Hi,

Please read the Instruction Sheet.

Amendment in Form 16 for
Acknowledgement no. of e-TDS of all the 4
Qr. Put Acknowledgement no. of e-TDS of all
the 4 Qr. at D14,D15,H14,H15 at Form 16
respectively.
Also will be available at my e-groups: -
CLICK HERE FOR Instruction Computation FORM 16 http://finance.groups.yahoo.com/group/guptanpsbi/

guptanpsbi@yahoogroups.com
nareshgupta@sbi.co.in http://finance.groups.yahoo.com/group/guptanpsbi/
guptnp@gmail.com
guptanpsbi@yahoogroups.com
nareshgupta@sbi.co.in http://finance.groups.yahoo.com/group/guptanpsbi/
guptnp@gmail.com
 COMPUTATION OF INCOME FROM SALARY [2009 - 10]
Please Read the Instructions on this page carefully before inserting the Data. YOU CAN CHANGE ONLY IN YELLOW HIGHLIGHTED CELL.
Form16, 12B & Saral are Auto Generated. This is only for Salaried Person for the Financial Year 2009 - 2010.
You should have to first save as in new file name as per your choice so that original file will remain BLANK for further new use.
Insert Your Org. Name, Branch, PAN, TAN, F. Yr. & Start Month of F.Yr., DDO's details, I T Ward, Place, Dt. of 16, Dt. of Form 16. (ROW A11 to 19) [Employee
Details]
Change the F. Yr.'s Start Month (C13), F. Yr. (B14) CITY (E19), & TDS Deposit Date (E43 to G55) from Dropdown Arrow Inserted there. Fill TOTAL TDS Amt.
Deducted on Salary in "Word" at Cell A60.
Insert Assessee (Employee) Details at this Sheet at A22 to E37 in appropriate Cell. Fill Name of Bank & Branch where Challan Deposited in Row A43 to B55.
Use Dropdown Arrow for Sex, Status & Date of Birth.
Insert Salary, Invest. & Perq. & H/L intt. Details at Computation Sheet. (B7 to O33) & (T8 to V43) & (U49 to X54). Fill Your Relief in Ent. Allow. & Proff. Tax in
Cell E39, E40. Fill TDS ded. by other in cell "I47" at Computation Sheet. Fill at P40 to Pay Excess Tax.
You can change the heading of computation sheet including cell A30 to A33 except BP,DA, HRA, Total, PF, I T Paid & Savings u/s 80C. You can use/change
also the cell below of each Month (space between the month) in the ROW.
You can change also the heading & rate of intt. in perquisite as you need (cell T8 to V43). You can insert any other Amt. of Perq. in lump sum at cell R21 to
V21 & R32 to V32. Put the Amt. by which U want to Pay More Tax at P40 in Computation Sheet.

nareshgupta@sbi.co.in Prepared By: - Naresh Prasad Gupta, Asstt. Manager,S.B.I. Patna Module

NAME OF ORGANISATION: - STATE BANK OF INDIA PAN: - AAACS8577K

BRANCH / DEPARTMENT: - TAN: - PTNS00376F
F. YR.'s START MONTH: - April END MONTH: - March
FINANCIAL YEAR: - 2009 - 2010 PERIOD: 01-04-2009 31-03-2010 ASSESSMENT YR.: 2010 - 2011
D. D. O.'s NAME: - DESIGNATION: -
Father's Name of DDO: - Short Name & Add. of Org.
I T WARD: - PIN Code: -
PLACE: - Relief U/S 89 attached Detail: -
DATE. OF FORM 16: - CITY: - OTHER Put the Amt. at I44 in Comp. Sheet.
EMPLOYEE / ASSESSEE's DETAILS HRA Exemption u/s 10 (13A): - Put at I51 in Comp. Sheet.
Other Exemption u/s 10 viz.
INSERT IN APPROPRIATE COLUMN Conv.,Hill & Fuel, Proj./Difficult Area
Allowances etc.: - Put at O55 in Comp. Sheet.
NAME: Relief in Entertainment Allow.: - Put at E39 (Comp. Sheet)
FATHER'S NAME: Proff./Employment Tax Relief: - Put at E40 (Comp. Sheet)

