First name Middle name Last name. Designation of Assessing Officer (Ward/Circle) Return filed under Section - [Please see instruction number-9(i)]

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1 FORM SARAL-II (ITR-1) INDIAN INCOME TAX RETURN [For Indvduals havng Income from Salary / Penson / Income from One House Property (excludng loss brought forward from prevous years) / Income from Other Sources (Excludng Wnnng from Lottery and Income from Race Horses)] (Please see rule 12 of the Income-tax Rules,1962) (Also see attached nstructons) Assessment Year Frst name Mddle name Last name PAN PERSONAL INFORMATION FILING STATUS Flat/Door/Block No Road/Street/Post Offce Town/Cty/Dstrct Name Of Premses/Buldng/Vllage Area/Localty State Pn code Emal Address (STD code)-phone Number ( ) Date of Brth (DD/MM/YYYY) / / Employer Category (Tck) Govt PSU Others Sex (Tck) Male Desgnaton of Assessng Offcer (Ward/Crcle) Return fled under Secton - [Please see nstructon number-9()] Whether orgnal or Revsed return? (Tck) Orgnal Revsed If revsed, enter Recept No and Date of flng orgnal return Female DD / MM / YYYY Resdental Status (Tck) Resdent Non-Resdent Resdent but Not Ordnarly Resdent 1 Income chargeable under the Head Salares (Salary/ Penson) 1 2 Income chargeable under the Head House Property (enter ve sgn n case of loss, f any) 2 3 Income chargeable under the Head Other Sources (enter ve sgn n case of loss, f any) 3 INCOME & DEDUCTIONS 4 Gross Total Income (1+2+3) 4 5 Deductons under chapter VI A (Secton) a 80C e 80DD 80GG b 80CCC f 80DDB j 80GGA c 80CCD g 80E k 80GGC d 80D h 80G l 80U 6 Deductons (Total of 5a to 5l) 6 7 Total Income (4-6) 7 8 Tax Payable on Total Income 8 9 Secondary and Hgher Educaton cess on 8 9 TAX COMPUTATION 10 Total Tax and Educaton Cess Payable (8+9) Relef under Secton Relef under Secton 90/ Balance Tax Payable ( ) Total Interest Payable U/s 234A/ B/C Total Tax and Interest Payable (12+13) 15 Do not wrte or stamp n ths area For Offce Use Only Seal and Sgnature of recevng offcal Recept No Date

2 16 Taxes Pad TAXES PAID a Advance Tax (from tem 25) 16a b TDS (column 7 of tem 23 +column 7 of tem 24) 16b c Self Assessment Tax (from tem 25) 16c 17 Total Taxes Pad (16a+16b+16c) Tax Payable (15-17) (Enter f 15 s greater than 17, else leave blank) Refund (17d-16) (enter f 17d s greater than 16, also gve Bank Account detals below) 19 REFUND 20 Enter your bank account number (mandatory n case of refund) 21 Do you want your refund by cheque, or deposted drectly nto your bank account? (tck as applcable ) 22 Gve addtonal detals of your bank account MICR Code Type of Account (tck as applcable ) Savngs 23 Detals of Tax Deducted at Source from Salary [As per Form 16 ssued by Employer(s)] TDS ON SALARY Sl No Tax Deducton Account Number (TAN) of the Employer Name and address of the Employer Income Deducton Tax payable chargeable under under (ncl. edn. the head Salares Chapter VI-A cess) Total tax deducted Tax payable/ refundable (1) (2) (3) (4) (5) (6) (7) (8) 24 Detals of Tax Deducted at Source other than salary TDS ON INTEREST Sl No Tax Deducton Account Number (TAN) of the Deductor Name and address of the Deductor Amount pad/ credted Date of Payment / Credt Total tax deducted Amount out of (6) clamed for ths year (1) (2) (3) (4) (5) (6) (7) Enter the total of column (7) of 23 and column (7) of 24 n Sl No. 17b of TAXES PAID 25 Detals of Advance Tax and Self Assessment Tax Payments TAX PAYMENTS Sl No Name of Bank & Branch BSR Code Date of Depost (DD/MM/YYYY) Enter the totals of Advance tax and Self Assessment tax n Sl No. 17 a and 17c of TAXES PAID Seral Number of Challan Amount (Rs) 26 Other Informaton (transactons reported through Annual Informaton Return) (Please see nstructon number-9() for