INDIAN INCOME TAX RETURN Assessment

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1 Form INDIAN INCOME TAX RETURN Assessment ITR-4 [For Indvduals & HUFs havng ncome from a propretory busness or professon) (Please See Rule 12 of the Income tax Rules,1962) (Also see attached nstructon) Year Part A-GEN GENERAL Frst Name Mddle Name Last Name PAN Flat / Door / Block No. Name of Premses / Buldng / Vllage Status (Tck) Indvdual HUF Road / Street / Post Offce Area/Localty Date of Brth (DD/MM/YYYY ) ( n case of ndvdual) Town/Cty/Dstrct State Pn code Sex (Tck) Male Female Emal Address (STD code)-phone Number Employer Category (f n employment) Govt. PSU Others Desgnaton of Assessng Off cer (Ward/Crcle) Return Fled Under Secton- [Please see nstructon number-9()] Whether Orgnal or Revsed return? (Tck) Orgnal Revsed If revsed, then enter Recept No. and Date of flng orgnal return(dd/mm/yyyy) Resdental Status (Tck) Resdent Non -Resdent Resdent but Not Ordnarly Resdent Whether ths return s beng fled by a representatve assessee? (Tck) Yes No If yes, please furnsh the followng nformaton :- (a) (b) (c) Name of the representatve Address of the representatve Permanent Account Number (PAN) of the representatve Are you lable to mantan accounts as per secton 44AA? (Tck) Yes No Are you lable for audt under secton 44AB? (Tck) Yes No If yes, furnsh followng nformaton (a) Name of the audtor (b) Membershp no. of the audtor (c) Name of the audtor (propretorshp/ frm) (d) Permanent Account Number (PAN) of the propretorshp/ frm (e) Date of audt report. For Offce Use Only For Offce Use Only Recept No. Date Seal and Sgnature of recevng offcal

2 Nature of busness or professon, f more than one busness or professon ndcate the three man actvtes/ products S.No. Code [Please see nstructon No. 9()] Trade name of the propretorshp, f any Descrpton Part A-BS BALANCE SHEET AS ON 31ST DAY OF MARCH, 2007 OF THE PROPRIETORY BUSINESS (fll tems 1 to 5 n a case where regular books of accounts are mantaned, otherwse fll tem 6) 1. Propretor's fund a. Propretor's captal a b. Reserves and surplus () Revaluaton Reserve b () Captal Reserve b () Statutory Reserve b (v) Any Other Reserve bv (v) Total ( b+b+b+bv) bv c. Total Propretor's fund (a+bv) 1c 2. Loan Funds a. Secured loans () Foregn Currency Loans a () Rupee Loans A. From Banks A B. From others B C. Total (A+B) C () Total (a+c) a b. Unsecured loans A. From Banks b B. From others b C. Total (b+b) b c. Total Loan Funds (a+b) 2c 3. Deferred tax lablty 3 4. Sources of funds (1c+2c+3) 4 1. Fxed Assets a. Gross : Block 1a b. Deprecaton 1b c. Net Block (a-b) 1c d. Captal work-n progress 1d e. Total (1c+1d) 1e 2. Investments a. Long-term nvestments () Government and other Securtes-Quoted a () Government and other Securtes-Unquoted a () Total (a+a) a b. Trade nvestments () Equty Shares b () Preference Shares b () Debentures b (v) Total (b+b+b) bv c. Total nvestments (a+bv) 2c 3. Currents assets, loans and advances a Current assets Inventores A Stores/Consumables and packng Materals A B Raw materals B C Stock-n-process C D Fnshed Goods/Traded Goods D E Total (A + B + C + D) E Sundry Debtors a Cash and Bank Balances A Cash-n-hand A B Balance wth banks B C Total (A + B) C v Other Current Assets av v Total current assets (E + a + C + av) av b Loans and advances

3 Advances recoverable n cash or n knd or for b value to be receved Deposts b Balance wth Revenue Authortes b v Total (b + b + b) bv c Total of curent assets,loans and advances(av + bv) 3c d Current labltes and provsons Current labltes A Sundry Credtors A B Lablty for Leased Assets B C Interest Accrued on above C D Interest accrued but not due on loans D E Total (A + B + C + D) E Provsons A Provson for Income Tax A B Provson for Wealth Tax B C Provson for Leave C encashment/superannuaton/gratuty D Other Provsons D E Total (A + B + C + D) E Total (E + E) d e Net current assets (3c d) 3e 4 a Mscellaneous expendture not wrtten off or adjusted 4a b Deferred Tax Asset 4b c Proft and loss account 4c d Total (4a + 4b +4c) 4d 5 Total, applcaton of funds (1e + 2c + 3e +4d) 5 6 In a case where regular books of account of busness or professon are not mantaned (furnsh the followng nformaton as on 31st day of march,2007,n respect of busness or professon) a Amount of total sundry debtors 6a b Amount of total sundry credtors 6b c Amount of total stock-n-trade 6c d Amount of the cash balance 6d Part A-P & L Proft and Loss Account for the prevous year of the propretory busness (fll tems 1 to 50 n a case where regular books of accounts are mantaned, otherwse fll tems 51) 1 Sales/ Gross recepts of busness or professon 1 (Net of returns and refunds and duty or tax, f any) 2 Dutes, taxes and cess, receved or recevable, n respect of goods and serves sold or suppled a Unon Excse dutes 2a b Servce tax 2b c VAT/Sales tax 2c d Any other duty, tax and cess 2d e Total of dutes, taxes and cess, receved of recevable (2a+2b+2c+2d) 2e 3 Other ncome a Rent 3a b commsson 3b c Dvdend 3c d Interest 3d e Proft on sale of fxed assets 3e f Proft on sale of nvestment beng securtes 3f chargeable to Securtes Transacton Tax (STT) g Proft on sale of other nvestment 3g h Proft on account of currency fluctuaton 3h Agrculture ncome 3 j Any other ncome 3j k Total of other ncome [3a to 3j] 3k 4 Closng Stock 4 5 Totals of credts to proft and loss account (1+2e+3k+4) 5 6 Openng Stock 6 7 Purchases (net of refunds and duty or tax, f any) 7 8 Dutes and taxes, pad or payable, n respect of goods and servces purchased a Custom duty 8a