SEX: MALE STATUS: INDIVIDUAL TDS By Others: Put at H&I47 (Comp. Sheet)
DATE OF BIRTH: DD MM YYYY Income/Loss from House Property U/S 24: -
Put from Dropdown Arrow Put your ALV, Taxes at cell U49 to U50 & H/L intt. At X49 to X54
Are You (Sr. Citizen) =>65 No in Comp. Sheet.
DESIGNATION: Deduction under Chapter VI A: - 2003 - 2004
PAN: CITY: OTHER
Put in cell D46 to D52 at Comp. Sheet in appropriate cell.
ADDRESS:
Deduction under SECTION 80 C (CHAPTER VI A) 2006 - 2007
PIN CODE: PHONE NO.: Put in cell O6 to O33 at Computation Sheet in appropriate cell.
Some Cell are Unprotected viz. N6,8……., & M6,8……
NAME OF BANK: STATE BANK OF INDIA
MICR Code: CODE: NSC Accrd Intt.: - 2009 - 2010
Add. of Bank Branch:
To calculate it Put the Amt. of NSC in cell M39 to M48 at
Computation Sheet in appropriate Cell.
Type of A/c:
Account No.: Perquisites: -
P F Index:
Put in cell R7 to Z45 at Computation Sheet in appropriate cell.
CHALLAN DETAILS (For use of Form 16) (Perq. under FBT are not taxable to the employee)

CHALLAN DEPOSITED AT TDS DEPOSIT DATE

AMOUNT
BANK's NAME BRANCH's NAME Click on Dropdown Arrow
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
PUT BELOW AT CELL A60 "TOTAL TDS AMT. IN WORD"
TOTAL TDS Deducted on Salary 0.00
TDS BY Others (Specify) 0 0.00
only) TOTAL TDS Rs. 0.00
DISCLAIMER SUMMARY OF TAX AMOUNT
TOTAL INCOME TAX: - 0.00
SURCHARGE: - 0.00
This is only for Salaried person. The author is not responsible
for any inaccuracies in the tax computed by this programme. If CESS: - 0.00
you find any inconsistency, please let me know and I will try to NET TAX PAYABLE: - 0.00
fix it at the earliest. Since I am not a chartered accountant or a LESS TDS: -
tax consultant, I am not in a position to answer specific ON SALARY: - 0.00
queries related to taxation. You will have to contact a tax ON OTHER: - 0 0.00
consultant for your specific queries. DIFF. To Pay / Receive: - 0.00
Put Acknowledgement no. of e-TDS of all the 4 Qr. At D14,D15,H14,H15 at Form 16
This XLS Pack. is also Available for free download at my e-group i.e.: - e-mail: - nareshgupta@sbi.co.in
http://finance.groups.yahoo.com/group/guptanpsbi/ Group e-mail: - guptanpsbi@yahoogroups.com
THANKS FOR USING IT : Naresh Prasad Gupta, Asstt. Manager
This XLS Pack. is also Available for free download at SBI
Phone: PATNA MODULE
TIMES > Creative Zone > More Other File

Also Available for free download at www.sbibriefcase.co.in & sbitimes (under utility folder)
Take Print of Computation, Form16, Form12 & Saral 2E on A4 size. You can change for other size in page setup as per your choice
 INCOME TAX CALCULATION SHEET

