

Details of Income included in Total Income in Part-B-TI above Country Taxpayer Income from Income from Code Identification Salary (included House Property in PART B-TI) (included in Number
(A) PART B-TI) (B)

Other source Income

(included in PART B-TI) (E)

Total Income from Outside India (F)=A+B+C+D+E

Total NIL Total Income from outside India (Total of F as per item no.1 above) 2 Total Income from outside India where DTAA is applicable 3 Total Income from outside India where DTAA is not applicable (2-3) 4 Please refer to the instructions for filling out this schedule. NOTE

NIL

NIL

NIL 2 3 4

NIL 0 0

Schedule TR
1 INCOME ACCRUING OR ARISING OUTSIDE INDIA

Details of Taxes Paid outside India

Total taxes paid on income declared in Schedule FSI (A) Tax Relief Claimed (B) Relief claimed u/s 90/90A (B1) Relief claimed u/s 91 (B2)

Details of Taxes Paid outside India Country Taxpayer Relevant Code Identification article of Number DTAA

Total NIL Total Taxes paid outside India (Total of 1A) 2 Total Taxes Paid outside India where DTAA is applicable 3 Total Taxes Paid outside India where DTAA is not applicable (2-3) 4 Please refer to the instructions for filling out this schedule. NOTE

NIL 2 3 4

NIL NIL NIL

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Schedule FA

Details of Foreign Assets

Name and Address of the Bank (4) Name mentioned in the account (5) Peak Balance During the Year (in rupees) (6)

A Details of Foreign Bank Accounts Sl Country Name Country Code No. (1)

(2)

(3)

B Sl No. (1)

Details of Financial Interest in any Entity Country Name Country Code (2) (3)

Nature of entity (4)

Name and Address of the Entity (5)

Total Investment (at cost) (in rupees) (6)

DETAILS OF FOREIGN ASSETS

C Sl No. (1)

Details of Immovable Property Country Name Country Code (2) (3)

Address of the Property (4)

Total Investment (at cost) (in rupees) (5)

D Sl No. (1)

Details of any other Asset Country Name (2)

Country Code (3)

Nature of Asset (4)

Total Investment (at cost) (in rupees) (5)

E Sl No. (1)

Details of account(s) in which you have signing authority and which has not been included in A to D above. Name of the Institution in which the Address of the Institution Name mentioned in the account is held account (2) (3) (4) (5)

Peak Balance/Investment during the year (in rupees) (6)

F Sl No

Details of trusts, created under the laws of a country outside India, in which you are a trustee Country Name Country Code Name and address of the Name and address of trust other trustees (2) (3) (4) (5) (1)

Name and address of Settlor (6)

Name and address (7)

Schedule 5A
Name of the spouse PAN of the spouse

Information regarding apportionment of income between spouses governed by Portuguese Civil Code

Heads of Income
1 2 3 4 5

Amount apportioned in the hands of the spouse

House Property Business or profession Capital gains Other sources Total

NIL

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ITR - V
Received with thanks from ITR No.
1 (SAHAJ)

ACKNWLEDGEMENT
2 3 4S (SUGAM) 4 5
6

AY 2013-14
a return of income in

for assessment year 2013-14, having

the following particulars

A1 A3 A5 A8

FIRST NAME 0 LAST NAME 0 SEX A6 DATE OF BIRTH Male Female 1/0/1900 FLAT/DOOR/BUILDING

A2 A4 A7

MIDDLE NAME 0 PERMANENT ACCOUNT NUMBER

A10 AREA/LOCALITY 0 A12 STATE 0 A14 Fill only one: filed

OR in response to notice

0 INCOME TAX WARD / CIRCLE 0 A9 ROAD/STREET 0 A11 TOWN/CITY/DISTRICT 0 COUNTRY A13 PINCODE 0 0
After due date - 139(4) Revised Return- 139(5) 153A / 153C

