PART-B. a from sources other than from owning race horses and Winnings from Lottery

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1 FORM ITR-2 Assessment Year INDIAN INCOME TAX RETURN [For Indvduals and HUFs not havng Income from Busness or Professon] (Please see Rule 12 of the Income-tax Rules,1962) (Also see attached nstructons) Part A-GEN GENERAL Frst name Mddle name Last name PAN PERSONAL INFORMATION FILING STATUS Flat/Door/Block Road/Street/Post Offce Town/Cty/Dstrct Emal Address Desgnaton of Assessng Offcer (Ward/Crcle) Name Of Premses/Buldng/Vllage Area/localty State Pn code (STD code)-phone Number Status (Tck) Indvdual HUF Date of Brth (DD/MM/YYYY) ( n case of ndvdual) / / Sex (n case of ndvdual) (Tck) Male Female Employer Category(f n employment) (Tck) ( ) Govt PSU Others Return fled under Secton [Please see nstructon number-9()] Whether orgnal or Revsed return? (Tck) Orgnal Revsed If revsed, then enter Recept and Date of flng orgnal return (DD/MM/YYYY) / / Resdental Status (Tck) Resdent n-resdent Resdent but t Ordnarly Resdent Whether ths return s beng fled by a representatve assessee? (Tck) Yes If yes, please furnsh followng nformaton - (a) (b) Name of the representatve Address of the representatve ( c) Permanent Account Number (PAN) of the representatve PART-B Part B - TI Computaton of total ncome 1 Salares (6 of Schedule S) 1 2 Income from house property (3c of Schedule HP) (enter nl f loss) 2 3 Captal gans TOTAL INCOME a Short term Short-term (u/s 111A) (enter nl, f loss) (A5 of Schedule CG) 3a Short-term (others) (A6 of Schedule CG) 3a Total short-term (3a + 3a) (A4 of Schedule CG) 3a b Long-term (B5 of Schedule CG) (enter nl f loss) 3b c Total captal gans (3a + 3b) (enter nl f 3c s a loss) 3c 4 Income from other sources a from sources other than from ownng race horses and Wnnngs from Lottery 4a (3 of Schedule OS) b from ownng race horses (4c of Schedule OS) (enter nl f loss) 4b c Total (a + b) (enter nl f 4c s a loss) 4c 5 Total (1+2+3c +4c) 5 Do not wrte or stamp n ths area (Space for bar code) For Offce Use Only Recept Date Seal and Sgnature of recevng offcal

2 6 Losses of current year set off aganst 5 (total of 2v and 3v of Schedule CYLA) 6 7 Balance after set off current year losses (5-6) (also total of column 4 of Schedule CYLA) 7 8 Brought forward losses set off aganst 7 (2v of Schedule BFLA) 8 9 Gross Total ncome (7-8)(also 3v of Schedule BFLA) 9 10 Deductons under Chapter VI-A (n of Schedule VIA) Total ncome (9-10) Net agrcultural ncome/ any other ncome for rate purpose (4 of Schedule EI) Aggregate ncome (11+12) Losses of current year to be carred forward (total of row x of Schedule CFL) 14 Part B - TTI Computaton of tax lablty on total ncome 1 Tax payable on total ncome a Tax at normal rates 1a b Tax at specal rates (11 of Schedule SI) 1b c Tax Payable on Total Income (1a + 1b) 1c COMPUTATION OF TAX LIABILITY TAXES PAID 2 Educaton cess, ncludng secondary and hgher educaton cess on 1c 2 3 Gross tax lablty (1c+ 2) 3 4 Tax relef a Secton 89 4a b Secton 90 4b c Secton 91 4c d Total (4a + 4b+4c) 4d 5 Net tax lablty (3 4d) 5 6 Interest payable a For default n furnshng the return (secton 234A) 6a b For default n payment of advance tax (secton 234B) 6b c For deferment of advance tax (secton 234C) 6c d Total Interest Payable (6a+6b+6c) 6d 7 Aggregate lablty (5 + 6d) 7 8 Taxes Pad a Advance Tax (from Schedule-IT) 8a b TDS (total of column 7 of Schedule-TDS1 and column 7 8b of Schedule-TDS2) c Self Assessment Tax(from Schedule-IT) 8c d Total Taxes Pad (8a+8b+8c) 8d 9 Amount payable (Enter f 7 s greater than 8d, else enter 0) 9 10 Refund (If 8d s greater than 7, also gve Bank Account detals below) 10 REFUND 11 Enter your bank account number (mandatory n case of refund) 12 Do you want your refund by cheque, or deposted drectly nto your bank account? (tck as applcable ) 13 Gve addtonal detals of your bank account MICR Code Type of Account (tck as applcable ) Savngs Current 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 14 If the return has been prepared by a Tax Return Preparer (TRP) gve further detals as below: Identfcaton. of TRP Name of TRP Counter Sgnature of TRP If TRP s enttled for any rembursement from the Government, amount thereof 15

