Is there any change in the company s name? If yes, please furnish the old name issued by MCA

Transcription

1 AUDIT INFORMATION FILING STATUS PERSONAL INFORMATION FORM ITR-6 INDIAN INCOME TAX RETURN [For Compnes other thn ompnes lmng exempton under seton 11] (Plese see rule 12 of the Inome-tx Rules,1962) (Also see tthed nstrutons) Assessment Yer Prt A-GEN Nme GENERAL PAN Is there ny hnge n the ompny s nme? If yes, plese furnsh the old nme Corporte Identty Numer (CIN) ssued y MCA Flt/Door/Blok No Nme of Premses/Buldng/Vllge Dte of norporton (DD/MM/YYYY) / / Rod/Street/Post Offe Are/Lolty Type of ompny (Tk ny one) () Domest Compny () Foregn Compny Town/Cty/Dstrt Stte Country Pn ode If pul ompny wrte 6, nd f prvte ompny wrte 7 (s defned n seton 3 of The Compny At) Offe Phone Numer wth STD ode/ Mole No. 1 Mole No. 2 Inome Tx Wrd/Crle Eml Address-1 Eml Address-2 () () () Return fled(tk)[plese see nstruton numer-5] On or efore due dte-139(1), After due dte-139(4), Revsed Return-139(5) Modfed return-92cd, under seton 119(2)(),Or In response to note 139(9)- Defetve, 142(1), 148, 153A, 153C If revsed/n response to defetve/modfed, then enter Reept No nd Dte of flng orgnl return / / (DD/MM/YYYY) If fled, n response to note u/s 139(9)/142(1)/148/153A/153C enter dte of suh note, or u/s 92CD enter dte of dvne prng greement (d) Resdentl Sttus (Tk) Resdent Non-Resdent / / (e) Whether optng for seton 115BA? (Yes/No) (pplle on Domest Compny) (f) (g) Whether totl turnover/ gross reepts n the prevous yer exeeds 5 rore rupees? (Yes/No) (pplle on Domest Compny) Whether ssessee s resdent of ountry or spefed terrtory wth whh Ind hs n greement referred to n se 90 (1) or Centrl Government hs dopted ny greement under se 90A(1)? (h) In the se of non-resdent, s there permnent estlshment (PE) n Ind (Tk) Yes No () (j) Whether ssessee s requred to seek regstrton under ny lw for the tme eng n fore reltng to ompnes? Whether ssessee s loted n n Interntonl Fnnl Serves Centre nd derves nome solely n onvertle foregn exhnge? (Tk) Yes No (k) Whether the ssessee ompny s under lqudton (Tk) Yes No (l) Whether you re n FII / FPI? Yes/No If yes, plese provde SEBI Regn. No. (m) (n) Whether ny trnston hs een mde wth person loted n jursdton notfed u/s 94A of the At? Yes No Whether ths return s eng fled y representtve ssessee? (Tk) Yes No If yes, plese furnsh followng nformton - (1) Nme of the representtve ssessee (2) Address of the representtve ssessee (3) Permnent Aount Numer (PAN) of the representtve ssessee () Whether lle to mntn ounts s per seton 44AA? (Tk) Yes No () Whether lle for udt under seton 44AB? (Tk) Yes No () If () s Yes, whether the ounts hve een udted y n ountnt? (Tk) Yes No If Yes, furnsh the followng nformton elow (1) Menton the dte of furnshng of udt report (DD/MM/YYYY) (2) Nme of the udtor sgnng the tx udt report (3) Memershp no. of the udtor (4) Nme of the udtor (propretorshp/ frm) Pge 1

