Flat/Door/Block No Name Of Premises/Building/Village Date of formation/incorporation (DD/MM/YYYY) / /

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1 FILING STATUS PERSONAL INFORMATION FORM ITR-7 INDIAN INCOME TAX RETURN [For persons ncludng companes requred to furnsh return under sectons 139(4A) or 139(4B) or 139(4C) or 139(4D) or 139(4E) or 139(4F)] (Please see rule 12 of the Income-tax Rules,1962) (Also see attached nstructons for gudance) Assessment Year Part A-GEN Name (as mentoned n deed of creaton/ establshng/ ncorporaton/ formaton) PAN Flat/Door/Block No Name Of Premses/Buldng/Vllage Date of formaton/ncorporaton (DD/MM/YYYY) / / Road/Street/Post Offce Area/Localty Status (see nstructons para 11b) Town/Cty/Dstrct State Pn code Offce Phone Number wth STD code/moble No. 1 Fax Number/Moble No. 2 Income Tax Ward/Crcle Emal Address 1 Emal Address 2 Detals of the projects/nsttutons run by you Sl. Name of the project/nsttuton Nature of actvty (see nstructon para 11d) Classfcaton (see nstructons para 11d) Approval/ Notfcaton/ Regstraton No. Approvng/ regsterng Authorty Secton under whch exempton clamed, f any (see nstructon para 11e) (a) Return fled[please see nstructon no.-6] 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 In response to notce u/s 139(9)- defectve, 142(1), 148, 153A, 153C (b) Return furnshed under secton 139(4A) 139(4B) 139(4C) 139(4D) 139(4E) 139(4F) (c) (d) If revsed/n response to defectve/modfed, then enter Recept No. and Date of flng orgnal return (DD/MM/YYYY) If 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 (e) Resdental status? (Tck) Resdent Non-resdent (f) (g) / / / / Whether any ncome ncluded n total ncome for whch for whch clam under secton 90/90A/91 has been made? Yes No [applcable n the case of resdent] [f yes, ensure to fll Schedule FSI and Schedule TR] Whether any transacton has been made wth a person located n a jursdcton notfed u/s 94A of the Act? Yes No (h) In the case of non-resdent, s there a permanent establshment (PE) n Inda (Tck) Yes No () For Offce Use Only Whether ths return s beng fled by a representatve assessee? (Tck) Yes No If yes, please furnsh followng nformaton - (1) Name of the representatve (2) Address of the representatve (3) Permanent Account Number (PAN) of the representatve For Offce Use Only Recept No. Date Seal and Sgnature of recevng offcal Page 1

2 OTHER DETAILS A Where, n any of the projects/nsttutons run by you, one of the chartable purposes s advancement of any other object of general publc utlty then,- a b whether there s any actvty n the nature of trade, commerce or busness referred to n provso to secton 2(15)? Yes No If yes, then percentage of recept from such actvty vs-à-vs total recepts % whether there s any actvty of renderng any servce n relaton to any trade, commerce or busness for any consderaton as referred to n provso to secton 2(15)? Yes No If yes, then percentage of recept from such actvty vs-à-vs total recepts % If a or b s YES, the aggregate annual recepts from such actvtes n respect of that nsttuton Sl. Name of the project/insttuton Amount of aggregate annual recepts from such actvtes a b B Unversty/ Educatonal Insttuton/ Hosptal/ Other Insttuton elgble for exempton u/s 10(23C)(ab), 10(23C)(ac) 10(23C)(ad) and 10(23C)(ae) Tck, f applcable Secton Name of the Unversty/ Educatonal Insttuton/ Hosptal/ Other Insttuton Aggregate annual recepts (Rs.) 10(23C)(ab) 10(23C)(ac) 10(23C)(ad) 10(23C)(ae) C Whether Regstered u/s 12A/12AA? Yes No If yes, then enter Regstraton No. Commssoner/Drector of Income-tax (Exemptons) who granted regstraton Date of Regstraton (DD/MM/YYYY) / / v Whether actvty s,- chartable, relgous or both? Please tck as applcable. D Whether approval obtaned under secton 35? Yes No If yes, then enter the relevant clause of secton 35 and Regstraton No. Date of Approval (DD/MM/YYYY) / / v Approvng Authorty v Whether research s,- Scentfc, Socal Scence or Statstcal? Please tck as applcable v In case of busness actvty n research, whether t s Incdental or Not ncdental? Please tck as applcable Whether approval obtaned u/s 80G? Yes No E F If yes, then enter Approval No. Date of Approval (DD/MM/YYYY) / / Is there any change n the objects/actvtes durng the Year on the bass of whch approval/regstraton was granted? Yes No If yes, date of such change (DD/MM/YYYY) / / G Whether a poltcal party as per secton 13A? (f yes, please fll schedule LA) Yes No If yes, then whether regstered? Yes No Page 2

