Residential/Office Phone Number with STD code Mobile No. Employer Category (if in employment) (Tick) Govt. PSU Others

Transcription

1 FORM ITR-4 INDIAN INCOME TAX RETURN ( For ndvduals and HUFs havng ncome from a propretary busness or professon) (Please see rule 12 of the Income-tax Rules,1962) (Also see attached nstructons) Assessment Year Part A-GEN GENERAL Frst name Mddle name Last name PAN Flat/Door/Block No Name Of Premses/Buldng/Vllage Status (Tck) PERSONAL INFORMATION Indvdual Road/Street/Post Offce Area/localty Date of Brth (DD/MM/YYYY) ( n case of ndvdual) / / HUF Town/Cty/Dstrct State Pn code Sex (n case of ndvdual) (Tck) Male Female Resdental/Offce Phone Number wth STD code Moble No. Employer Category (f n employment) (Tck) Govt. PSU Others Emal Address Income Tax Ward/Crcle Return fled (Tck)[Please see nstructon number-7] Before due date -139(1) After due date -139(4) Revsed Return- 139(5) FILING STATUS OR In response to notce 139(9) 142(1) A/153C If revsed, then enter Recept No and Date of flng / / orgnal return (DD/MM/YYYY) Resdental Status (Tck) Resdent Non-Resdent Resdent but Not Ordnarly Resdent Whether ths return s beng fled by a representatve assessee? (Tck) Yes No If yes, please furnsh followng nformaton - (a) Name of the representatve (b) Address of the representatve ( c) Permanent Account Number (PAN) of the representatve Are you lable to mantan accounts as per secton 44AA? (Tck) Yes No AUDIT INFORMATION Are you lable for audt under secton 44AB? (Tck) Yes No, If yes, furnsh followng nformaton- (a) Name of the audtor sgnng the tax audt report (b) Membershp no. of the audtor (c) Name of the audtor (propretorshp/ frm) (d) Permanent Account Number (PAN) of the propretorshp/ frm (e) Date of audt report. For Offce Use Only For Offce Use Only Recept No Date Seal and Sgnature of recevng offcal

2 NATURE OF BUSINESS S.No. NATURE OF BUSINESS OR PROFESSION, IF MORE THAN ONE BUSINESS OR PROFESSION INDICATE THE THREE MAIN ACTIVITIES/ PRODUCTS Code Trade name of the Descrpton [Please see nstructon No.7()] propretorshp, f any () () () Part A-BS SOURCES OF FUNDS APPLICATION OF FUNDS BALANCE SHEET AS ON 31 ST DAY OF MARCH, 2012 OF THE PROPRIETORY BUSINESS (fll tems 1 to 5 n a case where regular books of accounts are mantaned, otherwse fll tem 6) 1 Propretor s fund a Propretor s captal a b Reserves and Surplus Revaluaton Reserve b Captal Reserve b Statutory Reserve b v Any other Reserve bv v Total (b + b + b + bv) bv c Total propretor s fund (a + bv) 1c 2 Loan funds a Secured loans Foregn Currency Loans a Rupee Loans A From Banks A B From others B C Total ( A + B) C Total (a + C) a b Unsecured loans (ncludng deposts) From Banks b From others b Total (b + b) b c Total Loan Funds (a + b) 2c 3 Deferred tax lablty 3 4 Sources of funds (1c + 2c +3) 4 1 Fxed assets a Gross: Block 1a b Deprecaton 1b c Net Block (a b) 1c d Captal work-n-progress 1d e Total (1c + 1d) 2 Investments a Long-term nvestments Government and other Securtes - Quoted a Government and other Securtes Unquoted a Total (a + a) a b Short-term nvestments Equty Shares, ncludng share applcaton money b Preference Shares b Debentures b v Total (b + b + b) bv 1e

3 NO ACCOUNT CASE c Total nvestments (a + bv) 3 Current assets, loans and advances a Current assets Inventores Stores/consumables ncludng packng A materal B Raw materals C Stock-n-process D Fnshed Goods/Traded Goods E Total (A + B + C + D) Sundry Debtors a Cash and Bank Balances A Cash-n-hand B Balance wth banks C Total (A + B) v Other Current Assets av v Total current assets (E + a + C + av) av b Loans and advances Advances recoverable n cash or n knd or for value to be receved b Deposts, loans and advances to corporates and others b Balance wth Revenue Authortes b v Total (b + b + b ) bv c Total of current assets, loans and advances (av + bv) 3c d Current labltes and provsons Current labltes A Sundry Credtors A B Lablty for Leased Assets B C Interest Accrued on above C D Interest accrued but not due on loans D E Total (A + B + C + D) E Provsons A Provson for Income Tax A B Provson for Wealth Tax B Provson for Leave C encashment/superannuaton/gratuty C D Other Provsons D E Total (A + B + C + D ) E Total (E + E) d e Net current assets (3c d) 3e 4 a Mscellaneous expendture not wrtten off or adjusted 4a b Deferred tax asset 4b c Proft and loss account/ Accumulated balance 4c d Total (4a + 4b + 4c) 4d 5 Total, applcaton of funds (1e + 2c + 3e +4d) 5 6 In a case where regular books of account of busness or professon are not mantaned - (furnsh the followng nformaton as on 31 st day of March, 2012, n respect of busness or professon) a Amount of total sundry debtors 6a b Amount of total sundry credtors 6b c Amount of total stock-n-trade 6c d Amount of the cash balance 6d A B C D A B 2c E C Proft and Loss Account for the prevous year of the propretary busness Part A-P& L (fll tems 1 to 50 n a case where regular books of accounts are mantaned, otherwse fll tem 51) 1 Sales/ Gross recepts of busness or professon (Net of returns and refunds and duty or tax, f any) 1 PROFIT AND LOSS 2 Dutes, taxes and cess, receved or recevable, n respect of goods and servces sold or suppled a Unon Excse dutes 2a

