Form PDF 700884900051120

Acknowledgement Number : 700884900051120 Assessment Year : 2019-20
ITR-3
[For individuals and HUFs having income from profits and gains business
or profession] (Please see rule 12 of the Income-tax Rules,1962)
PART A-GEN- PERSONAL INFORMATION
First Name SHAIK Middle Name
Last Name RAMEEZA PAN HEAPS3268R
Date of Birth / Formation (DD/MM/ 01-Jul-1994 Status Individual
YYYY)
ADDRESS
Flat / Door / Building 7-1-625, Town / City / District Nellore
Name of Premises / Building / Village Road / Street / Post Office Railway Street,
Area / Locality Ranganayakulapeta State ANDHRA PRADESH
Country INDIA PIN Code 524001
Residential/Office Phone Number with STD code 09676579712
Mobile no.1 91 9676579712 Mobile no.2
Email Address - 1(Self) aca.prabha@gmail.com Email Address - 2
Aadhaar Number(Please enter the 439897257681 Aadhaar Enrolment Id (If Aadhaar
Aadhaar Number which is linked for Number is not yet allotted, then
your PAN in e-Filing portal. Applicable to Aadhaar Enrolment Id is required.
Individual only.) All the digits in enrolment ID and
Date and time of enrolment to be
entered continuously)
FILING STATUS
Filed u/s 139(4)- After due date
If revised/defective/Modified, enter Receipt no
Date of Filing original return(DD/MM/YYYY)
If filed, in response to a notice u/s 139(9)/142(1)/148/153A/153C enter date
of such notice or 119(2)(b) enter date of such order or u/s 92CD enter date of
advance pricing agreement
Residential Status in India Resident You were in India for 182 days or more during the previous year
[section 6(1)(a)]
(i) Please specify the jurisdiction(s) of residence during the previous year -
S.No. Jurisdiction(s) of residence Taxpayer Identification Number(s)
(ii) In case you are a Citizen of India or a Person of Indian Origin (POI), please specify -
Total period of stay in India during the previous year (in days) Total period of stay in India during the 4 preceding years (in days)
Do you want to claim the benefit u/s 115H (Applicable in case of Resident)? No
Yes/No
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Are you governed by Portuguese Civil Code as per section 5A? (If “YES” No
please fill Schedule 5A)
OTHER DETAILS
Whether return is being filed by a representative assessee? if yes,please No
furnish following information
(a) Name of the Representative
(b) Capacity of the Representative
(c) Address of the Representative
(d) Permanent Account Number (PAN) of the Representative
Whether you were a Director in a company at any time during the Previous No
year?If yes, please furnish following information
Sl. Name of company Type of Company PAN Whether its shares are listed Director Identification
No. or unlisted Number (DIN)
Whether you are a Partner in a Firm?If yes, please furnish following No
information
Sl. No. Name of Firm PAN
Whether you have held unlisted equity shares at any time during the previous No
year?If yes, please furnish following information in respect of Equity Shares
Sl. Name of Type of PAN Opening Shares acquired during the year Shares Closing balance
No. company company balance transferred during
the year
No. Cost of No. Date of Face Issue price Purchase No. of Sale No. of Cost of
of acquisitionof subscription
value
/ per share price per shares consideration
shares acquisition
shares shares purchase per (in case of share (in
share fresh issue) case of
purchase
from
existing
shareholder)
In case of non-resident, is there a permanent establishment (PE) in India?
Whether assessee is located in an International Financial Services Centre No
and derives income solely in convertible foreign exchange?
AUDIT INFORMATION
(a) Are you liable to maintain accounts as per section 44AA? No
(b) Are you liable for audit under section 44AB? No
(c) If (b) is Yes, whether the accounts have been audited by an accountant?
If yes, furnish the following information below
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(i) Date of furnishing of the audit report (DD/MM/YYYY)
(ii) Name of the auditor signing the tax audit report
(iii) Membership no. of the auditor
(iv) Name of the auditor (proprietorship/ firm)
(v) Proprietorship/firm registration number
(vi) Permanent Account Number (PAN) of the proprietorship/ firm
(vii) Date of report of the audit
(d.i) Are you liable for Audit u/s 92E?
No Date of audit report (DD/
MM/YYYY)
(d.ii) If liable to furnish other audit report, mention the date of furnishing the audit report? (DD/MM/YY) (Please see Instruction 5))
Sl.No. Section Code Date (DD/MM/YYYY)
(e) If liable to audit under any Act other than the Income-tax Act, mention the Act, section and date of furnishing the audit report?
Sl.No. Act Description Section Date (DD/MM/YYYY)
Nature of business/profession, if more than one business/profession indicate the three main activities/Products (OTHER THAN THOSE
DECLARING INCOME UNDER SECTIONS 44AD, 44ADA AND 44AE)
Sl.No. Nature of Business Trade name of the Trade name of the Trade name of the
proprietorship, if any proprietorship, if any proprietorship, if any
1 16019-Other professional SHAIK RAMEEZA RMP CLINIC
services n.e.c.
Part A-BS - BALANCE SHEET AS ON 31ST DAY OF MARCH, 2019 OF THE PROPRIETORY BUSINESS OR PROFESSION (fill items below in a
case where regular books of accounts are maintained, otherwise fill item 6)
Sources of Funds
1 Proprietor's fund
a. Proprietor's capital a 0
b. Reserves & Surplus
i Revaluation Reserve bi 0
ii Capital Reserve bii 0
iii Statutory Reserve bii 0
iv Any other Reserve biv 0
v Total (bi+bii+biii+biv) bv 0
c. Total proprietor’s fund (a + bv) 1c 0
2 Loan funds
a. Secured loans
i Foreign Currency Loans ai 0
ii. Rupee Loans
A.From Banks iiA 0
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B.From Others iiB 0
C.Total(iiA + iiB) iiC 0
iii. Total(ai + iiC) aiii 0
b. Unsecured loans (including deposits)
i From Banks bi 0
ii From others bii 0
iii. Total(bi + bii) biii 0
c. Total Loan Funds(aiii + biii) 2c 0
3 Deferred tax liability 3 0
4 Sources of funds(1c + 2c +3) 4 0
Application of Funds
1 Fixed assets
a Gross: Block 1a 0
b Depreciation 1b 0
c Net Block(1a-1b) 1c 0
d Capital work in progress 1d 0
e Total(1c + 1d) 1e 0
2 Investments
a Long-term investments
i Government and other Securities - Quoted ai 0
ii Government and other Securities – Unquoted aii 0
iii Total(ai + aii) aiii 0
b Short-term investments
i Equity Shares,including share application money bi 0
ii Preference Shares bii 0
iii Debentures biii 0
iv Total(bi+bii+biii) biv 0
c Total investments(aiii + biv) 2c 0
3 Current assets, loans and advances
a Current assets
i Inventories
A.Stores/consumables including packing material iA 0
B.Raw materials iB 0
C.Stock-in-process iC 0
D.Finished Goods/Traded Goods iD 0
E.Total(iA + iB + iC + iD) iE 0
ii Sundry Debtors aii 0

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iii Cash and Bank Balances
A.Cash-in-hand iiiA 0
B.Balance with banks iiiB 0
C.Total(iiiA + iiiB) iiiC 0
iv Other Current Assets aiv 0
v Total current assets(iE +aii + iiiC + aiv) av 0
b Loans and advances
i Advances recoverable in cash or in kind or for value to be received bi 0
ii Deposits,loans and advances to corporates and others bii 0
iii Balance with Revenue Authorities biii 0
iv Total(bi + bii + biii) biv 0
c Total of current assets, loans and advances (av + biv) 3c 0
d Current liabilities and provisions
i Current liabilities
A.Sundry Creditors iA 0
B.Liability for Leased Assets iB 0
C.Interest Accrued on above iC 0
D.Interest accrued but not due on loans iD 0
E.Total(iA +iB +iC+iD) iE 0
ii Provisions
A.Provision for Income Tax iiA 0
B.Provision for Leave encashment/Superannuation/ Gratuity iiB 0
C.Other Provisions iiC 0
D.Total(iiA + iiB + iiC ) iiD 0
iii Total(iE + iiD) diii 0
e Net current assets(3c – diii) e 0
4 a.Miscellaneous expenditure not written off or adjusted 4a 0
b.Deferred tax asset 4b 0
c.Profit and loss account/ Accumulated balance 4c 0
d.Total(4a + 4b + 4c) 4d 0
5 Total, application of funds (1e + 2c + 3e +4d) 5 0
No Accounts Case
6 In a case where regular books of account of business or profession are not maintained -(furnish the following information as on 31st
day of March, 2019, in respect of business or profession).
a.Amount of total sundry debtors 6a 0
b.Amount of total sundry creditors 6b 0
c.Amount of total stock-in-trade 6c 0

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d.Amount of the cash balance 6d 264140
Part A-Manufacturing Account-Manufacturing Account for the year 2018-19(fill items 1 to 3 in a case where regular books of accounts are
maintained, otherwise fill items from 61 to 64 as applicable)
1 Opening Inventory
A (i) Opening stock of raw-material A(i)
(ii) Opening stock of work in progress A(ii)
(iii) Total(i + ii) A(iii)
B Purchases(net of refunds and duty or tax, if any) B
C Direct wages C
D Direct expenses(Di + Dii + Diii) D
(i) Carriage inward (i)
(ii) Power and fuel (ii)
(iii) Other direct expenses (iii)
E Factory overheads
(i) Indirect wages (i)
(ii) Factory rent and rates (ii)
(iii) Factory insurance (iii)
(iv) Factory fuel and power (iv)
(v) Factory general expenses (v)
(vi) Depreciation of factory machinery (vi)
(vii) Total(i+ii+iii+iv+v+vi) (vii)
F Total of debits to manufacturing account(Aiii+B+C+D+Evii) F
2 Closing stock
(i) Raw material (2i)
(ii) Work in progress (2ii)
Total(2i+2ii) 2
3 Cost of goods produced- transferred to trading account(1F-2) 3
Part A-Trading Account -Trading Account for the financial year 2018-19 (fill items 4 to 12 in a case where regular books of accounts are
maintained, otherwise fill items 61 to 64 as applicable)
4 Revenue from operations
A Sales/ Gross receipts of business (net of returns and refunds and duty or tax, if any)
(i) Sale of goods A(i)
(ii) Sale of services A(ii)
(iii) Other operating revenues (specify nature and amount)
S. No. Nature of Income Amount
Total (iiia+iiib) iiic
(iv) Total(i+ii+iiic) A(iv)