3 MEMBER S INFORMATION AUDIT INFORMATION If yes, then enter regstraton number under secton 29A of the Representaton of People Act, 1951 H Whether an Electoral Trust? (f yes, please fll schedule ET) Yes No If yes, then enter approval number? Date of Approval (DD/MM/YYYY) / / I Whether regstered under Foregn Contrbuton (Regulaton) Act, 2010 (FCRA)? Yes No If yes, then enter Regstraton No. Date of Regstraton (DD/MM/YYYY) / / v a Total amount of foregn contrbuton receved durng the year, f any Rs. b Specfy the purpose for whch the above contrbuton s receved J Whether a busness trust regstered wth SEBI? Yes No If yes, then enter Regstraton No. Date of Regstraton (DD/MM/YYYY) / / K Whether lable to tax at maxmum margnal rate under secton 164? Yes No L Is ths your frst return? Yes No M Are you lable for audt under the Income-tax Act?(Tck) Yes No, If yes, furnsh followng nformaton- Secton under whch you are lable for audt (specfy secton). Please menton date of audt report. (DD/MM/YY) (see Instructon 6()) 12A N O a Name of the audtor sgnng the tax audt report 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 f Date of furnshng of the audt report / / (DD/MM/YYYY). If lable to audt under any Act other than the Income-tax Act, menton the Act, secton and date of furnshng the audt report? Act and secton (DD/MM/YY) Act and secton (DD/MM/YY) Partculars of persons who were members n the AOP on 31 st day of March, 2017 (to be flled by venture captal fund/nvestment fund) Percentage of share Aadhaar Number/ Enrolment Status S.No Name and Address PAN (f determnate) Id (f elgble for Aadhaar) (see nstructon) (1) (2) (3) (4) (5) (6) Part B TI STATEMENT OF INCOME FOR THE PERIOD ENDED ON 31 ST MARCH 2017 If regstered under secton 12A/12AA, fll out tems 1 to 7 1 Voluntary contrbuton formng part of corpus as per secton 11(1)(d) [(A + B) of schedule VC] 1 2 Voluntary Contrbutons other than corpus(c (A+B) of schedule VC) 2 3 Aggregate of ncome referred to n sectons 11 and 12 derved durng the prevous year excludng Voluntary contrbuton ncluded n 1 and 2 above (9 of Schedule AI) 3 Page 3

