Select applicable sheets below by choosing Y/N and Click on Apply Click on the sheets below PART A - GENERAL

PARTB - TI - TTI - SAL HOUSE_PROPERTY CG-OS CYLA-BFLA CFL VIA SPI - SI EI IT FSI TR_FA TDS SCH5A Schedules for filing Income Tax Return Personal Info., Filing Status PartB-TI,PartB-TTI,Verification,Schedule S Schedule HP Schedule CG, Schedule OS Schedule CYLA, Schedule BFLA ScheduleCFL Schedule VIA Schedule SPI, Schedule SI Schedule EI Schedule AIR, Schedule IT Schedule AIR, Schedule FSI Schedule TR, Schedule FA Schedule TDS1,Schedule TDS2 Schedule 5A

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

Y Y Y Y Y Y Y Y Y Y Y Y Y Y

Select sheets to print and click apply

Y Y Y Y Y Y Y Y Y Y Y Y Y Y

ScheduleName

GENERAL PART_B PART_B HOUSE_PROPERTY CG_OS CG_OS CYLA BFLA CYLA BFLA CFL VIA SPI - SI SPI - SI EI IT FSI TR FA TDS TDS SCH5A

PartA_Gen1 PartB-TI PartB-TTI ScheduleHP ScheduleCG ScheduleOS ScheduleCYLA ScheduleBFLA ScheduleCFL ScheduleVIA ScheduleSPI ScheduleSI ScheduleEI ScheduleIT ScheduleFSI ScheduleTR ScheduleFA ScheduleTDS1 ScheduleTDS2 Schedule5A

Appli cable YN Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y

Description Click on applicable links to navigate to the respective sheet / schedule. Click on any of the links on this page to navigate to the respective schedules. Computation of total income Computation of tax liability on total income Details of Income from House Property Capital Gains Income from other sources Details of Income after set-off of current years losses Details of Income after Set off of Brought Forward Losses of earlier years Details of Losses to be carried forward to future Years Deductions under Chapter VI-A Income chargeable to Income tax at special rates IB [Please see instruction Number-9(iii) for section code and rate of tax] Income chargeable to Income tax at special rates IB [Please see instruction Number-9(iii) for section code and rate of tax] Details of Exempt Income (Income not to be included in Total Income) Details of Advance Tax and Self Assessment Tax Payments of Income-tax Details of Income accruing or arising outside India Schedule TR Details of Tax Relief claimed under Section 90 or Section 90A or Section 91. Schedule FA Details of foreign assets Details of Tax Deducted at Source on Income [As per Form 16 A issued by Deductor(s)] Details of Tax Collected at Source [As per Form 27D issued by the Collector(s)] Information regarding apportionment of income between spouses governed by Portuguese Civil Code

FORM

INDIAN INCOME TAX RETURN

Assessment Year 2013-14

ITR-2
First Name DEEPA

[For Individuals and HUFs not having Income from Business or Profession] (Please see Rule 12 of the Income Tax-Rules,1962) (Also see attached Instructions) Middle Name Last Name GUPTA Name of Premises / Building / Village

PAN BJJPG1971R Status (I-Individual,H-HUF) I - Individual Dateof DD/MM/Y 06/11/1979 Country 91-INDIA Sex M-Male Pin Code 700007

PERSONAL INFORMATION

Flat / Door / Block No 30 Road / Street / Post Office MAHARSHI DEVENDRA ROAD Town/City/District KOLKATA

Area / Locality POSTA State 32-WEST BENGAL

Email Address-1 (self) Email Address-2 Mobile No 1 (Std code) Landline Phone Mobile No 2 Employer number Category (Residence / Office) arihantjain@live.in 9433031978 NA Income Tax Ward/Circle Return filed under section (Refer WD 42(2)/ KOL 11-On Or BeforeDueDt Instruction 7 ) Are you governed by Portuguese Civil Code ? FILING STATUS No Whether original or revised O-Original

If revised, enter Ack no and Date of filing Date original return (DD/MM/YYYY) (DD/MM/YYYY If u/s 139(9) - defective return, Enter Original Ack No If u/s 139(9) - defective return, Enter Enter Notice Notice No and Notice Date Date RES - Resident Residential Status Whether this return is being filed by a representative assessee? If yes, please furnish following information a Name of the representative b Address of the representative c Permanent Account Number (PAN) of the representative