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B Gross receipts from Profession B
C Duties, taxes and cess received or receivable in respect of goods and services sold or supplied
(i) Union Excise duties C(i)
(ii) Service Tax C(ii)
(iii) VAT/ Sales tax C(iii)
(iv) Central Goods & Service Tax (CGST) C(iv)
(v) State Goods & Services Tax (SGST) C(v)
(vi) Integrated Goods & Services Tax (IGST) C(vi)
(vii) Union Territory Goods & Services Tax (UTGST) C(vii)
(viii) Any other duty, tax and cess C(viii)
(ix) Total (i + ii + iii + iv +v+ vi+vii+viii) C(ix)
D Total Revenue from operations (A(iv) + B +C(ix)) D
5 Closing Stock of Finished Stocks 5
6 Total of credits to Trading Account (4D + 5 ) 6
7 Opening Stock of Finished Goods 7
8 Purchases (net of refunds and duty or tax, if any) 8
9 Direct Expenses 9
(i) Carriage inward 9(i)
(ii) Power and fuel (ii)
(iii) Other direct expenses
S. No. Nature of Income Amount
10 Duties and taxes, paid or payable, in respect of goods and services purchased
(i) Custom duty 10(i)
(ii) Counter veiling duty 10(ii)
(iii) Special additional duty 10(iii)
(iv) Union excise duty 10(iv)
(v) Service Tax 10(v)
(vi) VAT/ Sales tax 10(vi)
(vii) Central Goods & Service Tax (CGST) 10(vii)
(viii) State Goods & Services Tax (SGST) 10(viii)
(ix) Integrated Goods & Services Tax (IGST) 10(ix)
(x) Union Territory Goods & Services Tax (UTGST) 10(x)
(xi) Any other tax, paid or payable 10(xi)
(xii) Total (10i + 10ii + 10iii + 10iv + 10v + 10vi + 10vii + 10viii + 10ix + 10x+10xi) 10(xii)
11 Cost of goods produced – Transferred from Manufacturing Account 11
12 Gross Profit/Loss from Business/Profession - transferred to Profit and Loss account 12
(6-7-8-9-10xii-11)
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Part A-P & L- Profit and Loss Account for the financial year 2018-19 (fill items 13 to 60 in a case where regular books of accounts are
maintained, otherwise fill items 61 to 64 as applicable)
13 Gross profit transferred from Trading Account 13 0
14 Other income
i. Rent i 0
ii Commission ii 0
iii Dividend income iii 0
iv Interest income iv 0
v Profit on sale of fixed assets v 0
vi Profit on sale of investment being securities chargeable to Securities Transaction Tax vi 0
(STT)
vii Profit on sale of other investment vii 0
viii Gain (Loss) on account of foreign exchange fluctuation u/s 43AA viii 0
ix Profit on conversion of inventory into capital asset u/s 28(via) (Fair Market Value of ix 0
inventory as on the date of conversion)
x Agricultural income x 0
xi Any other income (specify nature and amount)
Sl.No Nature Amount
Total 0
xii Total of other income (i + ii + iii + iv + v + vi + vii + viii + ix + x + xi) 14xii 0
15 Total of credits to profit and loss account (13+14xii) 15 0
16 Freight outward 16 0
17 Consumption of stores and spare parts 17 0
18 Power and fuel 18 0
19 Rents 19 0
20 Repairs to building 20 0
21 Repairs to machinery 21 0
22 Compensation to employees
i Salaries and wages 22i 0
ii Bonus 22ii 0
iii Reimbursement of medical expenses 22iii 0
iv Leave encashment 22iv 0
v Leave travel benefits 22v 0
vi Contribution to approved superannuation fund 22vi 0
vii Contribution to recognised provident fund 22vii 0
viii Contribution to recognised gratuity fund 22viii 0
ix Contribution to any other fund 22ix 0
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x Any other benefit to employees in respect of which an expenditure has been incurred 22x 0
xi Total compensation to employees (22i + 22ii + 22iii + 22iv + 22v + 22vi + 22vii + 22viii 22xi 0
+22ix + 22x)
xii Whether any compensation, included in 22xi, paid to non-residents 22xiia No
If Yes, amount paid to non-residents 22xiib 0
23 Insurance
i. Medical Insurance 23i 0
ii. Life Insurance 23ii 0
iii. Keyman's Insurance 23iii 0
iv. Other Insurance including factory, office, car, goods,etc. 23iv 0
v Total expenditure on insurance (23i + 23ii + 23iii + 23iv) 23v 0
24 Workmen and staff welfare expenses 24 0
25 Entertainment 25 0
26 Hospitality 26 0
27 Conference 27 0
28 Sales promotion including publicity (other than advertisement) 28 0
29 Advertisement 29 0
30 Commission
i Paid outside India, or paid in India to a non-resident other than a company or a foreign i 0
company
ii To others ii 0
iii Total (i + ii) 30iii 0
31 Royalty
i. Paid outside India, or paid in India to a non-resident other than a company or a foreign i 0
company
ii. To others ii 0
iii. Total (i + ii) 31iii 0
32 Professional / Consultancy fees / Fee for technical services
i Paid outside India, or paid in India to a non-resident other than a company or a foreign i 0
company
ii To others ii 0
iii Total (i + ii) 32iii 0
33 Hotel , boarding and Lodging 33 0
34 Traveling expenses other than on foreign traveling 34 0
35 Foreign travelling expenses 35 0
36 Conveyance expenses 36 0
37 Telephone expenses 37 0
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38 Guest House expenses 38 0
39 Club expenses 39 0
40 Festival celebration expenses 40 0
41 Scholarship 41 0
42 Gift 42 0
43 Donation 43 0
44 Rates and taxes, paid or payable to Government or any local body (excluding taxes on income)
i Union excise duty 44i 0
ii Service tax 44ii 0
iii VAT/ Sales tax 44iii 0
iv Cess 44iv 0
v Central Goods & Service Tax (CGST) 44v 0
vi State Goods & Services Tax (SGST) 44vi 0
vii Integrated Goods & Services Tax (IGST) 44vii 0
viii Union Territory Goods & Services Tax (UTGST) 44viii 0
ix Any other rate, tax, duty or cess including STT and CTT 44ix 0
x Total rates and taxes paid or payable (44i + 44ii + 44iii + 44iv + 44v + 44vi + 44vii + 44viii 44x 0
+ 44ix)
45 Audit fee 45 0
46 Other expenses (specify nature and amount)
Sl.No Nature Amount
Total 0
47 Bad debts(specify PAN of the person, if available, for whom Bad Debt for amount of Rs. 1 lakh or more is claimed and amount)
i Sl.No PAN Amount
ii Others (more than Rs. 1 lakh) where PAN is not available (provide name and complete address)
Sl. Name Flat/ Door/ Name of Road/ Street/ Area/ Town/ State Country PIN Code ZIP Code Amount
No. Block No. Premises / Post office Locality City/
Building / District
Village
iii. Others (amounts less than Rs. 1 lakh) iii 0
iv. Total Bad Debt (47i (All PAN) + 47ii + 47iii) 47iv 0
48 Provision for bad and doubtful debts 48 0
49 Other provisions 49 0
50 Profit before interest, depreciation and taxes [15 – (16 to 21 + 22xi + 23v + 24 to 29 + 30iii + 31iii 50 0
+ 32iii + 33 to 43 + 44x + 45 + 46 + 47iv + 48 + 49)]
51 Interest
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i. Paid outside India, or paid in India to a non-resident other than a company or a foreign i 0
company
ii. To others ii 0
iii. Total (i + ii) 51iii 0
52 Depreciation and amortisation. 52 0
53 Net Profit before taxes (50 - 51iii - 52 ) 53 0
PROVISIONS FOR TAX AND APPROPRIATIONS
54 Provision for current tax. 54 0
55 Provision for Deferred Tax 55 0
56 Profit after tax(53 - 54 - 55) 56 0
57 Balance brought forward from previous year. 57 0
58 Amount available for appropriation (56 + 57) 58 0
59 Transferred to reserves and surplus. 59 0
60 Balance carried to balance sheet in proprietor’s account (58 –59) 60 0
61 COMPUTATION OF PRESUMPTIVE BUSINESS INCOME UNDER SECTION 44AD
Sl. Name of the Business Business Code Description
No.
i Gross turnover or Gross receipts (ia+ib) 61i
a 'Through a/c payee cheque or a/c payee bank draft or bank electronic clearing system a
received before specified date
b Any other mode b
ii Presumptive income under section 44AD(iia+iib) 61ii
a 6% of 61(i)(a), or the amount claimed to have been earned, whichever is higher a
b 8% of 61(i)(b), or the amount claimed to have been earned, whichever is higher b
Note: If income is less than the above percentage of Gross Receipts/Turnover, it is mandatory to maintain books of accounts and have a tax
audit under 44AB
62 COMPUTATION OF PRESUMPTIVE INCOME FROM PROFESSIONS UNDER SECTION 44ADA
No.
i Gross Receipts 62i
ii Presumptive Income under section 44ADA (50% of 62i, or the amount claimed to have 62ii
been earned, whichever is higher)
Note: If income is less than 50% of Gross Receipts, it is mandatory to maintain books of accounts and have a tax audit under 44AB
63 COMPUTATION OF PRESUMPTIVE INCOME FROM GOODS CARRIAGES UNDER SECTION 44AE
No.
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i Sl.No Registration No. Whether owned/ Tonnage Number of months for which Presumptive income u/s 44AE for
of goods carriage leased/hired Capacity of goods goods carriage was owned / the goods carriage (Computed @
carriage(in MT) leased / hired by assessee Rs.1000 per tone per month in
case tonnage exceeds 12MT, or
else @ Rs.7500 per month) or the
amount claimed to have been earned,
whichever is higher
Total
ii Total presumptive income from goods carriage u/s 44AE [total of column (5) of table at 63ii
Point 63(i)
Note: If the profits are lower than prescribed under S.44AE or the number of goods carriage owned / leased / hired at any time during the
year exceeds 10, then , it is mandatory to maintain books of accounts and have a tax audit under 44AB
64 IF REGULAR BOOKS OF ACCOUNT OF BUSINESS OR PROFESSION ARE NOT MAINTAINED, furnish the following information for
previous year 2018-19 in respect of business or profession
(i) For assessee carrying on Business
a Gross turnover/Gross receipts (a1+a2) ia 0
1 Through a/c payee cheque or a/c payee bank draft or bank electronic clearing a1 0
system received before specified date
2 Any other mode a2 0
b Gross profit ib 0
c Expenses ic 0
d Net profit 64i 0
(ii) For assessee carrying on Profession
a Gross turnover/Gross receipts (a1+a2) ia 758240
1 Through a/c payee cheque or a/c payee bank draft or bank electronic clearing a1 7700
system received before specified date
2 Any other mode a2 750540
b Gross profit ib 758240
c Expenses ic 339946
d Net profit 64ii 418294
iii Total Profit (64(i)d + 64(ii)d) 64iii 418294
65 i Turnover from speculative activity 65i 0
ii Gross Profit 65ii
iii Expenditure, if any 65iii
iv Net Income From Speculative Activity (65ii-65iii) 65iv 0
Part A : OI Other Information (mandatory if liable for audit under section 44AB, for other fill, if applicable).
1 Method of accounting employed in the previous year 1
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2 Is there any change in method of accounting 2
3a Increase in the profit or decrease in loss because of deviation, if any, as per Income Computation 3a
Disclosure Standards notified under section 145(2) [column 11a(iii) of Schedule ICDS]
3b Decrease in the profit or increase in loss because of deviation, if any, as per Income Computation 3b
Disclosure Standards notified under section 145(2) [column 11b(iii) of Schedule ICDS]
4 Method of valuation of closing stock employed in the previous year
a Raw Material (if at cost or market rates whichever is less write 1, if at cost write 2, if at market 4a
rate write 3)
b Finished goods (if at cost or market rates whichever is less write 1, if at cost write 2, if at market 4b
rate write 3)
c Is there any change in stock valuation method 4c
d Increase in the profit or decrease in loss because of deviation, if any, from the method of 4d
valuation specified under section 145A
e Decrease in the profit or increase in loss because of deviation, if any, from the method of 4e
valuation specified under section 145A
5 Amounts not credited to the profit and loss account, being
a The items falling within the scope of section 28 5a
b The proforma credits, drawbacks, refund of duty of customs or excise or service tax, or refund 5b
of sales tax or value added tax,or refund of GST,where such credits, drawbacks or refunds are
admitted as due by the authorities concerned
c Escalation claims accepted during the previous year 5c
d Any other item of income 5d
e Capital receipt, if any 5e
f Total of amounts not credited to profit and loss account (5a+5b+5c+5d+5e) 5f
6 Amounts debited to the profit and loss account, to the extent disallowable under section 36 due to non-fulfilment of conditions specified in
relevant clauses
a Premium paid for insurance against risk of damage or destruction of stocks or store[36(1)(i)] 6a
b Premium paid for insurance on the health of employees[36(1)(ib)] 6b
c Any sum paid to an employee as bonus or commission for services rendered, where such sum 6c
was otherwise payable to him as profits or dividend [36(1)(ii)]
d Any amount of interest paid in respect of borrowed capital[36(1)(iii)] 6d
e Amount of discount on a zero-coupon bond[36(1)(iiia)] 6e
f Amount of contributions to a recognised provident fund[36(1)(iv)] 6f
g Amount of contributions to an approved superannuation fund[36(1)(iv)] 6g
h Amount of contribution to a pension scheme referred to in section 80CCD [36(1)(iva)] 6h
i Amount of contributions to an approved gratuity fund[36(1)(v)] 6i
j Amount of contributions to any other fund 6j
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k Any sum received from employees as contribution to any provident fund or superannuation fund 6k
or any fund set up under ESI Act or any other fund for the welfare of employees to the extent not
credited to the employees account on or before the due date [36(1)(va)]
l Amount of bad and doubtful debts[36(1)(vii)] 6l
m Provision for bad and doubtful debts[36(1)(viia)] 6m
n Amount transferred to any special reserve[36(1)(viii)] 6n
o Expenditure for the purposes of promoting family planning amongst employees[36(1)(ix)] 6o
p Amount of securities transaction paid in respect of transaction in securities if such income is not 6p
included in business income [36(1)(xv)]
q Marked to market loss or other expected loss as computed in accordance with the ICDS notified 6q
u/s 145(2) [36(1)(xviii)]
r Any other disallowance 6r
s Total amount disallowable under section 36 (total of 6a to 6r) 6s
7 Amounts debited to the profit and loss account, to the extent disallowable under section 37
a Expenditure of capital nature [37(1)] 7a
b Expenditure of personal nature [37(1)] 7b
c Expenditure laid out or expended wholly and exclusively NOT for the purpose of business or 7c
profession [37(1)]
d Expenditure on advertisement in any souvenir, brochure, tract, pamphlet or the like, published by 7d
a political party[37(2B)]
e Expenditure by way of penalty or fine for violation of any law for the time being in force 7e
f Any other penalty or fine 7f
g Expenditure incurred for any purpose which is an offence or which is prohibited by law 7g
h Amount of any liability of a contingent nature 7h
i Any other amount not allowable under section 37 7i
j Total amount disallowable under section 37(total of 7a to 7i) 7j
8 A Amounts debited to the profit and loss account, to the extent disallowable under section 40
a Amount disallowable under section 40 (a)(i) on account of non-compliance with provisions of Aa
Chapter XVII-B
b Amount disallowable under section 40(a)(ia) on account of non-compliance with the provisions of Ab
Chapter XVII-B
c Amount disallowable under section 40 (a)(ib), on account of non-compliance with the provisions Ac
of Chapter XVII-B
d Amount disallowable under section 40(a)(iii) on account of non-compliance with the provisions of Ad
Chapter XVII-B
e Amount of tax or rate levied or assessed on the basis of profits[40(a)(ii)] Ae
f Amount paid as wealth tax[40(a)(iia)] Af
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g Amount paid by way of royalty, license fee, service fee etc. as per section 40(a)(iib) Ag
h Amount of interest, salary, bonus, commission or remuneration paid to any partner or Ah
member[40(b)]
i Any other disallowance Ai
j Total amount disallowable under section 40(total of Aa to Ai) Aj
8 B Any amount disallowed under section 40 in any preceding previous year but allowable during the 8B
previous year
9 Amounts debited to the profit and loss account, to the extent disallowable under section 40A
a Amounts paid to persons specified in section 40A(2)(b) 9a
b Amount paid otherwise than by account payee cheque Or account payee bank draft or use of 9b
electronic clearing system through a bank account, disallowable under section 40A(3)
c Provision for payment of gratuity[40A(7)] 9c
d Any sum paid by the assessee as an employer for setting up or as contribution to any fund, trust, 9d
company, AOP, or BOI or society or any other institution[40A(9)]
e Any other disallowance 9e
f Total amount disallowable under section 40A (total of 9a to 9e) 9f
10 Any amount disallowed under section 43B in any preceding previous year but allowable during the previous year
a Any sum in the nature of tax, duty, cess or fee under any law 10a
b Any sum payable by way of contribution to any provident fund or superannuation fund or gratuity 10b
fund or any other fund for the welfare of employees
c Any sum payable to an employee as bonus or commission for services rendered 10c
d Any sum payable as interest on any loan or borrowing from any public financial institution or a 10d
State financial corporation or a State Industrial investment corporation
e Any sum payable as interest on any loan or borrowing from any scheduled bank or a co- 10e
operative bank other than a primary agricultural credit society or a primary co-operative
agricultural and rural development bank
f Any sum payable towards leave encashment 10f
g Any sum payable to the Indian Railways for the use of railway assets 10g
h Total amount allowable under section 43B (total of 10a to 10g) 10h
11 Any amount debited to profit and loss account of the previous year but disallowable under section 43B
a Any sum in the nature of tax, duty, cess or fee under any law 11a
b Any sum payable by way of contribution to any provident fund or superannuation fund or gratuity 11b
fund or any other fund for the welfare of employees
c Any sum payable to an employee as bonus or commission for services rendered 11c
d Any sum payable as interest on any loan or borrowing from any public financial institution or a 11d
State financial corporation or a State Industrial investment corporation
Page 15
e Any sum payable as interest on any loan or borrowing from any scheduled bank or a co- 11e
operative bank other than a primary agricultural credit society or a primary co-operative
agricultural and rural development bank
f Any sum payable towards leave encashment 11f
g Any sum payable to the Indian Railways for the use of railway assets 11g
h Total amount disallowable under Section 43B(total of 11a to 11g) 11h
12 Amount of credit outstanding in the accounts in respect of
a Union Excise Duty 12a
b Service tax 12b
c VAT/sales tax 12c
d Central Goods & Service Tax (CGST) 12d
e State Goods & Services Tax (SGST) 12e
f Integrated Goods & Services Tax (IGST) 12f
g Union Territory Goods & Services Tax (UTGST) 12g
h Any other tax 12h
i Total amount outstanding (total of 12a to 12h) 12i
13 Amounts deemed to be profits and gains under section 33AB or 33ABA 13
i Section 33AB 13i
ii Section 33ABA 13ii
14 Any amount of profit chargeable to tax under section 41 14
15 Amount of income or expenditure of prior period credited or debited to the profit and loss account (net) 15
16 Amount of Expenditure disallowed u/s 14A 16
Part A-QD - Quantitative details (mandatory if liable for audit under section 44AB) (Note : Numeric values not filled will default to zero)
(a) In the case of a trading concern
Sl.No. Item Name Unit Opening Purchase during the Sales during the previous Closing Shortage/ excess, if any
stock previous year year stock
(b) In the case of a manufacturing concern - Raw Materials
Sl.No. Item Name Unit of Opening Purchase Consumption Sales during Closing Yield Percentage Shortage/
measure stock during the during the the previous stock Finished of yield excess, if
previous year previous year year Products any
(c) In the case of a manufacturing concern - Finished products/ By-products
Sl.No. Item Name Unit Opening Purchase during the Quantity manufactured Sales Closing Shortage/
stock previous year during the previous year during the stock excess, if
previous any
year
Schedule S:Details of Income from Salary
1 Total Gross Salary (from all employers) 1
Page 16
2 Less : allowances to the extent exempt u/s 10 2
S. No. Nature of Exempt Allowance Amount
3 Net Salary (1-2) 3
4 Deduction u/s 16 (4a+4b+4c) 4
4a Standard deduction u/s 16(ia) 4a
4b Entertainment allowance u/s 16(ii) 4b
4c Professional tax u/s 16(iii) 4c
5 Income chargeable under the Head ‘Salaries’ (3-4) 5
xyz
Schedule HP:Details of Income from House Property
1 Pass through income if any 1
2 Income under the head “Income from house property”(1k + 2k + 3)(if negative take the 2
figure to 2i of schedule CYLA)
Note: Please include the income of the specified persons referred to in Schedule SPI and Pass through income referred to in schedule PTI while
computing the income under this head
Furnishing PAN of tenant is mandatory, if rent received exceeds Rupees fifty thousand for a month or part of a month during the previous year.
Furnishing TAN of tenant is mandatory, if income by way of rent credited/paid during the financial year amounts to or exceeds one hundred
and eighty thousand rupees.
Schedule BP:Computation of income from business or profession
A From business or profession other than speculative business and specified business
1. Profit before tax as per profit and loss account (item 53 ,61(ii), 62(ii), 63(ii), 64(iii) and 65(iv) 1 418294
of P&L)
2a. Net profit or loss from speculative business included in 1 (enter -ve sign in case of loss) 2a 0
[Sl.no 65iv of Schedule P&L]
2b. Net profit or Loss from Specified Business u/s 35AD included in 1 (enter -ve sign in case of 2b 0
loss)
3. Income/ receipts credited to profit and loss account considered under other heads of income/chargeable u/s 115BBF/ chargeable u/s
115BBG
a. Salaries 3a 0
b. House property 3b 0
c. Capital gains 3c 0
d. Other sources 3d 0
e. u/s 115BBF 3e 0
f. u/s 115BBG 3f 0
4a Profit or loss included in 1, which is referred to in section 4a 0
44AD/44ADA/44AE/44B/44BB/44BBA/44DA
i 44AD 4i 0
Page 17
ii 44ADA 4ii 0
iii 44AE 4iii 0
iv 44B 4iv 0
v 44BB 4v 0
vi 44BBA 4vi 0
vii 44DA 4vii 0
4b Profit from activities covered under rule 7, 7A, 7B(1), 7B(1A) and 8 4b 0
i Profit from activities covered under rule 7 4i 0
ii Profit from activities covered under rule 7A 4ii 0
iii Profit from activities covered under rule 7B(1) 4iii 0
iv Profit from activities covered under rule 7B(1A) 4iv 0
v Profit from activities covered under rule 8 4v 0
5. Income credited to Profit and Loss account (included in 1)which is exempt
a. share of income from firm(s) 5a 0
b. Share of income from AOP/ BOI 5b 0
c. Any other exempt income
SI.No. Nature Amount
Total 5C 0
d Total exempt income (5a + 5b + 5d 0
5c)
6. Balance (1- 2a - 2b - 3a -3b - 3c - 3d -3e -3f - 4a - 4b - 5d) 6 418294
7. Expenses debited to profit and loss account considered under other heads of income/related to income chargeable u/s 115BBF or u/s
115BBG
a. Salaries 7a 0
b. House property 7b 0
c. Capital gains 7c 0
d. Other sources 7d 0
e. u/s 115BBF 7e 0
f. u/s 115BBG 7f 0
8a Expenses debited to profit and loss account which relate to exempt income 8a 0
8b Expenses debited to profit and loss account which relate to exempt income and disallowed 8b 0
u/s 14A (16 of Part A-OI)
9. Total (7a + 7b + 7c + 7d +7e + 7f+ 8a+8b) 9 0
10. Adjusted profit or loss (6+9) 10 418294
11. Depreciation and amoritisation debited to profit and loss account 11 0
12. Depreciation allowable under Income-tax Act
Page 18
i Depreciation allowable under section 32(1)(ii) and 32(1)(iia) (item 6 of 12i 0
Schedule-DEP)
ii Depreciation allowable under section 32(1)(i) (Make your own computation 12ii 0
refer Appendix-IA of IT Rules)
iii Total (12i + 12ii) 12iii 0
13. Profit or loss after adjustment for depreciation (10 +11 - 12iii) 13 418294
14. Amounts debited to the profit and loss account, to the extent disallowable under section 36 14 0
(6s of PartA-OI)
(7j of PartA-OI)
(8Aj of PartA-OI)
17. Amounts debited to the profit and loss account, to the extent disallowable under section 17 0
40A (9f of PartA-OI)
18. Any amount debited to profit and loss account of the previous year but disallowable under 18 0
section 43B (11h of PartA-OI)
19. Interest disallowable under section 23 of the Micro, Small and Medium Enterprises 19 0
Development Act,2006
20. Deemed income under section 41 20 0
21. Deemed income under section 21 0
32AD/33AB/33ABA/35ABA/35ABB/40A(3A)/72A/80HHD/80-IA
i Section 32AD 21i 0
ii Section 33AB 21ii 0
iii Section 33ABA 21iii 0
iv Section 35ABA 21iv 0
v Section 35ABB 21v 0
vi Section 40A(3A) 21vi 0
vii Section 72A 21vii 0
viii Section 80HHD 21viii 0
ix Section 80-IA 21ix 0
22. Deemed income under section 43CA 22 0
23. Any other item of addition under section 28 to 44DA 23 0
24. Any other expense not allowable / any other income not included in profit and loss account 24 0
