Country. Residential/Office Phone Number with STD code/ Mobile No. 1 Mobile No. 2 Employer Category(if in employment) (Tick) Govt.

Transcription

1 TOTAL NCOME FLNG STATUS PERSONAL NFORMATON FORM TR-2 NDAN NCOME TAX RETURN [For ndvduals and HUFs not carryng out busness or professon under any propretorshp] (Please see Rule 12 of the ncome-tax Rules,1962) (Also see attached nstructons) Assessment Year Part A-GEN GENERAL Frst name Mddle name Last name PAN Flat/Door/Block Name of Premses/Buldng/Vllage Status (Tck) ndvdual HUF Road/Street/Post Offce Date of Brth/ Formaton(DD/MM/YYYY) Area/localty Aadhaar Number (12 dgt)/ Aadhaar Enrolment d (28 dgt) (f elgble for Aadhaar) Town/Cty/Dstrct State Pn code Country Sex (n case of ndvdual) (Tck) Male Female Resdental/Offce Phone Number wth STD code/ Moble. 1 Moble. 2 Employer Category(f n employment) (Tck) Govt. PSU Others Emal Address-1 (self) ncome Tax Ward/Crcle Emal Address-2 (a) (b) (c) Return fled (Tck)[Please see nstructon number-7] On or before due date-139(1), After due date-139(4), Revsed Return- 139(5), Modfed return- 92CD, under secton 119(2)(b), or n response to notce 139(9)-Defectve, 142(1), 148, 153A/153C f revsed/defectve/modfed, then enter Recept. and Date of flng orgnal return (DD/MM/YYYY) / / f fled, n response to a notce u/s 139(9)/142(1)/148/153A/153C enter date of such notce, or u/s 92CD enter date of advance prcng agreement / / (d) Resdental Status (Tck) Resdent n-resdent Resdent but t Ordnarly Resdent (e) Whether any transacton has been made wth a person located n a jursdcton notfed u/s 94A of the Act? Yes (f) Are you governed by Portuguese Cvl Code as per secton 5A? Tck) Yes (f YES please fll Schedule 5A) (g) Whether ths return s beng fled by a representatve assessee? (Tck) Yes f yes, please furnsh followng nformaton - (1) Name of the representatve (2) Address of the representatve (3) Permanent Account Number (PAN) of the representatve PART-B Part B - T Computaton of total ncome 1 Salares (6 of Schedule S) 1 2 ncome from house property (3b of Schedule HP) (enter nl f loss) 2 3 Profts and gans from busness or professon (6 of Schedule BP) (enter nl f loss) 3 4 Captal gans a Short term Short-term 15% (7 of tem E of schedule CG) a Short-term 30% (7 of tem E of schedule CG) a Short-term chargeable at applcable rate (7v of tem E of schedule CG) a v Total Short-term (a + a + a) 4av Do not wrte or stamp n ths area (Space for bar code) For Offce Use Only Recept. Date Seal and Sgnature of recevng offcal Page 1

2 TAXE S PAD COMPUTATON OF TAX LABLTY b Long-term Long-term 10% (7v of tem E of schedule CG) b Long-term 20% (7v of tem E of schedule CG) b Total Long-term (b + b) (enter nl f loss) 4b c Total captal gans (4av + 4b) (enter nl f loss) 4c 5 ncome from other sources a from sources other than from ownng race horses and ncome chargeable to tax at specal rate (1 of Schedule OS) (enter nl f loss) 5a b ncome chargeable to tax at specal rate (1fv of Schedule OS) 5b c from the actvty of ownng and mantanng race horses (3c of Schedule OS) (enter nl f loss) 5c d Total (5a + 5b + 5c) (enter nl f loss) 5d 6 Total ( c+5d) 6 7 Losses of current year set off aganst 6 (total of 2x,3x and 4x of Schedule CYLA) 7 8 Balance after set off current year losses (6-7) (total of column 5 of Schedule CYLA+5b) 8 9 Brought forward losses set off aganst 8 (2x of Schedule BFLA) 9 10 Gross Total ncome (8-9) (3x of Schedule BFLA +5b) ncome chargeable to tax at specal rate under secton 111A, 112 etc. ncluded n Deductons under Chapter V-A [s t of Schedule VA and lmted to (10-11)] Total ncome (10 12) ncome whch s ncluded n 13 and chargeable to tax at specal rates (total of () of schedule S) Net agrcultural ncome/ any other ncome for rate purpose (4 of Schedule E) Aggregate ncome ( ) [applcable f (13-14) exceeds maxmum amount not chargeable to tax] Losses of current year to be carred forward (total of row x of Schedule CFL) 17 Part B -TT Computaton of tax lablty on total ncome 1 Tax payable on total ncome a Tax at normal rates on 16 of Part B-T b Tax at specal rates (total of () of Schedule S) c Rebate on agrcultural ncome [applcable f (13-14) of Part B-T exceeds maxmum amount not chargeable to tax] d Tax Payable on Total ncome (1a + 1b 1c) 1a 1b 1c 1d 2 Rebate under secton 87A (applcable f 13 of Part B-T does not exceed 5 lakh) 2 3 Tax payable after rebate (1d - 2) 3 4 Surcharge 25% of 12() of Schedule S 4 On [(3) (12() of Schedule S)] (applcable f 13 of Part B-T exceeds 1 crore) 4 Total Educaton cess, ncludng secondary and hgher educaton cess on (3 + 4) Gross tax lablty ( ) 6 7 Tax relef a Secton 89 7a b Secton 90/ 90A (2 of Schedule TR) 7b c Secton 91 (3 of Schedule TR) 7c d Total (7a + 7b+ 7c) 7d 8 Net tax lablty (6 7d) (enter zero f negatve) 8 9 nterest payable a For default n furnshng the return (secton 234A) 9a b For default n payment of advance tax (secton 234B) 9b c For deferment of advance tax (secton 234C) 9c d Total nterest Payable (9a+9b+9c) 9d 10 Aggregate lablty (8 + 9d) Taxes Pad a Advance Tax (from column 5 of 19A) 11a Page 2

