INDIAN INCOME TAX RETURN VERIFICATION FORM

[Where the data of the Return of Income/Fringe Benefits in Form ITR-1, ITR-2, ITR-3,
FORM

ITR- V ITR-4, ITR-5, ITR-6 & ITR-8 transmitted electronically without digital signature]
(Please see rule 12 of the Income-tax Rules,1962)
(Also see attached instructions)

Name PAN
PERSONAL INFORMATION & DATE OF
ELECTRONIC TRANSMISSION

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

Road/Street/Post Office Area/Locality

Town/City/District State

Designation of Assessing Officer (Ward/ Circle) Original or Revised

E-filing Acknowledgement Number Date (DD/MM/YYYY))
1 Gross Total Income
COMPUTATION OF INCOME AND TAX THEREON

2 Deductions Under Chapter VI-A

3 Total Income
4 Net tax payable
5 Interest payable
6 Total tax and interest payable
7 Taxes paid
a Advance Tax 7a -
b TDS 7b -
c TCS 7c -
d Self Assessment Tax 7d -
e Total Taxes Paid (7a+7b+7c+7d)
8 Tax Payable (6-7d)
9 Refund (7e-6)
10 Value of Fringe Benefits
COMPUTATION OF FRINGE BENEFITS

11 Total fringe benefit tax liability

12 Total interest payable
AND TAX THEREON

13 Total tax and interest payable

14 Taxes paid
a Advance Tax 14a
b Self Assessment Tax 14b
 COMPUTATION OF FRINGE
AND TAX THEREO c Total Taxes Paid (14a+14b)
15 Tax Payable (13-14c)

16 Refund (14c-13)
I, son/ daughter of , holding permanent account number
solemnly declare that to the best of my knowledge and belief, the information given in the return and the schedules th
transmitted electronically by me vide acknowledgement number mentioned above is correct and complete and that the am
fringe benefits and other particulars shown therein are truly stated and are in accordance with the provisions of the Income-ta
income and fringe benefits chargeable to income-tax for the previous year relevant to the assessment year 2009-10. I further d
this return in my capacity as ___________ and I am also competent to make this return and verify it.

Place Date Sign here

26 If the return has been prepared by a Tax Return Preparer (TRP) give further details as below :
Identification No. of TRP Name of TRP Counter Signature of TRP

For Office Use Only Seal and Signature off receiving official
Receiiptt No
Date
 FORM Assessment Year
R-1, ITR-2, ITR-3,
tal signature]
2009-10

Form No. which

uilding/Village has been
electronically
transmitted (fill
the code)

Status (fill the

code)
iginal or Revised
te (DD/MM/YYYY))
1 -
2 -
3 -
4 -
5 -
6 -

-
-
-
-
7e -
8 -
9 -
10 -
11 -
12 -
13 -
 14c -
15 -

16 -
rmanent account number _________________________
return and the schedules thereto which have been
and complete and that the amount of total income/
e provisions of the Income-tax Act, 1961, in respect of
ment year 2009-10. I further declare that I am making
it.

Counter Signature of TRP

eiving official
 FORM
INDIAN INCOME TAX RETURN Assessment Year
[For Individuals & HUFs having income from a proprietory business or profession]
ITR-4
(Please see Rule 12 of Income-tax Rules, 1962)
(Also see attached instructions) 2 0 0 9 - 1 0

Part A - GEN GENERAL

First Name Middle name Last name PAN
PERSONAL INFORMATION

Flat/Door/Block No. Name of Premises/Building/Village Status (Tick)

Individual HUF
Road/Street/Post Office Area/Locality Date of Birth (DD/MM/YYYY)
(in case of Individual)

Town/City/District State Pin code Sex (In case of Individuals) (Tick)

Male Female
Email Address (STD code)-Phone Number Employer Category
(If in employment) (Tick)
( ) Govt. PSU Others
Designation of Assessing Officer (Ward/Circle) Return filed under Section - [Please
see instruction number 9(i)]

Whether original or Revised return (Tick) Original Revised

If revised, then enter Receipt No and Date of filing original

FILING STATUS

return (DD/MM/YYYY)

Residential Status (Tick) Resident Non-Resident Resident but Not Ordinarily Resident
Whether this return is being filed by a representative of assessee? (Tick) Yes No
If yes, please furnish following information -
(a) Name of the representative
(b) Address of the representative
(c) Permanent account Number (PAN) of the representative
Are you liable to maintain accounts as per section 44AA? (Tick) Yes No
AUDIT INFORMATION

Are you liable for audit under section 44AB? (Tick) Yes No If yes, furnish following information-
(a) Name of the auditor signing the tax audit report
(b) Membership no. of the auditor
(c) Name of the auditor (proprietorship/firm)
(d) Permanent Account Number (PAN) of the proprietorship/ firm
(e) Date of audit report.

For Office Use only For Office Use Only

Receipt No.

Date

Seal and signature of receiving official

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 NATURE OF BUSINESS Nature of business or profession, if more than one business or profession indicate the three main activities/products
S. No. Code Trade name of the
Description
[Please see instruction No.9(ii)] proprietorship, if any

(i)

(ii)

(iii)

BALANCE SHEET AS ON 31ST DAY OF MARCH, 2009 OF THE PROPRIETORY BUSINESS

Part A - BS
(fill items 1 to 5 in a case where regular books of accounts are maintained, other wise fill item6)
1 Proprietor's fund
a Proprietor's capital a
b Reserves and Surplus
i Revaluation Reserve bi
ii Capital Reserve bii
iii Statutory Reserve biii
iv Any other Reserve biv
v Total (bi + bii + biii + biv) bv
c Total proprietor's funds (a + bv) 1c
SOURCES OF FUNDS