2 NATURE OF COMPANY AND ITS BUSINESS SHAREHOLDERS INFORMATION KEY PERSONS BUSINESS ORGANISATION HOLDING STATUS (d) (e) (5) Propretorshp/frm regstrton numer (6) Permnent Aount Numer (PAN) of the udtor (propretorshp/ frm) (7) Dte of udt report If lle to furnsh other udt report under the Inome-tx At, menton the dte of furnshng the udt report? (DD/MM/YY) (Plese see Instruton 5()) 92E 115JB Menton the At, seton nd dte of furnshng the udt report under ny At other thn the Inome-tx At At nd seton (DD/MM/YY) At nd seton (DD/MM/YY) () Nture of ompny (wrte 1 f holdng ompny, wrte 2 f susdry ompny, wrte 3 f oth, wrte 4 f ny other) () If susdry ompny, menton the detls of the Holdng Compny PAN Nme of Holdng Compny Address of Holdng Compny Perentge of Shres held () If holdng ompny, menton the detls of the susdry ompnes PAN Nme of Susdry Compny Address of Susdry Compny Perentge of Shres held () In se of mlgmtng ompny, menton the detls of mlgmted ompny PAN Nme of Amlgmted Compny Address of Amlgmted Compny () In se of mlgmted ompny, menton the detls of mlgmtng ompny PAN Nme of Amlgmtng Compny Address of Amlgmtng Compny () In se of demerged ompny, menton the detls of resultng ompny PAN Nme of Resultng Compny Address of Resultng Compny (d) In se of resultng ompny, menton the detls of demerged ompny PAN Nme of Demerged Compny Address of Demerged Compny Prtulrs of Mngng Dretor, Dretors, Seretry nd Prnpl offer(s) who hve held the offe durng the prevous yer S.No. Nme Desgnton Resdentl Address PAN Dretor Identfton Numer (DIN) ssued y MCA, n se of Dretor Prtulrs of persons who were enefl owners of shres holdng not less thn 10% of the votng power t ny tme of the prevous yer S.No. Nme nd Address Perentge of shres held PAN Nture of ompny (Tk) 1 Whether pul setor ompny s defned n seton 2(36A) of the Inome-tx At Yes No 2 Whether ompny owned y the Reserve Bnk of Ind Yes No 3 Whether ompny n whh not less thn forty perent of the shres re held (whether sngly or tken together) y the Government or the Reserve Bnk of Ind or orporton owned y tht Bnk Yes No 4 Whether nkng ompny s defned n luse () of seton 5 of the Bnkng Regulton At,1949 Yes No 5 6 Whether sheduled Bnk eng nk nluded n the Seond Shedule to the Reserve Bnk of Ind At Whether ompny regstered wth Insurne Regultory nd Development Authorty (estlshed under su-seton (1) of seton 3 of the Insurne Regultory nd Development Authorty At, 1999) 7 Whether ompny eng non-nkng Fnnl Insttuton Yes No Nture of usness or professon, f more thn one usness or professon ndte the three mn tvtes/ produts Yes Yes No No Pge 2

3 EQUITY AND LIABILITIES S.No. Code [Plese see nstruton No.7()] Desrpton () () () Prt A-BS BALANCE SHEET AS ON 31 ST DAY OF MARCH, 2017 OR AS ON THE DATE OF AMALGAMATION I Equty nd Lltes 1 Shreholder s fund A Shre ptl Authorsed A Issued, Susred nd fully Pd up A Susred ut not fully pd A v Totl (A + A) Av B Reserves nd Surplus Cptl Reserve B Cptl Redempton Reserve B Seurtes Premum Reserve B v Deenture Redempton Reserve Bv v Revluton Reserve Bv v Shre optons outstndng mount Bv Other reserve (spefy nture nd mount) v v v Totl (v + v) Bv v Surplus.e. Blne n proft nd loss ount (Det lne Bv to e shown s ve fgure) x Totl (B + B + B + Bv + Bv + Bv + Bv + Bv) (Det lne to e shown s ve fgure) Bx C Money reeved gnst shre wrrnts 1C D Totl Shreholder s fund (Av + Bx + 1C) 1D 2 Shre pplton money pendng llotment Pendng for less thn one yer Pendng for more thn one yer Totl ( + ) 2 3 Non-urrent lltes A Long-term orrowngs Bonds/ deentures Foregn urreny Rupee Totl ( + ) Term lons Foregn urreny Rupee lons 1 From Bnks 1 2 From others 2 3 Totl (1 + 2) 3 Totl Term lons ( + 3) Deferred pyment lltes v Deposts from relted prtes (see nstrutons) v v Other deposts v v Lons nd dvnes from relted prtes (see nstrutons) v v Other lons nd dvnes v Pge 3

4 v Long term mturtes of fnne lese olgtons x Totl Long term orrowngs ( v + v + v + v + v) B Deferred tx lltes (net) C Other long-term lltes Trde pyles Others Totl Other long-term lltes ( + ) D Long-term provsons Provson for employee enefts Others Totl ( + ) E Totl Non-urrent lltes (3A + 3B + 3C + 3D) 4 Current lltes A Short-term orrowngs v 3A 3B 3C 3D 3E Lons repyle on demnd From Bnks From Non-Bnkng Fnne Compnes From other fnnl nsttutons d From others e Totl Lons repyle on demnd ( d) Deposts from relted prtes (see nstrutons) Lons nd dvnes from relted prtes (see nstrutons) v Other lons nd dvnes v Other deposts v Totl Short-term orrowngs (e v + v) B Trde pyles Outstndng for more thn 1 yer Others Totl Trde pyles ( + ) d e v v 4A 4B C D Other urrent lltes Current mturtes of long-term det Current mturtes of fnne lese olgtons Interest rued ut not due on orrowngs v Interest rued nd due on orrowngs v Inome reeved n dvne v Unpd dvdends v Applton money reeved for llotment of seurtes nd due for refund nd nterest rued v Unpd mtured deposts nd nterest rued thereon x Unpd mtured deentures nd nterest rued thereon x Other pyles x Totl Other urrent lltes ( v + v + v + v + v + x + x) Short-term provsons Provson for employee eneft Provson for Inome-tx v v v v v x x 4C Proposed Dvdend v Tx on dvdend v Other v Totl Short-term provsons ( v + v) E Totl Current lltes (4A + 4B + 4C + 4D) v v 4D 4E Pge 4