code) Sl Code Amount (Rs) Sl Code Amount (Rs) Sl Code Amount (Rs) a 001 d 004 g 007 b 002 e 005 h 008 c 003 f Exempt ncome only for reportng purposes (from Dvdend, Captal gans etc) 27 VERIFICATION I, son/ daughter of solemnly declare that to the best of my knowledge and belef, the nformaton gven n the return 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 28 If the return has been prepared by a Tax Return Preparer (TRP) gve further detals as below: Identfcaton No. of TRP Name of TRP Counter Sgnature of TRP 29 If TRP s enttled for any rembursement from the Government, amount thereof (to be flled by TRP) 29

3 Government of Inda INCOME-TAX DEPARTMENT ACKNOWLEDGEMENT Receved wth thanks from a return of ncome n Form No. ITR for assessment year , havng the followng partculars. Name PAN PERSONALINFORMATION Flat/Door/Block No Road/Street/Post Offce Town/Cty/Dstrct Desgnaton of Assessng Offcer (Ward/ Crcle) Name Of Premses/Buldng/Vllage Area/Localty State Orgnal or Revsed Status (fll the code) 1 Gross total ncome 1 2 Deductons under Chapter-VI-A 2 3 Total Income 3 3a Current Year loss (f any) 3a COMPUTATION OF INCOME AND TAX THEREON 4 Net tax payable 4 5 Interest payable 5 6 Total tax and nterest payable 6 7 Taxes Pad a Advance Tax 7a b TDS 7b c TCS 7c d Self Assessment Tax 7d e Total Taxes Pad (7a+7b+7c +7d) 7e 8 Tax Payable (6-7e) 8 Recept No Date 9 Refund (7e-6) 9 Seal and Sgnature of recevng offcal

4 Instructons for fllng out Income Tax Return FORM SARAL-II ITR-1 These nstructons are gudelnes for fllng the partculars n ths Return Form. In case of any doubt, please refer to relevant provsons of the Income-tax Act, 1961 and the Income-tax Rules, Assessment Year for whch ths Return Form s applcable Ths Return Form s applcable for assessment year only,.e., t relates to ncome earned n Fnancal Year Who can use ths Return Form Ths Return Form s to be used by an ndvdual whose total ncome for the assessment year ncludes:- (a) Income from Salary/ Penson; or (b) Income from One House Property (excludng cases where loss s brought forward from prevous years); or (c) Income from Other Sources (Excludng Wnnng from Lottery and Income from Race Horses). Further, n a case where the ncome of another person lke spouse, mnor chld, etc. s to be clubbed wth the ncome of the assessee, ths Return Form can be used only f the ncome beng clubbed falls nto the above ncome categores. 3. Who cannot use ths Return Form Ths Return Form should not be used by an ndvdual whose total ncome for the assessment year ncludes,- (a) Income from more than one house property; or (b) Income from Wnnngs from lottery or ncome from Race horses; or (c) Income under the head Captal Gans, whch are not exempt from tax, e.g., short-term captal gans or long-term captal gans from sale of house, plot, etc.; or (d) Income from agrculture n excess of Rs. 5,000; or (e) Income from Busness or Professon. 4. Annexure-less Return Form No document (ncludng TDS certfcate) should be attached to ths Return Form. All such documents enclosed wth ths Return Form wll be detached and returned to the person flng the return. 5. Manner of flng ths Return Form Ths Return Form can be fled wth the Income Tax Department n any of the followng ways, - () by furnshng the return n a paper form; () by furnshng the return electroncally under dgtal sgnature; () by transmttng the data n the return electroncally and thereafter submttng the verfcaton of the return n Return Form ITR-V; (v) by furnshng a Bar-coded return. Where the Return Form s furnshed n the manner mentoned at 5(), the assessee should prnt out two copes of Form ITR-V. One copy of ITR-V, duly sgned by the assessee, has to be sent by ordnary post to Post Bag No. 1, Electronc Cty Offce, Bangaluru (Karnataka). The other copy may be retaned by the assessee for hs record. 