4 DEBITS TO PROFIT AND LOSS ACCOUNT b Servce tax c VAT/ Sales tax d Any other duty, tax and cess e Total of dutes, taxes and cess, receved or recevable(2a+2b+2c+2d) 3 Other ncome a Rent b Commsson c Dvdend d Interest e Proft on sale of fxed assets Proft on sale of nvestment beng securtes chargeable f to Securtes Transacton Tax (STT) g Proft on sale of other nvestment h Proft on account of currency fluctuaton Agrculture ncome 3 j Any other ncome k Total of other ncome (3a to 3j) 4 Closng Stock 4 5 Total of credts to proft and loss account (1+2e+3k+4) 5 6 Openng Stock 6 7 Purchases (net of refunds and duty or tax, f any) 7 8 Dutes and taxes, pad or payable, n respect of goods and servces purchased a Custom duty b Counter valng duty c Specal addtonal duty d Unon excse duty e Servce tax f VAT/ Sales tax g Any other tax, pad or payable h Total (8a+8b+8c+8d+8e+8f+8g) 8h 9 Freght 9 10 Consumpton of stores and spare parts Power and fuel Rents Repars to buldng Repars to machnery Compensaton to employees a Salares and wages b Bonus c Rembursement of medcal expenses d Leave encashment e Leave travel benefts f Contrbuton to approved superannuaton fund g Contrbuton to recognsed provdent fund h Contrbuton to recognsed gratuty fund Contrbuton to any other fund 15 j Any other beneft to employees n respect of whch an expendture has been ncurred 15j k Total compensaton to employees (15a+15b+15c+15d+15e+15f+15g+15h+15+15j) 16 Insurance a Medcal Insurance 16a b Lfe Insurance 16b c Keyman s Insurance 16c d Other Insurance 16d e Total expendture on nsurance (16a+16b+16c+16d) 2b 2c 2d 3a 3b 3c 3d 3e 3f 3g 3h 3j 8a 8b 8c 8d 8e 8f 8g 15a 15b 15c 15d 15e 15f 15g 15h 2e 3k 15k 16e

5 17 Workmen and staff welfare expenses Entertanment Hosptalty Conference Sales promoton ncludng publcty (other than advertsement) Advertsement Commsson Hotel, boardng and Lodgng Travelng expenses ncludng foregn travelng Conveyance expenses Telephone expenses Guest House expenses Club expenses Festval celebraton expenses Scholarshp Gft Donaton Rates and taxes, pad or payable to Government or any local body (excludng taxes on ncome) a Unon excse duty 34a b Servce tax c VAT/ Sales tax d Cess e Any other rate, tax, duty or cess ncl STT Pad 34b 34c 34d f Total rates and taxes pad or payable (34a+34b+34c+34d+34e) 35 Audt fee Other expenses Bad debts Provson for bad and doubtful debts Other provsons 39 Proft before nterest, deprecaton and taxes 40 [5 ( h + 9 to k + 16e + 17 to f + 35 to 39)] Interest Deprecaton Proft before taxes ( ) 43 34e 34f TAX PROVISIONS AND APPROPRIATIONS NO ACCOUNT CASE 44 Provson for current tax Provson for Deferred Tax Proft after tax ( ) Balance brought forward from prevous year Amount avalable for appropraton ( ) Transferred to reserves and surplus Balance carred to balance sheet n propretor s account (48 49) 50 In a case where regular books of account of busness or professon are not mantaned, 51 furnsh the followng nformaton for prevous year n respect of busness or professon a Gross recepts 51a b Gross proft 51b c Expenses 51c d Net proft 51d

6 Part A- OI OTHER INFORMATION Other Informaton (optonal n a case not lable for audt under secton 44AB) 1 Method of accountng employed n the prevous year (Tck) mercantle cash 2 Is there any change n method of accountng (Tck) Yes No 3 Effect on the proft because of devaton, f any, n the method of accountng employed n the prevous year from accountng standards prescrbed under secton 145A 4 Method of valuaton of closng stock employed n the prevous year a Raw Materal (f at cost or market rates whchever s less wrte 1, f at cost wrte 2, f at market rate wrte 3) b Fnshed goods (f at cost or market rates whchever s less wrte 1, f at cost wrte 2, f at market rate wrte 3) c Is there any change n stock valuaton method (Tck) Yes No d Effect on the proft or loss because of devaton, f any, from the method of valuaton prescrbed under secton 145A 5 Amounts not credted to the proft and loss account, beng - a the tems fallng wthn the scope of secton 28 5a b the proforma credts, drawbacks, refund of duty of customs or excse or servce tax, or refund of sales tax or value added tax, where such credts, drawbacks or 5b refunds are admtted as due by the authortes concerned c escalaton clams accepted durng the prevous year 5c d any other tem of ncome 5d e captal recept, f any 5e f Total of amounts not credted to proft and loss account (5a+5b+5c+5d+5e) 6 Amounts debted to the proft and loss account, to the extent dsallowable under secton 36:- a Premum pad for nsurance aganst rsk of damage or destructon of stocks or store 6a b Premum pad for nsurance on the health of employees 6b c Any sum pad to an employee as bonus or commsson for servces rendered, where such sum 6c was otherwse payable to hm as profts or dvdend. d Any amount of nterest pad n respect of borrowed captal 6d e Amount of dscount on a zero-coupon bond 6e f Amount of contrbutons to a recognsed provdent fund 6f g Amount of contrbutons to an approved superannuaton fund 6g h Amount of contrbutons to an approved gratuty fund 6h Amount of contrbutons to any other fund 6 j Amount of bad and doubtful debts 6j k Provson for bad and doubtful debts 6k l Amount transferred to any specal reserve 6l m Expendture for the purposes of promotng famly plannng amongst employees 6m n Any sum receved from employees as contrbuton to any provdent fund or superannuaton fund or any fund set up under ESI Act or any other fund for the 6n welfare of employees to the extent credted to the employees account on or before the due date o Any other dsallowance 6o p Total amount dsallowable under secton 36 (total of 6a to 6o) 7 Amounts debted to the proft and loss account, to the extent dsallowable under secton 37 a Expendture of personal nature; 7a Expendture on advertsement n any souvenr, b brochure, tract, pamphlet or the lke, publshed by a 7b poltcal party; c Expendture by way of penalty or fne for volaton of 7c any law for the tme beng n force; d Any other penalty or fne; 7d e Expendture ncurred for any purpose whch s an offence or whch s prohbted by law; 7e f Amount of any lablty of a contngent nature 7f Amount of expendture n relaton to ncome whch g does not form part of total ncome 7g 3 4d 5f 6p