3 TDS ON OTHER NCOME TDS ON SALARY ADVANCE/ SELF ASSESSMENT TAX BANK ACCOUNT b TDS (total of column 5 of 19B and column 8 of 19C) 11b c TCS (total of column 5 of 19D) 11c d Self-Assessment Tax (from column 5 of 19A) 11d e Total Taxes Pad (11a+11b+11c+11d) 11e 12 Amount payable (Enter f 10 s greater than 11e, else enter 0) Refund (f 11e s greater than 10) (Refund, f any, wll be drectly credted nto the bank account) Detals of all Bank Accounts held n nda at any tme durng the prevous year (excludng dormant accounts) Sl. FS Code of the Bank Name of the Bank Account Number (the number should be 9 dgts or more as per CBS system of the bank ) ndcate the account n whch you prefer to get your refund credted, f any (tck one account ) Cash deposted durng to (f aggregate cash deposts durng the perod Rs.2 lakh) 15 Do you at any tme durng the prevous year,- () hold, as benefcal owner, benefcary or otherwse, any asset (ncludng fnancal nterest n any entty) located outsde nda; or () have sgnng authorty n any account located outsde nda; or () have ncome from any source outsde nda? [applcable only n case of a resdent] [Ensure Schedule FA s flled up f the answer s Yes ] VERFCATON Yes, 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 ncome-tax Act, 1961, n respect of ncome chargeable to ncome-tax for the prevous year relevant to the Assessment Year further declare that the crtcal assumptons specfed n the agreement have been satsfed and all the terms and condtons of the agreement have been compled wth. (Applcable, n a case where return s furnshed under secton 92CD) Place Sgn here Date 17 f the return has been prepared by a Tax Return Preparer (TRP) gve further detals below: dentfcaton. of TRP Name of TRP Counter Sgnature of TRP f TRP s enttled for any rembursement from the Government, amount thereof TAX PAYMENTS A Detals of payments of Advance Tax and Self-Assessment Tax Sl BSR Code Date of Depost (DD/MM/YYYY) Seral Number of Challan Amount (Rs) (1) (2) (3) (4) (5) v B NOTE Enter the totals of Advance tax and Self-Assessment tax n Sl. 11a & 11d of Part B-TT Detals of Tax Deducted at Source from Salary [As per Form 16 ssued by Employer(s)] Sl Tax Deducton Account Number (TAN) of the Employer Name of the Employer ncome chargeable under Salares Total tax deducted (1) (2) (3) (4) (5) C NOTE Please enter total of column 5 of Schedule-TDS1 and column 8 of Schedule-TDS2 n 11b of Part B-TT Detals of Tax Deducted at Source (TDS) on ncome [As per Form 16 A ssued by Deductor(s) or Form 26QB ssued by Deductor(s)] Sl TAN of the Deductor/ PAN of the Buyer Name of the Deductor Unque TDS Certfcate Number Unclamed TDS brought forward (b/f) Fn. Year n whch deducted Amount b/f TDS of the current fn. Year Amount out of (6) or (7) beng clamed ths Year (only f correspondng ncome s beng offered for tax ths year) n own hands n the hands of spouse, f secton 5A s applcable Amount out of (6) or (7) beng carred forward (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) Page 3

4 TCS D NOTE Please enter total of column 5 of Schedule-TDS1 and column 8 of Schedule-TDS2 n 11b of Part B-TT Detals of Tax Collected at Source (TCS) [As per Form 27D ssued by the Collector(s)] Sl Tax Deducton and Collecton Account Number of the Collector Name of the Collector Tax Collected Amount out of (4) beng clamed Amount out of (4) beng clamed n the hands of spouse, f secton 5A s applcable (1) (2) (3) (4) (5) (6) NOTE Please enter total of column (5) of Schedule-TCS n 11c of Part B-TT NOTE: PLEASE FLL SCHEDULES TO THE RETURN FORM (PAGES S1 S12) AS APPLCABLE Page 4

