INDIAN INCOME TAX RETURN VERIFICATION FORM

Transcription

1 ., 2 O PERSONAL INFO RMATION AND THE DATE OF ELECTRONIC TRANSMISSION i4 1:4 F. z ap ITR-V Name t.,) 4 INDIAN INCOME TAX RETURN VERIFICATION FORM 'Where the data of the Return of Income in Benefits in Form (ITR-1 (SAHAJ), ITR-2, ITR-3, ITR-4, ITR-4S (SUGAM), ITR-5, ITR-6 transmitted electronically without digital PRATIK PRAKASH PATIL. Flat/Door/Block No PLOT NO 81/82. 0 i_, Road/Street/Post Office ta 59, MADHAVNAGAR ROAD signature'. (Please see Rule 12 of the Income-tax Rules, 1962) Name Of Premises/Building/Village SHIVAJ1 HOUSING SOCIETY Area/Locality OPPOSITE VSSSK Ltd PAN ABPPP5827N Form No. which has been electronically transmitted (fill the code) Town/City/District State Pin Status (fill the SANGLI MAHARASHTRA code) Designation of AO (Ward / Circle) ITO WD 2(1), SANGLI/PNE/W/95/1 Assessment Year Original or Revised E-fi ing Acknowledgement Number Date(DD/MM/YYYY) ITR-2 INDL Original 1 Gross total income Deductions under Chapter-V1-A w 0 z (...) p.. g w 0 64 z i-. T2 -t E-, i n 4 E 't O (..) 3 Total Income a Current Year loss, if any 3a 0 4 Net tax payable Interest payable Total tax and interest payable Taxes Paid. a Advance Tax 7a 0 b TDS 7b c TCS 7c d Self Assessment Tax 7d 0 e Total Taxes Paid (7a+7b+7c +71I) 7e Tax Payable (6-7d)' Refund (7e-6) VERIFICATION I, Pratik Prakash Patil son/ daughter of Prakash Patil, holding permanent account number ABPPP5827N solemnly declare to the best of my knowledge and belief, the information given in the return and the schedules thereto which have been transmitted electronically by me vide acknowledgement number mentioned above is correct and complete and that the amount of total income/ fringe benefit's and other particulars shown therein are truly stated and are in accordance with the provisions of the Income-tax Act, 1961, in respect of income and fringe benefits chargeable to income-tax for the previous year relevant to the assessment year I further declare that I am making this return in my capacity as and I am also competent to make this return and verify it. Sign here,. ;1 3, L1 Date Place Sangli If the return has been prepared by a Tax Return Preparer (TRP) give further details as below: Identification No. of TRP Name of TRP Counter Signature of TRP For Office Use Only Receipt No Date Seal and signature of receiving official Filed from IP address ,I. II.1. c en D!,.. i... ErV 112 1,p.. :14... '7.... L. ABPPP5827NO C9A A017C BC FCD 111 Please furnish Form ITR-V to "Income Tax Department - CPC, Post Bag No - 1, Electron'c City Post Office, Bangalore , Karnataka", by ORDINARY POST ONLY within 120 days from date of transmitting the data electronically. Form ITR-V shall not be received in any other office of the Income-tax Department or in any other manner. The receipt of this ITR-V at ITD-CPC will be sent to you at this address sachinpatil@pcpatil.com

2 DECLARATION OF ASSETS AND LIABILITIES FORM 1 A. ASSETS AND LIABILITIES OF MEMBER Name of the Member PRATIK PRAKASHBAPU PATIL Father's Name Late Shri Prakashrao Vasantrao Patil Permanent Address 'Shri Sai' Shivaji Housing Society, Madhavnagar Road, Opp. VSSSK, SANGLI (Maharashtra) Delhi Address AB-77, Shahjahan Road, New Delhi Party affiliation Indian National Congress Date of Election 16th May Date of taking oath/making affirmation in the House in Lok Sabha: 2nd June 2009 Date of taking oath as 28th May 2009 Minister of State in Union Cabinet

3 DETAILS OF IMMOVABLE PROPERTIES Name of the State, District, Sub-division and village in which property is situated Details of property (a) Agricultural Lands and present Value (b)non agricultural Lands and present value 1 Hector and 63 R At: Kavalapur, Survey No. 1836, 1839, 1840, 1889 Rs: 5.20 lakhs Open Plot : Shivaji Housing Society Plot No Sq ft. Rs lakhs (3) Venkatesh House Flat No. S-1 (City Survey No Sq. M. Rs lakhs (4) Kolhapur Kasaba Babda City Survey No. 828/1, 829/1 Bungalow No. RB 5 (Tirth Garden Area) Sq. M. Rs lakhs (5) Property in name of Wife 1) Bhose Mulubai Estate, Taluka Mahabaleshwar, and present Value District : Satara (Maharashtra) Survey No. 24/4, Plot No. 6, Area Sq. M. (in the Plot 95 Sq Mtr Built-up Area Rs lakhs 2) Pangari Nandanvan Colony, Taluka Mahabaleshwar, District: Satara (Maharashtra) Survey No. 15 Plot No. C- 138 (Area 278 Sq Mtr.) (in the Plot Sq. M. Built-up Area) Rs lakhs

4 DETAILS OF MOVABLE PROPERTIES 1) Cash in Hand Rs. 2,50,000/- 2) Cash in Wife's Hand Rs. 1,00,000/- 3) Deposits in Banks NIL 4) Deposits in Wife's Name Rs. 5,15,000/- 5) Shares in Sahyadri Motors Rs. 62,57,500/- in the name of wife Deposits in companies Rs. 8,43,096/- Others LIC & MEDICALIM Rs. 6,43,491/- (Yearly installment) Vehicles Ford (Fiesta) Make 2006 Rs. 7,48,000/- Maruti Swift Make 2007 Rs. 5,44,000/- ( WIFE) Tata Winger Make 2008 Rs. 6,95,000/- 8) Jewelery (self) Gold Rs. 11, /- Silver Rs. 2, 23,000/- in name of Wife Gold Rs. 18,00,000/- Silver Rs. 1,56,000/- in name of Elder Son Gold Rs. 2,50,000/- in name of Younger Son Gold Rs. 1,60,000/-

5 Details of Liabilities of the member to public Financial Institutions / Central Government and State Government 1) Bank Loan (for Car Loan). Sangli Sangli 2) Loan from Finance Co. (in the name of Wife) State Bank of India, Shivaji Nagar, Rs. 3,00,876/- State. Bank of India, Ganapati Peth, Rs. 4,42,648/- Mahindra Finance Ltd., Rs. 96,434/- I have been submitting the Income Tax Returns regularly. My PAN No. is ABPPP5827N. The latest income tax return or the financial year is enclosed. DECLARATION I, Pratik Prakashbapu Patil hereby declare that the information given above in true and correct to the best of my knowledge and belief. In the event of any change in the information given above. undertake to intimate the Speaker as provided under the rules. Yours faithfully, Date 27th Aug 2011 (Pratik Prakashbapu Patil)