5 Totl Equty nd lltes (1D E + 4E) I II ASSETS 1 Non-urrent ssets A Fxed ssets Tngle ssets Gross lok Depreton Imprment losses d Net lok ( - ) d Intngle ssets Gross lok Amortzton Imprment losses d Net lok ( - ) d Cptl work-n-progress v Intngle ssets under development v v Totl Fxed ssets (d + d + + v) Av B Non-urrent nvestments Investment n property Investments n Equty nstruments Lsted equtes Unlsted equtes Totl ( + ) Investments n Preferene shres v Investments n Government or trust seurtes v v Investments n Deenture or onds v v Investments n Mutul funds v v Investments n Prtnershp frms v v Others Investments v x Totl Non-urrent nvestments ( v + v + v + v + v) Bx C Deferred tx ssets (Net) C D Long-term lons nd dvnes Cptl dvnes Seurty deposts Lons nd dvnes to relted prtes (see nstrutons) v Other Lons nd dvnes v v Totl Long-term lons nd dvnes ( v) Dv v Long-term lons nd dvnes nluded n Dv whh s for the purpose of usness or professon not for the purpose of usness or professon gven to shreholder, eng the enefl owner of shre, or to ny onern or on ehlf/ eneft of suh shreholder s per seton 2(22)(e) of I.T. At E Other non-urrent ssets Long-term trde reevles Others Seured, onsdered good Unseured, onsdered good Doutful d Totl Other non-urrent ssets ( + + ) Totl (d + ) v v v d E Pge 5

6 v Non-urrent ssets nluded n E whh s due from shreholder, eng the enefl owner of shre, or from ny onern or on ehlf/ eneft of suh shreholder s per seton 2(22)(e) of I.T. At F Totl Non-urrent ssets (Av + Bx + C + Dv + E) 2 Current ssets A B C D E Current nvestments Investment n Equty nstruments Lsted equtes Unlsted equtes Totl ( + ) Investment n Preferene shres Investment n government or trust seurtes v Investment n deentures or onds v Investment n Mutul funds v Investment n prtnershp frms v Other nvestment v Totl Current nvestments ( v + v + v + v) Inventores Rw mterls Work-n-progress Fnshed goods v Stok-n-trde (n respet of goods qured for trdng) v v Stores nd spres v v Loose tools v v Others v Totl Inventores ( v + v + v + v) Trde reevles Outstndng for more thn 6 months Others Totl Trde reevles ( + + ) Csh nd sh equvlents Blnes wth Bnks Cheques, drfts n hnd Csh n hnd v Others v v Totl Csh nd sh equvlents ( v) Dv Short-term lons nd dvnes Lons nd dvnes to relted prtes (see nstrutons) Others Totl Short-term lons nd dvnes ( + ) v Short-term lons nd dvnes nluded n E whh s for the purpose of usness or professon not for the purpose of usness or professon v v v v v v v v 1F Av Bv C E gven to shreholder, eng the enefl owner of shre, or to ny onern or on ehlf/ eneft of suh shreholder s per seton 2(22)(e) of I.T. At v F Other urrent ssets F G Totl Current ssets (Av + Bv + C + Dv + E + F) Totl Assets (1F + 2G) 2G II Pge 6

