"PART-I B

RETURN OF TOTAL INCOME/STATEMENT OF FINAL TAXATION UNDER THE INCOME TAX ORDINANCE, 2001 (FOR COMPANY)
1

IT-1
N NTN Reg/Inc No. Year Ending Date

Taxpayer's Name Bussiness Name Business Address

City

Registration

2 3

Tax Year Res. Status Revised Assessed N N %

2011
Resident Non-Resident

4 5

Principal Activity Representative

NTN

Code

Name

NTN

Top 10 Share Holders' Names

Capital

NTN

Top 10 Share Holders' Names

Capital

Share Holding

Share Holding

Remaining Share Holders Total 100% Assets

107 108 109 110 111 112 Code 8199 8101 8111 812101 8181 8131 812109 812103 8299 8251 8201 8221 8231 8241 8401 8402 8499

Items
7 8

Code
3101 31011 31021 31012 31022

Amount Fixed Assets Land Building Plant & Machinery

Amount

Net Sales Gross Domestic Sales Domestic Commission/Brokerage Gross Exports Foreign Commission/Brokerage Rebates/Duty Drawbacks Cost of Sales To be reconciled with Annex-D-1 Local Raw Material/ Components Imported Raw Material/ Components Salaries,Wages Power Fuel Stores/Spares Insurance Repair & Maintenance Other Expenses Accounting Amortization Accounting Depreciation Opening Stock Finished Goods Purchases (Local) Finished Goods Purchases (Imports) Closing Stock Gross Profit/ (Loss) To be reconciled with Annex-D-1 Gross Receipts Markup/ Interest (for Financial Institutions) Leasing Oil & Gas Exploration Telecommunication Insurance Accounting Gain on Disposal of Intangibles Accounting Gain on Disposal of Assets Other Revenues/ Fee/ Charges for Services etc. Management, Administrative, Selling & Financial expenses Rent/ Rates/ Taxes Salaries & Wages Travelling/ Conveyance Electricity/ Water/ Gas Communication Charges Repairs & Maintenance Stationery/ Office Supplies Advertisement/ Publicity/ Promotion Insurance Professional Charges

Manufacturing/ Trading Account (Including Final/Fixed Tax)

9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40

Capital Work-in-Progress Motor Vehicles Office Equipment Furniture & Fixtures Current Assets Investments Cash & Cash Equivalents Stock in Trade/Stores/Spares Trade Receivables Advances/Deposits/Prepayments/Other Receivables Intangible assets Other Assets Total Assets Source Code
64013 64011 64012 64015 315901 316001 64021 64143 640511 640512 640521 640611 640612 640613 Payment to Ginners for supply of cotton lint. 640614 640631 640632 Exports/ Indenting Commission/Export Services 64071 64073 64076 64075 64091 64092 64101 64121 5% 10% 20% 10% 10% 1% 0.50% 1% 6% 6% 3.50% 1.50%

Balance Sheet

3107 3116 310411 310421 311101 311102 311103 311106 311107 311108 311118 3114 3115 3117 310412 310422 3118 3119 3139 31311 31312 31313

113 114 115 116 117 118 119 120 121 122 123

Receipts/ Value

Rate 5% 1% 2% 3% 5% 10% 4% 1% 15%

Code
65013 65011 65012 65015 315902 316002 65021 92143 650511 650512 650521 650611 650612 650613 650614 650631 650632 65071 65073 65076 65075 65091 65092 65101 65121

Tax Due

124 Imports 125 126 127 Insurance/Re-insurance (Non Resident) Media Services Payments received 129 By Non-Res 128 130 Gas consumption by CNG Station 131 Distribution of cigaratte and pharmaceutical products

132 Royalties/Fees

Final Tax Statement u/s 115(4)

31314 31315 3135 3136 3131 3189 3141 3144 3145 3148 3154 3153 3155 3157 3159 3160

133 134 Contracts (Non-Resident) 135 Supply of Goods 136 137 138

139 Contracts (Resident) 140 141 142 143 144 Foreign Indenting Commission 145 Prizes/winnings of cross word puzzles

& Loss Account (Including Final/Fixed Tax)