5 HOUSE PROPERTY SALARES SCHEDULES TO THE RETURN FORM (FLL AS APPLCABLE) Schedule S Name of Employer Detals of ncome from Salary PAN of Employer (optonal) Address of employer Town/Cty State Pn code 1 Salary (Excludng all exempt/ non-exempt allowances, perqustes & proft n leu of salary as they are shown separately below) 1 32 Allowances not exempt (refer Form 16 from employer) Value of perqustes (refer Form 16 from employer) Profts n leu of salary (refer Form 16 from employer) Deducton u/s 16 (Entertanment allowance by Government and tax on employment) ncome chargeable under the Head Salares ( ) 76 7 Allowances exempt under secton 10 (t to be ncluded n 6 above) 7 Travel concesson/assstance receved [(sec. 10(5)] 7 Tax pad by employer on non-monetary perquste [(sec. 10(10CC)] 7 Allowance to meet expendture ncurred on house rent [(sec. 10(13A)] 7 v Other allowances 7v Schedule HP Detals of ncome from House Property (Please refer to nstructons) Address of property 1 Town/ Cty State PN Code 1 s the property co-owned? Yes (f YES please enter followng detals) Your percentage of share n the property Name of Co-owner(s) PAN of Co-owner(s)e Percentage Share n Property 2 (Tck) f let out deemed let out Name(s) of Tenant (f let out) PAN of Tenant(s) (optonal) a Annual letable value or rent receved or recevable (hgher of the two, f let out for whole of the year, lower of the two 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 Annual value (1a 1d) (nl, f self -occuped etc. as per secton 23(2)of the Act) f Annual value of the property owned (own percentage share x 1e) g 30% of 1f h nterest payable on borrowed captal Total (1g + 1h) j ncome from house property 1 (1f 1) 1j Address of property 2 Town/ Cty State PN Code s the property co-owned? Yes (f YES please enter followng detals) Your percentage of share n the property. Name of Co-owner(s) PAN of Co-owner(s) Percentage Share n Property 1g 1h 1e 1f 1 Page S1

6 CAPTAL GANS Short-term Captal Gans NCOME FROM FRMS FRMS N WHCH PARTNER (Tck) f let out deemed let out Name(s) of Tenant (f let out) PAN of Tenant(s) (optonal) a Annual letable value or rent receved/ recevable (hgher of the two, f let out for whole of the year, lower of the two, f let out for part of the year) 2a b The amount of rent whch cannot be realzed 2b c Tax pad to local authortes 2c d Total (2b + 2c) 2d e Annual value (2a 2d) 2e f Annual value of the property owned (own percentage share x 2e) 2f g 30% of 2f 2g h nterest payable on borrowed captal 2h Total (2g + 2h) 2 j ncome from house property 2 (2f 2) 2j 3 ncome under the head ncome from house property a Unrealzed rent and Arrears of rent receved durng the year under secton 25A after deductng 30% 3a b Total (1j + 2j + 3a) (f negatve take the fgure to 2 of schedule CYLA) 3b NOTE Please nclude the ncome of the specfed persons referred to n Schedule SP whle computng the ncome under ths head Schedule F nformaton regardng partnershp frms n whch you are partner Number of frms n whch you are partner Sl Name of the Frm PAN of the frm Whether the frm s lable for audt? (Yes/) Whether secton 92E s applcable to frm? (Yes/ ) Percentage Share n the proft of the frm Amount of share n the proft Captal balance on 31 st March n the frm 4 Total Schedule BP Sl.. Frm PAN (From Schedule- F) Detals of ncome from Frms of whch partner Salary, bonus, commsson or remuneraton receved from the frm nterest receved from the frm on the captal Total + Expenses n relaton to v Net ncome v - v NOTE 4 Total () () () v 5 Deducton, f any, for payment of any sum for carryng out an elgble project or scheme as per secton 35AC 6 Net ncome from Busness [4(v) 5] (v) (v) (v) Please nclude the ncome of the specfed persons referred to n Schedule SP whle computng the ncome under ths head Schedule CG Captal Gans A Short-term Captal Gans (STCG) (tems 3, 4 and 7 are not applcable for resdents) 1 From sale of land or buldng or both a Full value of consderaton receved/recevable a Value of property as per stamp valuaton authorty Full value of consderaton adopted as per secton 50C for the purpose of Captal Gans (a or a) b Deductons under secton 48 Cost of acquston wthout ndexaton b Cost of mprovement wthout ndexaton Expendture wholly and exclusvely n connecton wth transfer v Total (b + b + b) c Balance (a bv) d Deducton under secton 54B (Specfy detals n tem D below) e Short-term Captal Gans on mmovable property (1c - 1d) a a b b bv 1c 1d A1e Page S2