7 DEBITS TO PROFIT AND LOSS ACCOUNT CREDITS TO PROFIT AND LOSS ACCOUNT Prt A-P& L 1 Revenue from opertons Proft nd Loss Aount for the fnnl yer (fll tems 1 to 52 n se where regulr ooks of ounts re mntned, otherwse fll tem 53) A Sles/ Gross reepts of usness (net of returns nd refunds nd duty or tx, f ny) Sle of produts/goods Sle of serves Other opertng revenues (spefy nture nd mount) Totl ( + ) v Interest (n se of fnne ompny) v Other fnnl serves (n se of fnne ompny v Totl ( v + v) B Dutes, txes nd ess reeved or reevle n respet of goods nd serves sold or suppled Unon Exse dutes Serve tx VAT/ Sles tx v Any other duty, tx nd ess v Totl ( v) C Totl Revenue from opertons (Av + Bv) 2 Other nome Interest nome (n se of ompny, other thn fnne ompny) Dvdend nome Proft on sle of fxed ssets v Proft on sle of nvestment eng seurtes hrgele to Seurtes Trnston Tx (STT) v Proft on sle of other nvestment v Rent v Commsson v Proft on ount of urreny flututon x Agrulturl nome x Any other nome (spefy nture nd mount) Totl (x + x) x Totl of other nome ( v + v + v + v + v + x + x) 3 Closng Stok Rw mterl 3 Work-n-progress Fnshed goods Totl ( ) 4 Totl of redts to proft nd loss ount (1C + 2x + 3v) 4 5 Openng Stok Rw mterl 5 Work-n-progress Fnshed goods v Totl ( ) 6 Purhses (net of refunds nd duty or tx, f ny) 6 7 Dutes nd txes, pd or pyle, n respet of goods nd serves purhsed Custom duty 7 Counter velng duty Spel ddtonl duty I I I I I Iv V I I I Iv I I v v v v v x x x x Av Bv 1C 2x 3v 5v Pge 7

8 v Unon exse duty v Serve tx v VAT/ Sles tx v Any other tx, pd or pyle v Totl ( v + 7v + 7v + 7v) 8 Freght 8 9 Consumpton of stores nd spre prts 9 10 Power nd fuel Rents Reprs to uldng Reprs to plnt, mhnery or furnture Compenston to employees 7v 7v 7v 7v Slres nd wges 14 Bonus Remursement of medl expenses v Leve enshment v Leve trvel enefts v Contruton to pproved supernnuton fund v Contruton to reognsed provdent fund v Contruton to reognsed grtuty fund x Contruton to ny other fund v 14v 14v 14v 14v x Any other eneft to employees n respet of whh n 14x expendture hs een nurred x Totl ompenston to employees ( v + 14v + 14v + 14v + 14v + 14x + 14x) Whether ny ompenston, nluded n 14x, pd to nonresdent x x Yes / No 15 Insurne If Yes, mount pd to non-resdents Medl Insurne 15 Lfe Insurne Keymn s Insurne v Other Insurne nludng ftory, offe, r, goods, et. v Totl expendture on nsurne ( v) 16 Workmen nd stff welfre expenses Entertnment Hosptlty Conferene Sles promoton nludng pulty (other thn dvertsement) Advertsement Commsson Pd outsde Ind, or pd n Ind to non-resdent other thn ompny or foregn ompny To others Totl ( + ) 23 Roylty Pd outsde Ind, or pd n Ind to non-resdent other thn ompny or foregn ompny To others Totl ( + ) 24 Professonl / Consultny fees / Fee for tehnl serves Pd outsde Ind, or pd n Ind to non-resdent other thn ompny or foregn ompny To others Totl ( + ) 14x x v 7v 14x 15v Pge 8

9 PROVISIONS FOR TAX AND APPROPRIATIONS 25 Hotel, ordng nd Lodgng Trvelng expenses other thn on foregn trvelng Foregn trvelng expenses Conveyne expenses Telephone expenses Guest House expenses Clu expenses Festvl elerton expenses Sholrshp Gft Donton Rtes nd txes, pd or pyle to Government or ny lol ody (exludng txes on nome) Unon exse duty 36 Serve tx VAT/ Sles tx v Cess 36v v Any other rte, tx, duty or ess nl. STT nd CTT 36v v Totl rtes nd txes pd or pyle ( v + 36v) 36v 37 Audt fee Other expenses (spefy nture nd mount) 39 Totl ( + ) Bd dets wrtten off (spefy PAN of the person, f t s vlle, for whom Bd Det for mount of Rs. 1 lkh or more s lmed nd mount) v Others (more thn Rs. 1 lkh) where PAN s not vlle v Others (mounts less thn Rs. 1 lkh) v 39v v Totl Bd Det ( v + 39v) 40 Provson for d nd doutful dets Other provsons Proft efore nterest, depreton nd txes [4 (5v v + 8 to x + 15v + 16 to to v v )] 43 Interest Pd outsde Ind, or pd n Ind to non-resdent other thn ompny or foregn ompny To others Totl ( + ) 44 Depreton nd mortzton Proft efore txes ( ) Provson for urrent tx Provson for Deferred Tx nd deferred llty 47 39v Proft fter tx ( ) Blne rought forwrd from prevous yer Amount vlle for pproprton ( ) Approprtons Trnsfer to reserves nd surplus 51 Proposed dvdend/ Interm dvdend Tx on dvdend/ Tx on dvdend for erler yers v Any other pproprton v Totl ( v) v 51v Pge 9