7 h Any other amount not allowable under secton 37 7h Total amount dsallowable under secton 37(total of 7a to 7h) 8 A. Amounts debted to the proft and loss account, to the extent dsallowable under secton 40 Amount dsallowable under secton 40 (a)(), a 40(a)(a) and 40(a)() on account of noncomplance wth the provsons of Chapter Aa XVII-B b Amount of tax or rate leved or assessed on the bass of profts Ab c Amount pad as wealth tax Ac d Amount of nterest, salary, bonus, commsson or remuneraton pad to any partner or member Ad e Any other dsallowance Ae f Total amount dsallowable under secton 40(total of Aa to Ae) Any amount dsallowed under secton 40 n any precedng prevous year but allowable B. durng the prevous year 9 Amounts debted to the proft and loss account, to the extent dsallowable under secton 40A a Amounts pad to persons specfed n secton 40A(2)(b) 9a b Amount n excess of twenty thousand rupees pad to a person n a day otherwse than by account payee cheque or account payee bank draft under secton 9b 40A(3) 100% dsallowable c Provson for payment of gratuty 9c d any sum pad by the assessee as an employer for settng up or as contrbuton to any fund, trust, company, AOP, or BOI or socety or any other 9d nsttuton; e Any other dsallowance 9e f Total amount dsallowable under secton 40A (total of 9a to 9e) 10 Any amount dsallowed under secton 43B n any precedng prevous year but allowable durng the prevous year a Any sum n the nature of tax, duty, cess or fee under any law 10a b Any sum payable by way of contrbuton to any provdent fund or superannuaton fund or gratuty 10b fund or any other fund for the welfare of employees c Any sum payable to an employee as bonus or commsson for servces rendered 10c d Any sum payable as nterest on any loan or borrowng from any publc fnancal nsttuton or a State fnancal corporaton or a State Industral 10d nvestment corporaton e Any sum payable as nterest on any loan or borrowng from any scheduled bank 10e f Any sum payable towards leave encashment 10f g Total amount allowable under secton 43B (total of 10a to 10f) 11 Any amount debted to proft and loss account of the prevous year but dsallowable under secton 43B:- a Any sum n the nature of tax, duty, cess or fee under any law 11a b Any sum payable by way of contrbuton to any provdent fund or superannuaton fund or gratuty 11b fund or any other fund for the welfare of employees c Any sum payable to an employee as bonus or commsson for servces rendered 11c d Any sum payable as nterest on any loan or borrowng from any publc fnancal nsttuton or a State fnancal corporaton or a State Industral 11d nvestment corporaton e Any sum payable as nterest on any loan or borrowng from any scheduled bank 11e f Any sum payable towards leave encashment 11f g Total amount dsallowable under Secton 43B(total of 11a to 11f) 12 Amount of credt outstandng n the accounts n respect of a Unon Excse Duty b Servce tax c VAT/sales tax d Any other tax 12a 12b 12c 12d 7 8Af 8B 9f 10g 11g

8 e Total amount outstandng (total of 12a to 12d) 13 Amounts deemed to be profts and gans under secton 33AB or 33ABA or 33AC Any amount of proft chargeable to tax under secton Amount of ncome or expendture of pror perod credted or debted to the proft and loss account (net) Part A QD QUANTITATIVE DETAILS Quanttatve detals (optonal n a case not lable for audt under secton 44AB) (a) In the case of a tradng concern 1 Openng stock 1 2 Purchase durng the prevous year 2 3 Sales durng the prevous year 3 4 Closng stock 4 5 Shortage/ excess, f any 5 (b) In the case of a manufacturng concern Part B - TI TOTAL INCOME 6 Raw materals a Openng stock b Purchases durng the prevous year c Consumpton durng the prevous year d Sales durng the prevous year e Closng stock f Yeld fnshed products 6f g Percentage of yeld h Shortage/ excess, f any 7 Fnshed products/ By-products a openng stock b purchase durng the prevous year c quantty manufactured durng the prevous year d sales durng the prevous year e closng stock f shortage/ excess, f any 7f Computaton of total ncome 1 Salares (6 of Schedule S) 1 2 Income from house property (4c of Schedule-HP) (enter nl f loss) 2 3 Profts and gans from busness or professon Proft and gans from busness other than speculatve busness (A37 of Schedule-BP) Proft and gans from speculatve busness (B41 of Schedule-BP) (enter nl f loss) Total (3 + 3) (enter nl f 3 s a loss) 4 Captal gans a Short term b Short-term (under secton 111A) (A7 of Schedule-CG) (enter nl f loss) Short-term (others) (A8 of Schedule-CG) (enter nl f loss) Total short-term (4a + 4a) Long-term wth Indexaton (B6-4e of Schedule- CG) (enter nl f loss) Long-term wthout Indexaton (4e of Schedule- CG) (enter nl f loss) Total Long-Term (4b + 4b() c Total captal gans (4a + 4b) (enter nl f 4c s a loss) 5 Income from other sources a from sources other than from ownng race horses (3 of Schedule OS) (enter nl f loss) b from ownng race horses (4c of Schedule OS) (enter nl f loss) c Total (5a + 5b) 6 Total ( c +5c) a 4a 4a 4b 4b 4b 5a 5b 12e 15 6a 6b 6c 6d 6e 6g 6h 7a 7b 7c 7d 7e 3 4c 5c

9 7 Losses of current year to be set off aganst 6 (total of 2x,3x and 4x of Schedule CYLA) 7 8 Balance after set off current year losses (6 7) 8 9 Brought forward losses to be set off aganst 6 (total of 2x, 3x and 4x of Schedule BFLA) 9 10 Gross Total ncome (8-9) (also 5x of Schedule BFLA) Deductons under Chapter VI-A (v of Schedule VIA) Total ncome (10 11) Net agrcultural ncome/ any other ncome for rate purpose (4 of Schedule EI) Aggregate ncome ( ) Losses of current year to be carred forward (total of x of CFL) 15 Part B - TTI Computaton of tax lablty on total ncome 1 Tax payable on total ncome a Tax at normal rates b Tax at specal rates (11 of Schedule-SI) COMPUTATION OF TAX LIABILITY TAXES PAID REFUND 2 Tax Payable on Total Income (1a + 1b) 2 3 Educaton cess, ncludng secondary and hgher educaton cess on (2+3) 3 4 Gross tax lablty (2 + 3) 4 5 Tax relef a Secton 89 b Secton 90 or 90A (column 7 of Schedule TR) c Secton 91(column 7 of Schedule TR) d Total (5a + 5b + 5c) 6 Net tax lablty (4 5d) 6 7 Interest payable a For default n furnshng the return (secton 234A) b For default n payment of advance tax (secton 234B) c For deferment of advance tax (secton 234C) d Total Interest Payable (7a+7b+7c) 8 Aggregate lablty (6 + 7d) 8 9 Taxes Pad a Advance Tax (from Schedule-IT) b TDS (total of column 5 of Schedule-TDS1 and column 7 of Schedule-TDS2) c TCS (column 5 of Schedule-TCS) d Self Assessment Tax (from Schedule-IT) e Total Taxes Pad (9a+9b+9c + 9d) 10 Amount payable (Enter f 8 s greater than 9e, else enter 0) Refund (If 9e s greater than 8) Enter your bank account number (mandatory n all cases) 13 Do you want your refund by cheque, or deposted drectly nto your bank account? (tck as applcable ) 14 Gve addtonal detals of your bank account 1a 1b 5a 5b 5c 7a 7b 7c 9a 9b 9c 9d MICR Code Type of Account (tck as applcable ) Savngs Current 15 Do you have, - () any asset (ncludng fnancal nterest n any entty) located outsde Inda or () sgnng authorty n any account located outsde Inda? [applcable only n case of a resdent] [Ensure Schedule FA s flled up f the answer s Yes] 5d 7d 9e Yes No VERIFICATION I, son/ daughter of, holdng permanent account number solemnly declare that to the best of my knowledge and belef, the nformaton gven n the return and schedules thereto s correct and complete and that the amount of total ncome and other partculars shown theren are truly stated and are n accordance wth the provsons of the Income-tax Act, 1961, n respect of ncome chargeable to Income-tax for the prevous year relevant to the Assessment Year Place Date Sgn here 15 If the return has been prepared by a Tax Return Preparer (TRP) gve further detals below: Identfcaton No. of TRP Name of TRP Counter Sgnature of TRP If TRP s enttled for any rembursement from the Government, amount thereof 16