(including income from salary, commission, bonus and interest from firms in which
individual/HUF/prop. concern is a partner)
(a) Salary 24a 0
(b) Bonus 24b 0
Page 19
(c) Commission 24c 0
(d) Interest 24d 0
(e) Others 24e 0
25. Increase in profit or decrease in loss on account of ICDS adjustments and deviation in 25 0
method of valuation of stock (Column 3a + 4d of Part-A OI)
26. Total (14 + 15 + 16 + 17 + 18 + 19 + 20 + 21 + 22 + 23 + 24 + 25) 26 0
27. Deduction allowable under section 32(1)(iii) 27 0
28. Deduction allowable under section 32AD 28 0
29. Amount of deduction under section 35 or 35CCC or 35CCD in excess of the amount 29 0
debited to profit and loss account (item X(4) of Schedule ESR) (if amount deductible under
section 35 or 35CCC or 35CCD is lower than amount debited to P and L account, it will go
to item 24)
30. Any amount disallowed under section 40 in any preceding previous year but allowable 30 0
during the previous year(8B of PartA-OI)
31. Any amount disallowed under section 43B in any preceding previous year but allowable 31 0
during the previous year(10 h of PartA-OI)
32. Any other amount allowable as deduction 32 0
33. Decrease in profit or increase in loss on account of ICDS adjustments and deviation in 33 0
method of valuation of stock (Column 3b + 4e of Part-A OI)
34. Total (27 + 28 + 29 + 30 + 31 + 32 + 33) 34 0
35. Income (13 + 26 - 34) 35 418294
36. Profits and gains of business or profession deemed to be under -
i Section 44AD (61(ii) of schedule P&L) 36i 0
ii Section 44ADA (62(ii) of schedule P&L) 36ii 0
iii Section 44AE (63(ii) of schedule P&L) 36iii 0
iv Section 44B 36iv 0
v Section 44BB 36v 0
vi Section 44BBA 36vi 0
vii Section 44DA 36vii 0
viii Total (36i to 36vii) 36viii 0
37. Net profit or loss from business or profession other than speculative business and specified 37 418294
business (35 + 36viii)
38. Net Profit or loss from business or profession other than speculative business and A38 418294
specified business after applying rule 7A, 7B or 8, if applicable (If rule 7A, 7B or 8 is not
applicable, enter same figure as in 37) (If loss take the figure to 2i of item E)(38a+ 38b +
38c + 38d + 38e + 38f)
a Chargeable income under Rule 7 38a 0
Page 20
b Deemed chargeable Income under Rule 7A 38b 0
c Deemed chargeable Income under Rule 7B(1) 38c 0
d Deemed chargeable Income under Rule 7B(1A) 38d 0
e Deemed chargeable Income under Rule 8 38e 0
f Income other than Rule7, 7A, 7B & 8 (Item No. 37) 38f 418294
39. Balance of income deemed to be from Agriculture, after applying Rule 7, 7A, 7B(1), 7B(1A) 39 0
and Rule 8 for aggregation of income purposes as per Finance Act.
B. Computation of income from speculative business
40 Net profit or loss from speculative business as per profit or loss account 40 0
(Item No.2a)
41 Additions in accordance with section 28 to 44DA 41 0
42 Deductions in accordance with section 28 to 44DA 42 0
43 Income from speculative business (40+41-42) (if loss, take the figure to 6xi 43 0
of schedule CFL)
C. Computation of income from specified business under section 35AD
44 Net profit or loss from specified business as per profit or loss account 44 0
45 Additions in accordance with section 28 to 44DA 45 0
46 Deductions in accordance with section 28 to 44DA (other than deduction 46 0
under section,- (i) 35AD, (ii) 32 or 35 on which deduction u/s 35AD is
claimed)
47 Profit or loss from specified business(44+45-46) 47 0
48 Deductions in accordance with section 35AD(1) 48 0
49 Income from specified business(47-48) (if loss, take the figure to 7xii of 49 0
schedule CFL)
50 Sl.No Relevant clause of sub-section (5) of section 35AD which covers the specified business
D. Income chargeable under the head ‘Profits and gains from business or D 418294
profession’ (A38+B43+C49)
E. Intra head set off of business loss of current year
SI Type of Income of current year (Fill this column Business loss set off Business income remaining after
Business only if figure is zero or positive) set off
income
(1) (2) (3) = (1) – (2)
i Loss to be 0
set off (Fill
this row only
if figure is
negative)
Page 21
ii Income from 0 0 0
speculative
business
iii Income from 0 0 0
specified
business
iv Total loss set off (ii + iii) 0
v Loss remaining after set off (i – iv) 0
Note: Please include the income of the specified persons referred to in Schedule SPI while computing the income under this head
Schedule DPM:Depreciation on Plant and Machinery(Other than assets on which full capital expenditure is allowable as deduction under
any other section)
1 Block of assets Plant and machinery
2 Rate (%) 15 30 40
(i) (ii) (iii)
3 Written down value on the first day of previous year
4 Additions for a period of 180 days or more in the
previous year
5 Consideration or other realization during the
previous year out of 3 or 4
6 Amount on which depreciation at full rate to be
allowed(3 + 4 -5) (enter 0, if result in negative)
7 Additions for a period of less than 180 days in the
previous year
8 Consideration or other realizations during the year
out of 7
9 Amount on which depreciation at half rate to be
allowed (7 - 8)(enter 0, if result is negative)
10 Depreciation on 6 at full rate
11 Depreciation on 9 at half rate
12 Additional depreciation, if any, on 4
13 Additional depreciation, if any, on 7
14 Additional depreciation relating to immediately
preceding year' on asset put to use for less than
180 days
15 Total depreciation (10+11+12+13+14)
16 Depreciation disallowed under section 38(2) of the
I.T. Act (out of column 15)
Page 22
17 Net aggregate depreciation (15-16)
18 Proportionate aggregate depreciation allowable in
the event of succession, amalgamation, demerger
etc. (out of column 17)
19 Expenditure incurred in connection with transfer of
asset/ assets
20 Capital gains/ loss under section 50(5 + 8 -3 -4 -7
-19) (enter negative only if block ceases to exist)
21 Written down value on the last day of previous year
(6+ 9 -15) (enter 0 if result is negative)
Schedule DOA - Depreciation on other assets (Other than assets on which full capital expenditure is allowable as deduction)
1 Block of assets Land Building(not including land) Furniture and Intangible Ships
Fittings assets
2 Rate (%) Nil 5 10 40 10 25 20
(i) (ii) (iii) (iv) (v) (vi) (vii)
3 Written down value on the first day of
previous year
4 Additions for a period of 180 days or
more in the previous year
5 Consideration or other realization
during the previous year out of 3 or 4
6 Amount on which depreciation at full
rate to be allowed(3 + 4 -5) (enter 0, if
result in negative)
7 Additions for a period of less than 180
days in the previous year
8 Consideration or other realizations
during the year out of 7
9 Amount on which depreciation at half
rate to be allowed (7 -8) (enter 0, if
result is negative)
10 Depreciation on 6 at full rate
11 Depreciation on 9 at half rate
12 Total depreciation (10+11)
13 Depreciation disallowed under section
38(2) of the I.T. Act (out of column 12)
14 Net aggregate depreciation (12-13)
Page 23
15 Proportionate aggregate depreciation
allowable in the event of succession,
amalgamation, demerger etc. (out of
column 14)
16 Expenditure incurred in connection with
transfer of asset/ assets
17 Capital gains/ loss under section 50(5
+ 8 -3-4 -7 -16) (enter negative only if
block ceases to exist)
18 Written down value on the last day
of previous year (6+ 9 -12) (enter 0 if
result is negative)
Schedule DEP:Summary of depreciation on assets(Other than assets on which full capital expenditure is allowable as deduction under any
other section)
1 Plant and machinery
a Block entitled for depreciation @ 15 percent ( Schedule DPM -17i or 18i as applicable) 1a
b Block entitled for depreciation @ 30 per cent ( Schedule DPM - 17ii or 18ii as applicable) 1b
c Block entitled for depreciation @ 40 percent ( Schedule DPM - 17iii or 18iii as applicable) 1c
d Total depreciation on plant and machinery ( 1a + 1b + 1c ) 1d
2 Building(not including land)
a Block entitled for depreciation @ 5 per cent (Schedule DOA- 14ii or 15ii as applicable) 2a
b Block entitled for depreciation @ 10 per cent (Schedule DOA- 14iii or 15iii as applicable) 2b
c Block entitled for depreciation @ 40 per cent (Schedule DOA- 14iv or 15iv as applicable) 2c
d Total depreciation on building (total of 2a + 2b + 2c) 2d
3 Furniture and fittings(Schedule DOA- 14v or 15v as applicable) 3
4 Intangible assets (Schedule DOA- 14vi or 15vi as applicable) 4
5 Ships (Schedule DOA- 14vii or 15vii as applicable) 5
6 Total depreciation ( 1d+2d+3+4+5) 6
Schedule DCG:Deemed Capital Gains on sale of depreciable assets
1 Plant and machinery
a Block entitled for depreciation @ 15 percent (Schedule DPM - 20i) 1a
b Block entitled for depreciation @ 30 per cent (Schedule DPM – 20ii) 1b
c Block entitled for depreciation @ 40 percent (Schedule DPM - 20iii) 1c
d Total depreciation on plant and machinery ( 1a + 1b + 1c ) 1d
2 Building(not including land)
a Block entitled for depreciation @ 5 per cent (Schedule DOA- 17ii) 2a
b Block entitled for depreciation @ 10 per cent (Schedule DOA- 17iii) 2b
Page 24
c Block entitled for depreciation @ 40 per cent (Schedule DOA- 17iv) 2c
d Total depreciation on building (total of 2a + 2b + 2c) 2d
3 Furniture and fittings (Schedule DOA- 17v) 3
4 Intangible assets (Schedule DOA- 17vi) 4
5 Ships (Schedule DOA- 17vii) 5
6 Total depreciation ( 1d+2d+3+4+5) 6
Schedule ESR Expenditure on Scientific Research ( Deduction under section 35 or 35CCC or 35CCD)
Sl No Expenditure of the nature referred to in section (1) Amount, if any, debited to profit and Amount of deduction Amount of deduction in
loss account (2) allowable (3) excess of the amount
debited to profit and loss
account (4) = (3) - (2)
i 35(1)(i)
ii 35(1)(ii)
iii 35(1)(iia)
iv 35(1)(iii)
v 35(1)(iv)
vi 35(2AA)
vii 35(2AB)
viii 35 CCC
ix 35 CCD
x Total
Note: In case any deduction is claimed under sections 35(1)(ii) or 35(1)(iia) or 35(1)(iii) or 35(2AA), please provide the details as per Schedule RA
Schedule CG:Capital Gains
A Short-term capital gain (STCG) (Items 4& 5 are not applicable for residents)
Note 1: Furnishing of PAN is mandatory, if the tax is deduced under section 194-IA.
Note 2: In case of more than one buyer, please indicate the respective percentage share and amount.
2 From slump sale
a Full value of consideration 2a 0
b Net worth of the under taking or division 2b 0
c Short term capital gains from slump sale(2a-2b) A2c 0
4 For NON-RESIDENT, not being an FII- from sale of shares or debentures of an Indian company (to be computed with foreign exchange
adjustment under first proviso to section 48)
a STCG on transactions on which securities transaction tax (STT) is paid A4a 0
b STCG on transactions on which securities transaction tax (STT) is not paid A4b 0
5 For NON-RESIDENT- from sale of securities (other than those at A2) by an FII as per section 115AD
a (i) In case securities sold include shares of a company other than quoted shares, enter the following details
a Full value of consideration received/receivable in respect of unquoted shares 5aia 0
Page 25
b Fair market value of unquoted shares determined in the prescribed manner 5aib 0
c Full value of consideration in respect of unquoted shares adopted as per section 50CA for the 5aic 0
purpose of Capital Gains (higher of a or b)
ii Full value of consideration in respect of securities other than unquoted shares 5aii 0
iii Total (ic + ii) 5aiii 0
b Deductions under section 48
i Cost of acquisition without indexation bi 0
ii Cost of Improvement without indexation bii 0
iii Expenditure wholly and exclusively in connection with transfer biii 0
iv Total (i + ii + iii) biv 0
c Balance (5aiii - biv) 5c 0
d Loss to be disallowed u/s 94(7) or 94(8)- for example if security bought/acquired within 3 months prior to 5d 0
record date and dividend/income/bonus units are received, then loss arising out of sale of such security to
be ignored (Enter positive value only)
e Short-term capital gain on sale of securities (other than those at A3 above) by an FII (5c +5d) A5e 0
6 From sale of assets other than at A1 or A2 or A3 or A4 or A5 above
a (i) In case assets sold include shares of a company other than quoted shares, enter the following details
6aii Full value of consideration in respect of assets other than unquoted shares 0
i Cost of acquisition without indexation bi 0
ii Cost of Improvement without indexation bii 0
iv Total (i + ii + iii) biv 0
c Balance (6aiii - 6biv) 6c 0
d In case of asset (security/unit) loss to be disallowed u/s 94(7) or 94(8)- for example if asset bought/ 6d 0
acquired within 3 months prior to record date and dividend/income/bonus units are received, then loss
arising out of sale of such asset to be ignored (Enter positive value only)
e Deemed short term capital gains on depreciable assets (6 of schedule- DCG) 6e 0
f Deduction under section 54D/54G/54GA
SL Section Amount
No
Total 6f 0
Page 26
g STCG on assets other than at A1 or A2 or A3 or A4 or A5 above (6c + 6d + 6e - 6f) A6g 0
7 Amount Deemed to be short-term capital gains
a Whether any amount of unutilized capital gain on asset transferred during the previous years shown below was
deposited in the Capital Gains Accounts Scheme within due date for that year? If yes, then provide the details below
Sl.No. Previous year Section under which New asset acquired/constructed Amount not used for new asset or
in which asset deduction claimed in Year in which asset Amount utilised out remained unutilized in Capital gains
transferred that year acquired/constructed of Capital Gains account (X)
account
b Amount deemed to be short term capital gains, other than at 'a'
Total amount deemed to be short term capital gains (Xi + Xii + b) A7 0
8 Pass Through Income in the nature of Short Term Capital Gain, (Fill up schedule PTI) A8 0
a Pass Through Income in the nature of Short Term Capital Gain, chargeable @ 15% A8a 0
b Pass Through Income in the nature of Short Term Capital Gain, chargeable @ 30% A8b 0
c Pass Through Income in the nature of Short Term Capital Gain, chargeable at applicable rates A8c 0
9 Amount of STCG included in A1-A8 but not chargeable to tax or chargeable at special rates in India as per DTAA
Sl.No (1) Amount Item No. A1 to A8 Country Article of Rate as Whether TRC Section of Rate as per Applicable rate [lower of
of income above in which Name,Code DTAA (5) per Treaty obtained(Y/N) I.T. Act (8) I.T. Act (9) (6) or (9)] (10)
(2) included (3) (4) (6) (7)
a)Total amount of STCG not chargeable to tax as per DTAA A9a 0
b)Total amount of STCG chargeable to tax at special rates in India as per DTAA A9b 0
10 Total short term capital gain (A1e+ A2c+ A3e+ A4a+ A4b+ A5e+ A6g + A7 +A8 - A9a) A10 0
B Long-term capital gain (LTCG) (Sub-items 6, 7, 8 & 9 are not applicable for residents)
Note 1: Furnishing of PAN is mandatory, if the tax is deduced under section 194-IA.
Note 2: In case of more than one buyer, please indicate the respective percentage share and amount.
2 From slump sale
b Net worth of the under taking or division 2b 0
c Balance(2a-2b) 2c 0
d Deduction u/s 54EC/54EE/54F (Specify details in item D below)
SL No Section Amount
Total 2d 0
e Long term capital gains from slump sale (2c-2d) B2e 0
3 From sale of bonds or debenture (other than capital indexed bonds issued by Government)
i Cost of acquisition without indexation 3bi 0
ii Cost of improvement without indexation 3bii 0
Page 27
iii Expenditure wholly and exclusively in connection with transfer 3biii 0
iv Total (bi + bii +biii) 3biv 0
c Balance (3a – 3biv) 3c 0
d Deduction under section 54EE/54F (Specify details in item D below) 3d
Total 3d 0
e LTCG on bonds or debenture (3c – 3d) B3e 0
5 From sale of equity share in a company or unit of equity oriented fund or unit of a business trust on which STT is paid under section 112A
ia Cost of acquisition without indexation(higher of iA and iB) 5ia 0
ia A Cost of acquisition 5iaA 0
ia B If the long term capital asset was acquired before 01.02.2018, lower of B1 and B2 5iaB 0
ia B1 Fair Market Value of capital asset as per section 55(2)(ac) 5ia 0
B1
ia B2 Full value of consideration 5ia 0
B2
bii Cost of improvement without indexation 5bii 0
biii Expenditure wholly and exclusively in connection with transfer 5biii 0
biv Total (bi + bii + biii) 5biv 0
c Balance (5a – biv) 5c 0
d LTCG threshold limit as per section 112A (5c – Rs. 1 lakh) (This exemption shall be considered in schedule 5d
SI)
e Deduction under sections 54EE/54F (Specify details in item D below)
Total 5e 0
f Long-term Capital Gains on assets at B5 above (5c – 5e) B5f 0
6 For NON-RESIDENTS- from sale of shares or debenture of Indian company (to be computed with foreign exchange adjustment under first
proviso to section 48)
a LTCG computed without indexation benefit 6a
b Deduction under sections 54EE/54F (Specify details in item D below)
Total 6b
c LTCG on share or debenture (6a – 6b) B6c
8 For NON-RESIDENTS - From sale of equity share in a company or unit of equity oriented fund or unit of a business trust on which STT is paid
under section 112A
Page 28
ia Cost of acquisition without indexation (higher of iA and iB) 8ia 0
ia A Cost of acquisition 8iaA 0
ia B If the long term capital asset was acquired before 01.02.2018, lower of B1 and B2 8iaB 0
ia B1 Fair Market Value of capital asset as per section 55(2)(ac) 8ia 0
B1
ia B2 Full value of consideration 8ia 0
B2
bii Cost of improvement without indexation 8bii 0
biii Expenditure wholly and exclusively in connection with transfer 8biii 0
biv Total (bi + bii + biii) 8biv 0
c Balance (8a – biv) 8c 0
d Less- LTCG threshold limit as per section 112A (8c – Rs. 1 lakh) (This exemption shall be considered in 8d
schedule SI)
e Deduction under sections 54EE/54F (Specify details in item D below)
SL Section Amount
No
Total 8e 0
f Long-term Capital Gains on assets at B4 above (8c – 8e) B8f 0
9 From sale of foreign exchange asset by NON-RESIDENT INDIAN (If opted under chapter XII-A)
a LTCG on sale of specified asset (computed without indexation) 9a 0
b Less deduction under section 115F (Specify details in item D below) 9b 0
c Balance LTCG on sale of specified asset (9a – 9b) B9c 0
d LTCG on sale of asset, other than specified asset (computed without indexation) 9d 0
e Less deduction under section 115F (Specify details in item D below) 9e 0
f Balance LTCG on sale of asset, other than specified asset (9d – 9e) B9f 0
10 From sale of assets where B1 to B9 above are not applicable
a (i) In case assets sold include shares of a company other than quoted shares, enter the following details
ii Full value of consideration in respect of assets other than unquoted shares 10aii 0
i Cost of acquisition with indexation bi 0
ii Cost of improvement with indexation bii 0
Page 29
iv Total (bi + bii +biii) biv 0
c Balance (10aiii - biv) 10c 0
d Deduction under sections 54D/54EE/54F/54G/54GA(Specify details in item D below)
S. No. Section Amount
Total 10d 0
e Long-term Capital Gains on assets at B10 above (10c-10d) B10e 0
11 Amount deemed to be long-term capital gains
a Whether any amount of unutilized capital gain on asset transferred during the previous years shown below was
deposited in the Capital Gains Accounts Scheme within due date for that year? If yes, then provide the details below
Sl.No. Previous year Section under which New asset acquired/constructed Amount not used for new asset or
in which asset deduction claimed in Year in which asset Amount utilised out remained unutilized in Capital gains
transferred that year acquired/constructed of Capital Gains account (X)
account
b Amount deemed to be short term capital gains, other than at 'a'
Total amount deemed to be short term capital gains (Xi + Xii + b) B11 0
12 Pass Through Income in the nature of Long Term Capital Gain,(Fill up schedule PTI) (B12a + B12b) B12 0
a Pass Through Income in the nature of Long Term Capital Gain, chargeable @ 10% B12a 0
b Pass Through Income in the nature of Long Term Capital Gain, chargeable @ 20% B12b 0
13 Amount of LTCG included in B1- B12 but not chargeable to tax or chargeable at special rates in India as per DTAA (to be taken to schedule
SI)
Sl.No (1) Amount Item No. B1 to Country Article of Rate as Whether TRC Section of Rate as Applicable rate [lower of
of income B11 above in Name,Code DTAA (5) per Treaty obtained(Y/N) I.T. Act (8) per I.T. (6) or (9)] (10)
(2) which included (4) (6) (7) Act (9)
(3)
a)Total amount of LTCG not chargeable to tax as per DTAA B13a 0
b)Total amount of LTCG chargeable to tax at special rates as per DTAA B13b 0
14 Total long term capital gain [B1e +B2e+ B3e +B4e + B5f + B6c + B7e + B8f + B9c+ B9f + B10e + B11 + B12 - B13a] (In B14 0
case of loss take the figure to 9xi of schedule CFL)
C Income chargeable under the head “CAPITAL GAINS” (A9 + B14) (take B14 as nil, if loss) C 0
D Information about deduction claimed
1 In case of deduction u/s 54/54B/54D/54EC/54EE/54F/54G/54GA/115F give following details
a Deduction claimed u/s 54
S. No. Date of transfer of Cost of new residential Date of purchase/ Amount deposited in Amount of deduction
original asset house construction of new Capital Gains Accounts claimed
residential house Scheme before due date
b Deduction claimed u/s 54B
Page 30
S. No. Date of transfer of Cost of new Date of purchase of new Amount deposited in Amount of deduction
original asset agricultural land agricultural land Capital Gains Accounts claimed
Scheme before due date
c Deduction claimed u/s 54D
S. No. Date of acquisition of Cost of purchase/ Date of purchase of new Amount deposited in Amount of deduction
original asset construction of new land or building Capital Gains Accounts claimed
land or building for Scheme before due date
industrial undertaking
d Deduction claimed u/s 54EC
S. No. Date of transfer of Amount invested in specified/notified bonds (not Date of investment Amount of deduction
original asset exceeding fifty lakh rupees) claimed
e Deduction claimed u/s 54EE
S. No. Date of transfer of Amount invested in specified/notified bonds (not Date of investment Amount of deduction
original asset exceeding fifty lakh rupees) claimed
f Deduction claimed u/s 54F
S. No. Date of transfer of Cost of new residential Date of purchase/ Amount deposited in Amount of deduction
original asset house construction of new Capital Gains Accounts claimed
residential house Scheme before due date
g Deduction claimed u/s 54G
S. No. Date of transfer of Cost and expenses Date of purchase/ Amount deposited in Amount of deduction
original asset from incurred for purchase construction of new asset Capital Gains Accounts claimed
urban area or construction of new in an area other than Scheme before due date
asset urban area
h Deduction claimed u/s 54GA
S. No. Date of transfer of Cost and expenses Date of purchase/ Amount deposited in Amount of deduction
original asset from incurred for purchase construction of new asset Capital Gains Accounts claimed
urban area or construction of new in SEZ Scheme before due date
asset
i Deduction claimed u/s 115F (for Non-Resident Indians)
S. No. Date of transfer Amount invested in new specified asset or savings Date of investment Amount of deduction
of original foreign certificate claimed
exchange asset
j Total deduction claimed (1a + 1b + 1c + 1d + 1e + 1f + 1g + 1h +1i) 1j
2 In case of deduction u/s 54GB, furnish PAN of the company
E Set-off of current year capital losses with current year capital gains (excluding amounts included in A9a & B13a which is not chargeable as per
DTAA)
Page 31
Sl.No Type of Capital Capital Gain Short term capital loss Long term capital loss Current
Gain of current 15% 30% applicable DTAA rate 10% 20% DTAA rate year’s
year (Fill this rate capital
column only gains
if computed remaining
figure is after set
positive) off (7=
1-2-3-4-5-6)
1 2 3 4 5 6 7 8 9
i Capital Loss to 0 0 0 0 0 0 0
be set off (Fill
this row only if
figure computed
is negative)
ii Short 15% 0 0 0 0 0
iii term 30% 0 0 0 0 0
iv capital applicable 0 0 0 0 0
gain rate
v DTAA 0 0 0 0 0
rates
vi Long 10% 0 0 0 0 0 0 0 0
vii term 20% 0 0 0 0 0 0 0 0
viii capital DTAA 0 0 0 0 0 0 0 0
gain rates
ix Total loss set off (ii + iii + iv + v + 0 0 0 0 0 0 0
vi + vii + viii)
x Loss remaining after set off(i – ix) 0 0 0 0 0 0 0
F Information about accrual/receipt of capital gain
Type of Capital gain / Date Upto 15/6 16/6 to 15/9 16/9 to 16/12 to 16/3 to 31/3
(i) (ii) 15/12 (iii) 15/3 (iv) (v)
1 Short-term capital gains taxable at the rate of 15% Enter value from item 5vi 0 0 0 0 0
of schedule BFLA, if any.
2 Short-term capital gains taxable at the rate of 30% Enter value from item 0 0 0 0 0
5vii of schedule BFLA, if any.
3 Short-term capital gains taxable at applicable rates Enter value from item 0 0 0 0 0
5viii of schedule BFLA, if any.
4 Short-term capital gains taxable at DTAA rates Enter value from item 5ix of 0 0 0 0 0
schedule BFLA, if any.