41 42 43 44 45 46 47 48 49

146 Winnings - Others 147 Petroleum Commission 148 Brokerage/Commission

Profit & Loss Account (Inclu

50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69

Profit on Debt (Markup/Interest) Donations Directors' Fees Workers Profit Participation Fund Loss on Disposal of Intangibles Loss on Disposal of Assets Accounting Amortization Accounting Depreciation Bad Debts Provision Obsolete Stocks/Stores/Spares Provision Diminution in Value of Investments Provision Bad Debts Written Off Obsolete Stocks/Stores/Spares Written Off Selling expenses(Freight outwards etc.) Others Net Profit/ (Loss)
Inadmissible Expenses (Including proportionate expenses relating to PTR)

3161 3163 3177 3179 3185 3186 3187 3188 31811 31812 31813

149 Advertising Commission 150 Goods Transport Vehicles Total

64122 64141

5%

65122 65141 6599

Source
151 Property Income Purchase of Locally Produced Edible Oil Services rendered / contracts executed outside Pakistan Capital gains on Securities held for < 6 months Capital gains on Securities held for >= 6 months and < 12 months Capital gains on Securities held for >= 12 months

Code
210101 310431 210102 64033 64034 64035

Receipts/Value

Rate

Code
920235

Tax Due

Fixed Tax

152 153 154 155 156 Total

1% 1%

920208 920236 65033 65034

0%

65035 9202

Misc.

31821 31822 31080 3170 3190 3191 319135 319136 319198 3192 319287 319288 319298 3199 3901 3902 3990 9099 3999 4999 312021 5999 6399 9139 9121 9122 9124 9199 6199 6102

Source
157 Dividend Income for Banks only

Code
64032

Receipts/Value

Rate 10%

Code
65032

Tax Due

158 159 160

15% surcharge on proportionate final/fixed tax due for 3-1/2 months Total of Final and Fixed Tax Due and Surcharge Tax Collected/Deducted as Final Tax including surcharge

93081 94592 94591 6699 9201 9249

Tax Gain on disposal of Intangibles Tax Gain on disposal of Assests Other Inadmissible Expenses Admissible Deductions Tax Amortization Tax Depreciation Other Admissible Deductions Income/(Loss) relating to Final and Fixed tax Loss for the year surrendered to Holding Company Loss acquired from Subsidiary Company and Adjusted
Brought Forward Loss Adjusted/(Loss for the year Carry Forward)

Balance Final and Fixed Tax Payable/Refundable to be transferred to Net Tax 161 Payable 162 163 Gross Tax on taxable income Tax Reductions, Credits & Averaging

Adjustments

70 71 72 73 74 75 76 77 78 79

Difference of minimum tax chargeable on certain business transactions [164(f)(v) 164 minus 164(f)(iii)]

(i)

(ii)

(iii)

(iv)

(v)

Tax Computation

Import Value/Service Proportionat s receipts subject to e chargeable collection or income deduction of tax at source

Proportionate tax *

Rate Minimum tax

Higher of (iii) or (iv)

(a) (b) (c) (d) (e) (f)

Imports Edible Oil U/S 148(8) Import Packing Material U/S 148(8) Transport Services U/S 153(6) Services to Zero rated taxpayers U/S 153(6) Other Services U/S 153(6) Total

3% 5% 2% 1% 6%

Total Income/ (Loss) Business Income/(Loss) Capital Gains Share income from AOP Other Sources Income/ (Loss) Foreign Income/ (Loss) Deductible Allowances Zakat Workers Welfare Fund Charitable Donations Admissible for Straight Deduction Taxable Income/ (Loss) Exempt Income Property Income/(Loss) Business Income/(Loss) Capital Gains Other Sources Income/ (Loss) Liabilities

Total / Taxable Income Computation

80 81 82 83 84 85 86 87 88 89 90 91 92 93

* [(162 minus 163) divided by 88 multiply by 164(a)(iI) or 164(b)(iI) or 164(c)(iI) or 164(d)(iI) or 164(e)(Ii), as the case may be] Adjustment of un-adjusted minimum tax paid in previous three years - Subject to 165 a maximum of [162 minus 163 plus 164] 920201 Difference of minimum tax chargeable U/S 113 [166(iv) minus (162 minus 163 166 plus 165 minus 165), if greater than zero, else zero] 9217 (i) (ii)
Total Turnover Minimum tax @ 1%

(iii) (iv)

Reduction @ Net Minimum tax

167 Balance tax chargeable on taxable income [162 minus 163 plus 164 minus 165 plus 166] 168 15% surcharge on proportionate net tax due on taxable income for 3-1/2 months 169 170 Payment/ Refund 171 172

9497 93082 9299 9499 99991 9471 9999

Net Tax [161 plus 167 plus 168] Tax Already paid including Adjustments Net Tax Payable Tax Paid as per CPR No.