4 4 Applcaton of ncome for chartable or relgous purposes Amount appled to chartable or relgous purposes n Inda durng the prevous year - Revenue Account (24 of Schedule ER) Amount appled to chartable or relgous purposes n Inda durng the prevous year Captal Account [Excludng applcaton from Borrowed Funds] (8 of Schedule EC) 4 4 v Amount appled to chartable or relgous purposes n Inda durng the prevous year - Captal Account (Repayment of Loan) Amount deemed to have been appled to chartable or relgous purposes n Inda durng the prevous year as per clause (2) of Explanaton to secton 11(1) a If (v) above applcable, whether opton Form No. 9A has been furnshed to the Assessng Offcer b If yes, date of furnshng Form No. 9A (DD/MM/YYYY) 4 4v 4va 4vb v Amount accumulated or set apart for applcaton to 4v chartable or relgous purposes to the extent t does not exceed 15 per cent of ncome derved from property held n trust/ nsttuton under secton 11(1)(a)/11(1)(b) [restrcted to the maxmum of 15% of (2 + 3) above] v Amount n addton to amount referred to n (v) above, 4v accumulated or set apart for specfed purposes f all the condtons n secton 11(2) and 11(5) are fulflled (fll out schedule I) v Amount elgble for exempton under secton 11(1)(c) 4v a Approval number gven by the Board 4va b Date of approval by board 4vb v Total [ v+4v+4v+4v] 4v 5 Addtons Income chargeable under secton 11(1B) 5 Income chargeable under secton 11(3) 5 Income n respect of whch exempton under secton 11 s not avalable by vrtue of provsons of secton 13 a Beng anonymous donaton at D of schedule VC to the extent appled for chartable purpose b Other than (a) above v Income chargeable under secton 12(2) 5v v Total [ a+5b+5v] 5v 6 Income chargeable u/s 11(4) [as per tem no. E36 of Schedule BP] 6 7 Total (2+3-4v +5v+6) 7 8 Amount elgble for exempton under secton 10(21), 10(22B), 10(23A), 10(23B), 10(23C)(v), 10(23C)(v), 10(23C)(v), 10(23C)(va) 9 Amount elgble for exempton under secton 10(23C)(ab), 10(23C)(ac), 10(23C)(ad), 9 10(23C)(ae), 10(23D), 10(23DA), 10(23FB), 10(24), 10(46), 10(47) 10 Amount elgble for exempton under any clause, other than those at 8 and 9, of secton Income chargeable under secton 11(3) read wth secton 10(21) Income clamed/ exempt under secton 13A or 13B n case of a Poltcal Party or Electoral Trust (fll Schedule LA or ET) 13 Income not formng part of tem no. 7 & 11 above 5a 5b Income from house property [3b of Schedule HP] (enter nl f loss) 13 Profts and gans of busness or professon [as per tem no. E 35 of 13 schedule BP] Income under the head Captal Gans a Short term (A5 of schedule CG) 13a b Long term (B3 of schedule CG) (enter nl f loss ) 13b 12 Page 4

5 TAX LIABILITY c Total captal gans (13a +13b) (enter nl f loss ) 13c v Income from other sources [as per tem no. 4 of Schedule OS] 13v v Total ( c + 13v) 13v 14 Gross ncome [ v] Losses of current year to be set off aganst 13v (total of 2x, 3x and 4x of Schedule CYLA) Gross Total Income (14-15) Income chargeable to tax at specal rate under secton 111A, 112 etc. ncluded n Deducton u/s 10A or 10AA Deductons under chapter VIA (lmted to 16-17) Total Income [ ] Income whch s ncluded n 20 and chargeable to tax at specal rates (total of () of schedule 21 SI) 22 Net Agrcultural ncome for rate purpose Aggregate Income ( ) [applcable f (20-21) exceeds maxmum amount not 23 chargeable to tax] 24 Anonymous donatons, ncluded n 28, to be taxed under secton 30% (D of 24 schedule VC) 25 Income chargeable at maxmum margnal rates 25 Part B - TTI Computaton of tax lablty on total ncome 1a Tax Payable on deemed total Income under secton 115JB or 115JC as applcable (7 of 1 Schedule MAT/ 4 of Schedule AMT) 1b Surcharge on (a) above 1c Educaton Cess on (1a+1b) above 1d Total Tax Payable u/s 115JB or 115JC as applcable (1a+1b+1c) 2 Tax payable on total ncome a Tax at normal rates on ( ) of Part B-TI b Tax at specal rates (total of () of Schedule-SI) Tax on anonymous donaton u/s on 24 of Part c B-TI d Tax at maxmum margnal rate on 25 of Part B-TI e Rebate on agrcultural ncome [applcable f (20-21) of Part B-TI exceeds maxmum amount not chargeable to tax] f Tax Payable on Total Income (2a + 2b+2c+2d 2e) 3 Surcharge 25% of 5() of Schedule SI 3 On [(2f) (5() of Schedule SI)] Total ( + ) 4 Educaton cess, ncludng secondary and hgher educaton cess on (2f+3) 4 5 Gross tax lablty (2f+3+4) 5 6 Gross tax payable (hgher of 5 and 1d) 6 7 Credt under secton 115JAA/115JD of tax pad n earler years (f 5 s more than 1d) (5 of Schedule MATC/AMTC) 8 Tax payable after credt under secton 115JAA/115JD [ (6 7)] 8 9 Tax relef a Secton 90/90A (2 of Schedule TR) b Secton 91 (3 of Schedule TR) c Total (9a + 9b) 10 Net tax lablty (8 9c) Interest payable a For default n furnshng the return (secton 234A) 9a 9b 11a b For default n payment of advance tax (secton 234B) 11b c For deferment of advance tax (secton 234C) d Total Interest Payable (11a+11b+11c) 12 Aggregate lablty ( d) 12 11c 2a 2b 2c 2d 2e 3 1a 1b 1c 1d 2f 3 7 9c 11d Page 5