10 OTHER INFORMATION NO ACCOUNT CASE 52 Blne rred to lne sheet (50 51v) In se where regulr ooks of ount of usness or professon re not mntned, furnsh the followng nformton for prevous yer n respet of usness or professon Gross reepts Gross proft Expenses d Net proft d Prt A- OI Other Informton (optonl n se not lle for udt under seton 44AB) 1 Method of ountng employed n the prevous yer (Tk) merntle sh 2 Is there ny hnge n method of ountng (Tk) Yes No 3 Effet on the proft euse of devton, f ny, s per Inome Computton Dslosure Stndrds notfed under seton 145(2) [olumn 11() of Shedule ICDS] 4 Method of vluton of losng stok employed n the prevous yer Rw Mterl (f t ost or mrket rtes whhever s less wrte 1, f t ost wrte 2, f t mrket rte wrte 3) Fnshed goods (f t ost or mrket rtes whhever s less wrte 1, f t ost wrte 2, f t mrket rte wrte 3) Is there ny hnge n stok vluton method (Tk) Yes No d Effet on the proft or loss euse of devton, f ny, from the method of vluton presred under seton 145A 5 Amounts not redted to the proft nd loss ount, eng - the tems fllng wthn the sope of seton 28 the proform redts, drwks, refund of duty of ustoms or exse or serve tx, or refund of sles tx or vlue dded tx, where suh redts, drwks or refunds re dmtted s due y the uthortes onerned eslton lms epted durng the prevous yer d ny other tem of nome e ptl reept, f ny f Totl of mounts not redted to proft nd loss ount ( d+5e) 6 Amounts deted to the proft nd loss ount, to the extent dsllowle under seton 36 due to nonfulflment of ondton spefed n relevnt luses Premum pd for nsurne gnst rsk of dmge or destruton of stoks or store [36(1)()] 6 Premum pd for nsurne on the helth of employees [36(1)()] 6 Any sum pd to n employee s onus or ommsson for serves rendered, where suh sum ws otherwse pyle to hm s 6 profts or dvdend [36(1)()] d Any mount of nterest pd n respet of orrowed ptl [36(1)()] 6d e Amount of dsount on zero-oupon ond [36(1)()] f Amount of ontrutons to reognsed provdent fund [36(1)(v)] 6f g Amount of ontrutons to n pproved supernnuton fund [36(1)(v)] 6g h Amount of ontruton to penson sheme referred to n seton 80CCD [36(1)(v)] 6h Amount of ontrutons to n pproved grtuty fund [36(1)(v)] j Amount of ontrutons to ny other fund k Any sum reeved from employees s ontruton to ny provdent fund or supernnuton fund or ny fund set up under ESI At or ny other fund for the welfre of employees to the extent not redted to the employees ount on or efore the due dte [36(1)(v)] l Amount of d nd doutful dets [36(1)(v)] m Provson for d nd doutful dets [36(1)(v)] n Amount trnsferred to ny spel reserve [36(1)(v)] Expendture for the purposes of promotng fmly plnnng o mongst employees [36(1)(x)] Amount of seurtes trnston pd n respet of trnston n p seurtes f suh nome s not nluded n usness nome [36(1)(xv)] q Any other dsllowne r Totl mount dsllowle under seton 36 (totl of 6 to 6q) s Totl numer of employees employed y the ompny (mndtory n se ompny hs reognzed Provdent Fund) d 5e 6e 6 6j 6k 6l 6m 6n 6o 6p 6q 3 4d 5f 6r Pge 10