Page 32
5 Long- term capital gains taxable at the rate of 10% Enter value from item 0 0 0 0 0
5x of schedule BFLA, if any. Enter value from item 3vi of schedule BFLA, if
any.
6 Long- term capital gains taxable at the rate of 20% Enter value from item 0 0 0 0 0
5xi of schedule BFLA, if any.
7 Long-term capital gains taxable at DTAA rates Enter value from item 5xii of 0 0 0 0 0
schedule BFLA, if any.
Note:Please include the income of the specified persons referred to in Schedule SPI while computing the income under this head
Tool-112A - From sale of equity share in a company or unit of equity oriented fund or unit of a business trust on which STT is paid under
section 112A
Sl.No ISIN Name No. of Sale- Total Cost of Cost of If the Fair Total Full Cost of Expenditure
Total Balance
Code of the Shares/ price per Sale acquisitionacquisition-

long Market Fair value of improvement wholly deductions
(5a –
Share/ Units Share/ Value without Item 5 term Value Market Consideration
without and (bi + bii biv) -
Unit Unit (4*5) indexation (b)(i) capital per Value of - item indexation exclusively
+biii) Item 5
Item 5 Item 5 (A) of asset share/ capital 4 (b)(i) - item 5 (b) in - item (c) of
(a) of (b)(i) of LTCG was unit as asset (B)(2) of (ii) of LTCG connection
5 (b) LTCG
LTCG LTCG Scheduleacquired on 31st as per LTCG Schedule of with (iv) of Schedule
ScheduleSchedule of ITR3 before January,2018