6103 6104 6105

173 Net Tax Refundable; may be credited to my bank account as under:

Code
8699 8621 8641 8661 8671 8799 8701 8711 8899 8801 8821 8901 8999 `

Amount
Bank

174 175 176 177

WWF 178

Bank City Branch Name & Code A/C Number WWF Payable holder of CNIC
9308

94 95 96 97

Capital Paid-up Capital Reserves Accumulated Profits Surplus on Revaluation Long Term Liabilities Long Term Loans Deferred Liabilities Current Liabilities Trade & Other Payables Short Term Loans Other Liabilities Total Capital & Liabilities

Balance Sheet

98 99 100 101 102 103 104 105 106

I,

in my capacity as Principal Officer/Trustee /Representative (as defined in section 172 of the Income Tax Ordinance, 2001) of the Taxpayer named above, do solemnly declare that to the best of my knowledge and belief the information given in this Return/Statement u/s 115(4) is correct, complete and in accordance with the provisions of the Income Tax Ordinance, 2001, Income Tax Rules, 2002 and the Companies Ordinance 1984.

Date (dd/mm/yyyy)

Signature

S. No.

NTN

Depreciable Assets
Brought forward Written Down Value

Code Additions Amount (Rs) Rate

Extent

Total (Deletions) Amount (Rs) 50% 0% 50% 50% 0% 50% 50% 50% 30% 15% 15% 15% 15% 15% 15% 10% Amount (Rs) Amount (Rs) Total / Annual Rate Amount (Rs) Amount (Rs) Business Use Amount (Rs) Initial/Ist Year Allowance on additions, if any Depreciation

Particulars/Description Amount (Rs) 8102 810303 810301 81042 81041 81043 810304 810302

Written Down Value carried forward

1.

Building (all types)

2.

Furniture including fittings

3.

Machinery and plant (not otherwise specified)

4.

Motor vehicles plying for hire

5.

Motor vehicles not plying for hire

6.

Ships

7.

Technical or professional books

8.

Computer hardware including printer, monitor and allied items

810308 50% 30%

9.

Machinery and equipment used in manufacture of IT products

810309 81044 810306 810307 50% 0%
100%

10. 50% 30%

Plant & machinery on which 1st year allowance/accelerated depreciation is allowed 90% 15%

11.

Air crafts and aero engines

Annex A-1

12.

13.

20%

14.

Below ground installations of mineral oil concerns Off shore platforms and production installations of mineral oil concerns Any plant or machinery that has been used previously in Pakistan
810310 0% 15%

Reg./Inc. No.

Total

Depreciation, Initial Allowance and Amortization (Purchased Assets)

Signature
Code dd/mm/yyyy 8105 8107 Year(s) Acquired on (Date) Useful Life Original Cost Amount (Rs) 8141

S. No.

Intangibles

Remarks Annual Amount (Rs) Actual Usage Days Amount (Rs)

Particulars/Description

Amortization Business Use Extent Amount (Rs)

1.

Intangibles

2.

Any expenditure providing advantage or benefit for a period exceeding one

3.

Others

Total

2011

A-1

Annex B-1
Carry forward and brought forward of Unabsorbed Depreciation, Initial Allowance, Amortization and Business Losses (Other than Speculation Business)
NTN Reg/Inc No. Particulars Code 1. (a) Business income/(loss) for the year after depreciation and amortization 261111 (b) Business income/(Loss) for the year transferred to Return of Total Income for adjustement 261112 against (loss)/income for the year under any other head of income 3901 (c) Loss for the year surrendered in favour of a holding company [Add (d) Balance business income/(loss) for the year after depreciation and amortization 261114 1(a) minus 1(b) minus 1(c)] 2. (a) (b) (c) 3. (a) (b) (c) (d) (e) (f) (g)
Breakup of balance income/(loss) for the year after depreciation and amortization:

2011

B-1
Amount (Rs.)