N-No

TOTAL INCOME

Computation of total income . PLEASE NOTE THAT CALCULATED FIELDS (IN WHITE) ARE PICKED UP FROM OTHER SCHEDULES AND ARE NOT TO BE ENTERED. For ex : The income Part B - TI figures below will get filled up when the Schedules linked to the Income are filled. 1 Salaries (7 of Schedule S) 1 2 Income from house property (C of Schedule-HP) (Enter nil if loss) 2 3 Capital gains a Short term 0 i Short-term (u/s 111A) (A1a+A 2e of Schedule 3ai CG) 0 ii Short-term (others) ((A5 A1a-A 2e) of Schedule 3aii CG) 0 iii Total short-term (3ai + 3aii) (A5 of Schedule CG) 3aiii 0 b i Long-term (B6 - B3e B4 of Schedule CG) 3bi 0 ii Long-term without indexation (B3e + B4 of 3bii Schedule CG) 0 iii Total Long-term (3bi +3bii) (enter nil if loss and 3biii take the figure to schedule CFL) c Total capital gains (3aiii + 3biii) (take the figure adjusted to Schedule CYLA)(In case 3c of negative figure enter nil and take the figure under respective head to schedule CFL) 4 Income from other sources 258185 a from sources other than from owning race horses and 4a winnings from Lottery etc. (1g of Schedule OS) 0 b winnings from lotteries, crossword puzzles, races, 4b games, gambling, betting etc. (2 of Schedule OS) c from owning and maintaining race horses (4c of Schedule OS) (enter nil if loss) 5 6 7 8 9 10 11 12 13 14 15 16 4c 0 4d 5 6 7 8 9 10 11 12 13 14 15 16

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

Computation of tax liability on total income Part B - TTI 1 Tax payable on total income a Tax at normal rates on 15 of Part B-TI b Tax at special rates (total of (ii) of Schedule-SI) ION OF TAX LIABILITY

1a 1b

1905 0

COMPUTATION OF TAX LIABILITY

c Rebate on Agricultural income [applicable if (12-13) of Part B-TI exceeds maximum amount not chargeable to tax] 2 3 4

1c

5 6

TAXES PAID

7 8

9 10 REFUND 11 12 13

d Tax Payable on Total Income (1a + 1b-1c) Education Cess, including secondary and higher education cess, on 1d Gross tax liability (1d+ 2) Tax relief a Section 89 4a b Section 90/90A (column 1B1 of Schedule TR) 4b c Section 91(column 1B2 of Schedule TR). 4c d Total (4a + 4b + 4c) Net tax liability (3 4d) Interest payable a For default in furnishing the return (section 234A) 6a b For default in payment of advance tax (section 234B) 6b c For deferment of advance tax (section 234C) 6c d Total Interest Payable (6a+6b+6c) Aggregate liability (5 + 6d) Taxes Paid a Advance Tax (from Schedule-IT) 8a b TDS (total of column 5 of Schedule-TDS1 and column 8b 7of Schedule-TDS2) c Self Assessment Tax (from Schedule-IT) 8c d Total Taxes Paid (8a+8b+8c) Amount payable (Enter if 7 is greater than 8d, else enter 0) Refund (If 8d is greater than 7) Enter your bank account number (mandatory and for direct deposit of refund into bank, the number should be 11 digits or more Select Yes if you want your refund by direct deposit into your bank account, Select No if you want refund by Cheque. In case of direct deposit to your bank account give additional details

1d 2 3

0 0 4d 5 0 0 0 6d 7 0 0 0 8d 9 10 11 12

IFSC Code VIJB0007203 Type of Account (Select) Do you have,(i) any asset (including financial interest in any entity) located outside India or (ii) signing authority in any account located outside India? [applicable only in case of a resident] [Ensure Schedule FA is filled up if the answer is 14 Yes ] VERIFICATION I,