section Schedule ITR3 transfer LTCG of ITR3
of ITR3 of ITR3 01.02.2018, 55(2) of ITR3 - item Schedule
lower (ac)- 5 (b) of ITR3
of B1 (4*10) (iii) of
and B2 - item LTCG
-Lower 5 (b)(i) Schedule
of 11 & (B)(1) of of ITR3
12-item LTCG
5 (b)(i) Schedule
(B) of of ITR3
LTCG
Schedule
of ITR3
(1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) (14) (15) (16)
Total
Tool-115AD (1)(iii)(P) -For NON-RESIDENTS - From sale of equity share in a company or unit of equity oriented fund or unit of a business
trust on which STT is paid under section 112A
Sl.No ISIN Name No. of Sale- Total Cost of Cost of If the Fair Total Full Cost of Expenditure
Total Balance
Code of the Shares/ price per Sale acquisitionacquisition-

long Market Fair value of improvement wholly deductions
(8a –
Share/ Units Share/ Value without Item 8 term Value Market Consideration
without and (bi + bii biv) -
Unit Unit (4*5) indexation (b)(i) capital per Value of - item indexation exclusively
+biii) Item 8
Page 33
Item 8 Item 8 (A) of asset share/ capital 8 (b)(i) - item 8 (b) in - item (c) of
(a) of (b)(i) of LTCG was unit as asset (B)(2) of (ii) of LTCG connection
8 (b) LTCG
LTCG LTCG Scheduleacquired on 31st as per LTCG Schedule of with (iv) of Schedule
ScheduleSchedule of ITR3 before January,2018