11 deployed n Ind deployed outsde Ind Totl 7 Amounts deted to the proft nd loss ount, to the extent dsllowle under seton 37 Expendture of ptl nture [37(1)] Expendture of personl nture [37(1)] d e Expendture ld out or expended wholly nd exlusvely NOT for the purpose of usness or professon [37(1)] Expendture on dvertsement n ny souvenr, rohure, trt, pmphlet or the lke, pulshed y poltl prty [37(2B)] Expendture y wy of penlty or fne for volton of ny lw for the tme eng n fore f Any other penlty or fne g Expendture nurred for ny purpose whh s n offene or whh s prohted y lw h Expendture nurred on orporte sol responslty (CSR) Amount of ny llty of ontngent nture j Any other mount not llowle under seton 37 k Totl mount dsllowle under seton 37 (totl of 7 to 7j) 8 A. Amounts deted to the proft nd loss ount, to the extent dsllowle under seton 40 B. Amount dsllowle under seton 40 ()(), on ount of non-omplne wth the provsons of Chpter XVII-B Amount dsllowle under seton 40()() on ount of non-omplne wth the provsons of Chpter XVII-B Amount dsllowle under seton 40()() on ount of non-omplne wth the provsons of Chpter VIII of the Fnne At, 2016 Amount dsllowle under seton 40()() on ount of d non-omplne wth the provsons of Chpter XVII-B e Amount of tx or rte leved or ssessed on the ss of profts [40()()] f Amount pd s welth tx [40()()] g Amount pd y wy of roylty, lense fee, serve fee et. s per seton 40()() h Amount of nterest, slry, onus, ommsson or remunerton pd to ny prtner or memer [40()] Any other dsllowne j Totl mount dsllowle under seton 40(totl of A to A ) Any mount dsllowed under seton 40 n ny preedng prevous yer ut llowle durng the prevous yer 9 Amounts deted to the proft nd loss ount, to the extent dsllowle under seton 40A 10 Amounts pd to persons spefed n seton 40A(2)() Amount pd otherwse thn y ount pyee heque or ount pyee nk drft under seton 40A(3) 100% dsllowle Provson for pyment of grtuty [40A(7)] d ny sum pd y the ssessee s n employer for settng up or s ontruton to ny fund, trust, ompny, AOP, or BOI or soety or ny other nsttuton [40A(9)] e Any other dsllowne f Totl mount dsllowle under seton 40A Any mount dsllowed under seton 43B n ny preedng prevous yer ut llowle durng the prevous yer Any sum n the nture of tx, duty, ess or fee under ny lw d e Any sum pyle y wy of ontruton to ny provdent fund or supernnuton fund or grtuty fund or ny other fund for the welfre of employees Any sum pyle to n employee s onus or ommsson for serves rendered Any sum pyle s nterest on ny lon or orrowng from ny pul fnnl nsttuton or Stte fnnl orporton or Stte Industrl nvestment orporton Any sum pyle s nterest on ny lon or orrowng from ny sheduled nk f Any sum pyle towrds leve enshment g Totl mount llowle under seton 43B (totl of 10 to 10f ) 11 Any mount deted to proft nd loss ount of the prevous yer ut dsllowle under seton 43B A A A Ad Ae Af Ag Ah A d 9e d 10e 10f d 7e 7f 7g 7h 7 7j 7k Aj 8B 9f 10g Pge 11

12 Reept nd pyment ount of ompny under lqudton QUANTITATIVE DETAILS Any sum n the nture of tx, duty, ess or fee under ny lw Any sum pyle y wy of ontruton to ny provdent fund or supernnuton fund or grtuty fund or ny other fund for the welfre of employees Any sum pyle to n employee s onus or ommsson for serves rendered d Any sum pyle s nterest on ny lon or orrowng from ny pul fnnl nsttuton or Stte fnnl orporton or Stte Industrl nvestment orporton e Any sum pyle s nterest on ny lon or orrowng from ny sheduled nk f Any sum pyle towrds leve enshment Any sum pyle to the Indn Rlwys for the use of rlwy g ssets h Totl mount dsllowle under Seton 43B(totl of 11 to 11g) 12 Amount of redt outstndng n the ounts n respet of Unon Exse Duty Serve tx VAT/sles tx d Any other tx e Totl mount outstndng (totl of 12 to 12d) 13 Amounts deemed to e profts nd gns under seton 33AB or 33ABA or 33AC Any mount of proft hrgele to tx under seton Amount of nome or expendture of pror perod redted or deted to the proft nd loss ount (net) 15 Prt A QD Quntttve detls (optonl n se not lle for udt under seton 44AB) () In the se of trdng onern 1 Openng stok 1 2 Purhse durng the prevous yer 2 3 Sles durng the prevous yer 3 4 Closng stok 4 5 Shortge/ exess, f ny 5 () In the se of mnufturng onern 6 Rw mterls d Openng stok 6 Purhses durng the prevous yer 6 Consumpton durng the prevous yer 6 Sles durng the prevous yer 6d e Closng stok f Yeld fnshed produts 6f g Perentge of yeld 6g h Shortge/ exess, f ny 7 Fnshed produts/ By-produts d e f openng stok 7 purhse durng the prevous yer 7 quntty mnuftured durng the prevous yer 7 sles durng the prevous yer 7d losng stok 7e shortge/ exess, f ny 7f d 11e 11f 11g d 11h 12e 6e 6h Prt A OL Reept nd pyment ount of ompny under lqudton 1 Openng lne Csh n hnd 1 Bnk 1 Totl openng lne 1 2 Reepts Pge 12