2 Loan funds
a Secured loans
i Foreign Currency Loans ai
ii Rupee Loans
A From Banks iiA
B From others iiB
C Total (iiA + iiB) iiC
iii Total (ai + iiC) aiii
b Unsecured loans
i From Banks bi
ii From others bii
iii Total (bi + bii) biii
c Total Loan funds (aiii + biii) 2c
3 Deferred tax liability 3
4 Sources of funds (1c + 2c + 3) 4
1 Fixed assets
a Gross: Block 1a
b Depreciation 1b
c Net Block (a - b) 1c
d Capital work-in-progress 1d
e Total (1c + 1d) 1e
APPLICATION OF FUNDS

2 Investments
a Long-term investments
i Government and other Securities - Quoted ai
ii Government and other Securities - Unquoted aii
iii Total (ai + aii) aiii
b Short-term investments
i Equity Shares, including share application money bi
ii Preference Shares bii
iii Debentures biii
iv Total (bi + bii + biii) biv
c Total investments (aiii + biv) 2c
3 Current assets, loans and advances
a Current assets

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 i Inventories
A Stores/consumables including packing material iA
B Raw materials iB
C Stock-in-process iC
D Finished Goods/Traded Goods iD
E Total (iA + iB + iC + iD) iE
ii Sundry Debtors aii
iii Cash and Bank Balances
2 Cash-in-hand iiiA
B Balance with banks iiiB
C Total (iiiA + iiiB) iiiC
iv Other Current Assets aiv
v Total current assets (iE + aii + iiiC + aiv) av
b Loans and advances
Advances recoverable in cash or in kind or for value to be
i bi
received
ii Deposits, Loans and advances to corporates and others bii
iii Balance with Revenue Authorities biii
iv Total (bi + bii + biii ) biv
c Total of current assets, loans and advances (av + biv) 3c
d Current liabilities and provisions
i Current liabilities
A Sundry Creditors iA
B Liability for Leased Assets iB
C Interest Accrued on above iC
D Interest accrued but not due on loans iD
E Total (iA + iB + iC + iD) iE
ii Provisions
A Provision for Income Tax iiA
B Provision for Wealth Tax iiB
Provision for Leave
C iiC
encashment/Superannuation/Gratuity
D Other Provisions iiD
E Total (iiA + iiB + iiC + iiD) iiE
iii Total (iE + iiE) diii
e Net current assets (3c - diii) 3e
4 a Miscellaneous expenditure not written off or adjusted 4a
b Deferred tax asset 4b
c Profit and loss account/ Accumulated balance 4c
d Total (4a + 4b + 4c) 4d
5 Total application of funds (1e + 2c + 3e + 4d) 5
In a case where regular books of account of business or profession are not maintained -
6
NO ACCOUNT

(furnish the following information as on 31st day of March 2009 in respect of business or profession)
a Amount of total sundry debtors 6a
CASE

b Amount of total sundry creditors 6b

c Amount of total stock-in-trade 6c
d Amount of cash balance 6d

Profit & Loss Account for the previous year 2008-09 of the proprietory business
Part A - P&L
(fill items 1 to 50 in a case where regular books of accounts are maintained, otherwise fill item 51)
Sales/ Gross receipts of business or profession
AND LOSS ACCOUNT
CREDITS TO PROFIT

1 1
(Net of returns and refunds and duty or tax, if any)
2 Duties, taxes and cess, received or receivable, in respect of goods and services sold or supplied
a Union Excise duties 2a
b Service tax 2b
c VAT/ Sales tax 2c
d Any other duty, tax and cess 2d

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 e Total of duties, taxes and cess, received or receivable (2a + 2b +2c+ 2d) 2e
3 Other income
a Rent 3a
b Commission 3b
c Dividend 3c
d Interest 3d
e Profit on sale of fixed assets 3e
Profit on sale of investment being securities chargeable to
f 3f
Securities Transaction Tax (STT)
g Profit on sale of other investment 3g
h Profit on account of currency fluctuation 3h
iAgriculture income 3i
j Any other income 3j
k Total of other income (3a to 3j) 3k
4 Closing Stock 4
5 Total of credits to profit and loss account (1 + 2e + 3k + 4) 5
6 Opening Stock 6
7 Purchases (net of refunds and duty or tax, if any) 7
8 Duties and taxes, paid or payable, in respect of goods and services purchased
a Custom duty 8a
b Counter vailing duty 8b
cSpecial additional duty 8c
d Union excise duty 8d
e Service tax 8e
fVAT/ Sales tax 8f
g Any other tax, paid or payable 8g
h Total (8a + 8b + 8c + 8d + 8e + 8f + 8g) 8h
9 Freight 9
10 Consumption of stores and spare parts 10
DEBITS TO PROFIT AND LOSS ACCOUNT

11 Power and fuel 11

12 Rents 12
13 Repairs to building 13
14 Repairs to machinery 14
15 Compensation to employees
a Salaries and wages 15a
b Bonus 15b
c Reimbursement of medical expenses 15c
d Leave encashment 15d
eLeave travel benefits 15e
f Contribution to approved superannuation fund 15f
g Contribution to recognised provident fund 15g
h Contribution to recognised gratuity fund 15h
i Contribution to any other fund 15i
Any other benefit to employees in respect of which an
j 15j
expenditure has been incurred
k Total compensation to employees (15a+15b+15c+15d+15e+15f+15g+15h+15i+15j) 15k
16 Insurance
a Medical Insurance 16a
b life Insurance 16b
cKeyman's Insurance 16c
d Other Insurance 16d
e Total expenditure on insurance (16a + 16 b + 16c + 16d) 16e
17 Workmen and staff welfare expenses 17
18 Entertainment 18
19 Hospitality 19