3 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 (t 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 1 PIN Code (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 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 1g h Total (1f + 1g) 1h Income from house property 1 (1e 1h) 1 Address of property 2 Town/ Cty State PIN Code (Tck) f let out Name of Tenant PAN of Tenant (optonal) NOTE a Annual letable value/ rent receved or recevable (hgher f let out for whole of the year, lower 2a f let out for part of the year) 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 Income under the head Income from house property a Rent of earler years realzed under secton 25A/AA 3a b Arrears of rent receved durng the year under secton 25B after deductng 30% 3b c Total (3a + 3b ) 3c Please nclude the ncome of the specfed persons referred to n Schedule SPI whle computng the ncome under ths head Schedule CG Captal Gans A Short-term captal gan 1 From assets n case of non-resdent to whch frst provso to secton 48 s applcable 1 CAPITAL GAINS 2 From assets n the case of others a Full value of consderaton 2a b Deductons under secton 48 Cost of acquston b Cost of Improvement b Expendture on transfer b v Total ( + + ) bv c Balance (2a bv) 2c d Loss, f any, to be gnored under secton 94(7) or 2d 94(8) (enter postve values only) e Deducton under secton 54B/54D 2e

4 f Short-term captal gan (2c + 2d 2e) 2f 3 Amount deemed to be short term captal gans under sectons 54B/54D/54EC/ 54ED/54G/ A3 54GA 4 Total short term captal gan (1 + 2f + A3) A4 5 Short term captal gan under secton 111A ncluded n 4 A5 6 Short term captal gan other than referred to n secton 111A (A4 A5) A6 B Long term captal gan 1 Asset n case of non-resdent to whch frst provso to secton 48 s applcable 1 2 Asset n the case of others where provso under secton 112(1) s not exercsed a Full value of consderaton 2a 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 (2a bv) 2c d Deducton under sectons 54/54B/54D/54EC/54F 2d 54G/54GA e Net balance (2c 2d) 3 Asset n the case of others where provso under secton 112(1) s exercsed a Full value of consderaton 3a 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 (3a bv) 3c d Deducton under sectons 54/54B/54D/54EC/54F 3d e Net balance (3c-3d) 3e 4 Amount deemed to be long term captal gans under sectons 54/54B/54D/54EC/54ED/54F B4 5 Total long term captal gan 1 + 2e [(enter 2e as nl f loss) + 3e (enter 3e as nl f loss) + 4)] B5 C Income chargeable under the head CAPITAL GAINS (A4 + B5) (enter B5 as nl, f loss) D Informaton about accrual/recept of captal gan Date Upto 15/9 () 1 Long- term where provso under secton 112(1) s exercsed (Wthout Indexaton)- Code n SI Schedule s 22, Tax Rate s 10% ; Enter only postve value from Item B3e 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 exercsed (Wth Indexaton)- Code n SI Schedule s 21, Tax Rate s 20%; Enter only postve value from Item (B5-B3e) 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. NOTE 16/9 to 15/12 () 2e C 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 OTHER SOURCES Income from other sources 1 Income a Dvdends, Gross b Interest, Gross c Rental ncome from machnery, plants, buldngs, d Others, Gross (excludng ncome from ownng race horses) e Total (1a + 1b + 1c + 1d) f Deductons under secton 57:- Expenses / Deductons Deprecaton Total 1a 1b 1c 1d f f f 1e

