FORM ITR-3 INDIAN INCOME TAX RETURN [For Indvduals/HUFs beng partners n frms and not carryng out busness or professon under any propretorshp] (Please see rule 12 of the Income-tax Rules,1962) (Also see attached nstructons) Assessment Year 2 0 1 2-13 Part A-GEN GENERAL Frst name Mddle name Last name PAN PERSONAL INFORMATION Flat/Door/Block No Road/Street/Post Offce Town/Cty/Dstrct Name Of Premses/Buldng/Vllage Area/localty State Pn code Status (Tck) Indvdual HUF Date of Brth (DD/MM/YYYY) ( n case of ndvdual) / / Sex (n case of ndvdual) (Tck) Male Female Resdental/Offce Phone Number wth STD code Moble No. Employer Category(f n employment) (Tck) Emal Address Govt. PSU Others Income Tax Ward/Crcle Return fled (Tck)[Please see nstructon number-7] Before due date -139(1) After due date -139(4) Revsed Return- 139(5) FILING STATUS OR In response to notce 139(9) 142(1) 148 153A/153C 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 followng nformaton - (a) (b) (c) Name of the representatve Address of the representatve Permanent Account Number (PAN) of the representatve PART-B Part B - TI Computaton of total ncome 1 Salares (6 of Schedule S) 1 2 Income from house property (3c of Schedule HP) (enter nl f loss) 2 3 Profts and gans from busness or professon (6v of Schedule BP) (enter nl f loss) 3 4 Captal gans a Short term Short-term (u/s 111A) (enter nl, f loss) (A5 of Schedule CG) 4a Short-term (others) (enter nl, f loss) (A6 of Schedule CG) Total short-term (4a + 4a) (enter nl f loss) (A4 of Schedule CG) b Long-term Long-term wth ndexaton (B 2e of Schedule CG) (enter nl f loss) Long-term wthout ndexaton (B 3e of Schedule CG) (enter nl f loss) 4a 4a 4b 4b
Total Long-term (4b+ 4b) 4b c Total captal gans (4a + 4b) (enter nl f 4c s a loss) Do not wrte or stamp n ths area (Space for bar code) 4c For Offce Use Only Recept No Date 5 Income from other sources a from sources other than from ownng race horses (3 of Schedule OS) (enter nl f loss) b from ownng race horses (4c of Schedule OS) (enter nl f loss) c Total (5a + 5b) (enter nl f 5c s a loss) 5a 5b Seal and Sgnature of recevng offcal 5c 6 Total (1+2+3+4c+5c) 6 7 Losses of current year set off aganst 6 (total of 2v,3v and 4v of Schedule CYLA) 7 8 Balance after set off current year losses (6-7) (also total of column 5 of Schedule CYLA) 8 9 Brought forward losses set off aganst 8 (2v of Schedule BFLA) 9 10 Gross Total ncome (8-9) (also 3x of Schedule BFLA) 10 11 Deductons under Chapter VI-A (p of Schedule VIA) 11 12 Total ncome (10 11) 12 13 Net agrcultural ncome/ any other ncome for rate purpose (4 of Schedule EI) 13 14 Aggregate ncome (12+ 13) 14 15 Losses of current year to be carred forward (x of Schedule 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 Educaton cess, ncludng secondary and hgher educaton cess on 1c 2 COMPUTATION OF TAX LIABILITY TAXES PAID 3 Gross tax lablty (1c+ 2) 3 4 Tax relef a Secton 89 4a b Secton 90 or 90A (column 7 of Schedule TR) 4b c Secton 91 (column 7 of Schedule TR) 4c d Total (4a + 4b+4c) 4d 5 Net tax lablty (3 4d) 5 6 Interest payable a For default n furnshng the return (secton 234A) 6a b For default n payment of advance tax (secton 234B) 6b c For deferment of advance tax (secton 234C) 6c d Total Interest Payable (6a+6b+6c) 6d 7 Aggregate lablty (5 + 6d) 7 8 Taxes Pad a Advance Tax (from Schedule-IT) 8a b TDS (total of column 5 of Schedule-TDS1 and column 7 8b of Schedule-TDS2) c Self Assessment Tax(from Schedule-IT) 8c d Total Taxes Pad (8a+8b+8c) 8d
9 Amount payable (Enter f 7 s greater than 8d, else enter 0) 9 10 Refund (If 8d s greater than 7) 10 REFUND 11 Enter your bank account number (mandatory n all cases) 12 Do you want your refund by cheque, or deposted drectly nto your bank account? (tck as applcable ) 13 Gve addtonal detals of your bank account MICR Code Type of Account (tck as applcable ) Savngs Current 14 Do you have,- () any asset (ncludng fnancal nterest n any entty) located outsde Inda or () sgnng authorty n any account located outsde Inda? [applcable only n case of a resdent] [Ensure Schedule FA s flled up f the answer s Yes] 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 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 2012-2013. Place