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 20 Conference 20
21 Sales promotion including publicity (other than advertisement) 21
22 Advertisement 22
23 Commission 23
24 Hotel, boarding and lodging 24
25 Traveling expenses including foreign traveling 25
26 Conveyance expenses 26
27 Telephone expenses 27
28 Guest House expenses 28
29 Club expenses 29
30 Festival celebration expenses 30
31 Scholarship 31
32 Gift 32
33 Donation 33

34 Rates and taxes, paid or payable to Government or any local body (excluding taxes on income)

a Union excise duty 34a

b Service tax 34b
c VAT/ Sales tax 34c
d Cess 34d
e Any other rate, tax, duty or cess 34e
f Total rates and taxes paid or payable (34a+34b+34c+34d+34e) 34f
35 Audit fee 35
36 Other expenses 36
37 Bad debts 37
38 Provision for bad and doubtful debts 38
39 Other provisions 39
Profit before interest, depreciation and taxes [5- (6 + 7 + 8h + 9 to 14 + 15k + 16e + 17 to 33 +34f
40 40
+ 35 to 39)
41 Interest 41
42 Depreciation 42
43 Profit before taxes (40 - 41 - 42) 43
44 Provision for current tax 44
TAX PROVISIONS &
APPROPRIATIONS

45 Provision for Deferred tax 45

46 Profit after tax (43 - 44 - 45) 46
47 Balance brought forward from previous year 47
48 Amount available for appropriation (46 + 47) 48
49 Transferred to reserves and surplus 49
50 Balance carried to balance sheet in proprietor's account (48 - 49) 50
NO ACCOUNT CASE

In a case where regular books of account of business or profession are not maintained, furnish
51
the following information for previous year 2008-09 in respect of business or profession

a Gross receipts 51a

b Gross profit 51b
c Expenses 51c
d Net profit 51d

Part A-OI Other Information (Optional in a case not liable for audit under section 44AB)
1 Method of accounting employed in the previous year (Tick) mercantile cash
2 Is there any change in method of accounting (Tick)
INFORMATION

Yes No
Effect on the profit because of deviation, if any, in the method of accounting employed in the
3 3
previous year from accounting standards prescribed under section 145A
OTHER

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 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 rate write 3)

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 c Is there any change in stock valuation method (Tick) Yes No
Effect on the profit or loss because of deviation, if any, from the method of valuation
d 4d
prescribed 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

the proforma credits, drawbacks, refund of duty of customs or

excise or service tax, or refund of sales tax or value added tax,
b 5b
where such credits, drawbacks or refunds are admitted as due
by the authorities concerned
escalation claims accepted during the previous year
c 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:-

a
Premium paid for insurance against risk of damage or 6a
destruction of stocks or store
b Premium paid for insurance on the health of employees 6b
Any sum paid to an employee as bonus or commission for
c services rendered, where such sum was otherwise payable to 6c
him as profits or dividend.
d Any amount of interest paid in respect of borrowed capital 6d
e Amount of discount on a zero coupon bond 6e
f Amount of contributions to a recognised provident fund 6f
g Amount of contributions to an approved superannuation fund 6g
h Amount of contributions to an approved gratuity fund 6h
i Amount of contributions to any other fund 6i
j Amount of bad and doubtful debts 6j
k Provision for bad and doubtful debts 6k
l Amount transferred to any special reserve 6l
m Expenditure for the purpose of promoting family planning
6m
amongst employees
n
Any sum received from employees as contribution to any
provident fund or superannuation fund or any fund set up
under ESI Act or any other fund for the welfare of employees 6n
to the extent credited to the employees account on or before
the due date
Any other disallowance
o 6o
Total amount disallowable under section 36 (total 6a to 6o)
p 6p
7 Amounts debited to the profit and loss account, to the extent disallowable under section 37:-
a Expenditure of personal nature; 7a
Expenditure on advertisement in any souvenir, brochure, tract,
b 7b
pamphlet or the like, published by a political party;
Expenditure by way of penalty or fine for violation of any law
c 7c
for the time being in force;
d Any other penalty or fine; 7d

e
Expenditure incurred for any purpose which is an offence or 7e
which is prohibited by law;
f Amount of any liability of a contingent nature 7f
Amount of expenditure in relation to income which does not
g 7g
form part of total income
h Any other amount not allowable under section 37 7h
i Total amount disallowable under section 37 (total of 7a to 7h) 7i

8 A Amounts debited to the profit and loss account, to the extent disallowable under section 40

Amount disallowable under section 40 (a)(i), 40(a)(ia) and 40(a)

a (iii) on account of non-compliance with the provisions of Aa
Chapter XVII-B
b Amount paid as fringe benefit tax Ab

c Amount of tax or rate levied or assessed on the basis of profits Ac

d Amount paid as wealth tax Ad

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 Amount of interest, salary, bonus, commission or remuneration
e Ae
paid to any partner or member

f Any other disallowance Af

g Total amount disallowable under section 40 (total of Aa to Af) 8Ag

Any amount disallowed under section 40 in any preceding previous year but allowable
B 8B
during the previous year
9 Amount debited to the profit and loss account, to the extent disallowable under section 40A
a Amount paid to persons specified in section 40A(2)(b) 9a