13 TOTAL INCOME Interest 2 Dvdend 2 Sle of ssets (pls. spefy nture nd mount) d Totl ( + + ) 2d v Relston of dues/detors 2v v Others (pls. spefy nture nd mount) 2v 2v Totl of other reepts (v + v) 2v v Totl reepts ( d+ 2v + 2v) 2v 3 Totl of openng lne nd reepts 3 4 Pyments Repyment of seured lon 4 Repyment of unseured lon 4 Repyment to redtors 4 v Commsson 4v v Others (pls. spefy) 4v 4v Totl of other pyments (4v + 4v) 4v v Totl pyments ( v + 4v) 4v 5 Closng lne Csh n hnd 5 Bnk 5 Totl of losng lne (5 + 5) 5 6 Totl of losng lne nd pyments (4v + 5) 6 Prt B - TI Computton of totl nome 1 Inome from house property (3 of Shedule-HP) (enter nl f loss) 1 2 Profts nd gns from usness or professon Profts nd gns from usness other thn speultve usness nd 2 spefed usness (A37 of Shedule-BP) (enter nl f loss) Profts nd gns from speultve usness (B42 of Shedule-BP) (enter 2 nl f loss nd tke the fgure to shedule CFL) Profts nd gns from spefed usness (C48 of Shedule BP)(enter nl 2 f loss nd tke the fgure to shedule CFL) v Inome from ptent u/s 115BBF (3d of Shedule BP) 2v v Totl ( v) 3 Cptl gns Short term Short-term 15% (7 of tem E of shedule CG) Short-term 30% (7 of tem E of shedule CG) Short-term hrgele t pplle rte (7v of tem E of shedule CG) v Totl Short-term ( + + ) Long-term Long-term 10% (7v of tem E of shedule CG) Long-term 20% (7v of tem E of shedule CG) Totl Long-term ( + ) (enter nl f loss) Totl ptl gns (3v + 3) (enter nl f loss) 4 Inome from other soures 3v 2v 3 Pge 13

14 COMPUTATION OF TAX LIABILITY from soures other thn from ownng nd mntnng re horses nd nome hrgele to tx t spel rte (1 of Shedule OS) (enter nl f loss) Inome hrgele to tx t spel rte (1fv of Shedule OS) from ownng nd mntnng re horses (3 of Shedule OS) (enter nl f loss) d Totl ( ) 5 Totl (1 + 2v d) 5 6 Losses of urrent yer to e set off gnst 5 (totl of 2x, 3x nd 4x of Shedule CYLA) 6 7 Blne fter set off urrent yer losses (5 6) (totl of olumn 5 of shedule CYLA + 4) 7 8 Brought forwrd losses to e set off gnst 7 (totl of 2x, 3x nd 4x of Shedule BFLA) 8 9 Gross Totl nome (7 8) (5x of Shedule BFLA + 4) 9 10 Inome hrgele to tx t spel rte under seton 111A, 112 et. nluded n Deduton u/s 10A or 10AA (e of Sh. 10A + e of Sh. 10AA) Dedutons under Chpter VI-A Prt-B of Chpter VI-A [1 of Shedule VI-A nd lmted upto (9-10)] Prt-C of Chpter VI-A [2 of Shedule VI-A nd lmted upto (9-10-2)] Totl ( ) [lmted upto (9-10)] 13 Totl nome ( ) Inome hrgele to tx t spel rtes (totl of () of shedule SI) Inome hrgele to tx t norml rtes (13-14) Net grulturl nome(4 of Shedule EI) Losses of urrent yer to e rred forwrd (totl of x of Shedule CFL) Deemed totl nome under seton 115JB (7 of Shedule MAT) d Prt B - TTI Computton of tx llty on totl nome 1 Tx Pyle on deemed totl Inome under seton 115JB (8 of Shedule MAT) 1 Surhrge on () ove Eduton ess, nludng seondry nd hgher eduton ess on (1+1) ove d Totl Tx Pyle u/s 115JB (1+1+1) 2 Tx pyle on totl nome Tx t norml rtes on 15 of Prt B-TI Tx t spel rtes (totl of ol. () of Shedule-SI) d Tx Pyle on Totl Inome (2 + 2) d Surhrge 25% of 12() of Shedule SI On [(2d) (12() of Shedule SI)] Totl ( + ) e Eduton ess, nludng seondry nd hgher eduton ess on (2+2d) 2d 2d 2g( ) f Gross tx llty (2+2d+2e) 2f 3 Gross tx pyle (hgher of 1d nd 2f) 3 4 Credt under seton 115JAA of tx pd n erler yers (f 2f s more thn 1d) ( 5 of Shedule MATC) 5 Tx pyle fter redt under seton 115JAA [ (3-4)] 5 6 Tx relef Seton 90/90A(2 of Shedule TR) Seton 91(3 of Shedule TR) Totl (6 + 6) 7 Net tx llty (5 6) (enter zero f negtve) 7 8 Interest pyle For defult n furnshng the return (seton 234A) For defult n pyment of dvne tx (seton 234B) For deferment of dvne tx (seton 234C) d Totl Interest Pyle (8+8+8) d 2e 4 6 8d Pge 14