4 b Counter velng duty 8b c Specal addtonal duty 8c d Unon excse duty 8d e Servce tax 8e f VAT/sales tax 8f g Any other tax, pad or payable 8g h Total(8a+8b+8c+8d+8e+8f+8g) 8h 9 Freght 9 10 Consumpton of stores and spare parts Power and fuel Rents Repars to buldng Repars to machnery Compenston to employees a Salares and wages 15a b Bonus 15b c Rembursement of medcal expenses 15c d Leave encashment 15d e Leave travel benefts 15e f Contrbuton to approved superannuaton fund 15f g Contrbuton to recognsed provdent fund 15g h Contrbuton to recognsed gratuty fund 15h Contrbuton to any other fund 15 j Any other beneft to employees n respect of whch an expendture has been ncurred 15j k Total compensaton to employees (15a+15b+15c+15d+15e+15f+15g+15h+15+15j) 15k 16 Insurance a Medcal Insurance 16a b Lfe Insurance 16b c Keyman s Insurance 16c d Other Insurance 16d e Total expendture on nsurance (16a+16b+16c+16d) 16e 17 Workmen and staff welfare expenses Entertanment Hosptalty Conference Sales promoton ncludng publcty (other than advertsement) Advertsement Commsson Hotel, Boardng and Lodgng Travelng expenses ncludng foregn travelng Conveyance expenses Telephone expense Guest House expenses Club expenses Festval celebraton expenses Scholarshp Gft Donaton Rates and taxes, pad or payable to Government or any local body( excludng taxes on ncome) a Unon excse duty 34a b Servce Tax 34b c VAT/Sales Tax 34c d Cess 34d e Any other rate, tax, duty or cess 34e f Total rates and taxes pad or payable (34a+34b+34c+34d+34e) 34f 35 Audt Fee Other expenses Bad bebts Provson for bad and doubtful bebts Other provson Proft before nterest, deprecaton and taxes [5-(6+7+8h+9 to 14+15l+16e+17 to f+35 to 39)]

5 41 Interest Deprecaton Proft before taxes ( ) Provson for current tax Provson for Deferred tax Proft after tax ( ) Balance brought forward from prevous year Amount avalable for appropraton (46+47) Transfer to reserves and surplus Balance carred to balance sheet n propretor's account (48-49) In a case where regular books of account of busness or professon are not mantaned,furnsh the followng nformaton for prevous year n respect of busness or professon. a Gross recepts 51a b Gross proft 51b c Expenses 51c d net proft 51d Part A-OI Other Informaton (optonal n a case not lable for audt under secton 44AB) 1 Method of accountng employed n the prevous year (tck) Mercantle Cash 2 Is there any change n method of accountng(tck) Yes No 3 Effect on the proft because of devaton, f any, n the method of accountng 3 employed n the prevous year from accountng standards prescrbed under secton 145A 4 Method of valuaton of closng stock employed n the prevous year a Raw Materal (f at cost or market rates whchever s less wrte 1, f at cost wrte 2, f at market rate wrte 3) b Fnshed goods 9t at cost or market rates whchever s less wrte 1, f at cost wrte 2, f at market rate wrte 3) c Is there any change n stock valuaton method(tck) Yes No d Effect on the proft or loss because of devaton, f any, from the method of valuaton prescrbed under secton 145A 5 Amounts not credted to the proft and loss account, benga the tems fallng wthn the scope of secton 28 5a b the proforma credts, drawbacks, refund of duty of 5b customs or excse or servce tax, or refund of sales tax or value added tax, where such credts, drawbacks or refunds are admtted as due by the authortes conerned c escalaton clams accepted durng the prevous 5c year d any other tem of ncome 5d e captal recept, f any 5e f Total of amounts not credted to proft and loss 5f account (5a+5b+5c+5d+5e) 6 Amounts debted to the proft and loss account, to the extent dsallowable under secton 36:- a Premum pad for nsurance aganst rsk of damage 6a or destructon of stocks or store b Premum pad for nsurance on the health of 6b employees c Any sum pad to an employee as bonus or 6c commsson for servces rendered, where such sum was otherwse payable to hm as profts or dvdend. d Any amount of nterest pad n respect or borrowed 6d captal e Amount of dscount on a zero-coupon bond 6e f Amount of contrbutons to a recognsed provdent 6f fund g Amount of contrbutons to an approved 6g superannuaton fund h Amount of contrbutons to a recognsed provdent 6h 4d