7 2 From sale of equty share or unt of equty orented Mutual Fund (MF) or unt of a busness trust on whch STT s pad under secton 111A or 115AD(1)() provso (for F) 3 a Full value of consderaton 2a b Deductons under secton 48 Cost of acquston wthout ndexaton b Cost of mprovement wthout ndexaton Expendture wholly and exclusvely n connecton wth transfer v Total ( + + ) c Balance (2a bv) d Loss to be dsallowed u/s 94(7) or 94(8)- for example f asset bought/acqured wthn 3 months pror to record date and dvdend/ncome/bonus unts are receved, then loss arsng out of sale of such asset to be gnored (Enter postve value only) e Short-term captal gan on equty share or equty orented MF (STT pad) (2c +2d) For NON-RESDENT, not beng an F- from sale of shares or debentures of an ndan company (to be computed wth foregn exchange adjustment under frst provso to secton 48) a STCG on transactons on whch securtes transacton tax (STT) s pad b STCG on transactons on whch securtes transacton tax (STT) s not pad 4 For NON-RESDENT- from sale of securtes (other than those at A2) by an F as per secton 115AD a Full value of consderaton b Deductons under secton 48 Cost of acquston wthout ndexaton b Cost of mprovement wthout ndexaton Expendture wholly and exclusvely n connecton wth transfer v Total ( + + ) c Balance (4a bv) d Loss to be dsallowed u/s 94(7) or 94(8)- for example f securty bought/acqured wthn 3 months pror to record date and dvdend/ncome/bonus unts are receved, then loss arsng out of sale of such securty to be gnored (Enter postve value only) e Short-term captal gan on sale of securtes by an F (other than those at A2) (4c +4d) 5 From sale of assets other than at A1 or A2 or A3 or A4 above a Full value of consderaton b Deductons under secton 48 Cost of acquston wthout ndexaton b Cost of mprovement wthout ndexaton Expendture wholly and exclusvely n connecton wth transfer v Total ( + + ) c Balance (5a bv) d n case of asset (securty/unt) loss to be dsallowed u/s 94(7) or 94(8)- for example f asset bought/acqured wthn 3 months pror to record date and dvdend/ncome/bonus unts are receved, then loss arsng out of sale of such asset to be gnored (Enter postve value only) e STCG on assets other than at A1 or A2 or A3 or A4 above (5c + 5d) 6 Amount deemed to be short term captal gans a Whether any amount of unutlzed captal gan on asset transferred durng the prevous years shown below was deposted n the Captal Gans Accounts Scheme wthn due date for that year? Yes t applcable. f yes, then provde the detals below Sl. Prevous year Secton under whch n whch asset deducton clamed n transferred that year D/54G/54GA New asset acqured/constructed Year n whch asset acqured/constructed b b bv 2c 2d 4a b b bv 4c 4d 5a b b bv 5c 5d Amount utlsed out of Captal Gans account Amount not used for new asset or remaned unutlzed n Captal gans account (X) A2e A3a A3b A4e A5e B b Amount deemed to be short term captal gans, other than at a Total amount deemed to be short term captal gans (ax + bx + b) 7 FOR NON-RESDENTS- STCG ncluded n A1-A6 but not chargeable to tax n nda as per DTAA Country name, Whether Tax Resdency tem no. A1 to A6 above n Amount of Sl. Artcle of DTAA code Certfcate obtaned? whch ncluded STCG A1e/A2e/A3a/A3b/A4e/A5e/A 6 A1e/A2e/A3a/A3b/A4e/A5e/A 6 Total amount of STCG not chargeable to tax n nda as per DTAA 8 Total Short-term Captal Gan (A1e+ A2e+ A3a+ A3b+ A4e+ A5e+A6-A7) A8 A6 A7 Page S3

8 Long-term Captal Gans B Long-term captal gan (LTCG) (tems 4, 5 6, & 9 are not applcable for resdents) 1 From sale of land or buldng or both a Full value of consderaton receved/recevable a Value of property as per stamp valuaton authorty Full value of consderaton adopted as per secton 50C for the purpose of Captal Gans (a or a) b Deductons under secton 48 Cost of acquston wth ndexaton b Cost of mprovement wth ndexaton Expendture wholly and exclusvely n connecton wth transfer v Total (b + b + b) c Balance (a bv) Deducton under secton 54/54B/54EC/54EE/54F/54GB (Specfy detals n tem D d below) e Long-term Captal Gans on mmovable property (1c - 1d) 2 From sale of bonds or debenture (other than captal ndexed bonds ssued by Government) a Full value of consderaton 2a b Deductons under secton 48 Cost of acquston wthout ndexaton Cost of mprovement wthout ndexaton Expendture wholly and exclusvely n connecton wth transfer v Total (b + b +b) c Balance (2a bv) d Deducton under sectons 54EC/54EE/54F (Specfy detals n tem D below) e LTCG on bonds or debenture (2c 2d) a a b b bv 1c 1d b b b bv 2c 2d B1e B2e 3 From sale of, () lsted securtes (other than a unt) or zero coupon bonds where provso under secton 112(1) s applcable () GDR of an ndan company referred n sec. 115ACA 4 a Full value of consderaton 3a b Deductons under secton 48 Cost of acquston wthout ndexaton b Cost of mprovement wthout ndexaton b Expendture wholly and exclusvely n connecton wth transfer b v Total (b + b +b) bv c Balance (3a bv) 3c d Deducton under sectons 54EC/54EE/54F (Specfy detals n tem D below) 3d e Long-term Captal Gans on assets at B3 above (3c 3d) B3e For NON-RESDENTS- from sale of shares or debenture of ndan company (to be computed wth foregn exchange adjustment under frst provso to secton 48) a LTCG computed wthout ndexaton beneft 4a b Deducton under sectons 54EC/54EE/54F (Specfy detals n tem D below) 4b c LTCG on share or debenture (4a-4b) B4c For NON-RESDENTS- from sale of, () unlsted securtes as per sec. 112(1)(c), () bonds or GDR as referred n 5 sec. 115AC, () securtes by F as referred to n sec. 115AD a Full value of consderaton 5a b Deductons under secton 48 Cost of acquston wthout ndexaton Cost of mprovement wthout ndexaton Expendture wholly and exclusvely n connecton wth transfer v Total (b + b +b) c Balance (5a bv) 5c d Deducton under sectons 54EC/54EE/54F (Specfy detals n tem D below) 5d e Long-term Captal Gans on assets at 5 above n case of NON-REESDENT (5c 5d) B5e 6 From sale of foregn exchange asset by NON-RESDENT NDAN (f opted under chapter X-A) a LTCG on sale of specfed asset (computed wthout ndexaton) 6a b Less deducton under secton 115F (Specfy detals n tem D below) 6b c Balance LTCG on sale of specfed asset (6a 6b) B6c d LTCG on sale of asset, other than specfed asset (computed wthout ndexaton) 6d e Less deducton under secton 115F (Specfy detals n tem D below) 6e f Balance LTCG on sale of asset, other than specfed asset (6d 6e) B6f 7 From sale of assets where B1 to B6 above are not applcable b b b bv Page S4