14

son/ daughter of DEEPA GUPTA solemnly declare that to the best of my knowledge and belief, the information given in the return and the schedules thereto is is corr and complete and that the amount of total income/ fringe benefits and other particulars shown therein are truly stated and are in accordance with the the provisions of the Income-tax Act, 1961, in respect of income and fringe benefits chargeable to Income-tax fo the previous year relevant to the assessment year 2013-2014 Place KOLKATA (Date) 06-05-2013 PAN BJJPG1971R 14 If the return has been prepared by a Tax Return Preparer (TRP) give further details below: Counter Signature of Identification No. of TRP TRP Name of TRP If TRP is entitled for any reimbursement from the Government, 14 amount thereof

Schedule S Details of Income from Salary (Fields marked in RED should not be left Blank) Name of Employer PAN of Employer (optional) Address of employer Town/City State (Select) 1 Salary (Excluding all exempt/ non-exempt allowances, perquisites & profit in lieu of salary) 2 Allowances exempt under section 10 2 3 Allowances not exempt 4 Value of perquisites 5 Profits in lieu of salary 6 Deduction u/s 16 (Entertainment allowance by Government and tax on employment) 7 Income chargeable under the Head Salaries (1+3+4+5-6) Total

1 3 4 5 6 7

n of total income . PLEASE NOTE THAT CALCULATED FIELDS (IN WHITE) ARE FROM OTHER SCHEDULES AND ARE NOT TO BE ENTERED. For ex : The income w will get filled up when the Schedules linked to the Income are filled. 0 0

258185 258185 0 258185 0 258185 0 39134 219050 0 0 219050 0

1905 57 1962

0 1962

0 1960

0 1960 0 720301011001251 YES

SAVINGS NO

VERIFICATION JITENDRA JAISWAL

owledge and belief, the information given in the return and the schedules thereto is is correct income/ fringe benefits and other particulars shown therein are truly stated and are in Income-tax Act, 1961, in respect of income and fringe benefits chargeable to Income-tax for nt year 2013-2014 06-05-2013

a Tax Return Preparer (TRP) give further details below:

Pin code 0 0 0 0 0 0 0

SCH HP Details of Income from House Property (Fields marked in RED must not be left Blank) ADDRESS OF Town/ City PROPERTY (NOTE : DO NOT LEAVE ADDRESS BLANK ) Is the property co-owned? (SELECT)

S.No

Name of Co-owner

i ii iii iv v

a b c d e f g

IS THE PROPERTY LET OUT ? ( Y - YES, NName of Tenant NO) (SELECT) Annual letable value or rent received or receivable (higher of the two, if let out for whole of the year, lower of the two if let out The amount of rent which cannot be realized Tax paid to local authorities Total (b + c) Annual value (a d) (nil, if self -occupied etc. as per section 23(2)of the Act) 30% of e Interest payable on borrowed capital

h i

Total (f + g) Income from house property (e h) ADDRESS OF PROPERTY (NOTE : DO NOT LEAVE ADDRESS BLANK ) Is the property co-owned? (Select)

Town/ City

S.No i ii iii iv v

Name of Co-owner

a b c

IS THE PROPERTY Name of Tenant LET OUT ? ( Y - YES, N(Select) Annual letable value or rent received or receivable (higher of the two, if let out for whole of the year, lower of the two if let out The amount of rent which cannot be realized Tax paid to local authorities

d e f g

Total (b + c) Annual value (a d) (nil, if self -occupied etc. as per section 23(2)of the Act) 30% of e Interest payable on borrowed capital

h i

Total (f + g) Income from house property (e h) ADDRESS OF PROPERTY (NOTE : DO NOT LEAVE ADDRESS BLANK ) Is the property co-owned? (Select)

Town/ City

S.No i ii iii iv v

Name of Co-owner

a b c d e f g

IS THE PROPERTY Name of Tenant LET OUT ? ( Y - YES, N(Select) Annual letable value or rent received or receivable (higher of the two, if let out for whole of the year, lower of the two if let out The amount of rent which cannot be realized Tax paid to local authorities Total (b + c) Annual value (a d) (nil, if self -occupied etc. as per section 23(2)of the Act) 30% of e Interest payable on borrowed capital

h Total (f + g) i Income from house property (e h) Income under the head Income from house property A Rent of earlier years realized under section 25A/AA B Arrears of rent received during the year under section 25B after deducting 30% C Total (A + B + Total of (i) for all properties above)

RED must not be left Blank) State PIN Code

(Select)
Your percentage of share in the property.