6 fund Amount of contrbutons to any other fund 6 j Amount of bad and doubtful debts 6j k Provson for bad and doubtful debts 6k l Amount transferred to any specal reserve 6l m Expendture for the purposes of promotng famly 6m plannng amongst employees n Any sum receved from employees as contrbuton 6n to any provdent fund or superannuaton fund or any fund set up under ESI Act or any other fund for the welfare of employees to the extent credted to the employees account on or before the due date o Any other dsallowance 6o p Total amount dsallowable under secton 36 (total of 6a to 6o) 7 Amounts debted to the proft and loss account, to the extent dsallowable under secton 37 a Expendture of personal nature; 7a b Expendture on advertsement n any souvenr, 7b brochure, tract, pamphlet or the lke, publshed by a poltcal party; c Expendture by way of penalty or fne for volaton of 7c any law for the tme beng n force; d Any other penalty or fne; 7d e Expendture ncurred for any purpose whch s an 7e offence or whch s prohbted by law; f Amount of any lablty of a contngent nature 7f g Amount of expendture n relaton to ncome whch 7g does not form part of total ncome h Any other amount not allowable under secton 37 7h Total amount dsallowable under secton 37(total of 7a to 7h) 8 A Amounts debted to the proft and loss account, to the extent dsallowable under secton 40 a Amount dsallowable under secton 40 (a) (),40(a)(a) and 40 (a)() on account of non-complance wth the provsons of Chapter XVII-B b Amount pad as securtes transacton tax Ab c Amount pad as frnge beneft tax Ac d Amount of tax or rate leved or assessed on Ad the bass of profts e Amount pad as wealth tax Ae f Amount of nterest, salary, bonus, commsson or remuneraton pad to any partner or member Af g Any other dsallowance Ag h Total amount dsallowable under secton 40(total of Aa to Ag) B Any amount dsallowed under secton 40 n any preceedng prevous year but allowable durng the prevous year 9 Amounts debted to the proft and loss account, to the extent dsallowable under secton 40A a Amounts pad to persons specfed n secton 9a 40A(2)(b) b Amount n excess of twenty thousand rupees, pad 9b otherwse than by account payee cheque or account payee bank draft. c Provson for payment of gratuty 9c Aa 6p 7 8Ah 8B d any sum pad by the assessee as an employer for 9d settng up or as contrbuton to any fund, trust, company, AOP, or BOI or socety or any other nsttuton; e Any other dsalowance 9e f Total amount dsallowable under secton 40A 9f

7 10 Any amount dsallowed under secton 43B n any precedng prevous year but allowable durng the prevous year a Any sum n the nature of tax, duty, cess or fee 10a under any law b Any sum payable by way of contrbuton to any 10b provdent fund or superannuaton fund or gratuty fund or any other fund for the welfare of employees c Any sum payable to an employee as bonus or 10c commsson for servces rendered d Any sum payable as nterest on any loan or 10d borrowng from any publc fnancal nsttuton or a State fnancal corporaton or a state ndustral nvestment corporaton. e Any sum payable as nterest on any loan or 10e borrowng from any scheduled bank f Any sum payable towards leave encashment 10f g Total amount allowable under secton 43B (total of 10a to 10f) 10g 11 Any amount debted to proft and loss account of the prevous year but dsallowable under secton 43B:- a Any sum n the nature of tax, duty, cess or fee 11a under any law b Any sum payable by way of contrbuton to any 11b provdent fund or superannuaton fund or gratuty fund or any other fund for the welfare of employees c Any sum payable to an employee as bonus or 11c commsson for servces rendered d Any sum payable as nterest on any loan or 11d borrowng from any publc fnancal nsttuton or a State fnancal corporaton or a state ndustral nvestment corporaton. e Any sum payable as nterest on any loan or 11e borrowng from any scheduled bank f Any sum payable towards leave encashment 11f g Total amount dsallowable under Secton 43B(total of 11a to 11f) 11g 12 Amount of credt outstandng n the accounts n respect of a Unon Excse Duty 12a b Servce tax 12b c VAT/sales tax 12c d Any other tax 12d e Total amount outstandng (total of 12a to 12d) 12e 13 Amounts deemed to be profts and gans under secton 33AB or 33ABA or 33AC Any amount of proft chargeable to tax under secton Amount of ncome or expendture of pror perod credted or debted to the proft 15 and loss account (net) Part A -QD Quanttatve detals (optonal n a case not lable for audt under secton 44AB) (a) In the case of a tradng concern 1 Openng stock 1 2 Purchase durng the prevous year 2 3 Sales durng the prevous year 3 4 Closng stock 4 5 Shortage/ excess, f any 5 (b) In the case of a manufacturng concern 6 Raw materals a Openng stock 6a b Purchases durng the prevous year 6b c Consumpton durng the prevous year 6c d Sales durng the prevous year 6d e Closng stock 6e f Yeld fnshed products 6f g Percentage of yeld 6g h Shortage/ excess, f any 6h