9 a Full value of consderaton 7a b Deductons under secton 48 Cost of acquston wth ndexaton b Cost of mprovement wth ndexaton Expendture wholly and exclusvely n connecton wth transfer v Total (b + b +b) c Balance (7a bv) 7c d Deducton under sectons 54EC/54EE/54F (Specfy detals n tem D below) 7d e Long-term Captal Gans on assets at B7 above (7c-7d) B7e 8 Amount deemed to be long-term captal gans a Whether any amount of unutlzed captal gan on asset transferred durng the prevous year shown below was deposted n the Captal Gans Accounts Scheme wthn due date for that year? b b bv Sl. Yes Prevous year t n applcable. Secton under f yes, whch then provde New asset the detals acqured/constructed below whch asset deducton clamed n Year n whch asset Amount utlsed transferred that year acqured/constructed out of Captal Gans account /54D/54F/54G/54GA Amount not used for new asset or remaned unutlzed n Captal gans account (X) B b Amount deemed to be long-term captal gans, other than at a Total amount deemed to be long-term captal gans (ax + ax + b) 9 FOR NON-RESDENTS- LTCG ncluded n B1- B8 but not chargeable to tax n nda as per DTAA B8 Sl. Country name, Artcle of DTAA code Total amount of LTCG not chargeable to tax as per DTAA Whether Tax Resdency tem B1 to B8 above n whch Certfcate obtaned? ncluded B1e/B2e/B3e/ B4c/ B5e/B6c/B6f/B7e/B8 B1e/B2e/B3e/ B4c/ B5e/B6c/B6f/B7e/B8 Amount of LTCG 10 Total long term captal gan chargeable under.t. Act [B1e +B2e +B3e + B4c + B5e +B6c+ B6f+ B7e+ B8 - B9] (n case of loss take the fgure to 5x of schedule CFL) C ncome chargeable under the head CAPTAL GANS (A8 + B10) (take B10 as nl, f loss) (f C s negatve, take the fgure to 4x of schedule CFL and f t s postve, take the fgure to respectve row n tem E) D nformaton about deducton clamed 1 n case of deducton u/s 54/54B/54EC/54EE/54F/54GB/115F gve followng detals a Secton under whch deducton clamed 1a amount of deducton Cost of new asset a Date of ts acquston/constructon a dd/mm/yyyy Amount deposted n Captal Gans Accounts a Scheme before due date b Secton under whch deducton clamed 1b amount of deducton Cost of new asset b Date of ts acquston/constructon b dd/mm/yyyy Amount deposted n Captal Gans Accounts Scheme before due date c Total deducton clamed (1a + 1b) 2 n case of deducton u/s 54GB, furnsh PAN of the company b 1c E Set-off of current year captal losses wth current year captal gans (excludng amounts ncluded n A7 & B9 whch s chargeable under DTAA) Sl. Type of Captal Gan Gan of current year (Fll ths column only f computed fgure s postve) Loss to be set off (Fll ths row f computed fgure s negatve) 15% (A2e+A3a) Short term 30% A4e captal gan v applcable rate (A1e+A3b+A5e+ v Long term 10% (B3e+ A6) B5e+B6c) captal gan v 20% (B1e+B2e+B4c+ B6f+ B7e+B8) Short term captal loss set off Long term captal loss set off 15% 30% applcable rate 10% 20% B9 B10 C Current year s captal gans remanng after set off (7= ) (A2e+A3a) A4e (A1e+A3b+ A5 +A6) (B3e+ B5e+B6c) (B1e+B2e+ B4c+ B6f+ B7e+B8) Page S5