Amount in excess of twenty thousand rupees, paid otherwise

b than by account payee cheque or account payee bank draft 9b
under section 40A(3) - 100% disallowable
c Provision for payment of gratuity 9c
Any sum paid by the assessee as an employer for setting up or
d as contribution to any fund, trust, company, AOP, or BOI or 9d
society or any other institution;
e Any other disallowance 9e
f Total amount disallowable under section 40A (total of 9a to 9e) 9f
Any amount disallowed under section 43B in any preceding previous year but allowable during
10
the previous year

a Any sum in the nature of tax, duty, cess or fee under any law 10a

Any sum payable by way of contribution to any provident fund

b or superannuation fund or gratuity fund or any other fund for 10b
the welfare of employees
Any sum payable to an employee as bonus or commission for
c 10c
services rendered
Any sum payable as interest on any loan or borrowing from
d any public financial institution or a State financial corporation 10d
or a State Industrial investment corporation
Any sum payable as interest on any loan or borrowing from
e 10e
any scheduled bank
f Any sum payable towards leave encashement 10f
g Total amount allowable under section 43B (Total of 10a to 10f) 10g
Any amount debited to profit and loss account of the previous year but disallowable under
11
section 43B:-

a Any sum in the nature of tax, duty, cess or fee under any law 11a

Any sum payable by way of contribution to any provident fund

b or superannuation fund or gratuity fund or any other fund for 11b
the welfare of employees
Any sum payable to an employee as bonus or commission for
c 11c
services rendered
Any sum payable as interest on any loan or borrowing from
d any public financial institution or a State financial corporation 11d
or a State Industrial investment corporation
Any sum payable as interest on any loan or borrowing from
e 11e
any scheduled bank
f Any sum payable towards leave encashement 11f
g Total amount disallowable under section 43B (Total of 11a to 11f) 11g
12 Amount of credit outstanding in the accounts in respect of
a Union Excise Duty 12a
b Service tax 12b
VAT/sales tax
c 12c
d Any other tax 12d
e Total amount outstanding (total of 12a to 12d) 12e
13 Amounts deemed to be profits and gains under section 33AB or 33ABA or 33AC 13
14 Any amount of profit chargeable to tax under section 41 14
Amount of income or expenditure of prior period credited or debited to the profit and loss
15 15
account (net)

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Part A - QD Quantitative details (Optional in a case not liable for audit under section 44AB)
(a) In the case of a trading concern
1 Opening stock 1
2 Purchases during the previous year 2
3 Sales during the previous year 3
4 Closing stock 4
5 Shortage/ excess, if any 5
(b) In the case of a manufacturing concern
6 Raw materials
QUANTITATIVE DETAILS

a Opening stock 6a
b Purchases during the previous year 6b
Consumption during the previous year
c 6c
d Sales during the previous year 6d
e Closing stock 6e
f Yield finished products 6f
g Percentage of yield 6g
h Shortage/ excess, if any 6h
7 Finished products/ By-products
a opening stock 7a
b purchase during the previous year 7b
c quantity manufactured during the previous year 7c
d sales during the previous year 7d
e closing stock 7e
f shortage/ excess, if any 7f

Part B - TI Computation of total income

1 Salaries (6 of Schedule S) 1
2 Income from house property (4c of Schedule - HP) (enter nil if loss) 2
3 Profits or gains from business or profession
Profit and gains from business other than speculative business
i 3i
(A37 of Schedule-BP)
Profit and gains from speculative business (B41 of Schedule-BP)
ii 3ii
(enter nil if loss)
iii Total (3i + 3ii) (enter nil if 3iii is a loss) 3iii
4 Capital gains
a Short term
Short term (under section 111A) (A7 of Schedule- CG)
i 4ai
(enter nil if loss)
ii Short term (others) (A8 of Schedule - CG) 4aii
TOTAL INCOME

iii Total Short -term (4ai + 4aii) 4aiii

b Long-term (B6 of Schedule-CG) (enter nil if loss) 4b
c Total capital gains (4aiii + 4b) (enter nil if 4c is a loss) 4c
5 Income from other sources
From sources other than owning race horses (3 of Schedule -OS)
a 5a
(enter nil if loss)

b from owning race horses (4c of Schedule OS) (enter nil if loss) 5b

c Total (5a + 5b) 5c

6 Total (1 + 2 + 3iii + 4c + 5c) 6
7 Losses of current year to be set off against 6 (total of 2vii, 3vii and 4vii of Schedule - CYLA) 7
8 Balance after set off of current year losses (6 - 7) 8
9 Brought forward losses to be set off against 6 (total of 2vii, 3vii and 4vii of Schedule - BFLA) 9
10 Gross total income (8 - 9) (also 5viii of Schedule BFLA) 10
11 Deductions under Chapter VI-A (s of Schedule VIA) 11
12 Total income (10 - 11) 12
13 Net agricultural income/ any other income for rate purpose (4 of Schedule EI) 13
14 'Aggregate income' (12 + 13) 14

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 15 Losses of current year to be carried forward (total of xi of Schedule CFL) 15

Part B - TTI Computation of tax liability on total income

Tax payable on total income
1 a Tax at normal rates 1a
b Tax at special rates (11 of Schedule-SI) 1b
2 Tax payable on Total Income (1a + 1b) 2
COMPUTATION OF TAX LIABILITY

3 Surcharge on 2 3
4 Education cess, including secondary and higher education cess on (2 + 3) 4
5 Gross tax liability (2 + 3 + 4) 5
6 Tax relief
a Section 89 6a
b Section 90 6b
c Section 91 6c
d Total (6a + 6b + 6c) 6d
7 Net tax liability (5 - 6d) 7
8 Interest payable
a For default in furnishing the return (section 234A) 8a
b For default in payment of advance tax (section 234B) 8b
c For deferment of advance tax (section 234C) 8c
d Total Interest Payable (8a + 8b + 8c) 8d
9 Aggregate liability (7 + 8d) 9
10 Taxes Paid
a Advance Tax (from Schedule-IT) 10a
TAXES PAID

b TDS (Total of column 7 of Schedule TDS1 and column 7 of Schedule- 10b

TDS2)
c TCS (column 7 of Schedule-TCS) 10c
d Self Assessment Tax (from Schedule-IT) 10d
e Total Taxes Paid (10a + 10b + 10c + 10d) 10e
11 Amount payable (Enter if 10 is greater than 11e, else enter 0) 11
12 Refund (if 11e is greater than 10, also give Bank Account details below) 13
REFUND