261211 3900 3988 3987 261311 261312 261313 261314 261315 261316 261317 261318 Balance carried forward

Business income/(loss) for the year before depreciation/amortization Depreciation for the year including unabsorbed depreciation brought forward Amortization for the year including unabsorbed amortization brought forward
Details of adjustments of brought forward business losses, losses of subsidiary, depreciation and amortization including unabsorbed depreciation and amortizaton

Business income/(loss) for the year before depreciation and amotization [from 2(a) above] Adjustment of brought forward business losses Adjustment of losses of subsidiary Adjustment of depreciation including unabsorbed depreciation brought forward Adjustment of amortization including unabsorbed amortization brought forward Balance business Income after adjsutment transferred to Return of Total Income [3(a) minus 3(b) minus 3(c) minus 3(d) minus 3(e), if greater than zero, else Nil] Balance business loss after adjsutment carry forward [3(a) minus 3(b) minus 3(c) minus 3(d) minus 3(e), if less than zero, else Nil] Code Balance brought forward OR For the current year Of amalgamating Taxpayers own
company

Assessment Year / Tax Year (starting from earliest year)

Adjusted against the income for the current year

forward)

Lapsed(not available for carry /Attributtable to PTR income

Amount (Rs.) Amount (Rs.) Amount (Rs.) 4. Details / breakup of business losses brought forward and carried forward (a) (b) (c) (d) (e) (f) (g) (h) (i) (j) (k)
Current year - 10 Year Current year - 9 Year Current year - 8 Year Current year - 7 Year Current year - 6 Year Current year - 5 Year Current year - 4 Year Current year - 3 Year Current year - 2 Year Current year - 1 Year Current year 3900 3900 3900 3900 3900 3900 3900 3900 3900 3900 3900 262422

Amount (Rs.)

Amount (Rs.)

Total

5. Details / breakup of un-absorbed depreciation brought forward and carried forward 319288 (a) B/Forward 319288 (b) Current year
Total
262513

6. Details / breakup of un-absorbed amortization brought forward and carried forward 319287 (a) B/Forward 319287 (b) Current year
Total
262613

7. Details / breakup of losses of subsidiaries brought forward and carried forward (a) Current year - 2 Year 3904 (b) Current year - 1 Year 3904 3904 (c) Current year
Total 262714

Signature

Annex C-1
Tax Already Paid Including Adjustments (Including Surcharge) NTN Reg/Inc No.

2011 C-1

Particulars Advance Tax U/S 147(1) - Incl. Surcharge 1. 2. 3. 4. 5. 6 7 8 9 10 First installment Second installment Third installment Fourth installment Sub-Total [Add 1 to 4] First installment Second installment Third installment CPR No. CPR No. CPR No. CPR No.
Evidence of payment attached Evidence of payment attached Evidence of payment attached Evidence of payment attached

Code 94611 94612 94613 94614 9461

Amount of Tax paid (Rs.)

Advance Tax U/S 147(5B) - Incl. Surcharge CPR No. CPR No. CPR No.
Evidence of payment attached Evidence of payment attached Evidence of payment attached

11 12 13 14

Fourth installment CPR No. Evidence of payment attached Sub-Total [Add 1 to 4] Tax Collected/Deducted at Source - Incl. Surcharge (Other than tax collected/deducted on receipts/value of goods subject to final taxation) On import of goods - Incl. Surcharge Evidence of payment attached 94019
On Import of CBU motor vehicle by manufacturers - Incl. Surcharge Evidence of payment attached 94018

Amount of Tax deducted (Rs.)

On dividend Income - Incl. Surcharge On profit on debt - Incl. Surcharge

Certificate/Account No. etc.

94039
Evidence of payment attached Branch Share%

94049

Bank

94049 94049 94049 15 16 17 18 19 20 21

On Government securities - Incl. Surcharge On payments received by non-resident - Incl. Surcharge
Evidence of payment attached Evidence of payment attached Evidence of payment attached Evidence of payment attached Evidence of payment attached Evidence of payment attached Evidence of payment attached Branch Share% 94043 940539 940619 940629 940630 ????? 94119

On payments for goods - Incl. Surcharge On payments for services - Incl. Surcharge On payments for execution of contracts - Incl. Surcharge On property income - Incl. Surcharge On cash withdrawal from bank - Incl. Surcharge
Certificate/Account No. etc.

Bank

22 23

On certain transactions in bank - Incl. Surcharge

On registration of new locally manufactured motor vehicle - Incl. Surcharge Engine / Seating Capacity Owner's Name Registration No.

Evidence of payment attached Evidence of payment attached Manufacturer Prticulars

94119 94119 94119 94120

94118

24 25 26 27

On commission paid to members of stock exchange - Incl. Surcharge On trading of shares at a Stock Exchange - Incl. Surcharge

Evidence of payment attached Evidence of payment attached Evidence of payment attached Evidence of payment attached Owner's Name Share%

On financing of carry over trade - Incl. Surcharge

With motor vehicle tax (Other than goods transport vehicles) - Incl. Surcharge Engine / Seating Capacity Registration No.