10 OTHER SOURCES v Total loss set off ( + + v + v + v) F v Loss remanng after set off ( v) nformaton about accrual/recept of captal gan Type of Captal gan / Date 1 Short-term captal gans taxable at the rate of 15% Enter value from tem 3 of schedule BFLA, f any. 2 Short-term captal gans taxable at the rate of 30% Enter value from tem 3v of schedule BFLA, f any. 3 Short-term captal gans taxable at applcable rates Enter value from tem 3v of schedule BFLA, f any. 4 Long- term captal gans taxable at the rate of 10% Enter value from tem 3v of schedule BFLA, f any. 5 Long- term captal gans taxable at the rate of 20% Enter value from tem 3v of schedule BFLA, f any. Upto 15/6 () 16/6 to 15/9 () 16/9 to 15/12 () NOTE Please nclude the ncome of the specfed persons referred to n Schedule SP whle computng the ncome under ths head 16/12 to 15/3 (v) 16/3 to 31/3 (v) Schedule OS ncome from other sources 1 ncome a Dvdends, Gross b nterest, Gross c Rental ncome from machnery, plants, buldngs, etc., Gross d Others, Gross (excludng ncome from ownng race horses)menton the nature Wnnngs from lotteres, crossword puzzles etc. a Cash credts u/s 68 b Unexplaned nvestments u/s 69 c Unexplaned money etc. u/s 69A d Undsclosed nvestments etc. u/s 69B e Unexplaned expendturte etc. u/s 69C f Amount borrowed or repad on hund u/s 69D Total (a + b + c + d + e + f) v v Total (1d + 1d+ 1d + 1dv) e Total (1a + 1b + 1c + 1dv) f ncome ncluded n 1e chargeable to tax at specal rate (to be taken to schedule S) ncome by way of wnnngs from lotteres, crossword puzzles, races, games, gamblng, bettng etc (u/s 115BB) Dvdend ncome from domestc company that exceeds Rs.10 Lakh (u/s 115BBDA Deemed ncome chargeable to tax u/s 115BBE 1a 1b 1c 1d 1d 1d 1 dv 1dv 1e 1f 1f 1f v ncome from patent chargeable u/s 115BBF v Any other ncome chargeable to tax at the rate specfed under Chapter X/X-A v FOR NON-RESDENTS- ncome chargeable to be taxed under DTAA Sl. Country Artcle Rate of tax Whether TRC Correspondng secton of the Amount of name, code of DTAA under DTAA obtaned? Act whch prescrbes rate ncome Total amount of ncome chargeable to tax under DTAA v ncome ncluded n 1e chargeable to tax at specal rate (1f +1f + 1f+fv+fv+fv) g Gross amount chargeable to tax at normal applcable rates (1e-1fv) h Deductons under secton 57 (other than those relatng to ncome under 1f, 1f, 1f, 1fv, 1fv, & 1fv for non-resdents) Expenses / Deductons h Deprecaton h Total h ncome from other sources (other than from ownng race horses and amount chargeable to tax at 1 specal rate) (1g h) (f negatve take the fgure to 3 of schedule CYLA) 2 ncome from other sources (other than from ownng race horses) (1fv + 1) (enter 1 as nl, f negatve) 2 1fv 1fv 1fv 1fv 1g 3 ncome from the actvty of ownng and mantanng race horses a Recepts 3a b Deductons under secton 57 n relaton to (4) 3b Page S6

11 CARRY FORWARD OF LOSS BROUGHT FORWARD LOSS ADJUSTMENT CURRENT YEAR LOSS ADJUSTMENT c Balance (3a 3b) (f negatve take the fgure to 4x of Schedule CFL) 3c 4 ncome under the head ncome from other sources (2 + 3c) (take 3c as nl f negatve) 4 NOTE Please nclude the ncome of the specfed persons referred to n Schedule SP whle computng the ncome under ths head. Schedule CYLA Sl. Head/ Source of ncome Detals of ncome after Set off of current year losses ncome of current year (Fll ths column only f ncome s zero or postve) House property loss of the current year set off Busness Loss Other sources loss (other than loss from race horses) of the current year set off Current year s ncome remanng after set off = Loss to be set off (3b of Schedule HP) (6 of Schedule BP) (1 of Schedule-OS) Salares (6 of Schedule S) House property (3b of Schedule HP) v Busness or professon (4v of Schedule BP) Short-term captal gan v 15% Short-term captal gan v 30% Short-term captal gan taxable at v applcable rates Long term captal gan v 10% Long term captal gan x 20% Other sources (excludng proft from x ownng race horses and amount chargeable to specal rate of tax) Proft from ownng and mantanng x race horses x (7 of tem E of schedule CG) (7 of tem E of schedule CG) (7v of tem E of schedule CG) (7v of tem E of schedule CG) (7v of tem E of schedule CG) (1 of schedule OS) (3c of schedule OS) Total loss set off ( + + v + v + v + v + v + x + x + x) x Loss remanng after set-off ( - x) Schedule BFLA Sl.. Detals of ncome after Set off of Brought Forward Losses of earler years Head/ Source of ncome ncome after set off, f any, of current year s losses as per 4 of Schedule CYLA) Salares (5 of schedule CYLA) Brought forward loss set off Current year s ncome remanng after set off House property (5 of schedule CYLA) (B/f house property loss) Busness or professon (5v of schedule CYLA) (B/f busness loss) v Short-term captal gan 15% (5v of schedule CYLA) (B/f short-term captal loss) v Short-term captal gan 30% (5v of schedule CYLA) (B/f short-term captal loss) v Short-term captal gan taxable at applcable rates (5v of schedule CYLA) (B/f short-term captal loss) v Long-term captal gan 10% (5v of schedule CYLA) (B/f short-term or long-term captal loss) v Long term captal gan 20% (5x of schedule CYLA) (B/f short-term or long-term captal loss) Other sources (excludng proft from x ownng race horses and wnnngs from (5x of schedule CYLA) lottery, game etc.) x Proft from ownng and mantanng race horses (5x of schedule CYLA) (B/f loss from horse races) x Total of brought forward loss set off ( v2 + v2+v2+v2+x2+x2) x Current year s ncome remanng after set off Total ( v3 + v3+ v3+ v3 + v3+ x3+ x3 + x3) Schedule CFL Detals of Losses to be carred forward to future years Assessment Year Date of Flng (DD/MM/YYYY) House property loss Busness or professon loss Short-term captal loss Long-term Captal loss Loss from ownng and mantanng race horses Page S7