section Schedule ITR3 transfer LTCG of ITR3
of ITR3 of ITR3 01.02.2018, 55(2) of ITR3 - item Schedule
lower (ac)- 8 (b) of ITR3
of B1 (4*10) (iii) of
and B2 - item LTCG
-Lower 8 (b)(i) Schedule
of 11 & (B)(1) of of ITR3
12-item LTCG
8 (b)(i) Schedule
(B) of of ITR3
LTCG
Schedule
of ITR3
(1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) (14) (15) (16)
Total
Schedule OS:Income from other sources
1 Gross income chargeable to tax at normal applicable rates (1a+ 1b+ 1c+ 1d + 1e) 1 1961
a Dividend, Gross 1a 0
b Interest, Gross(bi + bii + biii + biv + bv) 1b 96
bi From Savings Bank 1bi 96
bii From Deposit (Bank/ Post Office/ Co-operative) 1bii 0
biii From Income Tax Refund 1biii 0
biv In the nature of Pass through income 1biv 0
bv Others 1bv 0
c Rental income from machinery, plants, buildings, etc., Gross 1c 0
d Income of the nature referred to in section 56(2)(x) which is chargeable to tax (di + dii + diii + div 1d 0
+ dv)
di Aggregate value of sum of money received without consideration 1di 0
dii In case immovable property is received without consideration, stamp duty value of property 1dii 0
diii In case immovable property is received for inadequate consideration, stamp duty value of 1diii 0
property in excess of such consideration
div In case any other property is received without consideration, fair market value of property 1div 0
dv In case any other property is received for inadequate consideration, fair market value of property 1dv 0
in excess of such consideration
Page 34
1e Any other income (please specify nature)
S.No. Nature Amount
1 Family pension 0
2 Miscellaneous Income 1865
Total 1865
2 Income chargeable at special rates (2a+ 2b+ 2c+ 2d + 2e) 2 0
a Winnings from lotteries, crossword puzzles etc. chargeable u/s 115BB 0
b Income chargeable u/s 115BBE (bi + bii + biii + biv+ bv + bvi) 0
i Cash credits u/s 68 0
ii Unexplained investments u/s 69 0
iii Unexplained money etc. u/s 69A 0
iv Undisclosed investments etc. u/s 69B 0
v Unexplained expenditurte etc. u/s 69C 0
vi Amount borrowed or repaid on hundi u/s 69D 0
c Accumulated balance of recognized provident fund taxable u/s 111
SL Assessment Year Income Benefit Tax Benefit
No
Total 0 0
d Any other income chargeable at special rate (total of di to dxviii) dxix) 0
SL Nature Amount
No
e Pass through income in the nature of income from other sources chargeable at special rates 0
SL Nature Amount
No
f Amount included in 1 and 2 above, which is chargeable at special rates in India as per DTAA (total of column (2) of table
below)
Sl.No Amount of Item 1 and 2 in Country Article of Rate as per Whether TRC Section of Rate as Applicable
(1) income (2) which included Name,Code DTAA (5) Treaty (6) obtained(Y/N) I.T. Act (8) per I.T. rate [lower
(3) (4) (7) Act (9) of (6) or
(9)] (10)
3 Deductions under section 57:- (other than those relating to income chargeable at special rates under 2a, 2b & 2d)
a(i) Expenses / Deductions (in case of other than family pension) a(i) 0
a(ii) Deduction u/s 57(iia) (in case of family pension only) a(ii) 0
b Depreciation b 0
c Total c 0
4 Amounts not deductible u/s 58 4 0
5 Profits chargeable to tax u/s 59 5 0
Page 35
6 Net Income from other sources chargeable at normal applicable rates (1 – 3 + 4 + 5) (If negative take the figure to 3xi 6 1961
of schedule CYLA)
7 Income from other sources (other than from owning race horses)(2+6) (enter 6 as nil, if negative) 7 1961
8 Income from the activity of owning and maintaining race horses
a Receipts 8a 0
b Deductions under section 57 in relation to receipts at 8a only 8b 0
c Amounts not deductible u/s 58 8c 0
d Profits chargeable to tax u/s 59 8d 0
e Balance (8a - 8b + 8c + 8d) (if negative take the figure to 10xii of Schedule CFL) 8e 0
9 Income under the head “Income from other sources” (7+8e) (take 8e as nil if negative) 9 1961
10 Information about accrual/receipt of income from Other Sources
S. Upto 15/6(i) From 16/6 to From 16/9 From From 16/3
No. 15/9(ii) to 15/12(iii) 16/12 to to 31/3(v)
15/3(iv)
1 Dividend Income u/s 115BBDA 0 0 0 0 0
2 Income by way of winnings from lotteries, crossword puzzles, 0 0 0 0 0
races, games, gambling, betting etc. referred to in section 2(24)(ix)
NOTE:Please include the income of the specified persons referred to in Schedule SPI while computing the income under this head.
Schedule CYLA - Details of Income after set-off of current years losses
Sl.No Head/ Source of Income Income of current House property loss Business Loss (other Other sources loss Current
year (Fill this column of the current year than speculation loss (other than loss from year's Income
only if income is zero set off or specified business owning race horses) remaining after
or positive) loss) of the current of the current year set off
year set off set off
4 of Schedule -HP 2v of item E of 6 of Schedule-OS
Schedule BP
1 2 3 4 5=1-2-3-4
i Loss to be set off 0 0 0
ii Salaries 0 0 0 0
iii House property 0 0 0 0
iv Income from Business (excluding 418294 0 0 418294
speculation profit and income
from specified business) or
profession
v Speculative Income 0 0 0
vi Specified Business Income 0 0 0 0
Page 36
vii Short-term capital gain taxable 0 0 0 0 0
@ 15%
viii Short-term capital gain taxable 0 0 0 0 0
@ 30%
ix Short-term capital gain taxable at 0 0 0 0 0
applicable rates
x Short-term capital gain taxable 0 0 0 0 0
at Special Rates in India as per
DTAA
xi Long term capital gain taxable @ 0 0 0 0 0
10%
xii Long term capital gain taxable @ 0 0 0 0 0
20%
xiii Long term capital gains taxable 0 0 0 0
DTAA
xiv Net Income from Other sources 1961 0 0 1961
chargeable at Normal Applicable
rates
xv Profit from the activity of owning 0 0 0 0 0
and maintaining race horses
xvi Income from other sources 0 0 0 0 0
taxable at special rates in India
as per DTAA
xvii Total loss set-off 0 0 0
xviii Loss remaining after set-off (i - xvii) 0 0 0
Schedule BFLA - Details of Income after Set off of Brought Forward Losses of earlier years
Sl.No Head/ Source of Income Income after set Brought forward loss Brought forward Brought forward Current
off, if any, of current set off depreciation set off allowance under year’s income
year’s losses as per section 35(4) set off remaining after
5 of Schedule CYLA) set off
1 2 3 4 5
i Salaries 0 0
ii House property 0 0 0 0 0
iii Business (excluding speculation 418294 0 0 0 418294
income and income from
specified business)
Page 37
iv Speculation Income 0 0 0 0
v Specified Business Income 0 0 0 0
vi Short-term capital gain taxable at 0 0 0 0 0
15%
vii Short-term capital gain taxable at 0 0 0 0 0
30%
viii Short-term capital gain taxable at 0 0 0 0 0
applicable rates
ix Short-term capital gain taxable 0 0 0 0 0
DTAA
x Long term capital gain taxable at 0 0 0 0 0
10%
xi Long term capital gain taxable at 0 0 0 0 0
20%
xii Long term capital gains taxable 0 0 0 0 0
DTAA
xiii Net Income from Other sources 1961 0 0 1961
chargeable at Normal Applicable
rates
xiv Profit from the activity of owning 0 0 0 0 0
and maintaining race horses
xv Income from other sources
income taxable at special rates in
India as per DTAA
xvi Total of brought forward loss set off (2ii + 2iii + 2iv + 2v 0 0 0
+ 2vi + 2vii + 2viii + 2ix + 2x + 2xi + 2xii + 2xiv)
xvii Current year's income remaining after set off Total (5i + 5ii + 5iii + 5iv+ 5v + 5vi + 5vii + 5viii + 5ix + 5x + 5xi +5xii + 5xiii+ 420255
5xiv + 5xv)
Schedule CFL:Details of Losses to be carried forward to future years
Sl.No Assessment Year Date of Filing House Loss from Loss from Loss from Short-term Long-term Loss from
(DD/MM/ property loss business other speculative specified capital loss Capital loss owning and
YYYY) than loss from Business business maintaining
speculative race horses
business and
specified
business
Page 38
1 2 3 4 5 6 7 8 9 10
i 2010-11
ii 2011-12
iii 2012-13
iv 2013-14
v 2014-15
vi 2015-16
vii 2016-17
viii 2017-18
ix 2018-19
x Total of earlier
year losses b/f
xi Adjustment of
above losses in
Schedule BFLA
xii 2019-20(Current
year losses to be
carried forward)
xiii Total loss Carried
Forward to future
years
Schedule UD:Unabsorbed depreciation and allowance under section 35(4)
Sl.No Assessment Depreciation Allowance under section 35(4)
(1) Year (2) Amount Amount of Balance carried Amount of brought Amount of allowance Balance Carried
of brought depreciation set-off forward to the next forward unabsorbed set-off against the forward to the next
forward against the current year (5) allowance (6) current year income year (8)
unabsorbed year income (4) (7)
depreciation
(3)
1 2019-20 0 0
Total 0 0 0 0 0 0
Schedule ICDS - Effect of Income Computation Disclosure Standards on profit
Sl.No. ICDS Amount (+) or (-)
(i) (ii) (iii)
I Accounting Policies
II Valuation of Inventories (other than the effect of change in method of valuation u/s
145A, if the same is separately reported at col. 4d or 4e of Part A-OI)
Page 39
III Construction Contracts
IV Revenue Recognition
V Tangible Fixed Assets
VI Changes in Foreign Exchange Rates
VII Government Grants
VIII Securities
IX Borrowing Costs
X Provisions, Contingent Liabilities and Contingent Assets
11a Total effect of ICDS adjustments on profit (I+II+III+IV+V+VI+VII+VIII+IX+X) (if
positive)
11b Total effect of ICDS adjustments on profit (I+II+III+IV+V+VI+VII+VIII+IX+X) (if
negative)
Schedule 10AA:Deduction under Section 10AA
Deduction in respect of units located in Special Economic Zone
Sl.No. Undertaking Assessment year in which unit begins to manufacture/produce/provide Amount of deduction
services
Total deduction under section 10AA (a+b)
Schedule 80G:Details of donations entitled for deduction under section 80G
A. Donations entitled for 100% deduction without qualifying limit
Sl.No. Name of Address City or Town State PinCode PAN of Amount of donation Eligible
donee Detail or District Code Donee Donation in Donation in Total Amount of
cash other mode Donation Donation
Total A
B.Donations entitled for 50% deduction without qualifying limit
Total B
C. Donations entitled for 100% deduction subject to qualifying limit
Total C
D. Donations entitled for 50% deduction subject to qualifying limit
Page 40
Total D
E.Donation in cash(A + B + C + D)
F.Donation in other mode(A + B + C + D)
G.Total Amount of Donations (A+ B + C + D)
H.Total eligible amount of donations (A+ B + C+ D)
Schedule RA Details of donations to research associations etc. [deduction under sections 35(1)(ii) or 35(1)(iia) or 35(1)(iii) or 35(2AA)]
S Name of Address City or State Code PinCode PAN of Amount of donation Eligible Amount of
No. donee Detail Town or Donee Donation Donation in Total Donation
District in cash other mode Donation
Total A
Schedule 80 - Deductions under section 80-IA
A. Deduction in respect of profits of an undertaking referred to in section 80-IA(4)(ii) [Telecommunication services]
B. Deduction in respect of profits of an undertaking referred to in section 80-IA(4)(iii) [Industrial park and SEZs]
C. Deduction in respect of profits of an undertaking referred to in section 80-IA(4)(iv) [Power]
D. Deduction in respect of profits of an undertaking referred to in section 80-IA(4)(v) [Revival of power generating plant] and deduction in respect
of profits of an undertaking referred to in section 80-IA(4)(vi) [Cross-country natural gas distribution network]
E. Total deductions under section 80-IA (a+b+c+d)
Sch 80- IB Deductions under Section 80-IB
A. Deduction in respect of industrial undertaking located in Jammu & Kashmir [Section 80-IB(4)]
B. Deduction in respect of industrial undertaking located in industrially backward states specified in Eighth Schedule [Section 80-IB(4)]
C. Deduction in respect of industrial undertaking located in industrially backward districts [Section 80-IB(5)]
D. Deduction in the case of multiplex theatre [Section 80-IB(7A)]
E. Deduction in the case of convention centre [Section 80-IB(7B)]
F. Deduction in the case of undertaking which begins commercial production or refining of mineral oil [Section 80-IB(9)]
G. Deduction in the case of an undertaking developing and building housing projects [Section 80-IB(10)]
H. Deduction in the case of an undertaking operating a cold chain facility [Section 80-IB(11)]
I. Deduction in the case of an undertaking engaged in processing, preservation and packaging of fruits, vegetables, meat, meat products, poultry,
marine or dairy products [Section 80-IB(11A)]
J. Deduction in the case of an undertaking engaged in integrated business of handling, storage and transportation of foodgrains [Section 80-
IB(11A)]
K. Deduction in the case of an undertaking engaged in operating and maintaining a rural hospital [Section 80-IB(11B)]
L. Deduction in the case of an undertaking engaged in operating and maintaining a hospital in any area, other than excluded area [Section 80-
IB(11C)]
M. Total deduction under section 80-IB (Total of a1 to l2)
Sch 80-IC or 80-IE Deductions under section 80-IC or 80-IE
a Deduction in respect of undertaking located in Sikkim
b Deduction in respect of undertaking located in Himachal Pradesh
Page 41
c Deduction in respect of undertaking located in Uttarakhand
d Deduction in respect of undertaking located in North-East
da Assam
db Arunachal Pradesh
dc Manipur
dd Mizoram
de Meghalaya
df Nagaland
dg Tripura
dh. Total deduction for undertakings located in North-east (total of da1 to dg2)
e Total deduction under section 80-IC or 80-IE (a + b + c + d)
Schedule VI-A:Deduction under Chapter VI-A
Part B- Deduction in respect of certain payments
a 80C - Life insurance premia, deferred annuity, contributions to 15600 15600
provident fund, subscription to certain equity shares or debentures,
etc.
b 80CCC - Payment in respect Pension Fund 0 0
c 80CCD(1) - Contribution to pension scheme of Central 0 0
Government
d 80CCD(1B) - Contribution to pension scheme of Central 0 0
Government
e 80CCD(2) - Contribution to pension scheme of Central 0 0
Government by the Employer
f 80CCG - Investment made under an equity savings scheme 0 0
g 80D 5000
(A) Health Insurance Premium - 0
(B) Medical expenditure - 0
(C) Preventive health check-up - Self and Family 5800
h 80DD - Maintenance including medical treatment of a dependant 0 0
who is a person with disability -
i 80DDB - Medical treatment of specified disease - 0 0
j 80E - Interest on loan taken for higher education 0 0
k 80EE - Interest on loan taken for residential house property 0 0
l 80 G - Donations to certain funds, charitable institutions, etc 0 0
(Please fill 80G Schedule. This field is auto-populated from
schedule.)
m 80GG - Rent paid 90000 50044
Page 42
n 80GGC - Donation to Political party 0 0
Total Deduction under Part B (total of a to n) 111400 70644
2.Part C- Deduction in respect of certain incomes
o 80IA (e of Schedule 80-IA) - Profits and gains from industrial 0 0
undertakings or enterprises engaged in infrastructure
development, etc.
p 80IAB - Profits and gains by an undertaking or enterprise engaged 0
in development of Special Economic Zone
q 80IB (m of Schedule 80-IB) - Profits and gains from certain 0 0
industrial undertakings other than infrastructure development
undertakings
r 80-IBA - Profits and gains from housing projects 0 0
s 80IC / 80IE (e of Schedule 80-IC/ 80-IE) - Special provisions 0 0
in respect of certain undertakings or enterprises in certain
special category States/Special provisions in respect of certain
undertakings in North-Eastern States
t 80JJA - Profits and gains from business of collecting and 0 0
processing of bio-degradable waste.
u 80JJAA - Employment of new employees 0 0
v 80QQB - Royalty income of authors of certain books. 0 0
w 80RRB - Royalty on patents 0 0
Total Deduction under Part C (total of o to w) 0 0
3.Part CA and D- Deduction in respect of other incomes/other deduction
x 80TTA - Interest on saving bank Accounts in case of other than 96 96
Resident senior citizens
y 80TTB - Interest on deposits in case of Resident senior citizens
z 80 U - In case of a person with disability. 0 0
Total Deduction under Part CA and D (total of x to z) 96 96
4 Total deductions under Chapter VI-A (1+2+3) 111496 70740
Schedule AMT:Computation of Alternate Minimum Tax payable under section 115JC
1 Total Income as per item 14 of PART-B-TI 1 349520
2 Adjustment as per section 115JC(2)
2a Deduction Claimed under any section included in Chapter VI-A under the heading “C.—Deductions in 2a 0
respect of certain incomes"
2b Deduction Claimed u/s 10AA 2b 0
2c Deduction claimed u/s 35AD as reduced by the amount of depreciation on assets on which such 2c 0
deduction is claimed
Page 43
2d Total Adjustment (2a+ 2b+ 2c) 2d 0
3 Adjusted Total Income under section 115JC(1) (1+2d) 3 349520
4 Tax payable under section 115JC [18.5% or 9% of (3), as applicable](if 3 is greater than Rs. 20 lakhs) 4 0
Schedule AMTC-Computation of tax credit under section 115JD
1 Tax under section 115JC in assessment year 2019-20 (1d of Part-B-TTI) 1 0
2 Tax under other provisions of the Act in assessment year 2019-20 (2i of Part-B-TTI) 2 2575
3 Amount of tax against which credit is available [enter (2 - 1) if 2 is greater than 1, 3 2575
otherwise enter 0]
4 Utilisation of AMT credit Available (Sum of AMT credit utilized during the current year is subject to maximum of amount mentioned in 3 above
and cannot exceed the sum of AMT Credit Brought Forward)
S.No Assessment Year AMT Credit AMT Credit Utilised Balance AMT Credit
(A) Gross (B1) Set-off in earlier Balance brought during the Current Carried Forward (D)=
assessment years forward to the Assessment Year (B3) -( C)
(B2) current assessment (C)
year (B3) =
(B1) – (B2)
1 2013-14 0 0 0 0 0
2 2014-15 0 0 0 0 0
3 2015-16 0 0 0 0 0
4 2016-17 0 0 0 0 0
5 2017-18 0 0 0 0 0
6 2018-19 0 0 0 0 0
7 Current AY(enter 1 0 0
-2, if 1>2 else enter
0)
8 Total 0 0 0 0 0
5 Amount of tax credit under section 115JD utilised during the year [total of item no 4 (C)] 5 0
6 Amount of AMT liability available for credit in subsequent assessment years [total of 4 6 0
(D)]
Schedule SPI - Income of specified persons (spouse, minor child etc.) includable in income of the assessee as per section 64
S.No. Name of person PAN of person (optional) Relationship Amount (Rs) Head of Income
in which included
Schedule SI - Income chargeable to Income tax at special rates
Sl.No Section/Description Special rate (%) Income (i) Tax thereon (ii)
Total 0
Schedule IF:Information regarding partnership firms in which you are partner
Number of firms in which you are partner
Page 44
S.No. Name of PAN of the firm Whether the firm Whether section Percentage share Amount of share in Capital Balance as on
the firm is liable for audit? 92E is applicable in the profit of the the profit 31st March in the firm
(Yes/No) to firm? (Yes/ No) firm
Total
Schedule EI:Details of Exempt Income (Income not to be included in Total Income)
1 Interest income 1
2 Dividend income from domestic company (amount not exceeding Rs. 10 lakh) 2
3 i Gross Agricultural receipts (other than income to be excluded under rule 7A, 7B or 8 of I.T. Rules) i
ii Expenditure incurred on agriculture ii
iii Unabsorbed agricultural loss of previous eight assessment years iii
iv Net Agricultural income for the year (i – ii – iii) (enter nil if loss) iv
v In case the net agricultural income for the year exceeds Rs.5 lakh, please furnish the following details
Sl.No. Name of district along with pin code in which Measurement of Whether the agricultural Whether the agricultural
agricultural land is located agricultural land in Acre land is owned or held land is irrigated or rain-
Name of district. Pin code on lease fed
4 Others exempt income, (including exempt income of minor child) (please specify)
Sl.No. Nature of Income Amount
Total 4
5 Income not chargeable to tax as per DTAA
Sl.No. Amount of Income Nature of Income Country name & code Article of DTAA Head of Income Whether TRC
obtained
Total Income from DTAA not chargeable to tax 5
6 Pass through income not chargeable to tax (Schedule PTI) 6
7 Total (1 + 2 + 3(iv) + 4 + 5 + 6) 7
Schedule PTI:Pass Through Income details from business trust or investment fund as per section 115UA,115UB
Sl Name of business trust/ PAN of the business Sl Head of income Amount of income TDS on such amount,if
investment fund trust/investment fund any
NOTE : Please refer to the instructions for filling out this schedule
Schedule FSI:Details of Income from outside India and tax relief
Sl.No. Country Taxpayer Sl.No. Head of Income Tax paid outside Tax payable on Tax relief Relevant article
Code Identification Income from outside India such income available in of DTAA if relief
number India(included in under normal India(e)= (c) or claimed u/s 90
PART B-TI) provisions in (d) whichever is or 90A
India lower
(a) (b) (c) (d) (e) (f)
Note: Please refer to the instructions for filling out this schedule
Schedule TR:Summary of tax relief claimed for taxes paid outside India
Page 45
1 Details of Tax Relief claimed
Sl.No Country Code Taxpayer Identification Total taxes paid Total tax relief Section under
Number outside India (total of available(total of which relief
(c) of Schedule FSI (e) of Schedule FSI claimed(specify 90,
in respect of each in respect of each 90A or 91)
country) country
(a) (b) (c) (d) (e)
Total
2 Total Tax relief available in respect of country where DTAA is applicable (section 90/90A) (Part of total of 2
1(d))
3 Total Tax relief available in respect of country where DTAA is not applicable (section 91) (Part of total of 3
1(d))
4 Whether any tax paid outside India, on which tax relief was allowed in India, has been refunded/credited 4
by the foreign tax authority during the year? If yes, provide the details below
4a Amount of tax refunded 4a
4b Assessment year in which tax relief allowed in India 4b
Note:Please refer to the instructions for filling out this schedule.
Schedule FA:Details of Foreign Assets and Income from any source outside India
A1 Details of Foreign Depository Accounts held (including any beneficial interest) at any time during the relevant accounting period)
Sl Country Name of Address of ZIP Code Account Status(7) Account Peak Closing Gross interest paid/
No Name and the financial the financial (5) Number opening Balance balance credited to the
(1) Code(2) institution(3) institution(4) (6) date (8) During the (10)(?) account during the
Period (9) period (11)
A2 Details of Foreign Custodial Accounts held (including any beneficial interest) at any time during the relevant accounting period
Sl Country Name of Address of ZIP Code Account Status(7) Account Peak Closing Gross interest paid/
No Name and the financial the financial (5) Number opening Balance balance credited to the account
(1) Code(2) institution(3) institution(4) (6) date (8) During the (10)(?) during the period(11)
Period (9) Nature of Amount
Amount 11(b)
11(a)
A3 Details of Foreign Equity and Debt Interest held (including any beneficial interest) in any entity at any time during the relevant accounting period
Sl Country Name of Address of ZIP Code Nature of Date of Initial Peak Closing Total gross Total gross
No Name and entity(3) entity(4) (5) entity (6) acquiring value value of balance amount proceeds
(1) Code(2) the of the investment (10) paid/ from sale or
interest(7) investmentduring the credited redemption
(8) period (9) with respect of
to the investment
holding
Page 46
during the during the
period (11) period (12)
A4 Details of Foreign Cash Value Insurance Contract or Annuity Contract held (including any beneficial interest) at any time during the relevant
accounting period
Sl Country Name of financial institution Address ZIP Code (5) Date of The cash value or Total gross amount paid/
No Name and in which insurance contract of financial contract (6) surrender value of credited with respect to the
(1) Code(2) held(3) institution (4) the contract(7) contract during the period.
(8)
B Details of Financial Interest in any Entity held (including any beneficial interest) at any time during the relevant accounting period
Sl Country Zip Nature of Name Address Nature Date Total Income Nature of Income taxable and offered in
No Name and Code(2b) entity (3) of the of the of since Investment accrued Income this return
(1) Code(2a) Entity Entity Interest held (6) (at cost) from (9) Amount Schedule Item
(4a) (4b) (5) (7) such (10) where number
Interest(8) offered of
(11) schedule
(12)
C Details of Immovable Property held (including any beneficial interest) at any time during the relevant accounting period
Sl Country Zip Code Address Ownership Date of Total Income Nature of Income taxable and offered in this return
No Name and (2b) of the (4) acquisition Investmentderived Income Amount Schedule where Item number of
(1) Code (2a) Property (5) (at from the (8) (9) offered (10) schedule (11)
(3) cost) (in property
rupees) (7)
(6)
D Details of any other Capital Asset held (including any beneficial interest) at any time during the relevant accounting period
Sl Country Zip Nature Ownership Date of Total Income Nature of Income taxable and offered in this return
No Name and Code of Asset (4) acquisitionInvestmentderived Income (8) Amount Schedule where Item number of
Code (2a) (2b) (3) (5) (at cost) from the (9) offered (10) schedule (11)
(6) asset (7)
E Details of account(s) in which you have signing authority held (including any beneficial interest) at any time during the relevant accounting
period and which has not been included in A to D above.
Sl Name Address Country Zip Code Name Account Peak Whether If (7) If (7) is yes, Income offered in this
No of the of the Name and (3c) of the Number Balance/ income is yes, return
Institution Institution Code (3b) account (5) Investment accrued Income Amount Schedule Item
in which (3a) holder (4) during is taxable accrued (9) where number of
the the year in your in the offered schedule
account is (6) hands? account (10) (11)
held (2) (7) (8)
F Details of trusts, created under the laws of a country outside India, in which you are a trustee, beneficiary or settlor
Page 47
Sl Country Zip Name Address Name AddressName AddressName of Address of Date Whether If (8) If (8) is yes, Income
No Name Code of of the of of of of Beneficiaries Beneficiaries since income is yes, offered in this return
(1) and (2b) the trust trusteestrusteesSettlor Settlor (6a) (6b) position derived Income Amount Schedule Item
Code trust (3b) (4a) (4b) (5a) (5b) held is derived (10) where number
(2a) (3a) (7) taxable from offered of
in your the (11) schedule
hands? trust (12)
(8) (9)
G Details of any other income derived from any source outside India which is not included in,- (i) items A to F above and, (ii) income under the
head business or profession
Sl No Country Name Zip Name of Address of Income derived (4) Nature of income Whether taxable If (7) is yes, Income
(1) and Code(2a) Code the person the person (5) in your hands? offered in this return
(2b) from whom from whom (6) Amount Schedule Item
derived (3a) derived (3b) (8) where number
offered of
(9) schedule
(10)
NOTE Please refer to instructions for filling out this schedule. In case of an individual, not being an Indian citizen, who is in India on a business,
employment or student visa, an asset acquired during any previous year in which he was non-resident is not mandatory to be reported in this
schedule if no income is derived from that asset during the current previous year.
Schedule 5A:Information regarding apportionment of receipts between spouses governed by Portuguese Civil Code
Name of the spouse
PAN of the spouse
Heads of Income Receipts received under Amount apportioned in the Amount of TDS deducted TDS apportioned in the
the head hands of the spouse on income at (ii) hands of spouse
(i) (ii) (iii) (iv) (v)
1 House Property
2 Business or profession
3 Capital gains
4 Other sources
5 Total
Schedule AL:Assets and Liabilities at the end of the year (other than those included in Part A- BS) (applicable in a case where total income
exceeds Rs.50 lakh)
A Details of immovable asset
Sl.No. Description Address Amount (cost) in Rs.
Page 48
Flat/ Name of Road/ Street/ Area/ Town/ State CountryPincodeZip Code
Door/ Premises / Post office LocalityCity/
Block Building / District
No. Village
B Details of movable asset
Sl.no Description Amount (cost) in Rs.
(i) Jewellery, bullion etc.
(ii) Archaeological collections, drawings, painting, sculpture or any work of art.
(iii) Vehicles, yachts, boats and aircrafts.
(iv) Financial asset.
(a) Bank (including all deposits).
(b) Shares and securities.
(c) Insurance policies.
(d) Loans and advances given.
(e) Cash in hand.
C Do you have any Interest held in the assets of a firm or association of persons (AOP) as a partner or member
thereof ?
Sl.No. Name of Address of the firm(s)/ AOP(s)(2) PAN of the Assessee’s investment
the firm(s)/ firm/ AOP(3). in the firm/ AOP on cost
AOP(s)(1) basis(4)
Flat/ Name Road/ Street/ Area/ Town/ State CountryPincodeZip
Door/ of Post office Locality City/ Code
Block Premises / District
No. Building /
Village
D Liabilities in relation to Assets at (A+B+C)
Schedule-GST INFORMATION REGARDING TURNOVER/GROSS RECEIPT REPORTED FOR GST
S. GSTIN No(s) Annual value of outward supplies as per the GST return(s) filed
No.
Note: Please furnish the information above for each GSTIN No. separately
PART B - TI (Computation of Total Income)
1 Salaries (6 of Schedule S) 1 0
2 Income from house property (4 of Schedule-HP) (enter nil if loss) 2 0
3 Profits and gains from business or profession
i Profit and gains from business other than speculative business and specified 3i 418294
business (A38 of Schedule-BP) (enter nil if loss)
Page 49
ii Profit and gains from speculative business (B43 of Schedule BP) (enter nil if loss 3ii 0
and take the figure to schedule CFL)
iii Profit and gains from specified business (C49 of Schedule BP) (enter nil if loss 3iii 0
and take the figure to schedule CFL)
iv Income chargeable to tax at special rates (3e & 3f of Schedule BP) 3iv 0
v Total (3i + 3ii + 3iii + 3iv) (enter nil if 3v is a loss) 3v 418294
4 Capital gains
a Short term
i Short-term chargeable @ 15% (9ii of item E of schedule CG) 4ai 0
ii Short-term chargeable @ 30% (9iii of item E of schedule CG) 4aii 0
iii Short-term chargeable at applicable rate (9iv of item E of schedule CG) 4aiii 0
iv STCG chargeable at special rates as per DTAA(9v of item E of Schedule 4aiv 0
CG)
v Total short-term (ai+aii+aiii+aiv) 4av 0
b Long term
i Long-term chargeable @ 10% (9vi of item E of schedule CG) 4bi 0
ii Long-term chargeable @ 20% (9vii of item E of schedule CG) 4bii 0
iii LTCG chargeable at special rates as per DTAA(9viii of item E of Schedule 4biii 0
CG)
iv Total Long-term (bi + bii + biii) (enter nil if loss) 4biv 0
c Total capital gains (4av + 4biv) (enter nil if loss) 4c 0
5 Income from other sources
a Net Income from Other sources chargeable to tax at Normal Applicable rates (6 of 5a 1961
Schedule OS) (enter nil if loss)
b Income chargeable to tax at special rate(2 of Schedule OS) 5b 0
c Income from the activity of owning & maintaining race horses (8e of Schedule OS) 5c 0
(enter nil if loss)
d Total (5a + 5b + 5c) (enter nil if loss) 5d 1961
6 Total of Head Wise Income((1 + 2 +3vi+4c +5d) 6 420255
7 Losses of current year to be set off against 6 (total of 2xvii, 3xvii and 4xvii of Schedule 7 0
CYLA)
8 Balance after set off current year losses (6 - 7) (total of column 5 of Schedule CYLA+5b 8 420255
+3iv)
9 Brought forward losses to be set off losses against 8 (total of 2xvi, 3xvi and 4xvi of 9 0
Schedule BFLA)
10 Gross Total income (8 - 9) (5xvii of Schedule BFLA + 5b + 3iv ) 10 420255
Page 50
11 Income chargeable to tax at special rate under section 111A, 112, 112A etc. included in 11 0
10
12 Deductions under Chapter VI-A
a Part-B, CA and D of Chapter VI-A [(1 + 3) of Schedule VI-A and limited upto 12a 70740
(10-11)]
b Part-C of Chapter VI-A [(2 of Schedule VI-A and limited upto (10-11-3iii)] 12b 0
c Total (12a + 12b) [limited upto (10-11)] 12c 70740
13 Deduction u/s 10AA (c of Sch. 10AA) 13 0
14 Total income (10 - 12 - 13c) 14 349520
15 Income which is included in 14 and chargeable to tax at special rates (total of (i) of 15 0
schedule SI)
16 Net agricultural income for rate purpose (3 of Schedule EI) 16 0
17 Aggregate income (14-15+16) [applicable if (14-15) exceeds maximum amount not 17 349520
chargeable to tax]
18 Losses of current year to be carried forward (total of row xii of Schedule CFL) 18 0
19 Deemed income under section 115JC (3 of Schedule AMT) 19 349520
Part B-TTI - Computation of tax liability on total income
1 a Tax payable on deemed total income under section 115JC (4 of Schedule AMT) 1a 0
b Surcharge on (a) (if applicable) 1b 0
c Health and Education Cess on (1a+1b) above 1c 0
d Total Tax Payable on deemed total income (1a+1b+1c) 1d 0
2 Tax payable on total income
a Tax at normal rates on 17 of Part B-TI 2a 4976
b Tax at special rates (total of col(ii) of Schedule-SI) 2b 0
c Rebate on agricultural income [applicable if (14-15) of Part B-TI exceeds 2c 0
maximum amount not chargeable to tax]
d Tax Payable on Total Income (2a + 2b – 2c) 2d 4976
e Rebate u/s 87A 2e 2500
f Tax Payable after Rebate (2d-2e) 2f 2476
g Surcharge
(i) 25% of 16(ii) of Schedule SI 2gi 0
(ii) On [(2f) – (16(ii) of Schedule SI)] 2gii 0
(iii) Total (i + ii) 2giii 0
h Health and Education Cess, on (2f+2giii) 2h 99
i Gross tax liability (2f+2giii+2h) 2i 2575
3 Gross tax payable (higher of 1d and 2i) 3 2575
Page 51
4 Credit under section 115JD of tax paid in earlier years (applicable if 2i is more than 1d) (5 of 4 0
Schedule AMTC)
5 Tax payable after credit under section 115JD (3-4) 5 2575
6 Tax relief
a Section 89 (Please ensure to submit Form 10E to claim this relief) 6a 0
b Section 90/ 90A ( 2 of Schedule TR) 6b 0
c Section 91 ( 3 of Schedule TR) 6c 0
d Total (6a + 6b + 6c) 6d 0
7 Net tax liability (5 – 6d)(enter zero if negative) 7 2575
8 Interest and fee payable
a Interest for default in furnishing the return (section 234A) 8a 375
b Interest for default in payment of advance tax (section 234B) 8b 0
c Interest for deferment of advance tax (section 234C) 8c 0
d Fee for default in furnishing return of income (section 234F) 8d 1000
e Total Interest and Fee Payable (8a+8b+8c+8d) 8e 1375
9 Aggregate liability (7 + 8e) 9 3950
10 Taxes paid
a Advance Tax (from column 5 of 17A) 10a 0
b TDS (total of column 5 of 18B and column 9 of 17C1 and column 9 of 17C2) 10b 0
c TCS (total of column 7 of 17D) 10c 0
d Self Assessment Tax (from column 5 of 17A) 10d 3950
e Total Taxes Paid (10a+10b+10c+10d) 10e 3950
11 Amount payable (Enter if 9 is greater than 10e, else enter 0) 11 0
Refund
12 Refund (If 10e is greater than 9) (Refund, if any, will be directly credited into the bank account) 12 0
Bank Account Details
13 a) Details of all Bank Accounts held in India at any time during the previous year (excluding dormant accounts
Sl No. IFS Code of the Bank Name of the Bank Account Number(the number should be 9 Indicate the
digits or more as per CBS system of the bank ) account in
which you
prefer to get
your refund
credited
1 SBIN0016850 State bank of india 62266619890
b) Non-residents, who are claiming income-tax refund and not having bank account in India may, at their option, furnish the details of one
foreign bank account
Sl No. SWIFT Code Name of the Bank IBAN Country of Location