8 7 Fnshed products/ By-products a openng stock 7a b purchase durng the prevous year 7b c quantty manufactured durng the prevous year 7c d sales durng the prevous year 7d e closng stock 7e f shortage/ excess, f any 7f Part B -TI Computaton of total ncome 1 Salares (6 of Schedule S) 1 2 Income from house property (4c of Schedule-HP) (enter nl f loss) 2 3 Profts and gans from busness or professon 3 Proft and gans from busness other than speculatve 3 busness (A37 of Schedule-BP) (enter nl f loss) Proft and gans from speculatve busness (B41 of Schedule-BP) (enter nl f loss) 3 Total (3 + 3) 3 4 Captal gans a Short term Short-term (under secton 111A) (A7 of Schedule- CG) 4a Short-term (others) (A8 of Schedule-CG) 4a Total short-term (3a + 3a) (enter nl f loss) 4a b Long-term (B6 of Schedule-CG) (enter nl f loss) 4b c Total captal gans (4a + 4b) 4c 5 Income from other sources a from sources other than from ownng race horses (3 of 5a Schedule OS) (enter nl f loss) b from ownng race horses (4c of Schedule OS) (enter nl f loss) 5b c Total (a + b) 5c 6 Total ( c +5c) 6 7 Losses of current year to be set off aganst 6 (total of 2v,3v and 4v of Schedule 7 CYLA) 8 Balance after set off current year losses (6 7) 8 9 Brought forward losses to be set off aganst 6 (total of 2v, 3v and 4v of Schedule 9 BFLA) 10 Gross Total ncome (8-9) (also 5v of Schedule BFLA) Deductons under Chapter VI-A (s of Schedule VIA) Total ncome (10 11) Net agrcultural ncome/ any other ncome for rate purpose (4 of Schedule EI) Aggregate ncome ( ) Losses of current year to be carred forward (total of x of CFL) 15 Part B - TTI Computaton of tax lablty on total ncome 1 Tax payable on total ncome a Tax at normal rates 1a b Tax at specal rates (11 of Schedule SI) 1b c Tax Payable on Total Income (1a+1b) 1c 2 Rebate under secton 88E (4 of Schedule-STTR) 2 3 Balance Tax Payable (1-2) 3 4 Surcharge on Educaton Cess on (3+4) 5 6 Gross tax lablty (3+4+5) 6 7 Tax relef a Secton 89 7a b Secton 90 7b c Secton 91 7c d Total (7a + 7b + 7c) 7d 8 Net tax lablty (6-7d) 8 9 Interest payable a For default n furnshng the return (secton 234A) 9a b For default n payment of advance tax (secton 234B) 9b

9 c For deferment of advance tax (secton 234C) 9c d Total Interest Payable (9a+9b+9c) 9d 10 Aggregate lablty (8+9d) Taxes Pad a Advance Tax (from Schedule - IT) 11a b TDS (total of column 7 of Schedule -TDSI and 11b column 7 of Schedule-TDS2 c TCS (column 7 of Schedule-TCS) 11c d Self Assessment Tax (from Schedule-IT) e Total taxes Pad (11a+11b+11c+11d) 11e 12 Amount payable (Enter f 10 s greater than 11e, else enter 0) Refund (If 11e s greater than 10, also gve Bank Account detals below) Enter your bank account number (mandatory n case of refund) 15 Do you want your refund by Cheque, or deposted drectly nto your bank account? (tck as applcable ) 16 In case of drect depost to your bank account gve addtonal detals MICR Code Type of Account (tck as applcable ) Savngs Current 17 E-flng Acknowledgement Number Date (DD/MM/YYYY) / / VERIFICATION I, son/ daughter of 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 18 If the return has been prepared by a Tax Return Preparer (TRP) gve further detals below: Identfcaton No. of TRP Name of TRP Counter Sgnature of TRP If TRP s enttled for any rembursement from the Government, amount 19 thereof 19 art B - TI Schedule S Detals of Income from Salary Name of Employer PAN of Employer (optonal) Address of employer Town/Cty State Pn Code 1 Salary (Excludng all allowances, perquster & proft n leu of salary) 1 2 Allowances exempt under secton Allowances not exempt 3 4 Value of perqustes 4 5 Profts n leu of salary 5 6 Income chargeable under the Head 'Salares' ( ) 6 Schedule HP Detals of Income from House Property 1 Address of property 1 Town/Cty State Pn Code (tck) f let out Name of Tenant PAN of Tenant a Annual letable value/rent receved or recevable (hgher flet out for whole of the year, lower f let out for part of the year) 1a b The amount of rent whch cannot be realzed 1b c Tax pad to local authortes 1c d Total (1b + 1c) 1d e Balance (1a - 1b) 1e 1 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

10 2 Address of property 2 Town / Cty State PIN Code (tck) f let out Name of Tenant PAN of Tenant a Annual letable value/rent receved or recevable (hgher f let out for whole of the year, lower f let out for part of the year) 2a b The amount of rent whch cannot be relzed 2b c Tax pad to local authortes 2c d Total (2b + 2c) 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) 21 3 Address of property 3 Town / Cty State PIN Code (tck) f let out Name of Tenant PAN of Tenant a Annual letable value/ rent receved or recevable (hgher f let out for whole of the year. lower f let out for part of the year) 3a b The amount of rent whch cannot be realzed 3b c Tax pad to local authortes 3c d Total (3a - 3d) 3d e Balance (3a - 3d) 3e f 30% of 3e 3f g Interest payable on borrowed captal 3g h Total (3f + 3g) 3h Income from house property 3 (3e - 3h) 3 4 Incom under the head "Income from house property" a Rent of earler years realzed under secton 25A/AA 4a b Arrears of rent receved durng the year under secton 25B after deductng 30% 4b c Total (4a + 4b ) 4c Note: Please nclude the ncome of the specfed persons referred to n Schedule SPI whle computng the ncome under ths head Schedule BP Computaton of ncome from busness or professon A From busness or professon other than speculatve busness 1 Proft before tax as per proft and loss account (tem 43 or tem 51d of Part A-P&L) 1 2 Net proft or loss from speculatve busness ncluded n Income/ recepts credted to proft and loss account 3 consdered under other heads of ncome 4 Proft or loss ncluded n 1, whch s referred to n secton44ad/44ae/44af/44b/44bb/44bba/44bbb/44 D/44DA Chapter-XII-G/ Frst Schedule of Income- tax Act 4 5 Income credted to Proft and Loss account (ncluded n 1) whch s exempt a share of ncome from frm(s) 5a b Share of ncome from AOP/BOI 5b c Any other exempt ncome 5c d Total exempt ncome 5d 6 Balance ( d) 6 7 Expenses debted to proft and loss account 7 consdered under other heads of ncome 8 Expenses debted to proft and loss account whch 8 relate to exempt ncome 9 Total (7 + 8) 9 10 Adjusted proft or loss (6+9) Deprecaton debted to proft and loss account 11 ncluded n 9 12 Deprecaton allowable under Income-tax Act Depercaton allowable under secton 32(1)() 12 (Column 6 of Schedule-DEP) Depredcaton allowable under secton 32(1)() (Make your own computaton and enter) 12 Total ( ) Proft or loss after adjustment for deprecaton ( ) 13