94179 94179 94179 94059 94138 94139

94149

94149 94149 94149 28 With bill for electricity consumption - Incl. Surcharge
Consumer No. Subscriber's CNIC Evidence of payment attached Subscriber's Name Share% 94159

94159 94159 94159 29

With telephone bills, mobile phone and pre-paid cards - Incl. Surcharge Evidence of payment attached Subscriber's CNIC Subscriber's Name Number Share% 94169

30 31 32 33 34

On sale by auction - Incl. Surcharge

94169 94169 94169 94180

On purchase of domestic air travel ticket - Incl. Surcharge Evidence of payment attached 94121 Others Sub-Total [Add 11 to 32] 94599 Adjustment of Prior Year(s) Refunds Determined by Department
Refund adjustments (To the extent adjustment is required against the current year's tax payable, if any)
Refund Assessed Tax Year (a) (b) (c) (d) Amount (Rs.) Previous Adjustments Tax Year Amount (Rs.)
Available for Adjustment

Current Adjustment Amount (Rs.)

Amount (Rs.)

94981 94981 94981 Sub-Total [Add 34(a) to 34(c)]

Evidence of refund due attached

9498 9499 9495

35 36

Total Tax Already Paid Including Adjustments Transfer to the Return of Income [Add 5 plus 10 plus 33 plus 34(d)] Workers Welfare Fund Already Paid
CPR No.
Evidence of payment attached

Signature

Annex D-1
Breakup of Sales in case of Multipe Business
Reg./Inc. No.
Taxpayer Name

2011
D-1
NTN Tax Year RTO/LTU

Business Name

Business Name & Business Activity

Sr.

Sales (2)

Cost of Sales (3)

Gross Profit/Loss (4) = (2) - (3)

(1)
Business Name 1 Business Acitivity

BUSINESS WISE BREAKUP OF SALES

Business Name 2 Business Acitivity Business Name 3 Business Acitivity Business Name 4 Business Acitivity Business Name 5 Business Acitivity

Total (to be transferred to Sr-13 & 29 of the Main Return (IT-1)

Signature
Note : Grey blank fields are for official use

"PART-II B
RETURN OF TOTAL INCOME/STATEMENT OF FINAL TAXATION
UNDER THE INCOME TAX ORDINANCE, 2001 (FOR INDIVIDUAL / AOP)
CNIC
(for Individual)

IT-2 (Page 1 of 2)
N NTN
Gender Year Ending Tax Year Person Male Female

Taxpayer's Name Business Name

Registration

Business Address Res. Address E-Mail Address Principal Activity Employer Representative Authorized Rep.
NTN NTN NTN Name Name Name Phone Code

2011
IND
Non-Res.

AOP
Resident

Res. Status Birth Date Filing Section

RTO/LTU Authorized Rep. applicable

% in Capital

NTN Ownership

Proprietor/Member/Partners' Name

Capital Amount

Manufacturing/ Trading, Profit & Loss Account ( including Final/Fixed Tax)

Others Total Items

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17

Net Sales (excluding Sales Tax/ Federal Excise Duty & Net of Commission/ Brokerage) (To be reconciled with Annex-C) Cost of Sales [3 + 4 + 5 - 6] (To be reconciled with Annex-C) Opening Stock Net Purchases (excluding Sales Tax/ Federal Excise Duty & Net of Commission/ Brokerage) Manufacturing/ Trading Expenses Closing Stock Gross Profit/ (Loss) [1-2] (To be reconciled with Annex-C) Other Revenues/ Fee/ Charges for Professional and Other Services/ Commission Profit & Loss Expenses Net Profit/ (Loss) [(7 + 8) - 9] Inadmissible Deductions (including Accounting Depreciation) Admissible Deductions (excluding tax depreciation/ including proportionate FTR income Unadjusted Loss from business for previous year(s) [Transfer from Sr. 24 of Annex-A] Un-absorbed Tax Depreciation for previous/ current year(s) (Annex-A) Total Income [Sum of 16 to 21] Salary Income Business Income/ (Loss) [ (10 + 11) - 12 - 13 - 14 ] Share of income from AOP Capital Gains Other Sources Income/ (Loss) Foreign Income/ (Loss) Deductible Allowances [23 + 24 + 25] Zakat Workers Welfare Fund Charitable donations admissible as straight deduction Exempt Income/ (Loss) [Sum of 27 to 31] Salary Income Property Income/(Loss) Business Income/ (Loss) Capital Gains/(Loss) Other Sources Income/ (Loss) Agriculture Income Taxable Income/ (Loss) [15 - 22] Tax chargeable on Taxable Income Tax Reductions/Credits/Averaging (including rebate on Bahbood Certificates, etc.) Difference of minimum tax chargeable on certain business transactions [36(f)(v) minus 36(f)(iii)] (i) (ii) (iii) (iv)
Import Value/Services receipts subject to collection or deduction of tax at source