Before due date - 139(1) 142(1) 148

COMPUTATION OF INCOME AND TAX RETURN

B1 Gross Total Income B2 Deductions under Chapter VI-A B3 Total Income B4 Current Loss if any B5 Net Tax Payable B6 Interest Payable B7 Total Tax and Interest Payable B8 Total Advance Tax paid B9 Total Self Assessment Tax Paid B10 Total TDS Deducted B11 Total TCS Deducted B12 Total Prepaid Taxes (B8+B9+B10+B11) B13 Tax Payable ( B7-B12, If B7 > B12 ) B14 Refund ( B12-B7, If B12 > B7 ) B1 ( ) B2 B3 ( ) B4 B5 B6 B7 B8 B9 B10 B11 B12 B13 B14 0 0 0 0 0 0 0 0 0 0 0 0 0 0

FOR OFFICE USE ONLY

STAMP, RECEIPT NO, HERE

SEAL, DATE AND SIGNATURE OF RECEIVING OFFICIAL

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Annexure Details of Advance Tax Paid (Please carry the total to Shedule IT in the form) Sl. No. 1 2 3 4 5 6 7 8 9 10 11 12 Total NIL BSR Code Date of Deposit (DD/MM/YYYY) Serial Number of Challan Amount (Rs.)

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Annexure TDS1 Details of Tax Deducted at Source from Salary (Please carry totals to Schedule TDS1 of ITR form) Sl No. (1) 1 2 3 4 5 6 7 8 9 10 11 12 Total NIL NIL Tax Deduction Account Number (TAN) of the Employer (2) Income chargeable under the head Salaries (4) Total tax deducted (5)

Name of the Employer

(3)

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Annexure TDS 2 Details of Tax Deducted at Source on Income (Please carry totals to Schedule TDS2 of ITR form) Sl No. Tax Deduction Account Number (TAN) of the Deductor (2) Name of the Deductor Unique TDS Certificate Number (4) Financial Year in Total tax deducted Amount out of (7) which TDS is claimed for this Deducted year (5) (6) (7)

(1) 1 2 3 4 5 6 7 8 9 10 11 12 Total

(3)

NIL

NIL

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Address of property 3 Is the property co-owned?

Yes No

Town/City

State

Pin Code

(if YES please enter following details) Percentage Share in Property

Your percentage of share in the property.

S.No. Name of Co-owner(s)

PAN of Co-owner (s) (optional )

I HOUSE PROPERTY II (Tick) If let out Name of Tenant PAN of Tenant (Optional)

Annual Letable value/ rent received or receivable a (higher of the two, if let out for whole of the year, lower of the two if let out for part of the year) b The amount of rent which cannot be realized c Tax paid to local authorities 3b NIL 3c d Total (3b + 3c) 3d e Annual value (3a 3d) (nil, if self -occupied etc. as per section 23(2)of the Act) f 30% of 3e 3f 3g g Interest payable on borrowed capital h Total (3f + 3g) i Income from house property 3 (3e - 3h)

3a

NIL

3e NIL 3h 3i

NIL

NIL NIL

Address of property 4 Is the property co-owned?

Yes No

Town/City

State

Pin Code

(if YES please enter following details) Percentage Share in Property (optional)

Your percentage of share in the property.

S.No. Name of Co-owner(s)

PAN of Co-owner (s) (optional )

I HOUSE PROPERTY II (Tick) If let out Name of Tenant PAN of Tenant (Optional)

Annual Letable value/ rent received or receivable a (higher of the two, if let out for whole of the year, lower of the two, if let out for part of the year) b The amount of rent which cannot be realized c Tax paid to local authorities d Total (4b + 4c) e Annual value (4a 4d) f 30% of 2e g Interest payable on borrowed capital h Total (4f + 4g) i Income from house property 4 (4e - 4h) 4b 4c 4d 4f 4g NIL

4a

NIL

4e NIL 4h 4i

NIL

NIL NIL