10 Schedule S Detals of Income from Salary Name of Employer PAN of Employer (optonal) Address of employer Town/Cty State Pn code SALARIES 1 Salary (Excludng all exempt/ non-exempt allowances, perqustes & proft n leu of salary as they are shown 1 separately below) 2 Allowances exempt under secton 10 (Not to be ncluded n 6 below) 2 3 Allowances not exempt (refer Form 16 from employer) 3 4 Value of perqustes (refer Form 16 from employer) 4 5 Profts n leu of salary (refer Form 16 from employer) 5 6 Income chargeable under the Head Salares ( ) 6 Schedule HP Detals of Income from House Property (Please refer to nstructons) Address of property 1 Town/ Cty State PIN Code 1 Is the property co-owned? Yes No (f YES please enter followng detals) Your percentage of share n the property. S.No Name of Co-owner(s) PAN of Co-owner (s) (optonal ) Percentage Share n Property (optonal) (Tck) f let out Name of Tenant PAN of Tenant (optonal) HOUSE PROPERTY 2 a Annual letable value/ rent receved or recevable (hgher f let out for whole of the year, lower f let out for part of the year) 1a b The amount of rent whch cannot be realzed 1b c Tax pad to local authortes 1c d Total (1b + 1c) 1d e Balance (1a 1d) 1e f 30% of 1e 1f g Interest payable on borrowed captal 1g h Total (1f + 1g) 1h Income from house property 1 (1e 1h) 1 Address of property 2 Town/ Cty State PIN Code Is the property co-owned? Yes No (f YES please enter followng detals) Your percentage of share n the property. S.No Name of Co-owner(s) PAN of Co-owner (s) (optonal ) Percentage Share n Property (optonal) (Tck) f let out Name of Tenant PAN of Tenant (optonal) a Annual letable value/ rent receved or recevable (hgher f let out for whole of the year, lower f let out for part of the year) 2a b The amount of rent whch cannot be realzed 2b c Tax pad to local authortes 2c d Total (2b + 2c) 2d e Balance (2a 2d) 2e f 30% of 2e 2f g Interest payable on borrowed captal 2g h Total (2f + 2g) 2h Income from house property 2 (2e 2h) 2 3 Address of property 3 Town/ Cty State PIN Code

11 Is the property co-owned? Yes No (f YES please enter followng detals) Your percentage of share n the property. S.No Name of Co-owner(s) PAN of Co-owner (s) (optonal ) Percentage Share n Property (optonal) (Tck) f let out Name of Tenant PAN of Tenant (optonal) a Annual letable value/ rent receved or recevable (hgher f let out for whole of the year, lower f let out for part of the year) 3a b The amount of rent whch cannot be realzed 3b c Tax pad to local authortes 3c d Total (3b + 3c) 3d e Balance (3a 3d) 3e f 30% of 3e 3f g Interest payable on borrowed captal 3g h Total (3f + 3g) 3h Income from house property 3 (3e 3h) 3 4 Income under the head Income from house property a Rent of earler years realzed under secton 25A/AA 4a b Arrears of rent receved durng the year under secton 25B after deductng 30% 4b c Total (4a + 4b ) 4c NOTE Please nclude the ncome of the specfed persons referred to n Schedule SPI whle computng the ncome under ths head Schedule BP Computaton of ncome from busness or professon A From busness or professon other than speculatve busness and specfed busness 1 Proft before tax as per proft and loss account (tem 43 or tem 51d of Part A-P&L ) 1 2a Net proft or loss from speculatve busness ncluded 2a n 1(enter ve sgn n case of loss) 2b Net proft or Loss from Specfed Busness u/s 35AD 2b ncluded n 1 (enter ve sgn n case of loss) 3 Income/ recepts credted to proft and loss account 3 consdered under other heads of ncome 4 Proft or loss ncluded n 1, whch s referred to n 4 secton 44AD/44AE/44AF/44B/44BB/44BBA/44BBB/ 44D/44DA Chapter-XII-G/ Frst Schedule of Incometax Act 5 Income credted to Proft and Loss account (ncluded n 1)whch s exempt a share of ncome from frm(s) 5a b Share of ncome from AOP/ BOI 5b c Any other exempt ncome 5c d Total exempt ncome 5d 6 Balance (1 2a-2b 3 4 5d) 6 7 Expenses debted to proft and loss account 7 consdered under other heads of ncome 8 Expenses debted to proft and loss account whch 8 relate to exempt ncome 9 Total (7 + 8) 9 10 Adjusted proft or loss (6+9) Deprecaton debted to proft and loss account ncluded n Deprecaton allowable under Income-tax Act Deprecaton allowable under secton 32(1)() 12 (column 6 of Schedule-DEP) Deprecaton allowable under secton 32(1)() 12 (Make your own computaton refer Appendx-IA of IT Rules) Total ( ) Proft or loss after adjustment for deprecaton ( ) Amounts debted to the proft and loss account, to the 14 extent dsallowable under secton 36 (6p of Part-OI) 15 Amounts debted to the proft and loss account, to the 15 extent dsallowable under secton 37 (7 of Part-OI) 16 Amounts debted to the proft and loss account, to the 16 extent dsallowable under secton 40 (8Ae of Part-OI) INCOME FROM BUSINESS OR PROFESSION