6. Fllng out the acknowledgement Only one copy of ths Return Form s requred to be fled. Where the Return Form s furnshed n the manner mentoned at 5() or at 5(v), the acknowledgement slp attached wth ths Return Form should be duly flled. 7. Codes for fllng ths Return Form Under the headng Flng Status n the Return Form detals have to be flled out regardng secton under whch the return s beng fled on the bass of relevant codes. The codes correspondng to the secton under whch a return s beng fled are as under:- Sl.No. How the return s fled Code. Voluntarly before the due date under secton Voluntarly after the due date under secton In response to notce under secton 142(1) 13 v. In response to notce under secton v. In response to notce under secton 153A/ 153C Oblgaton to fle return Every ndvdual whose total ncome before allowng deductons under Chapter VI-A of the Income-tax Act, exceeds the maxmum amount whch s not chargeable to ncome tax s oblgated to furnsh hs return of ncome. The deductons under Chapter VI-A are mentoned n tem 5 ( Income and Deductons ) of ths Return Form. The maxmum amount not chargeable to ncome tax n case of dfferent categores of ndvduals s as follows:- Sl.No. Category Amount (n Rs.). In case of ndvduals below the age of 65 years (other than women) 1,60,000. In case of women below the age of 65 years 1,90,000. In case of ndvduals who are of the age of 65 years or more at any tme 2,40,000 durng the fnancal year Detals to be flled n ths Return Form The detals to be flled out n ths Return Form are self-explanatory. However, some of the tems whch are to be flled out have been explaned below:- (a) e-mal address and phone number are optonal; (b) In employer category, Government category wll nclude Central Government/ State Governments employees. PSU category wll nclude publc sector companes of Central Government and State Government; (c) In tem 1, fll the detals of salary/ penson as gven n TDS certfcate (Form 16) ssued by the employer. However, f the ncome has not been computed correctly n Form No. 16, please make the correct computaton and fll the same n ths tem. Further, n case there was more than one employer durng the year, please furnsh n ths tem the detals n respect of total salares from varous employers. (d) In Item 3, please fll the detals of Income whch s chargeable to ncome-tax under the head ncome from other sources other than ncome from Wnnngs from Lotteres or Income from Race Horses. (e) In Item 27, please fll total of Exempt ncome ncludng Dvdend ncome etc. (f) In tem 6, fll the detals of deductons allowable under followng sectons of Chapter VI-A as under:-

5 () Secton 80C (Some of the major tems for deducton under ths secton are- amount pad or deposted towards lfe nsurance, contrbuton to Provdent Fund set up by the Government, recognsed Provdent Fund, contrbuton by the assessee to an approved superannuaton fund, subscrpton to Natonal Savngs Certfcates, tuton fees, payment/ repayment for purposes of purchase or constructon of a resdental house and many other nvestments)(for full lst, please refer to secton 80C of the Income-tax Act) (Please note that as provded n secton 80CCE, aggregate amount of deducton under secton 80C, 80CCC and 80CCD shall not exceed one lakh rupees). () Secton 80CCC (Deducton n respect of contrbutons to certan penson funds) () Secton 80CCD (Deducton n respect of contrbutons to penson scheme of Central Government) (v) Secton 80D (Deducton n respect of Medcal Insurance Premum) (v) Secton 80DD (Deducton n respect of mantenance ncludng medcal treatment of dependent who s a person wth dsablty) (v) Secton 80DDB (Deducton n respect of medcal treatment, etc.) (v) Secton 80E (Deducton n respect of nterest