100

PAN of Coowner

Percentage Share in Property

PAN of Tenant (optional) of the two, if let out for whole of the year, lower of the two if let out for part of the year) a 0 0 0 e 0 0 Cannot exceed 1.5 lacs if not let out b i State PIN Code 0

0 0

(Select)
Your percentage of share in the property.

100

PAN of Coowner

Percentage Share in Property

PAN of Tenant (optional) of the two, if let out for whole of the year, lower of the two if let out for part of the year) a

0 e 0 Cannot exceed 1.5 lacs if not let out b i State PIN Code 0 0 0

(Select)
Your percentage of share in the property.

100

PAN of Coowner

Percentage Share in Property

PAN of Tenant (optional) of the two, if let out for whole of the year, lower of the two if let out for part of the year) a

0 e 0 Cannot exceed 1.5 lacs if not let out b i A B C 0 0 0

CAPITAL GAINS

Schedule CGCapital Gains A Short-term capital gain 1. In case of NON-RESIDENT to which first proviso to section 48 is applicable 1a a From assets where section 111A is not applicable 1b paid b From assets (shares/ units) in the case of others where section 111A is applicable (STT From assets (shares/ units) in the case of others where section 111A is applicable (STT 2. paid) 2a 0 a Full value of consideration b Deductions under section 48 i Cost of acquisition bi 0 ii Cost of Improvement bii 0 iii Expenditure on transfer biii 0 iv Total ( i + ii + iii) biv 0 2c 0 c Balance (2a 2biv) Loss, if any, to be ignored under section 94(7) or 94(8) d 2d (Enter positive values only) 0 e Short-term capital gain (2c + 2d ) 2e 3. From assets in case of others where section 111A is not applicable 3a 0 a Full value of consideration b Deductions under section 48 i Cost of acquisition bi 0 ii Cost of Improvement bii 0 iii Expenditure on transfer biii 0 iv Total ( i + ii + iii) biv 0 3c 0 c Balance (3a 3biv) 0 d Loss, if any, to be ignored under section 94(7) or 94(8) 3d 0 e Deduction under section 54B/54D 3e f Short-term capital gain (3c + 3d 3e) 3f 4. Amount deemed to be short term capital gains under sections 54B/54D/54G/ 54GA A4 5. Total short term capital gain (1a + 1b + 2e +3f + A4) A5 B Long term capital gain 1. From Asset in case of non-resident to which first proviso to section 48 applicable 1 2. From asset in the case of others where proviso under section 112(1) is not applicable a Full value of consideration 2a 0 b Deductions under section 48 i Cost of acquisition after indexation bi

0 0

0 0 0 0

CAPITAL GAINS

ii Cost of improvement after indexation bii iii Expenditure on transfer biii iv Total (bi + bii +biii) biv c Balance (2a 2biv) 2c Deduction under sections 54/54B/54D/54EC/54F d 2d 54G/54GA/54GB e Net balance (2c 2d) 3. From asset where proviso under section 112(1) is applicable (without indexation) a Full value of consideration 3a b Deductions under section 48 i Cost of acquisition without indexation bi ii Cost of improvement without indexation bii iii Expenditure on transfer biii iv Total (bi + bii +biii) biv c Balance (3a biv) 3c d Deduction under sections 54/54B/54D/54EC/54F/54GB e Net balance (3c-3d) 3d

0 0 0 0 0 2e 0 0 0 0 0 0 0 3e 4 5 B6 7 C 0 0 0 0 0

4. From unlisted securities in case of non-resident as per section 112(1)(c)(iii) Amount deemed to be long term capital gains under sections 5. 54/54B/54D/54EC/54F/54GB 6 Total long term capital gain [1 +2e +B3e + B4 + B5] 7. In case of deduction u/s 54GB, furnish PAN of the company C D Income chargeable under the head CAPITAL GAINS (A5 + B6) (enter B6 as nil, if loss) Information about accrual/receipt of capital gain Date : i Up to 15/9 (i) ii 16/9 to 15/12 (ii) iii 16/12 to 15/3 (iii) iv 16/3 to 31/3 (iv) Date i Up to 15/9 (i) ii 16/9 to 15/12 (ii)