12 17 Amounts debted to the proft and loss account, to the extent dsallowable under secton 40A (9f of Part-OI) 18 Any amount debted to proft and loss account of the prevous year but dsallowable under secton 43B (11g of Part-OI) Interest dsallowable under secton 23 of the Mcro, 19 Small and Medum Enterprses Development Act, Deemed ncome under secton Deemed ncome under secton 33AB/33ABA/35ABB/ 21 72A/80HHD/80-IA 22 Any other tem or tems of addton under secton to 44DA 23 Any other ncome (ncludng ncome from salary, 23 commsson, bonus and nterest from frms n whch an ndvdual/ HUF/ Prop. concern s a partner) not ncluded n proft and loss 24 Total ( ) Deducton allowable under secton 32(1)() Amount of deducton under secton 35 n excess of the 26 amount debted to proft and loss account (tem v(4) of Schedule ESR) 27 Any amount dsallowed under secton 40 n any 27 precedng prevous year but allowable durng the prevous year(8bof Part-OI) 28 Any amount dsallowed under secton 43B n any 28 precedng prevous year but allowable durng the prevous year(10g of Part-OI) 29 Deducton under secton 35AC a Amount, f any, debted to proft and loss 29a account b Amount allowable as deducton 29b c Excess amount allowable as deducton 29c (29b 29a) 30 Any other amount allowable as deducton Total ( c +30) Income ( ) Profts and gans of busness or professon deemed to be under - Secton 44AD 33 Secton 44AE 33 Secton 44AF 33 v Secton 44B 33v v Secton 44BB 33v v Secton 44BBA 33v v Secton 44BBB 33v v Secton 44D 33 v x Secton 44DA 33x x Chapter-XII-G 33 x x Frst Schedule of Income-tax Act 33x x Total (33 to 33x) 33x 34 Proft or loss before deducton under secton 10A/10AA/10B/10BA ( x) Deductons under secton 10A (6 of Schedule-10A) 35 10AA (d of Schedule-10AA) 35 10B (f of Schedule-10B) 35 v 10BA (f of Schedule-10BA) 35v v Total ( v) 35v 36 Net proft or loss from busness or professon other than speculatve busness (34 35v) Net Proft or loss from busness or professon (same as above n 36 except n case of specal A37 busness, after applyng rule 7A, 7B or 7C) B Computaton of ncome from speculatve busness 38 Net proft or loss from speculatve busness as per proft or loss account Addtons n accordance wth secton 28 to 44DA Deductons n accordance wth secton 28 to 44DA 40

13 NOTE 41 Proft or loss from speculatve busness ( ) B41 C Computaton of ncome from specfed busness 42 Net proft or loss from specfed busness as per proft or loss account Deductons n accordance wth secton 35AD Proft or loss from specfed busness (42-43) C44 D Income chargeable under the head Profts and gans (A37+B41+C44) D Please nclude the ncome of the specfed persons referred to n Schedule SPI whle computng the ncome under ths head C Schedule DPM Deprecaton on Plant and Machnery 1 Block of assets Plant and machnery 2 Rate (%) () () () (v) (v) (v) (v) 3 Wrtten down value on the frst day of prevous year 4 Addtons for a perod of 180 days or more n the prevous year 5 Consderaton or other realzaton durng the prevous year out of 3 or 4 6 Amount on whch deprecaton at full rate to be allowed ( ) (enter 0, f result s negatve) 7 Addtons for a perod of less than 180 days n the prevous year 8 Consderaton or other realzatons durng the year out of 7 9 Amount on whch deprecaton at half rate to be allowed (7-8) (enter 0, f result s negatve) 10 Deprecaton on 6 at full rate DEPRECIATION ON PLANT AND MACHINERY 11 Deprecaton on 9 at half rate 12 Addtonal deprecaton, f any, on 4 13 Addtonal deprecaton, f any, on 7 14 Total deprecaton* ( ) 15 Expendture ncurred n connecton wth transfer of asset/ assets 16 Captal gans/ loss under secton 50* ( ) (enter negatve only f block ceases to exst) 17 Wrtten down value on the last day of prevous year* ( ) (enter 0 f result s negatve) Schedule DOA Deprecaton on other assets 1 Block of assets Buldng Furnture and Intangble Shps fttngs assets 2 Rate (%) DEPRECIATION ON OTHER ASSETS 3 Wrtten down value on the frst day of prevous year 4 Addtons for a perod of 180 days or more n the prevous year 5 Consderaton or other realzaton durng the prevous year out of 3 or 4 6 Amount on whch deprecaton at full rate to be allowed ( ) (enter 0, f result s negatve) 7 Addtons for a perod of less than 180 days n the prevous year 8 Consderaton or other realzatons durng the year out of 7 9 Amount on whch deprecaton at half rate to be allowed (7-8) (enter 0, f result s negatve) 10 Deprecaton on 6 at full rate 11 Deprecaton on 9 at half rate () () () (v) (v) (v)

14 12 Addtonal deprecaton, f any, on 4 13 Addtonal deprecaton, f any, on 7 14 Total deprecaton* ( ) 15 Expendture ncurred n connecton wth transfer of asset/ assets 16 Captal gans/ loss under secton 50* ( ) (enter negatve only f block ceases to exst) 17 Wrtten down value on the last day of prevous year* ( ) (enter 0 f result s negatve) Schedule DEP Summary of deprecaton on assets 1 Plant and machnery SUMMARY OF DEPRECIATION ON ASSETS a Block enttled for 15 per cent 1a ( Schedule DPM - 14 ) b Block enttled for 30 per cent 1b ( Schedule DPM - 14 ) c Block enttled for 40 per cent 1c ( Schedule DPM - 14 ) d Block enttled for 50 per cent 1d ( Schedule DPM - 14 v) e Block enttled for 60 per cent 1e ( Schedule DPM - 14 v) f Block enttled for 80 per cent 1f ( Schedule DPM 14 v) g Block enttled for 100 per cent 1g ( Schedule DPM - 14 v) h Total deprecaton on plant and machnery ( 1a + 1b + 1c + 1d+ 1e + 1f + 1g ) 1h 2 Buldng a Block enttled for 5 per cent 2a (Schedule DOA- 14) b Block enttled for 10 per cent (Schedule 2b DOA- 14) c Block enttled for 100 per cent 2c (Schedule DOA- 14) d Total deprecaton on buldng (total of 2a + 2b + 2c) 2d 3 Furnture and fttngs(schedule DOA- 14 v) 3 4 Intangble assets (Schedule DOA- 14 v) 4 5 Shps (Schedule DOA- 14 v) 5 6 Total deprecaton ( 1h+2d+3+4+5) 6 Schedule DCG Deemed Captal Gans on sale of deprecable assets 1 Plant and machnery a Block enttled for 15 per cent 1a (Schedule DPM - 16) b Block enttled for 30 per cent (Schedule 1b DPM 16) c Block enttled for 40 per cent(schedule 1c DPM - 16) d Block enttled for 50 per cent 1d (Schedule DPM - 16v) e Block enttled for 60 per cent 1e (Schedule DPM 16v) f Block enttled for 80 per cent (Schedule 1f DPM 16v) g Block enttled for 100 per cent 1g (Schedule DPM 16v) h Total ( 1a +1b + 1c + 1d + 1e + 1f + 1g) 2 Buldng a Block enttled for 5 per cent 2a (Schedule DOA- 16) b Block enttled for 10 per cent (Schedule 2b DOA- 16) c Block enttled for 100 per cent 2c (Schedule DOA- 16) 1h