18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36

100% Code 3103 3116 3117 3106 3111 3118 3119 3131 3189 3190 3191 3192 3902 3988 9099 1999 3999 312021 4999 5999 6399 9139 9121 9122 9124 6199 6101 6102 6103 6104 6105 6106 9199 9201 9249 (v)
Higher of (Iii) or (iV)

Total

Total / Taxable Income Computation

Adjustments

Proportionate Chargeable income

Proportionate tax *

Rate 3% 5% 2% 1% 6%

Minimum tax

Tax Computation

(a) (b) (c) (d) (e) (f)

37 38 39

Imports Edible Oil U/S 148(8) Import Packing Material U/S 153(6) Transport Services U/S 153(6) Services to Zero rated taxpayers U/S 153(6) Other Services U/S 153(6) Total

9303

* [(34 minus 35) divided by 33 multiply by 36(a)(ii) or 36(b)(ii) or 36(c)(ii) or 36(d)(ii) or 36(e)(ii), as the case may be]

40 41 42 43 44 45 46

Minimum tax on electricity consumption under section 235(4) Amount of tax collected alongwith electricity bill where the monthly bill amount is upto Rs. 30,000 Balance tax chargeable [ (34 minus 35 plus 36) or 37, whichever is higher Difference of minimum Tax Chargeable U/S 113 [39(iv) minus 38, if greater than zero, else zero] Total Turnover (i) (iii) Reduction @ (ii) Minimum tax @ 1% (iv) Net Minimum tax Net tax chargeable [38 + 39 + 85] 15% surcharge on proportionate net tax chargeable for 3-1/2 months [(col 40 divided by 12 multiplied by 3.5)*0.15] Total Tax and Surcharge Chargeable [40 + 41] Total Tax Payments (Transfer from Sr. 28 of Annex-B) Tax Payable/ Refundable [42 - 43 + WWF Payable from Sr. 29 of Annex-B] Refund Adjustments (not exceeding current year's tax payable) Annual personal expenses for individual only (transfer from Sr. 10 of Annex-D) Net Tax Refundable, may be credited to my bank account as under: A/C No. Bank
Branch Name & Code

9304 9305 9306 9307 93080 9299 9499 9999 9998 6109

Refund

Signature

RETURN OF TOTAL INCOME/STATEMENT OF FINAL TAXATION

UNDER THE INCOME TAX ORDINANCE, 2001 (FOR INDIVIDUAL / AOP)

IT-2 (Page 2 of 2)
N NTN

CNIC

(for Individual)

Taxpayer's Name

Tax Year RTO/LTU

Rate (%)

2011
Tax Chargeable

Business Name

Source
47 Imports 48 49 50 51 Dividend 52 53 Profit on Debt 54 Royalties/Fees (Non-Resident) 55 56 Contracts (Non-Resident) 57 Insurance Premium (Non-Resident) 58 Advertisement Services (Non-Resident)

Code
64013 64011 64012 64015 64032 64033 64041 640511 640512 640521 640524 640525 640611 640612 640613 640614 640631 640641 64072 64075 64091 64092 64101 64121 64122

Receipts/Value

Code
92013 92011 92012 92015 92032 92033 92041 920511 920512

5 2 1 3 10 7.5 10 15 6 5 10 3.5 1.5 1 6 0.5 1 5 10 20 10 10 5 4 1 1

920521 920524 920525 920611 920612 920613 920614 920631 920641 92072 92075 92091 92092 92101 92121 92122 92141

Final Tax

59 Supply of Goods 60 61 62 Payments to Ginners 63 Contracts (Resident) 64 Exports/related Commission/Service 65 66 Foreign Indenting Commission 67 Prizes/Winnings of cross word puzzles 68 Winnings - Others 69 Petroleum Commission 70 Brokerage/Commission 71 Advertising Commission 72 Goods Transport Vehicles 73 Gas consumption by CNG Station 74
Distribution of cigaratte and pharmaceutical products