STATE BANK OF INDIA,

Name : 0 Designation : 0
S/O : 0 P A N NO. : 0
Sex : MALE Date of Birth: -- Financial Yr : 2009 - 2010
Month Basic Pay CCA P.Q.A. F.P.P./Per. All. Adj. All. D.A. HRA SCA Loss of pay Total P.F. Tax Paid Savings u/s 80 C
2009 0.00
April 0.00 PF 0.00
0.00 0
May 0.00 PLI 0.00
0.00
June 0.00 LIC
0.00
July 0.00 SBI Life
0.00
August 0.00 PPF
0.00
September 0.00 NSC
0.00
October 0.00 NSC Intt. 0.00
0.00
November 0.00 H L Inst.
0.00 Co-Op Inst.
December 0.00 Child Edu.
2010 0.00
January 0.00 ULIP
0.00
February 0.00 Other
Over Time 0.00
March 0.00 0.00 Time Deposit
Closing Allow. 0.00 Mutual Fund
Leave Encash. 0.00
LFC Encash. 0.00 Bond
Arrear 0.00
Total 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Total Rs. 0.00
Computation Of Income Tax Tax Upto 160000 NIL >300000 <=500000 0.00 Qly. Ded. 0.00
Total Income 0.00 Tax on Total Income 0.00 >160000 <=300000 0.00 >500000 0.00
Add Perquisites 0.00 (Intt. on NSC)
Less Allowances to the extent exempt u/s 10 0.00 0% 0.00 F.Yr. Purchased Dt. No. of Yr. Amt. @ Accrd. Intt.
Less Entertainment Allowance Total Tax 0.00 2003 - 2004 01-04-03 to 31-03-2004 6 12.08 0.00
Less Tax on Employment (Proff. Tax) 0.00 2004 - 2005 01-04-04 to 31-03-2005 5 11.17 0.00
Income Chargeable under the head of "Salary" 0.00 Total Tax Payabe 0.00 2005 - 2006 01-04-05 to 31-03-2006 4 10.33 0.00
Income / Loss from House Property U/S 24 0.00 Edu. CESS (2%+1%) = 0% 0.00 2006 - 2007 01-04-06 to 31-03-2007 3 9.55 0.00
Any other income reported by Employee 0.00 Tax Payable Including Surcharge 0.00 2007 - 2008 01-04-07 to 31-03-2008 2 8.83 0.00
Gross Total Income 0.00 - u/s 89 Attach Details 0.00 2008 - 2009 01-04-08 to 31-03-2009 1 8.16 0.00
Less Deduction Under Chapter VI A Net Tax Payable 0.00 2009 - 2010 01-04-09 to 31-03-2010 Current Yr. 0.00 0.00
Medical (a) U/S 80 D Tax Deducted at Source (a) Salary 0.00 0 0.00 0 0.00 0.00
(b) U/S 80 DD TDS By (b) Others 0 0.00 0
(c) U/S 80DDB Tax Payable/Refundable 0.00 0 0.00 0
(d) U/S 80 U HRA Calculation u/s 10(13A): - Least Amount TOTAL 0 Rs. 0.00
(e) U/S 80 C 0.00 A ) Actual HRA Recvd. 0.00 Less:- Not qly. u/s 80 C (6th yr) Rs. 0.00
Other (f) U/S 80E (Intt. On edu. Loan) Actual Rent Paid Net Accrd. Intt. qly. U/s 80 C Rs. 0.00
Other (g) U/S 80G Less % of Basic+DA 0% 0.00 Income on: NSC Rs. 0.00
Total Deduction Under Chapter VI A Rs. 0.00 B ) Exc. of Salary by 0% 0.00 On Others Rs.
Total Taxable Income (G T I - Total Deduction of VI A) 0.00 C ) % of Salary B+DA 0% 0.00 Total Intt. Income Rs. 0.00
OR SAY Rounded Off (U/S 288A) Rs. 0.00 Eligible Amt. for HRA Exempt. Rs. 0.00 Other Exemption u/s 10 viz. Conv.,Hill & Fuel,Proj/Difficult Area Allow. etc. upto Rs.
 INCOME TAX CALCULATION SHEET

Calculation of Perquisites: - 2009 - 2010

Name: - 0

A Type of Loan A/C No. Appld. @ Perq. @ Perq. Amt.