13 Enter your bank account number (mandatory in case of refund)

14 Do you want your refund by cheque, or deposited directly into your bank account (tick as applicable)
15 Give additional details of your bank account
MICR Code Type of Account (tick as applicable) Savings Current

VERIFICATION
I, son/daughter of holding permanent account number ____________ solemnly
declare that to the best of my knowledge and belief, the information given in the return and schedules thereto is correct and complete and that the
amount of total income and other particulars shown therein are truly stated and are in accordance with the provisions of the Income-tax Act, 1961, in
respect of income chargeable to Income Tax for the previous year relevant to the Assessment Year 2009-10.

Place Date Sign here

17 If the return has been prepared by a Tax Return Preparer (TRP) give further details as below:
Identification No. of TRP Name of TRP Counter Signature of TRP

If TRP is entitled for any reimbursement from the Government, amount thereof . . . . . . . . . 18

Schedule S Details of Income from Salary

Name of Employer PAN of Employer (Optional)

Address of Employer Town /City State Pin Code

SALARIES

1 Salary (Excluding all allowances, perquisites & profits in lieu of salary) 1

2 Allowances exempt under section 10 2
3 Allowances not exempt 3
4 Value of perquisites 4
5 Profits in lieu of Salary 5
6 Income chargeable under the Head 'Salaries' (1 + 3 + 4 + 5) 6

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Schedule HP Details of Income from House Property (Please refer to instructions)
Address of property 1 Town/City State Pin Code
1

(Tick) If let out Name of Tenant PAN of Tenant (Optional)

Annual Letable value/ rent received or receivable (higher if let out for whole of the year, lower
a 1a
if let out for part of the year)
b The amount of rent which cannot be realized 1b
c Tax paid to local authorities 1c
d Total (1b + 1c) 1d
e Balance (1a - 1d) 1e
f 30% of 1e 1f
g Interest payable on borrowed capital 1g
h Total (1f + 1g) 1h
i Income from house property 1 (1e - 1h) 1i
Address of property 2 Town/City State Pin Code
2

(Tick) If let out Name of Tenant PAN of Tenant (Optional)

Annual Letable value/ rent received or receivable (higher if let out for whole of the year, lower
a 2a
if let out for part of the year)
HOUSE PROPERTY

b The amount of rent which cannot be realized 2b

c Tax paid to local authorities 2c
d Total (2b + 2c) 2d
e Balance (2a - 2d) 2e
f 30% of 2e 2f
g Interest payable on borrowed capital 2g
h Total (2f + 2g) 2h
i Income from house property 2 (2e - 2h) 2i
Address of property 3 Town/City State Pin Code
3

(Tick) If let out Name of Tenant PAN of Tenant (Optional)

Annual Letable value/ rent received or receivable (higher if let out for whole of the year, lower
a 3a
if let out for part of the year)
b The amount of rent which cannot be realized 3b
c Tax paid to local authorities 3c
d Total (3b + 3c) 3d
e Balance (3a - 3d) 3e
f 30% of 3e 3f
g Interest payable on borrowed capital 3g
h Total (3f + 3g) 3h
i Income from house property 3 (3e - 3h) 3i
4 Income under the Head "Income from house property"
a Rent of earlier years realized under section 25A/AA 4a
b Arrears of rent received during the year under section 25B after deducting 30% 4b
c Total (4a + 4b +1i + 2i + 3i) 4c
NOTE ► Please include the income of the specified persons referred to in Schedule SPI while computing the income under this head

Schedule BP Computation of income from business or profession

A From business or profession other than speculative business
INCOME FROM BUSINESS OR

1 Profit before tax as per profit and loss account (item 43 or 51d of Part A - P&L) 1
2 Net profit or loss from speculative business included in 1 2
PROFESSION

Income/ receipts credited to profit and loss account considered

3 3
under other heads of income
Profit or loss included in 1, which is referred to in section
4 44AD/44AE/44AF/44B/44BB/44BBA/44BBB/44D/44DA 4
Chapter-XII-G/ First Schedule of Income-tax Act
5 Income credited to Profit and Loss account (included in 1) which is exempt
a share of income from firm(s) 5a
b Share of income from AOP/BOI 5b

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 c Any other exempt income 5c
d Total exempt income 5d
6 Balance (1 - 2 - 3 - 4 - 5d) 6
7 Expenses debited to profit and loss account considered under
7
other heads of income
8 Expenses debited to profit and loss account which relate to
8
exempt income
9 Total (7 + 8) 9
10 Adjusted profit or loss (6 + 9) 10
11 Depreciation debited to profit and loss account included in 9 11
12 Depreciation allowable under Income-tax Act
Depreciation allowable under section 32(1)(ii) (column 6 of
i 12i
Schedule-DEP)
Depreciation allowable under section 32(1)(i) (Make your
ii 12ii
own computation refer Appendix-1A of IT Rules)
iii Total (12i + 12ii) 12iii
13 Profit or loss after adjustment for depreciation (10 + 11 - 12iii) 13
Amounts debited to the profit and loss account, to the extent
14 14
disallowable under section 36 (6p of Part-OI)
Amounts debited to the profit and loss account, to the extent
15 15
disallowable under section 37 (7i of Part-OI)
Amounts debited to the profit and loss account, to the extent
16 16
disallowable under section 40 (8Ag of Part-OI)

17
Amounts debited to the profit and loss account, to the extent 17
disallowable under section 40A (9f of Part-OI)

Any amount debited to profit and loss account of the previous

18 18
year but disallowable under section 43B (11g of Part-OI)