11 14 Amounts debted to the proft and loss account, to the 14 extent dsallowable under secton 36 (6p of Part-OI) 15 Amounts debted to the proft and loss account, to the 15 extent dsallowable under secton 37 (7 of Part-OI) 16 Amounts debted to the proft and loss account, to the 16 extent dsallowable under secton 40 (8Ah of Part-OI) 17 Amounts debted to the proft and loss account, to the 17 extent dsallowable under secton 40 A (9f of Part-OI) 18 Any amount debted to proft and loss account of the 18 prevous year but dsallowable under secton 43B(11g of part-oi ) 19 Interest dsallowable under secton 23 of the Mcro, 19 Small and Medum Enterprses Development Act, Deemed ncome under secton Deemed ncome under secton 21 33AB/33ABA/35ABB/72A/80HHD/80-IA 22 Any other tem or tems of addton under secton 28 to 22 44DA 23 Any other ncome not ncluded n proft and loss account/any other expense not allowable Total ( ) Deducton allowable under secton 32(1)() Amount of Deduton under secton 35 n Excess of the 26 amount debted to proft and loss account(item VII(4) of schedule ESR) 27 Any amount dsallowed under secton 40 n any 27 preceedng prevous year but allowable durng the prevous year(8b of part-oi) 28 Any amount dsallowed under secton 43B n any 28 precedng prevous year but allowable durng the prevous year (10g of part-oi) 29 Deducton under secton35ac a Amount, f any, debted to proft and loss account 29a b Amount allowable as deducton 29b c Excess amount allowable as deducton (29b-29a) 29c 30 Any other amount allowable as deducton Total ( c+30) Income ( ) Profts and gans of busness or professon deemed to be under - Secton 44AD 33 Secton 44AE 33 Secton 44AF 33 v Secton 44B 33v v Secton 44BB 33v v Secton 44BBA 33v v Secton 44BBB 33v v Secton 44D 33v x Secton 44DA 33x x Chapter-XII-G 33x x Frst Schedule of Income-tax Act 33x x Total (33 to 33x) 33x 34 Proft or loss before deducton under secton 10A/10AA/10B/10BA(32 +33x) Deductons under secton 10A (6 of Schedule-10A) 35 10AA (d of Schedule-10AA) 35 10B (f of Schedule-10B) 35 v 10BA (f of Schedule-10BA) 35v v Total ( v) 35v 36 Net proft or loss from busness or professon other than speculatve busness (34-35v) Net Proft or loss from busness or professon after applyng rule 7A, 7B or 7c A37 B Computaton of ncome from speculatve busness 38 Net proft or loss from speculatve busness as per proft or loss account Addtons n accordance wth secton 28 to 44DA Deductons n accordance wth secton 28 to 44DA Proft or loss from speculatve busness ( ) B41 C Income chargeable under the head 'Profts and gans' (A37+B41) C Note: Please nclude the ncome of the specfed persons referred to n Schedule SPI whle computng the ncome under ths head Schedule DPM Deprecaton on Plant and Machnery 1 Block of assets Plant and machnery 2 Rate (%)

12 3 Wrtten down value on the frst day of prevous year 4 Addtons for a perod of 180 days or more n the prevous year 5 Consderaton or other realzaton durng the prevous year out of 3 or 4 6 Amount on whch deprecaton at full rate to be allowed ( ) 7 Addtons for a perod of less than 180 days n the prevous year 8 Consderaton or other realzatons durng the year out of 7 9 Amount on whch deprecaton at half rate to be allowed (7-8 ) 10 Deprecaton on 6 at full rate 11 Deprecaton on 9 at half rate 12 Addtonal deprecaton, f any, on 4 13 Addtonal deprecaton, f any, on 7 14 Total deprecaton ( ) 15 Expendture ncurred n connecton wth transfer of asset/assets 16 Captal gans/loss under secton 50 ( ) 17 Wrtten down value on the last day of prevous year* ( ) () () () (v) (v) (v) (v) Schedule DOA Deprecaton on other assets 1 Block of assets Buldng Furnture and fttngs Intangble assets Shps 2 Rate (%) () () () (v) (v) (v) 3 Wrtten down value on the frst day of prevous year 4 Addtons for a perod of 180 days or more n the prevous year 5 Consderaton or other realzaton durng the prevous year out of 3 or 4 6 Amount on whch deprecaton at full rate to be allowed ( ) 7 Addtons for a perod of less than 180 days n the prevous year 8 Consderaton or other realzatons durng the year out of 7 9 Amount on whch deprecaton at half rate to be allowed (7-8) 10 Deprecaton on 6 at full rate 11 Deprecaton on 9 at half rate 12 Addtonal deprecaton, f any, on 4 13 Addtonal deprecaton, f any, on 7 14 Total deprecaton ( ) 15 Expendture ncurred n connecton wth transfer of asset/ assets 16 Captal gans/loss under secton 50* ( ) 17 Wrtten down value on the last day of prevous year* ( ) Schedule DEP Summary of deprecaton on assets 1 Plant and machnery a Block Enttled for 15 per cent (Schedule DPM - 1a 14) b Block enttled for 30 per cent (Schedule DPM b ) c Block enttled for 40 per cent (Schedule DPM c ) d Block enttled for 50 per cent (Schedule DPM -14 1d v) e Block enttled for 60 per cent (Schedule DPM e v) f Block enttled for 80 per cent (Schedule 1f DPM-14v) g Block enttled for 100 per cent (Schedule DPM - 1g

