Ack 18-19

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INDIAN INCOME TAX RETURN VERIFICATION FORM Assessment Year

FORM 2018-19
ITR-V [Where the data of the Return of Income in Form ITR-1 (SAHAJ), ITR-2, ITR-3,
ITR-4(SUGAM), ITR-5, ITR-7 transmitted electronically without digital signature] .
(Please see Rule 12 of the Income-tax Rules, 1962)

Name PAN
HEMANT PRAKASHRAO TUPKARI
PERSONAL INFORMATION AND THE

AJEPT9507A

Form No. which


DATE OF ELECTRONIC

Flat/Door/Block No Name Of Premises/Building/Village


has been ITR-4
TRANSMISSION

WARD NO 3 SHIVAJI COLONY


electronically
transmitted
Road/Street/Post Office Area/Locality
PANCHDHARA ROAD PULGAON Individual
Status

Town/City/District State Pin/ZipCode Aadhaar Number/ Enrollment ID


WARDHA
MAHARASHTRA 442302 XXXX XXXX 6129

Designation of AO (Ward / Circle) WARD 2, WARDHA Original or Revised ORIGINAL

E-filing Acknowledgement Number 277102140310818 Date(DD-MM-YYYY) 31-08-2018


1 Gross Total Income 1 279932
2 Deductions under Chapter-VI-A 2 0
3 Total Income 3 279930
COMPUTATION OF INCOME

a Current Year loss, if any 3a 0


4
AND TAX THEREON

4 Net Tax Payable 0


5 Interest and Fee Payable 5 0
6 Total Tax, Interest and Fee Payable 6 0
7 Taxes Paid
a Advance Tax 7a 0
b TDS 7b 2259
c TCS 7c 0
d Self Assessment Tax 7d 0
e Total Taxes Paid (7a+7b+7c +7d) 7e 2259
8 Tax Payable (6-7e) 8 0
9 Refund (7e-6) 9 2260
10 Exempt Income Agriculture
10
Others 0 0
VERIFICATION

I, HEMANT PRAKASHRAO TUPKARI son/ daughter of PRAKASHRAO KRUSHNARAO , holding Permanent Account Number AJEPT9507A
TUPKARI
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 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 chargeable to income-tax for
the previous year relevant to the assessment year 2018-19. I further declare that I am making this return in my capacity as
Self and I am also competent to make this return and verify it.
Sign here Date 31-08-2018 Place PULGAON

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 Filed from IP address 42.106.238.171

Date
Seal and signature of AJEPT9507A04277102140310818F576C31B0AEF1C7E1045FE5664B3A8925C708085
receiving official

Please send the duly signed Form ITR-V to “Centralized Processing Centre, Income Tax Department, Bengaluru 560500”, by ORDINARY
POST OR SPEED 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 confirmation of receipt of this Form ITR-V at ITD-CPC will be sent to the e-mail
address tcwaqui.quazi@gmail.com

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