Interest disallowable under section 23 of the Micro, Small and

19 19
Medium Enterprises Development Act, 2006
20 Deemed income under section 41 20
Deemed income under section
21 21
33AB/33ABA/35ABB/72A/80HHD/80-IA
22 Any other item or items of addition under section 28 to 44DA 22

23 Any other income (including income from salary, commission,

bonus and interest from firms in which an indivisual/HUF/ 23
Prop. concern is a partner) not included in profit and loss
24 Total (14 + 15 + 16 + 17 + 18 + 19 + 20 + 21 + 22 + 23) 24
25 Deduction allowable under section 32(1)(iii) 25

Amount of deduction under section 35 in excess of the amount

26 26
debited to profit and loss account (item vii(4) of Schedule-ESR)

Any amount disallowed under section 40 in any preceding

27 previous year but allowable during the previous year (8B of 27
Part-OI)
Any amount disallowed under section 43B in any preceding
28 previous year but allowable during the previous year (10g of 28
Part-OI)
29 Deduction under section 35AC
a Amount, if any debited to profit and loss account 29a
b Amount allowable as deduction 29b
c Excess amount allowable as deduction (29b-29a) 29c
30 Any other amount allowable as deduction 30
31 Total (25 + 26 + 27 + 28 + 29c + 30) 31
32 Income (13 + 24 - 31) 32
33 Profits and gains of business or profession deemed to be under
i Section 44AD 33i
ii Section 44AE 33ii
ii Section 44AF 33iii
iv Section 44B 33iv
v Section 44BB 33v

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 vi Section 44BBA 33vi
vii Section 44BBB 33vii
viii Section 44D 33viii
ix Section 44DA 33ix
x Chapter-XII-G 33x
xi First Schedule of Income-tax Act 33xi
xii Total (33i to 33xi) 33xii
34 Profit or loss before deduction under section 10A/10AA/10B/10BA (32 + 33xii) 34
35 Deduction under section-
i 10A (6 of Schedule-10A) 35i
ii 10AA (d of Schedule-10AA) 35ii
iii 10B (f of Schedule-10B) 35iii
iv 10BA (f of Schedule-10BA) 35iv
v Total (35i + 35ii + 35iii + 35iv) 35v

36 Net profit or loss from business or profession other than speculative business (34 - 35v) 36

Net Profit of loss from business or profession (same as above in 36 except in case of special
37 A37
business, after applying rule 7A, 7B or 7C)
Computation of income from speculative business
B
38 Net profit or loss from speculative business as per profit or loss account 38
39 Additions in accordance with section 28 to 44DA 39
40 Deductions in accordance with sections 28 to 44DA 40
41 Profit or loss from speculative business (38 + 39 - 40) B41
C Income chargeable under the head 'Profits and gains' (A37 + B41) C
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

1 Block of assets Plant and machinery
2 Rate (%) 15 30 40 50 60 80 100
(i) (ii) (iii) (iv) (v) (vi) (vii)
3
Written down value on the first day of
previous year
Additions for a period of 180 days or more in
4
the previous year
Consideration or other realization during the
5
DEPRECIATION ON PLANT AND MACHINERY

previous year out of 3 or 4

Amount on which depreciation at full rate to
6 be allowed (3 + 4 - 5) (enter 0, if result is
negative)
Additions for a period of less than 180 days in
7
the previous year
Consideration or other realization during the
8
year out of 7

Amount on which depreciation at half rate to

9
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 Total depreciation* (10 + 11 + 12 + 13)
Expenditure incurred in connection with
15
transfer of asset/ assets
Capital gains/ loss under section 50* (5 + 8 - 3
16 -4 - 7 -15) (enter negative only if block ceases to
exist)
Written down value on the last day of
17 previous year* (6 + 9 -14) (enter 0 if result is
negative)

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Schedule DOA Depreciation on other assets
Building Furniture and Intangible Ships
1 Block of assets
fittings assets
2 Rate (%) 5 10 100 10 25 20
(i) (ii) (iii) (iv) (v) (vi)
Written down value on the first day of
3
previous year
Additions for a period of 180 days or more in
4
the previous year
Consideration or other realization during the
5
previous year out of 3 or 4
DEPRECIATION ON OTHER ASSETS

Amount on which depreciation at full rate to

6 be allowed (3 + 4 - 5) (enter 0, if result is
negative)
Additions for a period of less than 180 days in
7
the previous year
Consideration or other realization during the
8
year out of 7

Amount on which depreciation at half rate to

9
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 Total depreciation* (10 + 11 + 12 + 13)
Expenditure incurred in connection with
15
transfer of asset/ assets
Capital gains/ loss under section 50* (5 + 8 - 3
16 -4 - 7 -15) (enter negative only if block ceases to
exist)
Written down value on the last day of
17 previous year* (6 + 9 -14) (enter 0 if result is
negative)

Schedule DEP Summary of depreciation on assets

1 Plant and machinery
Block entitled for depreciation @ 15 per cent
a 1a
(Schedule DPM - 14i)
Block entitled for depreciation @ 30 per cent
b 1b
(Schedule DPM - 14ii)
Block entitled for depreciation @ 40 per cent
c 1c
(Schedule DPM - 14iii)
SUMMARY OF DEPRECIATION ON ASSETS