12 DETALS OF DONATONS TOTAL DEDUCTONS 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 (2 of schedule BFLA) (2x of schedule CYLA) (2 of schedule BFLA) (3x of schedule CYLA) ((2v+3v+4v) of tem E of schedule CG) ((5v+6v)of tem E of schedule CG) (2x of schedule BFLA) (3c of schedule OS, f ve) Schedule V-A Deductons under Chapter V-A 1 Part B- Deducton n respect of certan payments a 80C b 80CCC c 80CCD(1) d 80CCD(1B) e 80CCD(2) f 80CCG g 80D h 80DD 80DDB j 80E k 80EE l 80G m 80GG n 80GGA o 80GGC 2 Part C, CA and D- Deducton n respect of certan ncomes/other deducton p 80QQB r 80TTA q 80RRB s 80U t Total deductons under Chapter V-A (Total of a to s) t Schedule 80G A B C D Detals of donatons enttled for deducton under secton 80G Donatons enttled for 100% deducton wthout qualfyng lmt address of donee PAN of Donee Amount of donaton Total Donatons enttled for 50% deducton wthout qualfyng lmt address of donee PAN of Donee Amount of donaton Total Donatons enttled for 100% deducton subject to qualfyng lmt address of donee PAN of Donee Amount of donaton Total Donatons enttled for 50% deducton subject to qualfyng lmt address of donee PAN of Donee Amount of donaton Elgble Amount of donaton Elgble Amount of donaton Elgble Amount of donaton Elgble Amount of donaton Page S8

13 PASS THROUGH NCOME EXEMPT NCOME SPECAL RATE Total E Total donatons (A + B + C + D) ncome of specfed persons (spouse, mnor chld etc.) ncludable n ncome of the assessee (ncome of the mnor chld, n excess Schedule SP of Rs. 1,500 per chld, to be ncluded) Sl Name of person PAN of person (optonal) Relatonshp Nature of ncome Amount (Rs) Schedule S ncome chargeable to tax at specal rates (please see nstructons. 9 for rate of tax) Sl Secton Specal rate (%) ncome 1 111A (STCG on shares unts on whch STT pad) 15 (3v of schedule BFLA) 2 115AD (STCG for Fs on securtes where STT not pad) 30 (3v of schedule BFLA) provso (LTCG on lsted securtes/ unts wthout ndexaton) 10 (part of 3v of schedule BFLA) 4 112(1)(c)() (LTCG for non-resdent on unlsted securtes) 10 (part of 3v of schedule BFLA) 5 115AC (LTCG for non-resdent on bonds/gdr) 10 (part of 3v of schedule BFLA) 6 115ACA (LTCG for an employee of specfed companay on GDR) 10 (part of 3v of schedule BFLA) 7 115AD (LTCG for Fs on securtes) 10 (part of 3v of schedule BFLA) 8 115E (LTCG for non-resdent ndan on specfed asset) 10 (part of 3v of schedule BFLA) (LTCG on others) 20 (3v of schedule BFLA) BB (Wnnngs from lotteres, puzzles, races, games etc.) 30 (1f of schedule OS) BBDA (Dvdend ncome from domestc company exceedng Rs.10lakh) 10 (1f of schedule OS) BBE (ncome under secton 68, 69, 69A, 69B, 69C or 69D) 60 (1f of schedule OS) BBF (Tax on ncome from patent) 10 (1fv of schedule OS) 115AC (ncome of a non-resdent from bonds or GDR purchased n foregn 14 currency) 10 (part of 1fv of schedule OS) 15 Chargeable under DTAA rate (part of 1fv of schedule OS) Total Tax thereon Schedule E Detals of Exempt ncome (ncome not to be ncluded n Total ncome) 1 nterest ncome 1 2 Dvdend ncome from domestc company (amount not exceedng Rs. 10 lakh) 2 3 Long-term captal gans from transactons on whch Securtes Transacton Tax s pad 3 4 Gross Agrcultural recepts (other than ncome to be excluded under rule 7A, 7B or 8 of.t. Rules) Expendture ncurred on agrculture Unabsorbed agrcultural loss of prevous eght assessment years v Net Agrcultural ncome for the year ( ) (enter nl f loss) 4 5 Others, ncludng exempt ncome of mnor chld 5 6 Total ( ) 6 Schedule PT Pass Through ncome detals from busness trust or nvestment fund as per secton 115UA, 115UB Sl. Name of busness trust/ PAN of the busness Sl. Head of ncome Amount of ncome TDS on such nvestment fund trust/ nvestment fund amount, f any 1. House property Captal Gans a Short term b Long term Other Sources v ncome clamed to be exempt a u/s 10(23FBB) b u/s.. c u/s 2. House property Captal Gans a Short term b Long term Other Sources Page S9