64142 64143 310102 310103 210101 610401 610402 610403 310431 112001 63311 118301

92142 92143 920202 920203 920235

75 Retail Turnover upto 5 million 76 Retail Turnover above 5 million 77 Property Income 78 Capital gains on Securities held for < 6 months 79 80
Capital gains on Securities held for >= 6 months and < 12 months Capital gains on Securities held for >= 12 months

Fixed Tax

10 7.50 0 2 2.5 1

961041 961042 961043 920208 920234 920236 920211

81 Purchase of locally produced edible oil 82 Flying Allowance 83 Services rendered / contracts executed outside Pakistan 84 Employment Termination Benefits 85 I, holder of CNIC No.

Final/Fixed Tax Chargeable (47 to 84)

, in my capacity as

9202

Self/ Partner or Member of Association of Persons/ Representative (as defined in section 172 of the Income Tax Ordinance, 2001) of Taxpayer named above, do solemnly declare that to the best of my knowledge and belief the information given in th

Acknowledgement

Verification

Signatures & Stamp

Date :

Signatures

of Receiving Officer with Date

Tot al Note-1 : Grey blank fields are for official use

Annex-A

Description

Code 3202 320301 320302 320303 320304 320306 320307

WDV (BF)

Additions

Deletions

Rate (%) 50% 50% 50% 0% 50% 50% 50% 50% 0% 50% 50% 50% 90%

Initial Allowance Rate (%) . 10% 15% 30% 15% 15% 100% 20% 30% 15% 15% 15% 30% 15%

Extent (%)

Depreciation -

WDV (CF) -

2011

1 2 3 4 Depreciable Assets 5 6 7 8 9

Building (all types) Machinery and plant (not otherwise specified) Computer hardware (including allied items) Furniture (including fittings) Technical and professional books Below ground installations of mineral oil concerns Off shore installations of mineral oil concerns

Tax Year

Machinery and equipment used in manufacture of IT products 320308 Motor vehicles (not plying for hire) 32041 32042 32043 32044 320309 Description Code 3205 3207 Original Expenditure Original Cost

10 Motor vehicles (plying for hire) 11 Ships 12 Air crafts and aero engines Plant & Machinery on which 1st year allowance/ 13 accelerated depreciation is allowed u/s 23A/23B Total

Depreciation, Initial Allowance and Amortization

Reg/Inc/CNIC No.

Acquisition Date Useful Life(Years)

Extent (%)

Amortization

Intangibles

14 Intangibles 15 Expenditure providing long term advantage/benefit 16 Total Description 17 Pre commencement expenditure Description Unadjusted Business loss for previous year adjusted against Business income for current year 18

. Rate (%) 20% Amortization

Code 3206 Code Amount Tax Year

Description Unabsorbed Amortization of intangibles / expenditure providing long term advantage/benefit for previous year(s) adjusted against Total Income for current year Amortization of intangibles / expenditure providing long term advantage/benefit for current year adjusted against Total Income for current year Unabsorbed tax depreciation/initial allowance of fixed assets for previous year(s) adjusted against Total Income for current year Depreciation/initial allowance of fixed assets for current year adjusted against Total Income for current year

Code

Amount

Tax Year

3902 Unadjusted Business loss for previous year adjusted against Business income for current year

2005

3987

upto 2010

Brought Forward Adjustments

19 Unadjusted Business loss for previous year adjusted against Business income for current year Unadjusted Business loss for previous year adjusted against Business income for current year

3902

2006

3987

2011

20

3902

2007

3988

upto 2010

21

3902 3902 3902 -

2008 2009 2010

3988

2011

Unadjusted Business loss for previous year adjusted 22 against Business income for current year Unadjusted Business loss for previous year adjusted 23 against Business income for current year

NTN

Total (Not exceeding the amount of Business Income available 24 for adjustment) (transfer to Sr. 13 of Main Return)

Total (Not exceeding the amount of Total Income available for adjustment) (transfer to Sr. 14 of Main Return)

Annex-B

2011
B
Code
94019 94029 94039 94043

Tax Already Paid (Including Surcharge)

NTN CNIC (for individual)

Particulars
1 2 3 4 5 On import of goods (other than tax deduction treated as final tax) - Incl. Surcharge From salary - Incl. Surcharge On dividend Income (other than tax deduction treated as final tax) - Incl. Surcharge
On Government securities - Incl. Surcharge

Amount of Tax deducted (Rs.)