Block entitled for depreciation @ 50 per cent

d 1d
(Schedule DPM - 14iv)
Block entitled for depreciation @ 60 per cent
e 1e
(Schedule DPM - 14v)
Block entitled for depreciation @ 80 per cent
f 1f
(Schedule DPM - 14vi)
Block entitled for depreciation @ 100 per cent
g 1g
(Schedule DPM - 14vii)
h Total depreciation on plant and machinery (1a + 1b + 1c + 1d + 1e + 1f + 1g) 1h
2 Building
Block entitled for depreciation @ 5 per cent
a 2a
(Schedule DOA - 14i)
Block entitled for depreciation @ 10 per cent
b 2b
(Schedule DOA - 14ii)
Block entitled for depreciation @ 100 per cent
c 2c
(Schedule DOA - 14iii)
d Total depreciation on building (total of 2a + 2b + 2c) 2d
3 Furniture and fittings (Schedule DOA- 14iv) 3
4 Intangible Assets (Schedule DOA - 14v) 4
5 Ships (Schedule DOA - 14vi) 5
6 Total depreciation (1h + 2d + 3 + 4 +5) 6

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Schedule DCG Deemed Capital Gains on sale of depreciable assets
1 Plant and machinery
Block entitled for depreciation @ 15 per cent
a 1a
(Schedule DPM - 16i)
Block entitled for depreciation @ 30 per cent
b 1b
(Schedule DPM - 16ii)
Block entitled for depreciation @ 40 per cent
c 1c
(Schedule DPM - 16iii)
Block entitled for depreciation @ 50 per cent
d 1d
(Schedule DPM - 16iv)
Block entitled for depreciation @ 60 per cent
e 1e
(Schedule DPM - 16v)
Block entitled for depreciation @ 80 per cent
f 1f
(Schedule DPM - 16vi)
Block entitled for depreciation @ 100 per cent
g 1g
(Schedule DPM - 16vii)
h Total (1a + 1b + 1c + 1d + 1e + 1f + 1g) 1h
2 Building
Block entitled for depreciation @ 5 per cent (Schedule
a 2a
DOA - 16i)
Block entitled for depreciation @ 10 per cent
b 2b
(Schedule DOA - 16ii)
Block entitled for depreciation @ 100 per cent
c 2c
(Schedule DOA - 16iii)
d Total (2a + 2b + 2c) 2d
3 Furniture and fittings (Schedule DOA- 16iv) 3
4 Intangible Assets (Schedule DOA - 16v) 4
5 Ships (Schedule DOA - 16vi) 5
6 Total (1h + 2d + 3 + 4 + 5) 6

Schedule ESR Deduction under section 35

Expenditure of the nature Amount, if any, debited to Amount of deduction Amount of deduction in excess of the
Sl. No. referred to in section profit and loss account allowable amount debited to profit and loss account
(1) (2) (3) (4) = (3) - (2)
i 35(1)(i)
ii 35(1)(ii)
iii 35(1)(iii)
iv 35(1)(iv)
v 35(2AA)
vi 35(2AB)
vii total

Schedule CG Capital Gains

A Short-term capital gain
1 From slump sale
a Full value of consideration 1a
b Net worth of the under-taking or division 1b
c Short term capital gainss from slump sale 1c
d Deduction under sections 54B/54D 1d
e Net short term capital gain from slump sale (1c - 1d) 1e
2 From assets in case of non-resident to which first proviso to section 48 is applicable 2
CAPITAL GAINS

3 From assets in the case of others

a Full value of consideration 3a
b Deduction under section 48
i Cost of acquisition bi
ii Cost of improvement bii
iii Expenditure on transfer biii
iv Total (bi + bii + biii) biv
c Balance (3a - biv) 3c
Loss, if any, to be ignored under section 94(7) or 94(8)
d 3d
(enter positive values only)
e Deduction under section 54B/54D 3e
f Short term capital gain (3c - 3d - 3e) 3f

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4 Deemed short term capital gain on depreciable assets (6 of Schedule - DCG) 4

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 Amount deemed to be short term capital gains under sections
5 5
54B/54D/54EC/54ED/54G/54GA
6 Total short term capital gain (1e + 2 + 3f + 4 + 5) A6
7 Short term capital gain under section 111A included in 6 A7
8 Short term capital gain other than referred to in section 111A (6 - 7) A8
B Long term capital gain
1 From slump sale
a Full value of consideration 1a
b Net worth of the under-taking or division 1b
c Long term capital gain from slump sale 1c
Deductrion under sections
d 1d
54/54B/54D/54EC/54F/54G/54GA
e Net long term capital gain from slump sale (1c - 1d) 1e
2 Asset in case of non-resident to which first proviso to section 48 applicable 2
3 Assets in the case of others where proviso to section 112(1) not exercised
a Full value of consideration 3a
b Deductions under section 48
i Cost of acquisition after indexation bi
ii Cost of improvement after indexation bii
iii Expenditure on transfer biii
iv Total (bi + bii + biii) biv
c Balance (3a - biv) 3c

d Deduction under section 54/54B/54D/54EC/54F/54G/54GA 3d

e Net balance (3c - 3d) 3e
4 Assets in the case of others where proviso to section 112(1) exercised
a Full value of consideration 4a
b Deductions under section 48
i Cost of acquisition without indexation bi
ii Cost of improvement without indexation bii
iii Expenditure on transfer biii
iv Total (bi + bii + biii) biv
c Balance (4a - biv) 4c

d Deduction under section 54/54B/54D/54EC/54F/54G/54GA 4d

e Net balance 4e
5 Amount deemed to be long term capital gains under sections
5
54/54B/54D/54EC/54ED/54F/54G/54GA
Total long term capital gain (1e (enter nil if loss)+ 2 + 3e (enter nil if loss) + 4e (enter nil if
6 B6
loss) + 5)
C Income chargeable under the Head "CAPITAL GAINS" (A6 + B6) (enter B6 as nil, if loss) C
D Information about accrual/receipt of capital gain
Date Upto 15/9 16/9 to 15/12 16/12 to 15/3 16/3 to 31/3
(i) (ii) (iii) (iv)
1 Long-term
2 Short-term
NOTE ► Please include the income of the specified persons referred to in Schedule SPI while computing the income under this head