14 DETALS OF FOREGN ASSETS NOTE Please refer to the nstructons for fllng out ths schedule. v ncome clamed to be exempt a u/s 10(23FBB) b u/s.. c u/s Schedule FS Sl. Country Code Taxpayer dentfcaton Number Detals of ncome from outsde nda and tax relef Sl. Head of ncome ncome from outsde nda (ncluded n PART B-T) Tax pad outsde nda Tax payable on such ncome under normal provsons n nda Tax relef avalable n nda (e)= (c) or (d) whchever s lower Relevant artcle of DTAA f relef clamed u/s 90 or 90A (a) (b) (c) (d) (e) (f) 1 Salary House Property Busness or Professon v Captal Gans v Other sources 2 Salary House Property Busness or Professon v Captal Gans v Other sources Total NOTE Total Please refer to the nstructons for fllng out ths schedule. Schedule TR 1 Summary of Tax relef clamed Country Code Summary of tax relef clamed for taxes pad outsde nda Taxpayer dentfcaton Number Total taxes pad outsde nda (total of (c) of Schedule FS n respect of each country) Total tax relef avalable (total of (e) of Schedule FS n respect of each country) Tax Relef Clamed under secton (specfy 90, 90A or 91) (a) (b) (c) (d) (e) Total 2 Total Tax relef avalable n respect of country where DTAA s applcable (secton 90/90A) (Part of total of 1(d)) 2 3 Total Tax relef avalable n respect of country where DTAA s not applcable (secton 91) (Part of total of 1(d)) 3 4 Whether any tax pad outsde nda, on whch tax relef was allowed n nda, has been refunded/credted by the foregn tax authorty durng the year? f yes, provde the detals below NOTE a Amount of tax refunded Please refer to the nstructons for fllng out ths schedule. b Assessment year n whch tax relef allowed n nda 4 Yes/ Schedule FA Detals of Foregn Assets and ncome from any source outsde nda A Detals of Foregn Bank Accounts held (ncludng any benefcal nterest) at any tme durng the prevous year Sl Country Code Address of the Bank Account holder name Status- Owner/ Benefcal owner/ Benefcary Account Number Account openng date Peak Balance Durng the Year (n rupees) nterest accrued n the account nterest taxable and offered n ths return Amount Schedule where offered tem number of schedule (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) () () B Detals of Fnancal nterest n any Entty held (ncludng any benefcal nterest) at any tme durng the prevous year Page S10

15 Sl Country Nature of code entty Address of the Entty Nature of nterest- Drect/ Benefcal owner/ Benefcary Date snce held Total nvestment (at cost) (n rupees) ncome Nature of accrued from ncome such nterest ncome taxable and offered n ths return Amount Schedule where offered tem number of schedule (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) () () C Detals of mmovable Property held (ncludng any benefcal nterest) at any tme durng the prevous year Sl Address of the Property Date of acquston Nature of ncome ncome taxable and offered n ths return Amount Country code Ownershp- Drect/ Benefcal owner/ Benefcary Total nvestment (at cost) (n rupees) ncome derved from the property Schedule where offered tem number of schedule (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) () () D Detals of any other Captal Asset held (ncludng any benefcal nterest) at any tme durng the prevous year Sl Nature of Asset Date of acquston Nature of ncome ncome taxable and offered n ths return Amount Country code Ownershp- Drect/ Benefcal owner/ Benefcary Total nvestment (at cost) (n rupees) ncome derved from the asset Schedule where offered tem number of schedule (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) () () E Detals of account(s) n whch you have sgnng authorty held (ncludng any benefcal nterest) at any tme durng the prevous year and whch has not been ncluded n A to D above. Sl Account Number f (7) s yes, ncome offered n ths return Amount Name of the nsttuton n whch the account s held Address of the nsttuton Name of the account holder Peak Balance/ nvestment durng the year (n rupees) Whether ncome accrued s taxable n your hands? f (7) s yes, ncome accrued n the account Schedule where offered tem number of schedule (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) () () F Detals of trusts, created under the laws of a country outsde nda, n whch you are a trustee, benefcary or settlor Sl f (8) s yes, ncome offered n ths return Amount Country code address of the trust address of trustees address of Settlor address of Benefcares Date snce poston held Whether ncome derved s taxable n your hands? f (8) s yes, ncome derved from the trust Schedule where offered tem number of schedule (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) () () G Sl Detals of any other ncome derved from any source outsde nda whch s not ncluded n,- () tems A to F above and, () ncome under the head busness or professon f (6) s yes, ncome offered n ths return Country Name address of the Whether taxable ncome derved Nature of ncome and code person from whom derved n your hands? Amount Schedule where offered tem number of schedule (1) (2) (3) (4) (5) (6) (7) (8) (9) () () NOTE Please refer to nstructons for fllng out ths schedule. n case of an ndvdual, not beng an ndan ctzen, who s n nda on a busness, employment or student vsa, an asset acqured durng any prevous year n whch he was non-resdent s not mandatory to be reported n ths schedule f no ncome s derved from that asset durng the current prevous year. Schedule 5A nformaton regardng apportonment of ncome between spouses governed by Portuguese Cvl Code Name of the spouse PAN of the spouse Page S11

16 DETALS OF ASSETS AND LABLTES Heads of ncome 1 House Property 2 Busness or professon 3 Captal gans 4 Other sources 5 Total ncome receved under the head Amount apportoned n the hands of the spouse Amount of TDS deducted on ncome at () TDS apportoned n the hands of spouse () () () (v) (v) Schedule AL Asset and Lablty at the end of the year (applcable n a case where total ncome exceeds Rs.50 lakh) A Detals of mmovable asset Sl. Descrpton Address Amount (cost) n Rs.. (1) (2) (3) (4) () () B Detals of movable asset Sl. Descrpton Amount (cost) n Rs.. (1) (2) (3) () Jewellery, bullon etc. Archaeologcal collectons, drawngs, pantng, sculpture or any work of art () () Vehcles, yachts, boats and arcrafts (v) Fnancal asset (a) Bank (ncludng all deposts) (b) Shares and securtes (c) nsurance polces (d) Loans and advances gven (e) Cash n hand Amount (cost) n Rs. C nterest held n the assets of a frm or assocaton of persons (AOP) as a partner or member thereof Sl. address of the frm(s)/ AOP(s) PAN of the frm/ AOP Assessee s nvestment n the frm/ AOP on cost bass. (1) (2) (3) (4) () () D Lablty n relaton to Assets at (A + B + C) NOTE Please refer to nstructons for fllng out ths schedule. Page S12