Page 52
14 Do you at any time during the previous year :- (i) hold, as beneficial owner, beneficiary or otherwise, any asset
(including financial interest in any entity) located outside India or (ii) have signing authority in any account
located outside India or (iii) have income from any source outside India? [applicable only in case of a resident]
[Ensure Schedule FA is filled up if the answer is Yes ]
15 If the return has been prepared by a Tax Return Preparer (TRP) give further details below:
Identification No. of TRP:
Name of TRP :
16 If TRP is entitled for any reimbursement from the Government, amount thereof
18A - IT. Details of payments of Advance Tax and Self-Assessment Tax
Sl.No. BSR Code Date of Deposit (DD/MM/YYYY) Serial number of challan Amount
1 0271852 2020-11-05 50970 3950
Total 3950
NOTE Enter the totals of Advance tax and Self-Assessment tax in Sl No. 10a and 10d of Part B-TTI
Schedule TDS 1
18B - Details of Tax Deducted at Source from Salary [As per Form 16 issued by Employer(s)]
Sl.No. Tax Deduction Account Number Name of the Employer (3) Income chargeable under Total Tax Deducted (5)
(1) (TAN) of the Employer (2) Salaries (4)
TOTAL
NOTE Please enter total of column 5 in 10b of Part B-TTI
Schedule TDS 2
18C(1)- Details of Tax Deducted at Source on Income [As per FORM 16A issued by Deductor(s)]
Sl.No. TDS PAN Of Tax Unclaimed TDS TDS of the current TDS credit being claimed this Year Corresponding TDS
(1) credit in Other Deductionbrought forward financial Year (TDS (only if corresponding income is Receipt offered credit
the name Person(If Account (b/f) deducted during the FY being offered for tax this year) being
of relating TDS Number 2018-19) carried
to Self/ credit (TAN) Fin. TDS b/ DeductedDeducted in the claimed Claimed in the hands of Gross Head forward
Other related of the Year in f (6) in own hands of spouse in own spouse as per section 5A Amount of
Person[Spouse
to other Deductorwhich hands* as per section hands or any other person as per Income
as per person) (4) TDS (7) 5A or any other (9) rule 37BA(2) (If applicable)
section (3) deducted person as per
5A/Other (5) rule 37BA(2) (if
person as applicable)Col (8)
per Rule (if applicable) (8)
37BA(2)] Income TDS Income TDS PAN
(2)
TOTAL
NOTE Please enter total of column 5 of TDS1 and column 9 of TDS2 and column 9 of TDS3 in 11(b) of Part B-TTI
Page 53
Schedule TDS 3
18C(2) - Details of Tax Deducted at Source (TDS) on Income [As per Form 16B/16C furnished issued by Deductor(s)]
Sl.No. TDS PAN Of PAN Unclaimed TDS TDS of the current TDS credit out of being claimed Corresponding TDS
(1) credit in Other of the brought forward financial Year (TDS this Year (only if corresponding Receipt offered credit
the name Person(If buyer/ (b/f) deducted during the FY income is being offeredfor tax this out of
of relating TDS Tenant 2018-19) year) being
to Self/ Credit (4) Financial Amount DeductedDeducted in the claimed Claimed in the hands of Gross Head carried
Other related year in b/f(6) in own hands of spouse in own spouse as per section Amount of forward
Person[Spouse
to other which hands as per section hands 5A or any other person Income
as per person) TDS is (7) 5A or any other (9) as per rule 37BA(2)(If
section (3) deducted person as per applicable) (10)
5A/Other (5) rule 37BA(2) (if
person as applicable)(if
per Rule applicable) (8)
37BA(2)] Income TDS Income TDS PAN
(2)
TOTAL
NOTE Please enter total of column 5 of TDS1 and column 9 of TDS2 and column 9 of TDS3 in 11(b) of Part B-TTI
18D - TCS. Details of Tax Collected at Source (TCS) [As per Form 27D issued by the Collector(s)]
Sl.No. Tax Deduction Name of the Unclaimed TCS brought forward (b/f) TCS of the Amount out of Amount out of
(1) and Tax Collection Collector (3) current fin. Year (5) or (6) being (5) or (6) being
Account Number of (6) claimed this carried forward
the Collector (2) Financial year in Amount b/f (5) Year (only if (8)
which Collected (4) corresponding
income is
being offered
for tax this
year) (7)
TOTAL
NOTE Please enter total of column (7) in 10c of Part B-TTI
Verification
I,SHAIK RAMEEZAson/ daughter of SHAIK AHMED BASHA solemnly declare that to the best of my knowledge and belief, the information given in
the return and the schedules thereto is correct and complete and is in accordance with the the provisions of the Income-tax Act, 1961. I further declare
that I am making returns in my capacity as Selfand I am also competent to make this return and verify it. I am holding permanent account number
HEAPS3268R .I further declare that the critical assumptions specified in the agreement have been satisfied and all the terms and conditions of the
agreement have been complied with. (Applicable, in a case where return is furnished under section 92CD).
Page 54