STCG 111A 0 0 0 0 LTCG PROVISO 0 0

STCG OTH 0 0 0 0 LTCG NO PROVISO 0 0

iii 16/12 to 15/3 (iii) iv 16/3 to 31/3 (iv) Break up of Capital Gain cannot exceed total gain : Short term u/s 111A, Short term others, Long Term Without Proviso Long Term With Proviso

0 0

0 0

Schedule OS Income 1 Income other than from owning race horse(s):a Dividends, Gross b Interest, Gross c Rental income from machinery, plants, buildings, etc., Others, Gross (excluding income from owning race horses) (Fill up the Source and the Income Below) d Source (i) 1 COMMISSION 2 TUITION FEES 3 1d Total

OTHER SOURCES

1a 1b 1c

0 961 0

1 2 3

Income (2) 204134 65000 269134

2 3 4

Total (1a + 1b + 1c + 1d) 1e Deductions under section 57:i Expenses / Deductions fi 11910 ii Depreciation fii 0 iii Total fiii 11910 g Balance (1e fiii) 1g 2 Winnings from lotteries, crossword puzzles, races, games, gambling, betting etc. (Gross). Income from other sources (other than from owning race horses) (1g + 2) (enter1g as nil, if loss) 3 Income from owning and maintaining race horses a Receipts 4a 0 b Deductions under section 57 in relation to (4) 4b 0 c Balance (4a 4b) 4c Income chargeable under the head Income from other sources (3 + 4c) (enter 4c as nil if 5 loss and take 4c loss figure to Schedule CFL)

e f

270095

258185

258185

0 258185

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

Schedule CYLA

Details of Income after set-off of current years losses Income of current year (Fill this House property column only if loss of the current income is zero or year set off positive) Other sources loss (other than loss from race horses) of the current year set off Current years Income remaining after set off

Sl.No

Head/ Source of Income

CURRENT YEAR LOSS ADJUSTMENT

Total loss (3 of ScheduleOS) Total loss (C of Schedule HP) 0 2 0 0 0 0 0 0 0

Loss to be adjusted 1 i Salaries ii House property iii Short-term capital gain iv Long term capital gain Other sources (excluding profit from v owning race horses and winnings from lottery) Profit from owning and maintaining race vi horses

0 3 0 0 0 0 4=1-2-3 0 0 0 0

258185

258185

0 vii Total loss set-off viii Loss remaining after set-off out of 2 & 3

0 0 0

0 0 0

Schedule BFLA

BROUGHT FORWARD LOSS ADJUSTMENT

Sl. No.

Head/ Source of Income

i Salaries ii House property iii Short-term capital gain iv Long-term capital gain

Details of Income after Set off Brought Forward Losses of earlier years Income after set off, if Brought forward Current years any, of current loss income remaining years set off after set off losses as per 4 of Schedule CYLA) 1 2 3 0 0 0 0 0 0 0 0 0 0 0

BROUGHT FORWARD LOSS ADJUST

vi vii viii

Other sources (excluding profit from owning race horses and winnings from lottery) 258185 0 Profit from owning and maintaining race horses 0 0 Total of brought forward loss set off 0 Current years income remaining after set off Total (i3 + ii3 + iii3 + iv3 + v3+vi3)

258185

258185

Note : Short Term Capital Loss Brought Forward will be adjusted against STCG and LTCG in the sequence of STCG Other than 111A, LTCG Non Proviso, STCG u/s 111A, LTCG Proviso to the extent of loss brought forward available for set off Please click on "Compute Set off" button on top to allow the utility to auto fill the Adjustment of Current Year and Brought Forward Loss in yellow fields .

Schedule CFL Sl. No. i ii iii iv v vi vii viii ix

CARRY FORWARD OF LOSS

Details of Losses to be carried forward to future Years Date of Assessmen House Short-term Long-term Filing t Year property loss capital loss Capital loss (DD/MM/ YYYY) 2005-06 2006-07 2007-08 2008-09 2009-10 2010-11 2011-12 2012-13 Total of earlier year losses Adjustmen t of above losses in ScheduleB FLA 2013-14 (Current year losses) Total loss Carried Forward to future 0 0 0

Other sources loss (other than loss from race horses)

Other sources loss (from owning race horses)

xi xii

0 0

0 0

0 0

0 0

Schedule 80G Details of donations entitled for deduction under section 80G Donations entitled for 100% deduction without qualifying limit. (Please see the NOTE given below) (Note : If no A entry is made in Donee Name, then other columns will not be considered for that row) Name of donee 1 2 3 4 Total 80GA Address City or Town or District State Code PinCode PAN of Donee