15 TDS ON INCOME ADVANCE/ SELF ASSESSMENT TAX BANK ACCOUNT TAXES PAID 9 Aggregte llty (7 + 8d) 9 10 Txes Pd Advne Tx (from olumn 5 of 15A) 10 TDS (totl of olumn 8 of 15B) 10 TCS (totl of olumn 7 of 15C) 10 d Self-Assessment Tx (from olumn 5 of 15A) 10d e Totl Txes Pd ( d) 10e 11 Amount pyle (9-10e) (Enter f 9 s greter thn 10e, else enter 0) Refund (If 10e s greter thn 9) (Refund, f ny, wll e dretly redted nto the nk ount) Detls of ll Bnk Aounts held n Ind t ny tme durng the prevous yer (exludng dormnt ounts) Sl. IFS Code of the Bnk Nme of the Bnk Aount Numer (the numer should e 9 dgts or more s per CBS system of the nk ) Indte the ount n whh you prefer to get your refund redted, f ny (tk one ount ) Csh deposted durng to (f ggregte sh deposts durng the perod Rs.2 lkh) 14 Do you t ny tme durng the prevous yer,- () hold, s enefl owner, enefry or otherwse, ny sset (nludng fnnl nterest n ny entty) loted outsde Ind; or () hve sgnng uthorty n ny ount loted outsde Ind; or () hve nome from ny soure outsde Ind? [pplle only n se of resdent] [Ensure Shedule FA s flled up f the nswer s Yes ] Yes No VERIFICATION I, son/ dughter of, holdng permnent ount numer solemnly delre tht to the est of my knowledge nd elef, the nformton gven n the return nd the shedules thereto s orret nd omplete nd tht the mount of totl nome nd other prtulrs shown theren re truly stted nd re n ordne wth the provsons of the Inome-tx At, 1961, n respet of nome hrgele to nome-tx for the prevous yer relevnt to the ssessment yer I further delre tht I m mkng ths return n my pty s nd I m lso ompetent to mke ths return nd verfy t. I further delre tht the rtl ssumptons spefed n the greement hve een stsfed nd ll the terms nd ondtons of the greement hve een ompled wth. (Applle, n se where return s furnshed under seton 92CD) Ple Dte Sgn here 15 TAX PAYMENTS A B Detls of pyments of Advne Tx nd Self-Assessment Tx Sl BSR Code Dte of Depost (DD/MM/YYYY) Serl Numer of Chlln Amount (Rs) No (1) (2) (3) (4) (5) NOTE Enter the totls of Advne tx nd Self-Assessment tx n Sl No. 10 & 10d of Prt B-TTI Detls of Tx Deduted t Soure (TDS) on Inome [As per Form 16 A or Form 26QB ssued y Dedutor(s)] Sl No TAN of the Dedutor/ PAN of the Buyer Nme of the Dedutor Unque TDS Certfte Numer Unlmed TDS rought forwrd (/f) Fn. Yer n whh deduted Amount /f TDS of the urrent fn. yer Amount out of (6) or (7) eng lmed ths Yer (only f orrespondng nome s eng offered for tx ths yer) Amount out of (6) or (7) eng rred forwrd (1) (2) (3) (4) (5) (6) (7) (8) (9) C Sl TCS ON INCOME NOTE Plese enter totl of olumn (8) of Shedule-TDS n 10 of Prt B-TTI Detls of Tx Colleted t Soure (TCS) [As per Form 27D ssued y the Colletor(s)] No Tx Deduton nd Tx Colleton Aount Numer of the Colletor Nme of the Colletor Unlmed TCS rought forwrd (/f) Fn. Yer n whh olleted Amount /f TCS of the urrent fn. yer Amount out of (5) or (6) eng lmed ths Yer (only f orrespondng nome s eng offered for tx ths yer) Amount out of (5) or (6) eng rred forwrd (1) (2) (3) (4) (5) (6) (7) (8) Pge 15

16 NOTE Plese enter totl of olumn (7) of Shedule-TCS n 10 of Prt B-TTI NOTE: PLEASE FILL SCHEDULES TO THE RETURN FORM (PAGES S1- S19) AS APPLICABLE Pge 16