Date Sgn here 14 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 thereof 15 Schedule S Detals of Income from Salary Name of Employer PAN of Employer (optonal) Address of employer Town/Cty State Pn code SALARIES 1 Salary (Excludng all exempt/ non-exempt allowances, perqustes & proft n leu of salary as they are shown 1 separately below) 2 Allowances exempt under secton 10 (Not to be ncluded n 6 below) 2 3 Allowances not exempt (refer Form 16 from employer) 3 4 Value of perqustes (refer Form 16 from employer) 4 5 Profts n leu of salary (refer Form 16 from employer) 5 6 Income chargeable under the Head Salares (1+3+4+5) 6 Schedule HP Detals of Income from House Property (Please refer to nstructons) Address of property 1 Town/ Cty State 1 HOUSE PROPERTY Is the property co-owned? Yes No (f YES please enter followng detals) Your percentage of share n the property. S.N Name of Co-owner(s) o PAN of Co-owner(s) (optonal) PIN Code Percentage Share n Property(optonal)
(Tck) f let out Name of Tenant PAN of Tenant (optonal) 2 a Annual letable value/ rent receved or recevable (hgher f let out for whole of the year, lower 1a f let out for part of the year) b The amount of rent whch cannot be realzed 1b c Tax pad to local authortes 1c d Total (1b + 1c) 1d e Balance (1a 1d) 1e f 30% of 1e 1f g Interest payable on borrowed captal 1g h Total (1f + 1g) 1h Income from house property 1 (1e 1h) 1 Address of property 2 Town/ Cty State PIN Code Is the property co-owned? Yes No (f YES please enter followng detals) Your percentage of share n the property. S.N Name of Co-owner(s) o PAN of Co-owner(s) (optonal) Percentage Share n Property(optonal) (Tck) f let out Name of Tenant PAN of Tenant (optonal) a Annual letable value/ rent receved or recevable (hgher f let out for whole of the year, lower 2a f let out for part of the year) b The amount of rent whch cannot be realzed 2b c Tax pad to local authortes 2c d Total (2b + 2c) 2d e Balance (2a 2d) 2e f 30% of 2e 2f g Interest payable on borrowed captal 2g h Total (2f + 2g) 2h Income from house property 2 (2e 2h) 2 3 Income under the head Income from house property a Rent of earler years realzed under secton 25A/AA 3a b Arrears of rent receved durng the year under secton 25B after deductng 30% 3b c Total (3a + 3b + 1 + 2) 3c NOTE Please nclude the ncome of the specfed persons referred to n Schedule SPI whle computng the ncome under ths head Schedule IF Informaton regardng partnershp frms n whch you are partner Number of frms n whch you are partner FIRMS IN WHICH PARTNER Sl. No. 1 2 3 4 5 6 Total Name of the Frm PAN of the frm Percentage Share n the proft of the frm Amount of share n the proft Captal balance on 31 st March n the frm
Schedule BP INCOME FROM FIRMS Sl. No. 1 2 3 4 5 NOTE Frm PAN (From Schedule-IF) 6 Total Detals of Income from Frms of whch partner Salary, bonus, commsson or remuneraton receved from the frm Interest receved from the frm on the captal Total + Expenses n relaton to v Net Income v - v v v v Please nclude the ncome of the specfed persons referred to n Schedule SPI whle computng the ncome under ths head Schedule CG Captal Gans A Short-term captal gan 1 From assets n case of non-resdent to whch frst provso to secton 48 s applcable 1 2 From assets n the case of others a Full value of consderaton 2a b Deducton under secton 48 Cost of acquston b Cost of Improvement b Expendture on transfer b v Total ( + + ) bv c Balance (2a bv) 2c d Loss, f any, to be gnored under secton 94(7) or 2d 94(8) (enter postve values only) e Deducton under secton 54B/54D 2e f Short-term captal gan (2c + 2d 2e) 2f 3 Amount deemed to be short term captal gans under sectons 54B/54D/54EC/ 54ED/54G/ A3 54GA 4 Total short term captal gan (1 + 2f + A3) A4 5 Short term captal gan under secton 111A ncluded n 4 A5 6 Short term captal gan other than referred to n secton 111A (A4 A5) A6 B Long term captal gan 1 Asset n case of non-resdent to whch frst provso to secton 48 s applcable 1 2 Asset n the case of others where provso under secton 112(1) not exercsed a Full value of consderaton 2a b Deductons under secton 48 Cost of acquston after ndexaton b Cost of mprovement after ndexaton b Expendture on transfer b v Total (b + b +b) bv c Balance (2a bv) 2c d Deducton under sectons 54/54B/54D/54EC/54F 2d 54G/54GA e Net balance (2c 2d) 2e 3 Asset n the case of others where provso under secton 112(1) s exercsed a Full value of consderaton 3a b Deductons under secton 48 Cost of acquston wthout ndexaton b Cost of mprovement wthout ndexaton b Expendture on transfer b v Total (b + b +b) bv c Balance (3a bv) 3c d Deducton under sectons 54/54B/54D/54EC/54F 3d e Net balance (3c 3d) 3e 4 Amount deemed to be long term captal gans under sectons 54/54B/54D/54EC/54ED/54F B4