(Select) (Select) (Select) (Select)

Donations entitled for 50% deduction without qualifying limit Name of Address City or State Code PinCode donee Town or District (Select) 1 (Select) 2 (Select) 3 (Select) 4 Total 80GB :

PAN of Donee

Donations entitled for 100% deduction subject to qualifying limit Name of Address City Or State Code PinCode donee Town Or District (Select) 1 (Select) 2 (Select) 3 (Select) 4 Total 80GC :

PAN of Donee

Donations entitled for 50% deduction subject to qualifying limit Name of Address City Or State Code PinCode donee Town Or District (Select) 1 (Select) 2 (Select) 3 (Select) 4 Total 80GD

PAN of Donee

Donations (A + B + C + D)

NOTE : (IN CASE OF DONEE FUNDS SETUP BY GOVERNMENT AS DESCRIBED IN SECTION 80G(2), PLEASE USE PAN AS "GGGGG0000G")

Amount of donation

Eligible Amount of Donation 0 0 0 0 0 0

Amount of donation

Eligible Amount of Donation 0 0 0 0 0 0

Amount of donation

Eligible Amount of Donation 0 0 0 0 0 0

Amount of donation

Eligible Amount of Donation 0 0 0 0 0 0

ED IN SECTION 80G(2),

Schedule VI-A Deductions under Chapter VI-A a 80C a b 80CCC b c(i) 80CCD(1) (assessees contribution) c(ii) c(ii) 80CCD(2) (employers contribution) c(i) d 80CCG d e 80D e f 80DD f g 80DDB g h 80E h i 80G (Eligible Amount) i j 80GG j k 80GGA k l 80GGC l m 80QQB m n 80RRB n o 80TTA o p p 80U q Total deductions (total of a to p)

39134 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 q

System Calculated 39134 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 39134 39134

TOTAL DEDUCTIONS

Schedule SPI Income of specified persons(spouse, minor child etc) includable in income of the assessee (income of the minor child, in excess of Rs. 1,500 per child, to be included) Sl No Name of person PAN of person (optional) Relationship Nature of Income Amount (Rs) 1 2 3 0

Please clilck on Recalculate initially, and also subsequently if Gender, Date of Birth , Residential Status or Assessee Status (Indl / HUF etc) is changed (Note "Recalculate button is provided in Sheet PART B - TI - TTI) Income chargeable to Income tax at special rates IB [Please see instruction Schedule SI Number-9 for section code and rate of tax] Section SPECI System calculated code Sr nos 1 to 5 AL Taxable Income tax thereon are auto filled RATE Sl Special rate Income after adjusting for from Sch CG. No (%) i Min Chargeable to Enter rates for Sl Tax no 6 and 7 manually) 1 21 20 0 0 0 2 1A 15 0 0 0 3 22 10 0 0 0 4 21ciii 10 0 0 0 5 5BB 30 0 0 0 6 1 10 0 0 0 7 DTAA 1 0 0 0 8 5A1b1 30 0 0 9 5A1b2 20 0 0 0 10 5A1ai 20 0 0 11 5BBA 20 0 0 SI Total (1ii to 10 ii) 0 0 0

Please Click on Compute Tax button in Part B TI to re calculate Tax at Normal Rate and Tax at Special Rate

Schedule EI Details of Exempt Income (Income not to be included in Total Income) 1 Interest income 2 Dividend income 3 Long-term capital gains on which Securities Transaction Tax is paid 4 Net Agricultural income (other than income to be excluded under rule 7A, 7B or 8 of I.T. Rules) 5 Others, (including exempt income of minor child) 6 Total (1+2+3+4+5)

EXEMPT INCOME

1 2 3 4 5 6

0 0 0 0

Schedule ITDetails of Advance Tax and Self Assessment Tax Payments TA X Date of Credit into PA Sl Serial Number BSR Code Govt Account Amount (Rs) YM No of Challan (DD/MM/YYYY) EN TS 2 If no entry is made in this column, then 1 3 4 5 columns (3) to (5) will not be considered for that row 1 2 3 4 5 6 NOTE Enter totals of Advance and Self Assessment tax in Sl No. 8a & 8c of PartB-TTI