13 14 v) h Total deprecaton on plant and machnery (1a + 1b + 1c + 1d + 1e + 1f + 1g) 1h 2 Buldng a Block enttled for 5 per cent (Schedule DOA-14) 2a b Block enttled for 10 per cent (Schedule DOA-14) 2b c Block enttled for 100 per cent (Schedule DOA - 14) 2c d Total deprecaton on buldng (2a + 2b + 2c) 2d 3 Furnture and fttngs (Schedule DOA - 14v) 3 4 Intangble assets (Schedule DOA - 14v) 4 5 Shps (Schedule DOA - 14 v) 5 6 Total deprecaton (1h+2d+3+4+5) 6 Schedule DCG Deemed Captal Gans on sale of deprecable assets 1 Plant and machnery a Block enttled for 15 per cent (Schedule DPM -16) 1a b Block enttled for 30 per cent (Schedule DPM-16) 1b c Block enttled for 40 per cent (Schedule DPM - 16) 1c d Block enttled for 50 per cent (Schedule DPM - 16v 1d e Block enttled for 60 per cent (Schedule DPM - 16v) 1e f Block enttled for 80 per cent (Schedule DPM - 16v) 1f g Block enttled for 100 per cent (Schedule DPM - 16v) 1g h Total (1a + 1b + 1c + 1d + 1e + 1f + 1g) 1h 2 Buldng a Block enttled for 5 per cent (Schedule DOA - 16) 2a b Block enttled for 10 per cent (Schedule DOA - 2b 16) c Block enttled for 100 per cent (Schedule DOA- 16) 2c d Total (2a+2b+2c) 2d 3 Furnture and fttngs (Schedule DOA - 16v) 3 4 Intangble assets (Schedule DOA-16v) 4 5 Shps (Schedule DOA - 16v) 5 6 Total (1h+2d+3+4+5) 6 Shedule ESR Deducton under secton 35 Slno Expendture of the nature referred to n secton Amount,If any,debted to proft an d los account v v v v (1) 35(1)() 35(1)() 35(1)() 35(1)(v) 35(2AA) 35(2AB) Total (2) Amount of deducton allowable (3) Amount of deducton n excess of the amount debted to proft and loss account (4)=(3)-(2) Schedule CG Captal Gans A Short-term captal gan 1 From slump sale a Full value of consderaton 1a b Net worth of the under takng or dvson 1b c Short term captal gans from slump sale 1c d Deducton under sectons 54/54B/54D/54EC/54F/54G/54GA 1d e Net short term captal gans from slum sale (1c-1d) 1e 2 From assets n case of non-resdent to whch frst provso to secton 48 applcable 2 3 From other assets a Full value of consderaton 3a b Deducton under secton 48 Cost of acquston b Cost of mprovement b Expendture on transfer b v Total ( + + ) bv c Balance (3a-bv) 3c d Loss, f any, to be gnored under secton 94(7) or 94(8) 3d e Exempton under sectons 54B/54D/54EC/54G/54GA 3e f Short-term captal gan (3c-3d-3e) 3f 4 Deemed short captal gan on deprecable assets (6 of Schedule-DCG) 4 5 Amount deemed to be short term captal gans under sectons 5 54/54B/54D/54EC/54F/54ED/54G/54GA 6 Total short term captal gan (1e e ) 6

14 7 Short term captal gan under secton 111A ncluded n Short term captal gan other than referred to n secton 111A (6-7) A8 B Long term captal gan 1 From slump sale a Full value of consderaton 1a b Net worth of the under takng or dvson 1b c Long term captal gans from slump sale 1c d Deducton under sectons 54/54B/54D/54EC/54F/54ED/54G/54GA 1d e Net long term captal gan from slump sale (1c-1d) 1e 2 Asset n case of non-resdent to whch frst provso to secton 48 applcable 2 3 Other assets for whch opton under provso to secton 112(1) not exercsed a Full value of consderaton 3a b Deductons under secton 48 Cost of acquston after ndexaton b Cost of mprovement after ndexaton b Expendture on transfer b v Total (b + b +b) bv c Balance (3a - bv) 3c d Deducton under sectons 54/54B/54D/54EC/54F/54ED/54G/54GA 3d e Net balance (3c - 3d) 3e 4 Other assets for whch opton under provso to secton 112(1) exercsed a Full value of consderaton 4a b Deductons under secton 48 Cost of acquston wthout ndexaton b Cost of mprovement wthout ndexaton b Expendture on transfer b v Total (b + b + b) bv c Balance (4a -bv) 4c d Deducton under sectons 54/54B/54D/54EC/54F/54ED/54G/54GA 4d e Net balance 4e 5 Amount deemed to be long term captal gans under sectons 5 54/54B/54D/54EC/54F/54ED/54G/54GA 6 Total long term captal gan (1e e +4e + 5) B6 C Income chargeable under the head "CAPITAL GAINS" (A8 + B6) C D Informaton about accrual/recept of captal gan Date Upto 15/9 () 16/9 to 15/12 () 16/12 to 15/3 () 1 Long-term 2 Short-term Note: Please nclude the ncome of the specfed persons referred to n Schedule SPI whle computng the ncome under ths head 16/3 to 31/3 (v) Schedule OS Income from other sources 1 Income other than from ownng race horse (s):- a Dvdends, Gross 1a b Interest, Gross 1b c Rental ncome from machnery, plants, buldngs 1c d Others, Gross 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 Wnnngs from lotteres, crossword puzzles, races, etc. 2 3 Income from other sources (other than from ownng race horses) (1g + 2) 3 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) 4c 5 Income chargeable under the head Income from other sources (1g c) 5 Note: Please nclude the ncome of the specfed persons referred to n Schedule SPI whle computng the ncome under ths head