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Acknowledgement Number : 700884900051120 Assessment Year : 2019-20

PART A-GEN- PERSONAL INFORMATION

First Name SHAIK Middle Name

Last Name RAMEEZA PAN HEAPS3268R

Date of Birth / Formation (DD/MM/ 01-Jul-1994 Status Individual

Flat / Door / Building 7-1-625, Town / City / District Nellore

Area / Locality Ranganayakulapeta State ANDHRA PRADESH

Country INDIA PIN Code 524001

Residential/Office Phone Number with STD code 09676579712

Mobile no.1 91 9676579712 Mobile no.2

Email Address - 1(Self) aca.prabha@gmail.com Email Address - 2

Aadhaar Number(Please enter the 439897257681 Aadhaar Enrolment Id (If Aadhaar

your PAN in e-Filing portal. Applicable to Aadhaar Enrolment Id is required.

Individual only.) All the digits in enrolment ID and

Date and time of enrolment to be

Filed u/s 139(4)- After due date

If revised/defective/Modified, enter Receipt no

Date of Filing original return(DD/MM/YYYY)

If filed, in response to a notice u/s 139(9)/142(1)/148/153A/153C enter date

advance pricing agreement

S.No. Jurisdiction(s) of residence Taxpayer Identification Number(s)

please fill Schedule 5A)

Whether return is being filed by a representative assessee? if yes,please No

furnish following information

(a) Name of the Representative

(b) Capacity of the Representative

(c) Address of the Representative

(d) Permanent Account Number (PAN) of the Representative

year?If yes, please furnish following information

No. or unlisted Number (DIN)

Whether you are a Partner in a Firm?If yes, please furnish following No

Sl. No. Name of Firm PAN

year?If yes, please furnish following information in respect of Equity Shares

No. company company balance transferred during

shares shares purchase per (in case of share (in

share fresh issue) case of

In case of non-resident, is there a permanent establishment (PE) in India?

Whether assessee is located in an International Financial Services Centre No

and derives income solely in convertible foreign exchange?

(a) Are you liable to maintain accounts as per section 44AA? No

(b) Are you liable for audit under section 44AB? No

If yes, furnish the following information below

(i) Date of furnishing of the audit report (DD/MM/YYYY)

(ii) Name of the auditor signing the tax audit report

(iii) Membership no. of the auditor

(iv) Name of the auditor (proprietorship/ firm)

(v) Proprietorship/firm registration number

(vi) Permanent Account Number (PAN) of the proprietorship/ firm

(vii) Date of report of the audit

(d.i) Are you liable for Audit u/s 92E?

No Date of audit report (DD/

Sl.No. Section Code Date (DD/MM/YYYY)

Sl.No. Act Description Section Date (DD/MM/YYYY)

DECLARING INCOME UNDER SECTIONS 44AD, 44ADA AND 44AE)

proprietorship, if any proprietorship, if any proprietorship, if any

1 16019-Other professional SHAIK RAMEEZA RMP CLINIC

b. Reserves & Surplus

ii Capital Reserve bii 0

iii Statutory Reserve bii 0