CA O/D 10.00% 13.00% P-A
YTD
Last Month's Accrd.
Total 0.00 0.00 0.00
Consumer 11.00% 13.00%
YTD
Last Month's Accrd.
Total 0.00 0.00 0.00
Others Mention here in lump sum (Cell for amt. is unlock)

B Vehicle 7.50% 10.00%

YTD
Last Month's Accrd.
Total 0.00 0.00 0.00
Home Loan 1 5.00% 10.00%
YTD
Last Month's Accrd.
Total 0.00 0.00
PERQUISITE FOR HOME LOAN 1 Rs. 0.00
Home Loan 2 11.00% 10.00%
YTD
Last Month's Accrd.
Total 0.00 0.00
PERQUISITE FOR HOME LOAN 2 Rs. 0.00
TOTAL PERQUISITE ON HOME LOAN 0.00 0.00 Rs. 0.00
Others Mention here in lump sum (Cell for amt. is unlock) 2 Wheeler
Total Perquisites on Interest free or concessional loan Rs. 0.00 Conveyance Reimbursed Relief
C Amt. Paid (Yly) Relief (yly) Taxable Apr 0.00
Accommodation + Furniture 0.00 May 0.00
Car/Conveyance 2 Wheeler 0.00 0.00 0.00 June 0.00
Sweeper,Gardener,Watchman or Personal attendant 0.00 0.00 July 0.00
Gas,Electricity,Water 0.00 Aug 0.00
Club expenses 0.00 Sep 0.00
Entertainment 0.00 Oct 0.00
Cleansing 0.00 Nov 0.00
Others 0.00 Dec 0.00
0.00 Jan 0.00
Total Perquisites on Others Rs. 0.00 Feb 0.00
Mar 0.00
TOTAL PERQUISITES Taxable Rs. 0.00 Total 0.00 0.00
Perquisite Amt. Rs. 0.00
INCOME/LOSS FROM HOUSE PROPERTY U/S 24 Amount H/L Intt. Amt.
Annual lettable value (ALV) ( fill ) H/L 1
(-) Municipal Taxes paid ( fill ) H/L 2
NET Annual Lettable Value 0.00 H/L 3
(-) Std. Ded. U/S 24(a)( % of Net ALV) 30% 0.00 Co-Op 1
(-) Interest paid on borrowed Capital U/S 24(b) (fill) 0.00 Co-Op 2
Income/Loss from house Property (Net ALV - (Std. Ded. + Intt. On Loan) Rs. 0.00 Others
Total 0.00
 FORM NO. 16
[See rule 31(1)(a)] SERIAL NO.: -

Certificate under section 203 of the Income-Tax Act, 1961 for tax deducted at source
from income chargeable under the head "Salaries"

Name and Address of the Employer Name and Designation of the Employee
STATE BANK OF INDIA 0
0 0
PAN: - AAACS8577K TAN: - PTNS00376F PAN/GIR NO.:- 0
TDS Circle where annual return/statement Period Assessment
under section 206 is to be filed From To Year
I T WARD: - 0 01-04-2009 31-03-2010 2010 - 2011
Acknowledg. No. of 24 Qr.1:- Acknowledg. No. of 24 Qr.3:-
Acknowledg. No. of 24 Qr.2:- Acknowledg. No. of 24 Qr.4:-
DETAILS OF SALARY PAID AND ANY OTHER INCOME AND TAX DEDUCTED
1. GROSS SALARY Rs. Rs. Rs.
(a) Salary as per provisions contained in sec.17 (1) 0.00
(b) Value of Perquisites u/s 17 (2) [as per Form No.
12 BA, wherever applicable] 0.00
(c) Profits in lieu of salary under section 17 (3) [as per
Form No. 12 BA, wherever applicable]
(d) TOTAL 0.00