15 d Total ( 2a + 2b + 2c) 3 Furnture and fttngs ( Schedule DOA- 16v) 3 4 Intangble assets (Schedule DOA- 16v) 4 5 Shps (Schedule DOA- 16v) 5 6 Total ( 1h+2d+3+4+5) 6 2d Schedule ESR Deducton under secton 35 Sl No v v v v Expendture of the nature referred to n secton (1) 35(1)() 35(1)() 35(1)() 35(1)(v) 35(2AA) 35(2AB) total Amount, f any, debted to proft and loss account (2) Amount of deducton allowable (3) Amount of deducton n excess of the amount debted to proft and loss account (4) = (3) - (2) Schedule CG Captal Gans A Short-term captal gan 1 From slump sale CAPITAL GAINS a Full value of consderaton 1a b Net worth of the under takng or dvson 1b c Short term captal gans from slump sale 1c d Deducton under sectons 54B/54D 1d e Net short term captal gans from slum sale (1c 1d) 1e 2 From assets n case of non-resdent to whch frst provso to secton 48 s applcable 2 3 From assets n the case of others a Full value of consderaton 3a b Deductons under secton 48 Cost of acquston b Cost of Improvement b Expendture on transfer b v Total ( b + b + b) bv c Balance (3a bv) 3c d Loss, f any, to be gnored under secton 94(7) or 3d 94(8) (enter postve values only) e Deducton under secton 54B/54D 3e f Short-term captal gan (3c 3d 3e) 3f 4 Deemed short captal gan on deprecable assets (6 of Schedule-DCG) 4 5 Amount deemed to be short term captal gans under sectons 54B/54D/54EC/ 54ED/54G/ 5 54GA 6 Total short term captal gan (1e f +4 +5) 6 7 Short term captal gan under secton 111A ncluded n Short term captal gan other than referred to n secton 111A (6 7) A8 B Long term captal gan 1 From slump sale a Full value of consderaton 1a b Net worth of the under takng or dvson 1b c Long term captal gans from slump sale 1c d Deducton under sectons 54/54B/54D/54EC/ 1d 54F/54G/54GA e Net long term captal gan from slump sale (1c 1d) 1e 2 Asset n case of non-resdent to whch frst provso to secton 48 applcable 2 3 Asset n the case of others where provso under secton 112(1) s not exercsed a Full value of consderaton 3a b Deductons under secton 48 Cost of acquston after ndexaton b Cost of mprovement after ndexaton b Expendture on transfer b v Total (b + b +b) bv c Balance (3a bv) 3c d Deducton under sectons 54/54B/54D/54EC/ 3d 54F/54G/54GA

16 NOTE e Net balance (3c 3d) 3e 4 Asset n the case of others where provso under secton 112(1) s exercsed a Full value of consderaton 4a b Deductons under secton 48 Cost of acquston wthout ndexaton b Cost of mprovement wthout ndexaton b Expendture on transfer b v Total (b + b +b) bv c Balance (4a bv) 4c d Deducton under sectons 54/54B/54D/54EC/ 4d 54F/54G/54GA e Net balance 4e 5 Amount deemed to be long term captal gans under sectons 54/54B/54D/54EC/ 54ED/ 5 54F/54G/54GA 6 Total long term captal gan (1e (enter nl f loss) e (enter nl f loss) + 4e (enter nl f B6 loss) + 5) C Income chargeable under the head CAPITAL GAINS (A6 + B6) (enter B6 as nl, f loss) C D Informaton about accrual/recept of captal gan Date Upto 15/9 () 16/9 to 15/12 () 1 Long- term where provso under secton 112(1) s applcable (Wthout Indexaton)- Code n SI Schedule s 22, Tax Rate s 10% ; Enter only postve value from Item B4c of Schedule CG AFTER loss adjustment under ths category n Schedule CYLA and BFLA, f any. 2 Long- term where provso under secton 112(1) s NOT applcable (Wth Indexaton)- Code n SI Schedule s 21, Tax Rate s 20%; Enter only postve value from Item (B6-B4c) of Schedule CG AFTER loss adjustment under ths category n Schedule CYLA and BFLA, f any. 3 Short-term under 111A- Code n SI Schedule s 1A, Tax Rate s 15% ; Enter only postve value from Item A7 of Schedule CG AFTER loss adjustment under ths category n Schedule CYLA and BFLA, f any. 4 Short-term OTHERS- Taxed at normal rates; Enter only postve value from Item A8 of Schedule CG AFTER loss adjustment under ths category n Schedule CYLA and BFLA, f any. 16/12 to 15/3 () Please nclude the ncome of the specfed persons referred to n Schedule SPI whle computng the ncome under ths head 16/3 to 31/3 (v) Schedule OS Income from other sources 1 Income other than from ownng race horse(s):- a Dvdends, Gross 1a b Interest, Gross 1b c Rental ncome from machnery, plants, buldngs, 1c d Others, Gross (excludng ncome from ownng race horses) 1d e Total (1a + 1b + 1c + 1d) 1e f Deductons under secton 57:- Expenses / Deductons f Deprecaton f Total f g Balance (1e f) 1g 2 Wnnngs from lotteres, crossword puzzles, races, etc. 2 3 Income from other sources (other than from ownng race horses) (1g + 2) (enter 1g as nl f loss) 3 4 Income from ownng and mantanng race horses a Recepts 4a b Deductons under secton 57 n relaton to (4) 4b c Balance (2a 2b) 4c 5 Income chargeable under the head Income from other sources (3 + 4c) (enter 4c as nl f loss and take 4c loss fgure to Schedule CFL) 5 NOTE Please nclude the ncome of the specfed persons referred to n Schedule SPI whle computng the ncome under ths head OTHER SOURCES Schedule CYLA Detals of Income after set-off of current years losses