15 Schedule CYLA Sl.No Head/ Source of Income Salares House property Busness (ncludng speculaton proft) v Short-term captal gan v Long term captal gan v Other sources (ncl proft from ownng race horses) v Total loss set-off v Loss remanng after set-off Detals of Income after set-off of current years losses Income of House property Busness Loss current loss of (other than year (Fll ths the current year speculaton column only set off loss) of the f ncome s zero current year set or postve) off Other sources loss (other than loss from race horses) of the current year set off Current year s Income remanng after set off Total loss (4c of Sched ule HP) Total loss (A37 of Schedu le- BP) Total loss (3 of Sched ule- OS) = Schedule BFLA Sl. Head/ Source of Income Income after set off, No. f any, of current year s losses as per 5 of Schedule CYLA) v v v v v Detals of Income after Set off of Brought Forward Losses of earler years Brought Brought Brought forward forward loss forward allowance under set off deprecaton secton Current year s ncome remanng after set off set off 35(4) set off Salares House property Busness (ncludng speculaton proft) Short-term captal gan Long-term captal gan Other sources (ncludng proft from ownng race horses) Total of brought forward loss set off Current year s ncome remanng after set off Total ( v5+v5+v5) Schedule CFL Sl. Assessment No. Year v v v v v x Total of earler year losses Date of Flng (DD/MM/ YYYY) Detals of Losses to be carred forward to future Years House Short-term property loss captal loss Loss from busness other than loss from speculatve busness Loss from speculatve busness Long-term Captal loss Other sources loss (other than loss from race horses) Other sources loss (from ownng race horses)

16 x Adjustment of above losses n Schedule BFLA x (Current year losses) x Total loss Carred Forward to future years Schedule 10A Deducton under secton 10A 1 Deducton n respect of unts located n Software Technology Park a Undertakng No.1 1a b Undertakng No.2 1b c Undertakng No.3 1c d Undertakng No.4 1d e Undertakng No.5 1e f Total (1a + 1b+ 1c + 1d + 1e) 1f 2 Deductons n respect of unts located n Electronc Hardware Technology Park a Undertakng No.1 2a b Undertakng No.2 2b c Undertakng No.3 2c d Total (2a + 2b+ 2c) 2d 3 Deductons n respect of unts located n Free Trade Zone a Undertakng No.1 3a b Undertakng No.2 3b c Undertakng No.3 3c d Total (3a + 3b+ 3c) 3d 4 Deductons n respect of unts located n Export Processng Zone a Undertakng No.1 4a b Undertakng No.2 4b c Undertakng No.3 4c d Total (4a + 4b+ 4c) 4d 5 Deductons n respect of unts located n Specal Economc Zone a Undertakng No.1 5a b Undertakng No.2 5b c Undertakng No.3 5c d Total (5a + 5b+ 5c) 5d 6 Total of ( 1f +2d +3d+ 4d+ 5d) 6 Schedule 10AA Deducton under secton 10AA Deductons n respect of unts located n Specal Economc Zone a Undertakng No.1 a b Undertakng No.2 b c Undertakng No.3 c d Total (a + b + c) d Schedule 10B Deducton under secton 10B Deducton n respect of hundred percent Export Orented unts a Undertakng No.1 a b Undertakng No.2 b c Undertakng No.3 c d Undertakng No.4 d e Undertakng No.5 e f Total (a + b + c + d + e) f Schedule 10BA Deducton under secton 10BA Deducton n respect of exports of hand-made wooden artcles a Undertakng No.1 a b Undertakng No.2 b c Undertakng No.3 c

17 d Undertakng No.4 d e Undertakng No.5 e f Total (a + b + c + d + e) f Schedule 80G Detals of donatons enttled for deducton under secton 80G A Donatons enttled for 100% deducton Name and address of donee B c A A A v Av v Av v Total Av Donatons enttled for 50% deducton where donee not requred to be approved under secton 80G(5) (v) Name and address of donee Amount of donaton Amount of donaton B B B v Bv v Bv v Total Bv Donatons enttled for 50% deducton where donee s requred to be approved under secton 80G(5) (v) Name and address of donee PANof donee Amount of donaton C C C v Cv v Cv v Total Cv D Total donatons (Av + Bv + Cv) D Schedule 80-IA Deductons under secton 80-IA a Deducton n respect of profts of an enterprse referred to n secton a 80-IA (4) () [Infrastructure faclty] b Deducton n respect of profts of an undertakng referred to n secton b 80-IA(4)() [Telecommuncaton servces] c Deducton n respect of profts of an undertakng referred to n secton c 80-IA(4)() [Industral park and SEZs] d Deducton n respect of profts of an undertakng referred to n secton d 80-IA(4)(v) [Power] e Deducton n respect of profts of an undertakng referred to n secton 80-IA(4)(v) [Revval of power generatng plant] e f Total deductons under secton 80-IA (a + b + c + d + e) f Schedule 80-IB Deductons under secton 80-IB a Deducton n respect of ndustral undertakng referred to n secton a 80-IB(3) [Small-scale ndustry] b Deducton n respect of ndustral undertakng located n Jammu & Kashmr [Secton 80-IB(4)] b c Deducton n respect of ndustral undertakng located n ndustrally backward states specfed n Eghth Schedule [Secton 80-IB(4)] c d Deducton n respect of ndustral undertakng located n ndustrally d backward dstrcts [Secton 80-IB(5)] e Deducton n the case of multplex theatre [Secton 80- IB(7A)] e f Deducton n the case of conventon centre [Secton 80- IB(7B)] f g Deducton n the case of company carryng on scentfc research [Secton g 80-IB(8A)] h Deducton n the case of undertakng whch begns commercal h producton or refnng of mneral ol [Secton 80-IB(9)] Deducton n the case of an undertakng developng and buldng housng projects [Secton 80-IB(10)] j Deducton n the case of an undertakng operatng a cold chan faclty j [Secton 80-IB(11)] k Deducton n the case of an undertakng engaged n processng, k preservaton and packagng of fruts and vegetables [Secton 80-IB(11A)] l Deducton n the case of an undertakng engaged n ntegrated busness l of handlng, storage and transportaton of foodgrans [Secton 80-IB(11A)] m Deducton n the case of an undertakng engaged n operatng and m