2. Less Allowances to the extent exempt u/s 10 0.00

3. BALANCE (1 - 2 ) 0.00

4. DEDUCTIONS:-
(a) Standard deduction Rs.
(b) Entertainment Allowance Rs. 0.00
(c) Tax on Employment Rs. 0.00

5. AGGREGATE OF 4 (a) TO 4 (c) 0.00

6. Income Chargeable under the head 'Salaries' (3 - 5) 0.00

7. Income / Loss from House Property U/S 24 0.00 0.00

8. Add: Any other income reported by the employee 0.00 0.00

9. GROSS TOTAL INCOME (6 TO 8) 0.00

10. DEDUCTION UNDER CHAPTER VI A Gross Amount Qualify. Amt. Deduct. Amt.
(a) U/S 80 D Rs. 0.00 0.00 0.00
(b) U/S 80 DD Rs. 0.00 0.00 0.00
(c) U/S 80DDB Rs. 0.00 0.00 0.00
(d) U/S 80 U Rs. 0.00 0.00 0.00
(e) U/S 80 C* Details are in next page * Rs. 0.00 0.00 0.00
(f) U/S 80E Rs. 0.00 0.00 0.00
(g) U/S 80G Rs. 0.00 0.00 0.00
11. Aggregate of Deduction Amount under Chapter VI A 0.00 0.00

12. TOTAL INCOME (9 - 11) 0.00

OR SAY 0.00
13. TAX ON TOTAL INCOME Rs. 0.00

FORM16.XLS...NPG Free Downlaod from:

http://finance.groups.yahoo.com/group/guptanpsbi/ or sbitimes
* Details of Deposits U/S 80 C Rs. Rs. Rs.
PF 0.00 0 0.00 Qualifying Tax Rebate/
PLI 0.00 0 0.00 Amount Relief
LIC 0.00 0 0.00
SBI Life 0.00 0 0.00
PPF 0.00 0 0.00
NSC 0.00 0 0.00
NSC Intt. 0.00 0 0.00
H L Inst. 0.00 0 0.00
Child Edu. 0.00 0 0.00
ULIP 0.00 Time Deposit 0.00
Other 0.00 0 0.00
Mutual Fund 0.00 0 0.00
Bond 0.00 Total Deposits u/s 80 C Rs. 0.00
Eligible Amt. For Qly. Ded u/s 80 C under Chapter VI A Rs. 0.00

14. TAX PAYABLE & SURCHARGE THEREON 0.00

15. RELIEF Under Section 89 (1) [Attach Details] 0.00 0.00

16. NET TAX PAYABLE Including Surcharge (14 - 15) 0.00

17. LESS: TAX DEDUCTED AT SOURCE (a) SALARY 0.00

TAX DEDUCTED BY OTHERS (b) 0.00
18. TAX PAYABLE / REFUNDABLE (16 - 17) 0.00

DETAILS OF TAX DEDUCTED AND DEPOSITED INTO CENTRAL GOVERNMENT ACCOUNT

Amount Date of Payment Name of Bank and Branch Where Tax Deposited
0.00 0 0 0 0 0
0.00 0 0 0 0 0
0.00 0 0 0 0 0
0.00 0 0 0 0 0
0.00 0 0 0 0 0
0.00 0 0 0 0 0
0.00 0 0 0 0 0
0.00 0 0 0 0 0
0.00 0 0 0 0 0
0.00 0 0 0 0 0
0.00 0 0 0 0 0
0.00 0 0 0 0 0
0.00 0 0 0 0 0
0.00 0 0 0 0 0
0.00 0 0 0 0 0
0.00 0 0 0 0 0
Total Rs. 0.00 (Rupees only)

I, S/O working in the capacity of

do hereby certify that a sum of Rs. 0.00 (Rupees only)
has been deducted at source & paid to the credit of the Central Government. I further certify that the information given
above is true and correct based on the book of accounts, document and other available records.