5 Total long term captal gan (1 + 2e [(enter 2e as nl f loss) + 3e (enter 3e as nl f loss) + 4)] B5 NOTE C Income chargeable under the head CAPITAL GAINS (A4 + B5) (enter B5 as nl, f loss) D Informaton about accrual/recept of captal gan Date Upto 15/9 () 16/9 to 15/12 () C 16/12 to 15/3 () 1 Long- term where provso under secton 112(1) s exercsed (Wthout Indexaton)- Code n SI Schedule s 22, Tax Rate s 10% ; Enter only postve value from Item B3e of Schedule CG AFTER loss adjustment under ths category n Schedule CYLA and BFLA, f any. 2 Long- term where provso under secton 112(1) s NOT exercsed (Wth Indexaton)- Code n SI Schedule s 21, Tax Rate s 20%; Enter only postve value from Item (B5-B3e) of Schedule CG AFTER loss adjustment under ths category n Schedule CYLA and BFLA, f any. 3 Short-term under 111A- Code n SI Schedule s 1A, Tax Rate s 15% ; Enter only postve value from Item A7 of Schedule CG AFTER loss adjustment under ths category n Schedule CYLA and BFLA, f any. 4 Short-term OTHERS- Taxed at normal rates; Enter only postve value from Item A8 of Schedule CG AFTER loss adjustment under ths category n Schedule CYLA and BFLA, f any. 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 a Dvdends, Gross 1a b Interest, Gross 1b c Rental ncome from machnery, plants, buldngs, 1c d Others, Gross (excludng ncome from ownng race horses) 1d e Total (1a + 1b + 1c + 1d) 1e f Deductons under secton 57:- Expenses / Deductons 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) (enter1g as nl, f loss) 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 (3 + 4c) (enter 4c as nl f loss and take 4c loss fgure to Schedule CYLA) 5 NOTE Please nclude the ncome of the specfed persons referred to n Schedule SPI whle computng the ncome under ths head OTHER SOURCES Schedule CYLA Sl.No CURRENT YEAR LOSS ADJUSTMENT Head/ Source of Income Loss to be adjusted -> Salares House property Detals of Income after set-off of current years losses House property loss of Busness Loss the current year set off Income of current year (Fll ths column only f ncome s zero or postve) Other sources loss (other than loss from race horses) of the current year set off Total loss (3 of Schedule-OS) Current year s Income remanng after set off Total loss Total loss (3c of Schedule HP) (6v of Schedule-BP) 1 2 3 4 5=1-2-3-4
Busness or professon v Short-term captal gan v Long term captal gan v Other sources (excludng proft from ownng race horses and wnnngs from lottery) v Proft from ownng and mantanng race horses v Total loss set off x Loss remanng after set-off Schedule BFLA Detals of Income after Set off of Brought Forward Losses of earler years Sl. Head/ Source of Income Income after set off, f any, of current Brought forward loss set off Current year s ncome No. year s losses as per 4 of Schedule CYLA) remanng after set off 1 2 3 BROUGHT FORWARD LOSS ADJUSTMENT Salares House property Busness or professon v Short-term captal gan v Long-term captal gan v Other sources (excludng proft from ownng race horses and wnnngs from lottery) v Proft from ownng and mantanng race horses v Total of brought forward loss set off x Current year s ncome remanng after set off Total (3 + 3 + 3 + v3 + v3+v3+v3) Schedule CFL Detals of Losses to be carred forward to future years Sl. Assessment Year Date of Flng House Busness or No. (DD/MM/YYYY) property loss professon 2004-05 Short-term captal loss Long-term Captal loss Other sources loss (from ownng race horses) 2005-06 CARRY FORWARD OF LOSS 2006-07 v 2007-08 v 2008-09 v 2009-10 v 2010-11 v 2011-12 x Total of earler year losses x Adjustment of above losses n Schedule BFLA x 2012-13 (Current year losses) x Total loss Carred Forward to future years Schedule VIA TOTAL DEDUCTIO NS Deductons under Chapter VI-A (Secton) a 80C 80G b 80CCC j 80GG c 80CCD k 80GGA d 80CCF l 80GGC