FSI

Details of Income accruing or arising outside India 1 Details of Income included in Total Income in Part-B-TI above Sr No Country Code Taxpayer Income from (Note : If no Identification number Salary (included entry is made in in PART B-TI) (A) this column, then other columns will not be considered for that row) 1 2 3 4 (Select) (Select) (Select) (Select)

Income from House Property (included in PART B-TI) (B)

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

Business Capital Gains Other Sources Total Income From Income Income (included in Income (included Outside India (included in PART B-TI) in PART B-TI) (F) PART B-TI) (D) (E) = A+B+C+D+E (C)

0 0 0 0

0 0 0 0

0 0

(Note : If no entry is made in the Country Code column, then other columns will not be considered for that row) Schedule TR Details of Tax Relief claimed under Section 90 or Section 90A or Section 91. TR Sr No Country Code Tax Identification number Relevant article of DTAA 1

1 2 3 4 Total:

(Select) (Select) (Select) (Select)

2 3 4

Total Taxes paid outside India (Total of 1A) Total Taxes Paid outside India where DTAA is applicable Total Taxes Paid outside India where DTAA is not applicable (2-3)

FA A

Schedule FA Details of foreign assets NOTE : This Schedule is not Applicable for NRI \(Non Resident Indians) as per Reseidential Status Details of Foreign Bank Accounts Sr No Country Code Name of the Bank Address of the Bank 1 2 3 4 (Select) (Select) (Select) (Select)

Total:

Details of Financial Interest in any Entity Sr No Country Code 1 2 3 4 (Select) (Select) (Select) (Select)

Nature of entity

Name of the Entity

Total:

Details of immovable property Sr No Country Code 1 2 3 4 (Select) (Select) (Select) (Select)

Address of the Property

Total Investment (at cost) (in rupees)

Total:

Details of any other Asset in the nature of Investment Sr No Country Code Nature of Asset 1 2 3 4 (Select) (Select) (Select) (Select)

Total Investment (at cost) (in rupees)

Total:

`1 Total:

Details of account(s) in which you have signing authority and which has not been included in A to D above. Sr No Name of the Institution Address of the Institution Name of the Account in which the account is Holder held (Note : If no entry is made in this column, then other columns will not be considered for that row) 1 2 3 4

Details of trusts, created under the laws of a country outside India, in which you are a trustee Sr No Country Code Name of the trust Address of the trust 1 2 3 4 (Select) (Select) (Select) (Select)

ered for that row) Total taxes paid on income declared in Schedule FSI (A) 0 0 0 0 0 Relief claimed u/s 90/90A (B1) 0 0 0 0 0 Relief claimed u/s 91 (B2)

0 0 0 0 0

0 0 0

Reseidential Status Name mentioned in the account Account Number Peak Balance during the year (in Rupees)

Address of the Entity

Total Investment (at cost) (in rupees)

n included in A to D above. Account Number

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

u are a trustee Name of Other trustees Address of Other trustees Name of Settlor Address of Settlor

Name of Beneficiaries

Address of Beneficiaries

Schedule TDS1

Details of Tax Deducted at Source from SALARY [As per FORM 16 issued by Employer(s)]

Sl No

Tax Deduction Account Number (TAN) of the Deductor 2 If no entry is made in this column, then columns (3) to (5) will not be considered for that row

Name of Deductor

Income chargeable under Salaries

Total tax deducted

1 2 3

Schedule TDS2

Details of Tax Deducted at Source on Income [As per FORM 16 A issued by Deductor(s)]

Sl No

Tax Deduction Account Number (TAN) of the Deductor 2 If no entry is made in this column, then columns (3) to (7) will not be considered for that row

Name of Deductor

Unique TDS Financial Year in which Certificate Number TDS is deducted

Total tax deducted

Amount out of (6) claimed for this year

1 2 3

Information regarding apportionment of income between spouses governed by Portuguese Civil Code Schedule 5A Nane of the Spouse PAN of the Spouse Heads Amount apportioned in the of hands of the spouse 1 House Property 1 2 Business or profession 2 0 3 Capital Gains 3 4 Other Sources 4 5 Total (1+2+3+4) 5 0

erned by Portuguese Civil Code