PLACE: - 0 Signature of the person responsible for deduction of tax

DATE: - 30/Dec/1899 Full Name: - 0
© http://groups.yahoo.com/group/guptanpsbi Designation: - ,

FORM16.XLS...NPG Free Downlaod from:

http://finance.groups.yahoo.com/group/guptanpsbi/ or sbitimes
 FORM NO. 12 BA
[See Rule 26 A (2)
Statement showing particulars of perquisites, other fringe benefits or amenities and profit in lieu of thereof.
1. Name and Address of Employer : - STATE BANK OF INDIA. CORPORATE CENTRE MUMBAI.
2. T A N : - PTNS00376F
3. TDS Assessment Range of the employer :-
4. Name, Designation & PAN of Employee : -0
0
PAN: - 0
5. Is the employee director or a person with substantial interest
in the company [where the employer is a company] : - NO
6. Income under the head "Salaries" of the employee : - 0.00
7. Financial Year : - 2009 - 2010
8. Valuation of Perquisites :-
Sl. No. Nature of Perquisites Value of Perq. Amount, if any Amount of Tax-
as per rules paid by employee able perquisites
Rs. Rs. Rs.
1 Accommodation + Furniture 0.00
(please see note 1)
2 Car/Conveyance 0.00
3 Sweeper,Gardener,Watchman or Personal attendant 0.00
4 Gas,Electricity,Water 0.00
5 Interest free or concessional loan 0.00
6 Holiday expenses
7 Free or concessional travel
8 Free meal
9 Education
(please see note 2)
10 Gifts, vouchers etc.
11 Credit card expenses
12 Club expenses 0.00
(Please see Note 3)
13 Use of movable assets by employees
14 Transfer of assets to employees
15 Value of any other benefit / amenity /service / privilege 0.00
16 Stock option (non-qualified option)
17 Other benefits or amenities
(Please see Notes 4 & 5)
18 Total value of PERQUISITES Rs. 0.00 0.00 0.00
19 Total value of Profit in lieu of salary as per 17(3)
9. Details of Tax: -
a. Tax deducted from salary of the employee U/S 192 (1) 0.00
b. Tax paid by employer on behalf of the employee U/S 192 (1A) 0.00
c. Total tax paid 0.00
d. Date of payment into Government treasury On different date as stated in Form 16
DECLARATION BY EMPLOYER
I S/O working as 0 ( Design.)
declare on behalf of STATE BANK OF INDIA ( Name of employer ) that the information given above is based on the books of account,
documents and other relevant records or information available with us and the details of value of each perquisites are inaccordance
with section 17 and rules framed thereunder and that such information is true and correct.

Signature of the person responsible for deduction of tax

Place: - 0 Full Name:- 0
Date: - 30/Dec/1899 Design. :- ,

12B.XLS…NPG
 Note: -
1. Followingthe under noted cases and as standard rent [Rs. 157/- P. M. for house and Rs. 49/- P.M. for furniture] is recovered
as per Service Rules. Accommodation & Furniture provided by the Bank are therefore not considered as perquisite.

a. Indian Bank Officers' Assn. Vs.Indian Bank & Ors. (209 ITR 72) (Cal)
b. Steel Executives Association Vs Rashtriya Ispat Nigam Ltd. (241 ITR 20) (AP)
c. Officers; Association Vs Bhilai Steel Plant (139 ITR 937) (MP)
d. All India Vijaya Bank Officers' Assn. & Others Vs Vijaya Bank & Others (250 ITR 500) (Cal)
e. CIT Vs Smt. Godavari Devi Saraf (113 ITR 589) (Bom) - (as per the decision in this case, the Hon'ble High
Court has held that until a contrary is given by any other High Court, law declared by High Court, though of a different State,
is binding).