e 80D m 80QQB f 80DD n 80RRB g 80DDB o 80U h 80E p Total deductons (total of a to o) p Schedule 80G Detals of donatons enttled for deducton under secton 80G A Donatons enttled for 100% deducton wthout qualfyng lmt PAN of Donee Amount of donaton Elgble Amount of Name and address of donee donaton DETAILS OF DONATIONS B v v v Total Donatons enttled for 50% deducton wthout qualfyng lmt Name and address of donee v v v Total C Donatons enttled for 100% deducton subject to qualfyng lmt Name and address of donee v v v Total D Donatons enttled for 50% deducton subject to qualfyng lmt E Name and address of donee v v v Total Total donatons (Av + Bv + Cv + Dv) PAN of Donee Amount of donaton Elgble Amount of donaton B PAN of Donee Amount of donaton Elgble Amount of donaton PAN of Donee Amount of donaton Elgble Amount of donaton
Schedule SPI Income of specfed persons(spouse, mnor chld etc) ncludable n ncome of the assessee Sl No Name of person PAN of person (optonal) Relatonshp Nature of Income Amount (Rs) 1 2 3 Schedule SI Sl No Secton code Income chargeable to Income tax at specal rates IB [Please see nstructon Number-9() for secton code and rate of tax] Specal rate Income Tax thereon Sl Secton Specal Income Tax thereon (%) No code rate (%) SPECIAL RATE 1 1A 15 6 2 22 10 7 3 21 20 8 4 5BB 30 9 5 10 11 Total (1 to 10 ) Schedule EI Detals of Exempt Income (Income not to be ncluded n Total Income) 1 Interest ncome 1 EXEMPT INCOME 2 Dvdend ncome 2 3 Long-term captal gans on whch Securtes Transacton Tax s pad 3 4 Net Agrculture ncome /any other ncome for rate purpose 4 5 Share n the proft of frm/aop etc. 5 6 Others 6 7 Total (1+2+3+4+5+6) 7 Schedule IT Sl No TAX PAYMENTS v v NOTE Detals of Advance Tax and Self Assessment Tax Payments of Income-tax BSR Code Date of Depost (DD/MM/YYYY) Seral Number of Challan Amount (Rs) Enter the totals of Advance tax and Self Assessment tax n Sl No. 9a & 9c of PartB-TTI Schedule TDS1 Detals of Tax Deducted at Source from Salary [As per Form 16 ssued by Employer(s)] Sl Tax Deducton Account Name of the Employer Income chargeable under Salares Total tax deducted No Number (TAN) of the Employer (1) (2) (3) (4) (5) TDS ON SALARY NOTE Please enter total of column 5 of Schedule-TDS1 and column 7 of Schedule-TDS2 n 9(b) of Part B-TTI
Schedule TDS2 TDS ON OTHER INCOME Sl No Tax Deducton Account Number (TAN) of the Deductor Detals of Tax Deducted at Source on Income [As per Form 16 A ssued by Deductor(s)] Name of the Deductor Unque TDS Certfcate Number Fnancal Year n whch TDS s Deducted Total Tax Deducted Amount out of (6) clamed Ths Year (1) (2) (3) (4) (5) (6) (7) NOTE Please enter total of column 5of Schedule-TDS1 and column 7 of Schedule-TDS2 n 8(b) of Part B-TTI Schedule TR Detals of Tax Relef clamed under secton 90 or secton 90A or secton 91 DETAILS OF TAX RELIEF Sl No Country Name Country Code Tax Identfcaton number of the tax payer n respectve country Income (n rupees) Tax Pad (n rupees) Total Tax Relef Clamed (n rupees) (1) (2) (3) (4) (5) (6) (7) NOTE Please enter the detals of column (7) of Schedule TR n 4b or 4c of Part B TTI Schedule FA Detals of Foregn Assets A Detals of Foregn Bank Accounts Sl No Country Name Country Code Name and Address of the Bank Name mentoned n the account Peak Balance Durng the Year (n rupees) (1) (2) (3) (4) (5) (6) DETAILS OF FOREIGN ASSETS B Sl No () () Detals of Fnancal Interest n any Entty Country Name (1) Country Code (2) Nature of entty (3) Name and Address of the Entty (4) Total Investment (at cost) (n rupees) (5) C Sl No (1) Detals of Immovable Property Country Name (2) Country Code (3) Address of the Property (4) Total Investment (at cost) (n rupees) (5) ()
() D Sl No (1) Detals of any other Asset Country Name (2) Country Code (3) Nature of Asset (4) Total Investment (at cost) (n rupees) (5) () () E Sl No (1) Detals of account(s) n whch you have sgnng authorty and whch has not been ncluded n A to D above. Name of the Insttuton n whch the account s held (2) Address of the Insttuton (3) Name mentoned n the account (4) Peak Balance/Investment durng the year (n rupees) (5) () ()