5 NOTE g Balance (1e f) 1g 2 Wnnngs from lotteres, crossword puzzles, races, etc. 2 Income from other sources (other than from ownng race horses and Wnnngs from Lottery) 3 (1g + 2) (enter1g as nl, f loss) 4 Income from ownng and mantanng race horses a Recepts 4a b Deductons under secton 57 n relaton to (4) 4b c Balance (4a 4b) Income chargeable under the head Income from other sources (3 + 4c) (enter 4c as nl f loss 5 and take 4c loss fgure to Schedule CFL) Please nclude the ncome of the specfed persons referred to n Schedule SPI whle computng the ncome under ths head. Schedule CYLA Detals of Income after Set off of current year losses. Head/ Source of Income Income of current year House property loss of the current year set off (Fll ths column only f ncome s zero or Total loss (3c of Schedule HP) postve) CURRENT YEAR LOSS ADJUSTMENT v v v Loss to be adjusted Salares House property Short-term captal gan Long term captal gan Other sources (ncl. proft from ownng race horses but excludng wnnngs from lottery) Total loss set off v Loss remanng after set-off out of 2 & 3 3 4c Other sources loss (other than loss from race horses) of the current year set off Total loss (3 of Schedule-OS) 5 Current year s Income remanng after set off =1-2-3 Schedule BFLA Detals of Income after Set off of Brought Forward Losses of earler years. Head/ Source of Income Income after set off, f any, of Brought forward loss set off Current year s ncome. current year s losses as per 4 of Schedule CYLA remanng after set off BROUGHT FORWARD LOSS ADJUSTMENT Salares House property Short-term captal gan v Long-term captal gan v v Other sources (proft from ownng race horses but excludng wnnngs from lottery) Total of brought forward loss set off v Current year s ncome remanng after set off Total ( v3 + v3) Schedule CFL Detals of Losses to be carred forward to future years Assessment Year Date of Flng (DD/MM/YYYY) House property loss Short-term captal loss Long-term Captal loss Other sources loss (from ownng race horses) CARRY FORWARD OF LOSS v v v v v x Total of earler year losses x Adjustment of above losses n Schedule BFLA x (Current year losses) x Total loss Carred Forward to future years

6 Schedule VIA Deductons under Chapter VI-A (Secton) a 80C h 80G TOTAL DEDUCTIONS b 80CCC 80GG c 80CCD j 80GGA d 80D k 80GGC e 80DD l 80RRB f 80DDB m 80U g 80E n Total deductons (total of a to m) n Income of specfed persons (spouse, mnor chld etc) ncludable n ncome of the assessee (ncome of the mnor chld to Schedule SPI be ncluded after Rs. 1,500 per chld) Name of person PAN of person (optonal) Relatonshp Nature of Income Amount (Rs) Income chargeable to Income tax at specal rates [Please see nstructon.9() for secton code and rate of tax] Secton Specal rate Income Tax thereon Secton Specal Income code (%) code rate (%) 1 1A BB Schedule SI SPECIAL RATE 11 Total (1 to 10 ) Tax thereon Schedule EI EXEMPT INCOME Detals of Exempt Income (Income not to be ncluded n Total Income) 1 Interest ncome 1 2 Dvdend ncome 2 3 Long-term captal gans from transactons on whch Securtes Transacton Tax s pad 3 4 Net Agrculture ncome /any other ncome for rate purpose 4 5 Others, ncludng exempt ncome of mnor chldren 5 6 Total ( ) 6 Schedule AIR Other Informaton (transactons reported through Annual Informaton Return) [Please see nstructon number-9() for code] Code of Transacton Amount (Rs) Code of Transacton Amount (Rs) Schedule IT TAX PAYMENTS v v Detals of Advance Tax and Self Assessment Tax Payments of Income-tax Name of Bank & Branch 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. 8a & 8c of Part B-TTI

7 Schedule TDS1 TDS ON SALARY Tax Deducton Account Number (TAN) of the Employer Detals of Tax Deducted at Source from Salary [As per Form 16 ssued by Employer(s)] Name and address of the Employer Income chargeable under Salares Deducton under Chapter VI-A Tax payable (ncl. edn. cess) Total tax deducted Tax payable/ refundable (1) (2) (3) (4) (5) (6) (7) (8) Schedule TDS2 TDS ON OTHER INCOME Tax Deducton Account Number (TAN) of the Deductor Detals of Tax Deducted at Source on Income [As per Form 16 A ssued by Deductor(s)] Name and address of the Deductor Amount Pad Date of Payment / Credt Total tax deducted Amount out of (6) clamed for ths year (1) (2) (3) (4) (5) (6) (7) NOTE Please enter total of column 7 of Schedule-TDS1 and column 7 of Schedule-TDS2 n 8(b) of Part B-TTI

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