2. Scholarship to two children of officer (Rs. 700/- P. M. for both children together) not considered as perquisite
( 161 ITR 544 ) (Bombay).
3. Club admission and annual subscription Rs. …………. Incurred for official purpose not included.
4. Entertainment expenses Rs. …….. P.a. incurred for official purpose not included.
5. News Paper cost Rs. ……. Reimbursed for office purpose not included.

IMPORTANT: -
All Perquisites and allowances in the nature of perquisites, including valuation thereof should be listed. In case, some of
them are reckoned as not taxable or taxable at lesser proportion, reasons therefore should be stated.

© http://groups.yahoo.com/group/guptanpsbi
e-mail: guptanp@sancharnet.in

12B.XLS…NPG
Form No. 2E NAYA SARAL ITS 2E
[Income-Tax return for Resident Individual/Hindu Undivided Family not having income from business or profession or capital gains or agricultural income]
[See proviso to rule 12(1)(b)(iii)]
1. NAME 0
2. ADDRESS (in case of change) 0
0 PIN 0 TELEPHONE 0
3. Permanent Account Number 0 7. Sex: M/F M
4. DATE OF BIRTH - - 8. Assessment Year 2010 - 2011
5. STATUS: Individual/Hindu Undivided Family INDIVIDUAL 9. Return: Original or Revised ORIGINAL
6. Ward/Circle/Special Range 10. Particulars of Bank Account (for payment of refund)
Name of Bank MICR Code (9 Digit) Address of Bank Branch Type of A/C Account No. ECS (Y/N)

STATE BANK OF INDIA 0 0 0

COMPUTATION OF INCOME
AMOUNT AMOUNT
1. Income Chargeable under the head "Salaries" (Attach Form No. 16) 701 0.00
2. Amount Value/Higher of Annual rent received or receivable/Reduced annual 307 0.00
rent received or receivable because of vacancy:
3. Taxes actually paid to local authority 312 0.00
4. Annual value of property (2 - 3) 313 0.00
5. Less: Deductions claims u/s 24
(a) Thirty percent of annual value 321 0.00
(b) Interest payable on borrowed capital 322 0.00
6. Total of 5 above 325 0.00
7. Income chargeable under the head "Income from House Property" (4 - 6) 702 0.00
8. Gross Income from other sources: Gross Amount Amount Exempted
(a) Dividends from companies 454 0.00 460
(b) Dividends from units 455 0.00 463
(c) Interest 456 0.00 461
(d) Rental Income from machinery, Plant, etc. 457 0.00 462
(e) Others 458 0.00 464
Total 459 0.00 465 0.00
9. Total of 8 above (Gross amount minus Amount exempt) 470 0.00
10. Deduction u/s 57:
(a) Depreciation 0.00
(b) 0.00
(c) 0.00
11. Total of 10 above 471 0.00
12. Income chargeable under the head "Income from Other Sources" (9 - 11) 706 0.00
13. Gross Total Income (1 + 7 + 12) 746 0.00
14. Deduction u/s Ch VI A Amount Amount
(a) U/S 80 D 235 0.00 (e) U/S 80 C* Details are in next page 260 0.00
(b) U/S 80 DD 236 0.00 (f) U/S 80E 275 0.00
(c) U/S 80DDB 239 0.00 (g) U/S 80G 282 0.00
(d) U/S 80 U 242 0.00 Others U/S
15. Total of 14 above 747 0.00
16. Total Income: (13 - 15) 760 0.00
OR SAY ROUNDED OFF (u/s 288A) Rs. 0.00
17. Tax on Total Income 810 0.00
18. Less: Rebate Amount Amount
(a) Sec. 88 812 (c) Sec. 88C 814
(b) Sec. 88B 813 (d) Sec. 88D 815
19. Total of 18 above 820
20. Balance Tax Payable (17 - 19) 827 0.00
21. Add: Surcharge 0% 0.00 0.00
828
+ Edu. CESS 0% 0.00
22. Tax Payable (20 + 21) 832 0.00
23. Relief u/s 89 837 0.00
24. Balance Tax Payable (22 - 23) 841 0.00
25. Less: Tax deducted at source (a) Salaries 868 0.00 (b) Others 872 0.00
26. Total of 25 above 873 0.00