on loan taken for hgher educaton) (v) Secton 80G (Deducton n respect of donatons to certan funds, chartable nsttutons, etc.) (x) Secton 80GG (Deducton n respect of rents pad) (x) Secton 80GGA (Deducton n respect of certan donatons for scentfc research or rural development) (x) Secton 80GGC (Deducton n respect of contrbutons gven by any person to poltcal partes) (x) Secton 80U (Deducton n case of a person wth dsablty) (g) In tem No. 8, the tax lablty has to be computed for tems as under:- () In case of ndvduals (other than women and ndvduals who are of the age of 65 years or more at any tme durng the fnancal year ) - Income (In Rs.) Tax Lablty (In Rs.) Upto Rs. 1,60,000 Nl Between Rs. 1,60,001 - Rs. 3,00,000 10% of ncome n excess of Rs. 1,60,000 Between Rs. 3,00,001 Rs. 5,00,000 Rs. 14, % of ncome n excess of Rs. 3,00,000 Above Rs.5,00,000 Rs. 54, % of ncome n excess of Rs. 5,00,000 () In case of women (other than women who are of the age of 65 years or more at any tme durng the fnancal year )- Income (In Rs.) Tax Lablty (In Rs.) Upto Rs. 1,90,000 Nl Between Rs. 1,90,001 - Rs. 3,00,000 10% of ncome n excess of Rs. 1,90,000 Between Rs. 3,00,001 Rs. 5,00,000 Rs. 11, % of ncome n excess of Rs. 3,00,000 Above Rs.5,00,000 Rs. 51, % of ncome n excess of Rs. 5,00,000 () In case of ndvduals who are of the age of 65 years or more at any tme durng the fnancal year Income (In Rs.) Tax Lablty (In Rs.) Upto Rs. 2,40,000 Nl Between Rs. 2,40,001 Rs. 3,00,000 10% of ncome n excess of Rs. 2,40,000 Between Rs. 3,00,001 Rs. 5,00,000 Rs. 6, % of ncome n excess of Rs. 3,00,000 Above Rs.5,00,000 Rs. 46, % of ncome n excess of Rs. 5,00,000 (h) There s no surcharge for AY () In tem No. 9, calculate the educaton cess ncludng secondary and hgher educaton cess at the rate of three per cent of tem No.8 (j) In tem No. 11, clam the relef, f any, allowable under secton 89 n respect of arrears or advances of salary receved durng the year. In Item 12, enter detals of any relef under sectons 90/91. (k) In tem 22- Please quote the MICR code of the bank f you desre to receve the refund through electronc clearng system (ECS). However, t may not be possble to ssue the refund n all cases through ECS snce the ECS faclty s not avalable across the country. (l) In tems 23 and 24, please furnsh the detals n accordance wth Form 16 ssued by the employer(s) n respect of salary ncome and Form 16A ssued by a person n respect of nterest ncome and other sources of ncome. Further n order to enable the Income Tax Department to provde accurate, qucker and full credt for taxes deducted at source, the taxpayer must ensure to quote complete detals of every TDS transacton. (m) In tem No.25, please enter detals of tax payments,.e., advance tax and self-assessment tax made by you. (n) In tem No.26, the detals of followng transactons, f any, entered by you durng the fnancal year are to be entered. (If a transacton s not entered, please leave blank the relevant column n ths tem). Sl.No Code Nature of transacton Cash deposts aggregatng to ten lakh rupees or more n a year n any savngs account by you mantaned n a bankng company to whch the Bankng Regulaton Act, 1949 (10 of 1949), appled (ncludng any bank or bankng nsttuton referred to n secton 51 of that Act) Payment made by you aganst blls rased n respect of a credt card aggregatng to two lakh rupees or more n a year Payment made by you of an amount of two lakh rupees or more for purchase of unts of Mutual Fund Payment made by you of an amount of fve lakh rupees or more for acqurng bonds or debentures ssued by a company or nsttuton Payment made by you of an amount of one lakh rupees or more for acqurng shares ssued by a company Purchase by you of any mmovable property valued at thrty lakh rupees or more.