6 TCS ON INCOM E TDS ON INCOME ADVANCE/ SELF ASSESSMENT TAX B A TAXES PAID 13 Taxes Pad a Advance Tax (from column 5 of 18A) b TDS (total of column 8 of 18B) c TCS (total of column 7 of 18C) d Self-Assessment Tax (from column 5 of 18A) e Total Taxes Pad (13a+13b+13c + 13d) 14 Amount payable (Enter f 12 s greater than 13e, else enter 0) Refund(If 13e s greater than 12) (refund, f any, wll be drectly credted nto the bank account) Detals of all Bank Accounts held n Inda at any tme durng the prevous year (excludng dormant accounts) Sl. IFS Code of the Bank Name of the Bank 13a 13b 13c 13d Account Number (the number should be 9 dgts or more as per CBS system of the bank ) 13e Indcate 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) 17 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 Inda; or () have sgnng authorty n any account located outsde Inda; or Yes () have ncome from any source outsde Inda? [applcable only n case of a resdent] [Ensure Schedule FA s flled up f the answer s Yes ] No 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 the schedules, statements, etc. accompanyng t 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 ncome-tax for the prevous year relevant to the assessment year I further declare that I am makng ths return n my capacty as - and I am also competent to make ths return and verfy t. I 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 Date Sgn here 18 TAX PAYMENTS A B 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) No (1) (2) (3) (4) (5) v NOTE Enter the totals of Advance tax and Self-Assessment tax n Sl No. 13a & 13d of Part B-TTI Detals of Tax Deducted at Source (TDS) on Income [As per Form 16 A ssued by Deductor(s) or Form 26QB] Sl No TAN of the Deductor/ PAN of the Buyer Name of the Deductor Unque TDS Certfcate Number Unclamed TDS brought forward (b/f) TDS of the current fn. year Amount out of (6) or (7) beng Amount out of clamed ths Year (only f (6) or (7) beng correspondng ncome s beng carred offered for tax ths year) forward Fn. Year n Amount whch deducted b/f (1) (2) (3) (4) (5) (6) (7) (8) (9) C NOTE Please enter total of column (8) of Schedule-TDS n 13b of Part B-TTI Detals of Tax Collected at Source (TCS) [As per Form 27D ssued by the Collector(s)] Sl Name of the Collector Unclamed TCS brought No forward (b/f) Tax Deducton and Tax Collecton Account Number of the Collector Fn. Year n whch collected Amount b/f TCS of the current fn. year Amount out of (5) or (6) beng Amount out of clamed ths Year (only f (5) or (6) beng correspondng ncome s beng carred offered for tax ths year) forward Page 6

7 (1) (2) (3) (4) (5) (6) (7) (8) NOTE Please enter total of column (7) of Schedule-TCS n 13c of Part B-TTI NOTE: PLEASE FILL SCHEDULES TO THE RETURN FORM (S1 - S14) AS APPLICABLE Page 7

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