On profit on debt (other than tax deduction treated as final tax) - Incl. Surcharge
Certificate/Account No. etc.

Bank

Branch

Share%

94049

Tax Collected/Deducted at Source (Adjustable Tax only)

6 7 8 9 10 11 12

On payments received by non-resident (other than tax deduction treated as final tax) - Incl. Surcharge On payments for goods (other than tax deduction treated as final tax) - Incl. Surcharge On payments for services (other than tax deduction treated as final tax) - Incl. Surcharge On payments for execution of contracts (other than tax deduction treated as final tax) - Incl. Surcharge On property income - Incl. Surcharge

940539 940619 940629 940639

On withdrawal from pension fund - Incl. Surcharge

On cash withdrawal from bank - Incl. Surcharge
Certificate/Account No. etc.

94028 Branch Share% 94119

Bank

13 On certain transactions in bank - Incl. Surcharge 14 With Motor Vehicle Registration Fee - Incl. Surcharge
Registration No.
Engine / Seating Capacity

94120 Owner's Name 94179 Manufacturer Particulars

15 16 17 18

On sale/purchase of shares through a Member of Stock Exchange - Incl. Surcharge On trading of shares through a Member of Stock Exchange - Incl. Surcharge On financing of carry over trade - Incl. Surcharge With motor vehicle token tax (Other than goods transport vehicles) - Incl. Surcharge
Registration No.
Engine / Seating Capacity

94131 94138 94139 Share% 94149

Owner's Name

19 With bill for electricity consumption - Incl. Surcharge

Consumer No. Subscriber's CNIC Subscriber's Name Share%

94159

20 With telephone bills, mobile phone and pre-paid cards - Incl. Surcharge
Number Subscriber's CNIC Subscriber's Name Share%

94169

21 22 23 24

On Sale by Auction - Incl. Surcharge On purchase of domestic air travel ticket - Incl. Surcharge

94180 94121 94599 94591 9461

Total Tax Deductions at source (Adjustable Tax) [Sum of 1 to 22] - Incl. Surcharge Total Tax Deductions at source (Final Tax) - Incl. Surcharge

25 Advance Tax U/S 147(1) [ a + b + c + d] - Incl. Surcharge a. First installment CPR No. b. Second installment CPR No. c. Third installment CPR No. d. Fourth installment CPR No. 26 Advance Tax U/S 147(5B) [ a + b + c + d] - Incl. Surcharge a. First installment b. Second installment c. Third installment d. Fourth installment CPR No. CPR No. CPR No. CPR No.

Tax Payments

9461

27 Admitted Tax Paid U/S 137(1) CPR No. 28 Total Tax Payments [23 + 24 + 25 + 26] (Transfer to Sr. 43 of Main Return)
WWF Payable with Return (WWF payable will be

9471

29 adjusted against the excess payments made during the

current year)

9308

Note-1 : Grey blank fields are for official use

Annex C
Breakup of Sales in case of Multiple Business
CNIC (for individual)
Taxpayer Name

2011
C
NTN Tax Year RTO/LTU

2011
Gross Profit/Loss (4) = (2) - (3)

Business Name

Business Name & Business Activity

Sr.

Net Sales (2)

Cost of Sales (3)

(1)
Business Name 1

BUSINESS WISE BREAKUP OF SALES

Business Acitivity Business Name 2 Business Acitivity Business Name 3 Business Acitivity Business Name 4 Business Acitivity Business Name 5 Business Acitivity

Total (to be reconciled with Sr. 1, 2 & 7 of Main Return)

Signature
Note : Grey blank fields are for official use

Annex - D

Details of Personal Expenses (for individual)

NTN Name Sr Description 1 2 3 4 5 6 7 8 9 Residence electricity bills Residence telephone/mobile/internet bills Residence gas bills Residence rent/ground rent/property tax/fire insurance/security services/water bills Education of children/ spouse/ self Travelling (foreign and local)
CNIC (for individual)

2011 D

Expenses

PESONAL EXPENSES

Motor vehicle in use (whether owned or not) running and maintinance including lease rentals and insurance Club membership fees/bills Other personal and household expenses including repair/maintenance of residence, driver/servants, food, clothing, medical, marriages and functions

10 Total personal expenses (Sum of 1 to 9) transfer to Sr-46 of Main Return Adults 11 Number of family members/dependenets Minor

Signature