6 Sale by you of any mmovable property valued at thrty lakh rupees or more Payment made by you of an amount of fve lakh rupees or more n a year for nvestment n bonds ssued by Reserve Bank of Inda. (o) In Item No. 27 Please enter detals of all exempt ncomes, e.g., Dvdend Income, Income from long-term captal gans on whch securtes transacton tax has been pad. Income from agrculture not exceedng Rs. 5,000, etc. (p) In Item No Ths return can be prepared by a Tax Return Preparer (TRP) also n accordance wth the Tax Return Preparer Scheme, 2006 dated 28 th November, If the return has been prepared by hm, the relevant detals have to be flled by hm n tem No.28 and the return has to be countersgned by hm n the space provded n the sad tem. The Tax Return Preparer s enttled to a maxmum fees of Rs. 250/- from the taxpayer. TRP s also enttled to a rembursement from the Government for followng three years as under:- () 3 per cent of the tax pad on the ncome declared n the return for the frst elgble assessment year (frst elgble assessment year means the assessment year f no return has been furnshed for at least three assessment years precedng to that assessment year); () 2 per cent of the tax pad on the ncome declared n the return for the second elgble assessment year (second elgble assessment year means the assessment year mmedately followng the frst elgble assessment year); () 1 per cent of the tax pad on the ncome declared n the return for the thrd elgble assessment year (thrd elgble assessment year means the assessment year mmedately followng the second elgble assessment year); For these three elgble assessment years, the TRP wll be elgble for the fee from the taxpayer to the extent of the amount by whch Rs. 250/- exceeds the amount of rembursement recevable by hm from the Government. 10. How to compute In the case of salared employees, perqustes have to be valued n accordance wth the notfcaton No. SO.3245(E) dated , for the purposes of ncludng ther value n the salary ncome. How to compute Income from Salary (In case of multple employers replcate tems 1 to 6 for addtonal employers) Name of Employer 1: 1 Salary (Excludng all allowances, perqustes & proft n leu of salary)from Form Allowances exempt under secton 10 (not to be ncluded n 2 Salary) 3 Allowances not exempt 3 4 Value of perqustes 4 5 Profts n leu of salary 5 6 Taxable Salary from Employer 1 ( ) 6 To be mentoned n Item 1 of ITR 1 Return Form Total Salary Income SALARIES How to compute Income from House Property 1 House Property a Annual letable value/ rent receved or recevable (hgher f let out for whole of the year, lower 1a f let out for part of the year) 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 (restrcted to Rs 1g 1,50,000 f NOT Let Out ) h Total (1f + 1g) 1h Income from house property 1 (1e 1h) 1 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 To be mentoned n Item 2 of ths Return Form Total Income from House Property (4a + 4b + 1) 4c Please nclude the ncome, f any, of specfed persons such as mnor chldren whle computng the ncome under ths head, f property s n ther name HOUSE PROPERTY How to compute Income from Other Sources (In case of multple FD nterest, other nterest from savngs account fll the total n tem 1b) 1 Income other than from ownng race horse(s):- a Taxable Dvdends, Gross 1a b Interest, Gross 1b c Rental ncome from machnery, plants, buldngs, etc., Gross 1c d Others, Gross 1d e Total (1a + 1b + 1c + 1d) 1e f Deductons under secton 57:- Expenses f Deprecaton f Total f g Balance (1e f) 1g 2 To be mentoned n Item 3 of ths Return Form Total Income from other sources (1e + 1g) 2 Please nclude the ncome, f any, of specfed persons such as mnor chldren whle computng the ncome under ths head, f FD etc s n ther name. OTHER SOURCES

7 How to compute Exempt Income (Income not to be ncluded n Total Income) 1 Interest ncome 1 2 Dvdend ncome 2 3 Long-term captal gans on whch Securtes Transacton Tax s pad 3 4 Net Agrculture ncome (not exceedng Rs. 5,000) 4 EXEMPT INCOME 5 Others, ncludng exempt ncome of mnor chld 5 6 To be mentoned n Item 27 of ths Return Form Total ( ) 6 How to compute deducton under secton 80G (Please lst donatons of dfferent types below) A Donatons enttled for 100% deducton (eg Prme Mnster s Natonal Relef Fund) Name of donee Total DETAILS OF DONATIONS B C D Donatons enttled for 50% deducton where donee not requred to be approved under secton 80G(5) (v) (eg Prme Mnster s Drought Relef Fund) Name of donee Total Donatons enttled for 50% deducton where donee s requred to be approved under secton 80G(5) (v) (elgble donaton s restrcted to 10 % of Total Income after other deductons) Name and address of donee Total To be mentoned n Item 6 of ths Return Form Total Deducton under Secton 80 G = {100% of A + 50 % of B + 50% of [Maxmum of 10% of Total Income After Other Deductons ((Item 4 Sum of Items (5a to 5l except 5h)) or (C)]} A A A B B B C C C D Amount of donaton Amount of donaton Amount of donaton

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