27. Advance Tax Paid (Attach copy of challans) Date Amount Date Amount
(a) Up to 15/09 858 0.00 (c) 16/12 to 15/03 860 0.00
(b) 16/09 to 15/12 859 0.00 (d) 16/03 to 31/03 861 0.00
28. Total of 27 above 862 0.00
29. Tax paid during the previous year (26+28) 892 0.00
30. Interest payable Amount Amount
(a) Section 234A : 842 0.00 (c) Section 234C : 844 0.00
(b) Section 234B : 843 0.00 (d) Total Interest (a+b+c) 846 0.00
31. Less: Self assessment tax paid (a+b): 888 0.00
(a) Self assessment tax paid up to 31st May 2004 (Attach challan)
(b) Self assessment tax paid after 31st May 2004
Name of the Bank BSR Code of Bank Date of Deposit
Serial No. of Challan Amount
Branch Branch (7 Digit) DDMMYY

32. Tax Payable / Refundable (24-29+30-31) 891 0.00

Verification
I, 0 (Name in full and in block letters), Son/Daughter of
0 ,solemnly declare that to the best of my knowledge and belief, the
Information given in this return and the annexure and statements accompanying it are correct, complete and
truly stated and in accordance with the provisions of Income - Tax Act, 1961, in respect of income
chargeable to Income - Tax for the previous year
Receipt No.: - Date: -

Seal Signature

Date: - / /
Signature of the receiving official Place: - 0
* Please go through the instructions. These will help you in filling in the return.
Enclosures: -
1) Form 16
2) Salary Statement with computation of income 6) Photocopy of
3) Form 12 B (Perquisites) a) PPF Deposit
4) Details of Perquisites b) Infra. Bond
5) Others c) SBI Group Insurance Certificate
a) d) LIC Premium Deposit Certificate
b) e)
NPG SARAL.XLS…NPG © http://groups.yahoo.com/group/guptanpsbi
PFINDEX : PAN :
DOB : Name :
EARNINGS Apr-09 May-09 Jun-09 Jul-09 Aug-09 Sep-09 Oct-09 Nov-09 Dec-09 Jan-10 Feb-10 Mar-10 TOTAL
BASIC 0.00
DA 0.00
HR 0.00
CCA 0.00
FPA 0.00
PQP 0.00
DISCOM 0.00
SCA 0.00
SPLPAY 0.00
ADJALL 0.00
PERALL 0.00
PERPAY 0.00
OFFGALL 0.00
MISC 0.00
GROSS 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

DEDUCTIONS Apr-09 May-09 Jun-09 Jul-09 Aug-09 Sep-09 Oct-09 Nov-09 Dec-09 Jan-10 Feb-10 Mar-10 TOTAL
EAPF 0.00
EPF 0.00
HRR 0.00
INCOME_TAX 0.00
UNION_PAY 0.00
CRSOC 0.00
LIC 0.00
SBILIFE 0.00
HOUSING 0.00
PERLOAN 0.00
CONSUMER 0.00
FESTIVAL 0.00
DL 0.00
DLPF 0.00
EDULOAN 0.00
CARLOAN 0.00
OTHERLOAN 0.00
FURN_RECY 0.00
MISCCONT 0.00
TOT_DED 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

NET PAY Apr-09 May-09 Jun-09 Jul-09 Aug-09 Sep-09 Oct-09 Nov-09 Dec-09 Jan-10 Feb-10 Mar-10 TOTAL
NET PAY 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
BRCODE