18 mantanng a rural hosptal [Secton 80-IB(11B)] n Total deducton under secton 80-IB (Total of a to m) n Schedule 80-IC Deductons under secton 80-IC 1 Deducton n respect of ndustral undertakng located n Skkm 1 2 Deducton n respect of ndustral undertakng located n Hmachal Pradesh 2 3 Deducton n respect of ndustral undertakng located n Uttaranchal 3 4 Deducton n respect of ndustral undertakng located n North-East a Assam 4a b Arunachal Pradesh 4b c Manpur 4c d Mzoram 4d e Meghalaya 4e f Nagaland 4f g Trpura 4g h Total of deducton for undertakngs located n North-east (Total of 4a to 4g) 4h 5 Total deducton under secton 80-IC ( h) 5 Schedule VI-A Deductons under Chapter VI-A (Secton) a 80C j 80GGC b 80CCC k 80IA (f of Schedule 80-1A) c 80CCD l 80IAB d 80D m 80IB(n of Schedule 80-1B) e 80DD n 801C (5 of Schedule 80-1C) f 80DDB o 80JJA g 80E p 80QQB h 80G q 80RRB 80GG r 80U s Total deductons under Chapter VI - A ( Total of a to k ) s Schedule STTR Rebate under secton 88E 1 Income arsng from transactons chargeable to Securtes Transacton Tax (STT) chargeable under the head Proft from busness or professon and ncluded n the gross total ncome Beng from non speculatve busness ncluded n A34 of 1 schedule BP Beng from speculatve busness ncluded n B38 of Schedule BP 1 Total 1 2 Tax payable on (1)() above on average rate of tax 2 3 STT pad durng the year on the transactons chargeable to STT whch have been entered nto n the course of busness durng the year 3 4 Rebate under secton 88E, lower of (2) and (3) 4 Schedule SPI Income of specfed persons (spouse, mnor chld etc.)ncludable n ncome of the assessee Sl. Name of person PAN of person(optonal) Relatonshp Nature of Amount (Rs.) No. Income 1 Schedule SI Sl No. Secton code Income chargeable to Income tax at specal rates IB [Please see nstructon No. 9() for secton code and rate of tax] Specal rate (%) Income Tax Sl No. Secton Specal Income Tax thereon thereon Code rate (%) Total (1 to 10)

19 Schedule IF Informaton regardng partnershp frms n whch you are partner Number of frms n whch you are partner Frm No Name of the Frm PAN of the frm Percentage Share n the Proft of the frm 1 Amount of share n the proft Captal balance on 31st March n the frm Schedule EI 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 on whch Securtes Transacton Tax s pad 3 4 Net Agrculture ncome(other than ncome to be excluded under rule 7, 7A, 7B or 8) 4 5 Share n the proft of frm / AOP etc. 5 6 Others 6 7 Total ( ) 7 Schedule AIR Other Informaton (transactons reported through Annual Informaton Return) [Please see nstructon number-9(v) for code] Sl Code of Transacton Amount (Rs.) Sl. No. Code of Transacton Amount (Rs.) No Schedule IT Detals of Advance Tax and Self Assessment Tax Payments of Income - tax Sl No Name of Bank & Branch BSR Code Date of Depost (DD/MM/YYYY) Seral Number of Challan Note: Enter the totals of Advance tax and Self Assessment tax n Sl No. 9a & 9c of PartB - TTI Amount (Rs) Schedule TDS1 Sl Tax Deducton Account No. Number (TAN) of the Detals of Tax Deducted at Source on Salary [As per Form 16 A ssued by Employer(s)] Name and Income Deducton Tax payable Total tax address of the chargeable under Chapter (ncl. surch. deposted Employer under Salares VI-A and edn. cess Tax payable / refundable Employer (1) (2) (3) (4) (5) (6) (7) (8) Schedule TDS2 Sl No Detals of Tax Deducted at Source on Income [As per Form 16 A ssued by Deductor(s)] Name and Amount Pad Date of Payment Total tax address of the / Credt deposted Deductor Tax Deducton Account Number (TAN) of the Deductor Amount out of (6) clamed for ths year (1) (2) (3) (4) (5) (6) (7) Note: Enter the total of column 7 n Schedule-TDS1 and column 7 of Schedule-TDS2 n 11(b) of PartB-TTI Schedule TCS Detals of Tax Collected at Source [As per Form 27D ssued by the Collector(s)] Sl No Name and address of the Collector Total tax deposted Tax Deducton and Tax Collecton Account Number of the Collector Amount receved/ debted Date of recept/ debt Amount out of (6) to be allowed as credt durng the year (1) (2) (3) (4) (5) (6) (7) Note: Enter the total of column (7) n Sl No. 11c of PartB-TTI

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