17 CURRENT YEAR LOSS ADJUSTMENT Sl.No v Head/ Source of Income Loss to be adjusted -> Salares House property Busness Income (excludng speculaton proft and ncome from specfed busness) Speculatve Income v Specfed Busness Income v Short-term captal gan V Long term captal gan V Other sources (excludng proft from ownng race horses and wnnngs from Lottery) Income of current year (Fll ths column only f ncome s zero or postve) House property loss of the current year set off Busness Loss (other than speculaton loss) of the current year set off Total loss (A37 of Schedule-BP) Other sources loss (other than loss from race horses) of the current year set off Total loss (3 of Schedule-OS) Current year s Income remanng after set off Total loss (4c of Schedule HP) = x x x Proft from ownng and mantanng race horses Total loss set off Loss remanng after set-off Schedule BFLA Detals of Income after Set off of Brought Forward Losses of earler years Sl. Head/ Source of Income Income after set off, f Brought forward loss Brought forward No. any, of current year s set off deprecaton set off losses as per 5 of Schedule CYLA) BROUGHT FORWARD LOSS ADJUSTMENT House property Busness Income (excludng speculaton proft and ncome from specfed busness) Speculatve Income v Specfed Busness Income v Short-term captal gan v Long-term captal gan v Other sources (excludng proft from ownng race horses) v Proft from ownng and mantanng race horses x Total of brought forward loss set off Brought forward allowance under secton 35(4) set off Current year s ncome remanng after set off x Current year s ncome remanng after set off Total ( v5+v5+v5+v5+v5) Schedule CFL CARRY FORWARD OF LOSS Sl. No v Assessment Year Detals of Losses to be carred forward to future years Date of Flng (DD/MM/ YYYY) House property loss Loss from busness other than loss from speculatve busness ncludng unabsorbed deprecaton allowance u/s 35(4) Loss from speculatve busness ncludng unabsorbed deprecaton allowance u/s 35(4) Loss from specfed busness Shortterm captal loss Long-term Captal loss Other sources loss (from ownng race horses) v

18 v v v x Total of earler year losses x Adjustment of above losses n Schedule BFLA (see nstructon) x (Current year losses) x Total loss Carred Forward to future years Schedule UD Sl No (1) Unabsorbed deprecaton Assessment Year (2) Amount of brought forward unabsorbed deprecaton (3) Amount of deprecaton set-off aganst the current year ncome (4) Balance Carred forward to the next year (5) v v v v Total Schedule 10A Deducton under secton 10A 1 Deducton n respect of unts located n Software Technology Park a Undertakng No.1 1a b Undertakng No.2 1b c Undertakng No.3 1c d Undertakng No.4 1d e Undertakng No.5 1e f Total (1a + 1b+ 1c + 1d + 1e) 1f 2 Deductons n respect of unts located n Electronc Hardware Technology Park a Undertakng No.1 2a b Undertakng No.2 2b c Undertakng No.3 2c d Total (2a + 2b+ 2c) 2d 3 Deductons n respect of unts located n Free Trade Zone a Undertakng No.1 3a b Undertakng No.2 3b c Undertakng No.3 3c d Total (3a + 3b+ 3c) 3d 4 Deductons n respect of unts located n Export Processng Zone a Undertakng No.1 4a b Undertakng No.2 4b c Undertakng No.3 4c d Total (4a + 4b+ 4c) 4d 5 Deductons n respect of unts located n Specal Economc Zone a Undertakng No.1 5a b Undertakng No.2 5b c Undertakng No.3 5c d Total (5a + 5b+ 5c) 5d 6 Total deducton under secton 10A (1f + 2d + 3d + 4d + 5d) 6 DEDUCTIONS U/S 10A Schedule 10AA Deducton under secton 10AA Deductons n respect of unts located n Specal Economc Zone a Undertakng No.1 a b Undertakng No.2 b c Undertakng No.3 c DEDUCTI ON U/S

19 d Total (a + b + c) d Schedule 10B Deducton under secton 10B Deducton n respect of hundred percent Export Orented unts a Undertakng No.1 b Undertakng No.2 c Undertakng No.3 d Undertakng No.4 e Undertakng No.5 f Total (a + b + c + d + e) DEDUCTIONS U/S 10B a b c d e f Schedule 10BA Deducton under secton 10BA Deducton n respect of exports of handmade wooden artcles a Undertakng No.1 b Undertakng No.2 c Undertakng No.3 d Undertakng No.4 e Undertakng No.5 f Total (a + b + c + d + e) DEDUCTIONS U/S 10BA a b c d e f Schedule 80G Detals of donatons enttled for deducton under secton 80G A Donatons enttled for 100% deducton wthout qualfyng lmt PAN of Donee Amount of donaton Elgble Amount of Name and address of donee donaton DETAILS OF DONATIONS B v v v Total Donatons enttled for 50% deducton wthout qualfyng lmt Name and address of donee v v v Total C Donatons enttled for 100% deducton subject to qualfyng lmt Name and address of donee v v v Total D Donatons enttled for 50% deducton subject to qualfyng lmt Name and address of donee PAN of Donee Amount of donaton Elgble Amount of donaton B PAN of Donee Amount of donaton Elgble Amount of donaton PAN of Donee Amount of donaton Elgble Amount of donaton

20 E v v v Total Total donatons (Av + Bv + Cv + Dv) Schedule 80-IA Deductons under secton 80-IA a Deducton n respect of profts of an enterprse referred to n secton 80-IA(4)() [Infrastructure faclty] b Deducton n respect of profts of an undertakng referred to n secton 80-IA(4)() [Telecommuncaton servces] c Deducton n respect of profts of an undertakng referred to n secton 80-IA(4)() [Industral park and SEZs] d Deducton n respect of profts of an undertakng referred to n secton 80-IA(4)(v) [Power] e Deducton n respect of profts of an undertakng referred to n secton 80-IA(4)(v) [Revval of power generatng plant] and deducton n respect of profts of an undertakng referred to n secton 80-IA(4)(v)[Cross-country natural gas dstrbuton network] f Total deductons under secton 80-IA (a + b + c + d + e) DEDUCTIONS U/S 80-IA a b c d e f Schedule 80-IB Deductons under secton 80-IB a Deducton n respect of ndustral undertakng referred to n secton 80-IB(3) [Small-scale ndustry] b Deducton n respect of ndustral undertakng located n Jammu & Kashmr [Secton 80-IB(4)] c Deducton n respect of ndustral undertakng located n ndustrally backward states specfed n Eghth Schedule [Secton 80-IB(4)] d Deducton n respect of ndustral undertakng located n ndustrally backward dstrcts [Secton 80-IB(5)] e Deducton n the case of multplex theatre [Secton 80- IB(7A)] f Deducton n the case of conventon centre [Secton 80- IB(7B)] g Deducton n the case of company carryng on scentfc research [Secton 80-IB(8A)] h Deducton n the case of undertakng whch begns commercal producton or refnng of mneral ol [Secton 80-IB(9)] Deducton n the case of an undertakng developng and buldng housng projects [Secton 80-IB(10)] j Deducton n the case of an undertakng operatng a cold chan faclty [Secton 80-IB(11)] k Deducton n the case of an undertakng engaged n processng, preservaton and packagng of fruts and vegetables [Secton 80-IB(11A)] l Deducton n the case of an undertakng engaged n ntegrated busness of handlng, storage and transportaton of foodgrans [Secton 80-IB(11A)] m Deducton n the case of an undertakng engaged n operatng and mantanng a rural hosptal [Secton 80- IB(11B)] n Total deducton under secton 80-IB (Total of a to m) DEDUCTIONS U/S 80-IB a b c d e f g h j k l m n Schedule 80-IC or 80-IE Deductons under secton 80-IC or 80-IE 1 Deducton n respect of ndustral undertakng located n Skkm 1 DEDUCTIONS U/S 80-IC/ID/IE 2 Deducton n respect of ndustral undertakng located n Hmachal Pradesh 2 3 Deducton n respect of ndustral undertakng located n Uttaranchal 3 4 Deducton n respect of ndustral undertakng located n North-East a Assam 4a b Arunachal Pradesh 4b c Manpur 4c d Mzoram 4d e Meghalaya 4e

21 f Nagaland 4f g Trpura 4g h Total of deducton for undertakngs located n North-east (Total of 5a to 5g) 4h 5 Total deducton under secton 80-IC or 80-IE ( h) 5 Schedule VI-A a 80C b 80CCC c 80CCD Deductons under Chapter VI-A (Secton) l 80GGC m 80IA (f of Schedule 80-IA) n 80IAB TOTAL DEDUCTIONS d 80CCF e 80D f 80DD g 80DDB h 80E 80G o 80IB (n of Schedule 80-IB p 80IC/ 80-IE (5 of Schedule 80-IC/ 80- q 80ID r 80JJA s 80QQB t 80RRB 80GG u 80U k 80GGA v Total deductons under Chapter VI-A (Total of a to u) v Schedule SPI Income of specfed persons(spouse, mnor chld etc) ncludable n ncome of the assessee Sl No Name of person PAN of person (optonal) Relatonshp Nature of Income Amount (Rs) 1 2 Schedule SI Sl No Secton code Income chargeable to Income tax at specal rates IB [Please see nstructon Number-9() for secton code and rate of tax] Specal rate Income Tax thereon Sl Secton Specal Income Tax thereon (%) No code rate (%) SPECIAL RATE 1 1A BB Total (1 to 10 ) FIRMS IN WHICH PARTNER Schedule IF Informaton regardng partnershp frms n whch you are partner Number of frms n whch you are partner Name of the Frm PAN of the frm Percentage Share n the proft of the frm Total Amount of share n the proft Captal balance on 31 st March n the frm Schedule EI Detals of Exempt Income (Income not to be ncluded n Total Income) 1 Interest ncome 1 T INCOM 2 Dvdend ncome 2 3 Long-term captal gans on whch Securtes Transacton Tax s pad 3

22 4 Net Agrculture ncome(other than ncome to be excluded under rule 7, 7A, 7B or 8) 4 5 Share n the proft of frm/aop etc. 5 6 Others, ncludng exempt ncome of mnor chld 6 7 Total ( ) 7 Schedule IT Sl No TAX PAYMENTS v v Detals of Advance Tax and Self Assessment Tax Payments of Income-tax BSR Code Date of Depost (DD/MM/YYYY) Seral Number of Challan Amount (Rs) NOTE Enter the totals of Advance tax and Self Assessment tax n Sl No.11a & 11d of Part B-TTI Schedule TDS1 Detals of Tax Deducted at Source from Salary [As per Form 16 ssued by Employer(s)] Sl Tax Deducton Account Name of the Employer Income chargeable under Salares Total tax deducted No Number (TAN) of the Employer (1) (2) (3) (4) (5) TDS ON SALARY Schedule TDS2 TDS ON OTHER INCOME Sl No Detals of Tax Deducted at Source on Income [As per Form 16 A ssued by Deductor(s)] Tax Deducton Name of the Deductor Unque TDS Fnancal Year n Total Tax Deducted Account Number Certfcate whch TDS s (TAN) of the Number Deducted Deductor Amount out of (6) clamed ths Year (1) (2) (3) (4) (5) (6) (7) NOTE Please enter total of column 5of Schedule-TDS1 and column 7 of Schedule-TDS2 n 9(b) of Part B-TTI Schedule TCS TCS ON INCOME Sl No Tax Deducton and Tax Collecton Account Number of the Collector Detals of Tax Collected at Source [As per Form 27D ssued by the Collector(s)] Name of the Collector Total tax collected Amount out of (4) clamed durng the year (1) (2) (3) (4) (5) NOTE Enter the total of column (5) n Sl No. 11c of Part B-TTI

23 Schedule TR Detals of Tax Relef clamed under secton 90 or secton 90A or secton 91 DETAILS OF TAX RELIEF Sl No Country Name Country Code Tax Identfcaton number of the tax payer n respectve country Income (n rupees) Tax Pad (n rupees) Total Tax Relef Clamed (n rupees) (1) (2) (3) (4) (5) (6) (7) NOTE Please enter the detals of column (7) of Schedule TR n 5b or 5c of Part B TTI Schedule FA Detals of Foregn Assets A Detals of Foregn Bank Accounts Sl No Country Name Country Code Name and Address of the Bank Name mentoned n the account Peak Balance Durng the Year (n rupees) (1) (2) (3) (4) (5) (6) DETAILS OF FOREIGN ASSETS B Detals of Fnancal Interest n any Entty Sl No () () Country Name (1) Country Code (2) C Detals of Immovable Property Sl No (1) () Country Name (2) Country Code (3) Nature of entty (3) Address of the Property (4) Name and Address of the Entty (4) Total Investment (at cost) (n rupees) (5) Total Investment (at cost) (n rupees) (5) () D Detals of any other Asset Sl No (1) () () Country Name (2) Country Code (3) Nature of Asset (4) Total Investment (at cost) (n rupees) (5) E Detals of account(s) n whch you have sgnng authorty and whch has not been ncluded n A to D above. Sl No (1) () Name of the Insttuton n whch the account s held (2) Address of the Insttuton (3) Name mentoned n the account (4) Peak Balance/Investment durng the year (n rupees) (5) ()