Schedule OS Income from other sources

1 Income other than from owning race horse(s):-
a Dividends, Gross 1a
b Interest, Gross 1b
c Rental income from machinery, plants, buildings, 1c
d Others, Gross (excluding income from owning race horses) 1d
e Total (1a + 1b + 1c + 1d) 1e
OTHER SOURCES

f Deductions under section 57:-

i Expenses fi
ii Depreciation fii
iii Total fiii
g Balance (1e - fiii) 1g
2 Winnings from lotteries, crossword puzzles, races etc. 2
3 Income from other sources (other than from owning race horses) (1g + 2) (enter 1g as nil if loss) 3
4 Income from owning and maintaining race horses
a Receipts 4a
b Deductions under section 57 in relation to (4) 4b
c Balance (4a - 4b) 4c

20 of 28 Source: www.taxguru.in
 5
Income chargeable under the head "Income from other sources" (3 + 4c) (enter 4c as nil if loss 5
and take 4c loss figure to Schedule CFL)
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 year losses
Sl. Head/Source of Income Income of House property loss Business Loss (other than Other sources loss (other Current year's
No. current year (Fill of the current year set speculation loss) of the than loss from race income remaining
this column only off current year set off horse(s) of the current after set off
if income is zero year set off
or positive)
CURRENT YEAR LOSS ADJUSTMENT

Total loss Total loss Total loss

(4c of Schedule-HP) (A37 of Schedule-BP) (3 of Schedule-OS)
1 2 3 4 5=1-2-3-4
Loss to be adjusted
i Salaries
ii House property
Business (including
iii
speculation profit)

iv Short-term capital gain

v Long term capital gain

Other sources (incl.

vi profit from owning race
horses)
vii Total loss set off
viii Loss remaining after set off

Schedule BFLA Details of income after set off of Brought Forward Losses of earlier years
Sl. Head/Source of Income Income after set off, if Brought forward Brought forward Brought forward Current year's
No. any, of current year's loss set off depreciation set off allowance under income remaining
losses as per 5 of section 35(4) set off after set off
BROUGHT FORWARD LOSS

schedule-CYLA

1 2 5 4 5
ADJUSTMENT

i Salaries
ii House property
Business (including
iii
speculation profit)
iv Short-term capital gain
v Long-term capital gain
Other sources (profit from
vi
owning race horses)
vii Total of brought forward loss set off
viii Current year's income remaining after set off Total (i5 + ii5 + iii5 + iv5 + v5)

Schedule CFL Details of losses to be carried forward to future years

Sl. Assessment year Date of Filing House Loss from business Loss from speculative Short-term Long-term Other
No. (DD/MM/ property loss other than loss from business including capital loss Capital loss sources loss
YYYY) speculative business unabsorbed (from
including unabsorbed depreciation allowance owning race
depreciation u/s 35(4) horses)
allowance u/s 35(4)

i 2001-02
CARRIED FORWARD LOSS

ii 2002-03
iii 2003-04
iv 2004-05
v 2005-06
vi 2006-07
vii 2007-08
viii 2008-09
Total of earlier year
ix
losses
Adjustment of
above losses in
x
Schedule BFLA (see
instruction)
2009-10 (Current
xi
year losses)

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 Total loss Carried
xii Forward to future
years

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Schedule 10A Deduction under section 10A
1 Deductions in respect of units located in Software Technology Park
a Undertaking No. 1 1a
b Undertaking No. 2 1b
c Undertaking No. 3 1c
d Undertaking No. 4 1d
e Undertaking No. 5 1e
f Total (1a + 1b + 1c + 1d + 1e) 1f
2 Deductions in respect of units located in Electronic Hardware Technology Park
a Undertaking No. 1 2a
b Undertaking No. 2 2b
c Undertaking No. 3 2c
DEDUCTION U/S 10A

d Total (2a + 2b + 2c) 2d

3 Deductions in respect of units located in Free Trade Zone
a Undertaking No. 1 3a
b Undertaking No. 2 3b
c Undertaking No. 3 3c
d Total (3a + 3b + 3c) 3d
4 Deductions in respect of units located in Export Processing Zone
a Undertaking No. 1 4a
b Undertaking No. 2 4b
c Undertaking No. 3 4c
d Total (4a + 4b + 4c) 4d
5 Deductions in respect of units located in Special Economic Zone
a Undertaking No. 1 5a
b Undertaking No. 2 5b
c Undertaking No. 3 5c
d Total (5a + 5b + 5c) 5d
6 Total deduction under section 10A (1f + 2d + 3d + 4d + 5d) 6

Schedule 10AA Deduction under section 10AA

Deductions in respect of units located in Special Economic Zone
DEDUCTION
U/S 10AA

a Undertaking No. 1 a
b Undertaking No. 2 b
c Undertaking No. 3 c
d Total (a + b + c) d

Schedule 10B Deduction under section 10B

Deduction in respect of hundred percent Export Oriented units
DEDUCTION U/S

a Undertaking No. 1 a
b Undertaking No. 2 b
10B

c Undertaking No. 3 c
d Undertaking No. 4 d
e Undertaking No. 5 e
f Total (a + b + c + d + e) f

Schedule 10BA Deduction under section 10BA

Deduction in respect of export of handmade wooden articles
a Undertaking No. 1 a
DEDUCTION U/S
10BA

b Undertaking No. 2 b
c Undertaking No. 3 c
d Undertaking No. 4 d
e Undertaking No. 5 e
f Total (a + b + c + d + e) f

Schedule 80G Details of donations entitled for deduction under section 80G
A Donations entitled for 100% deduction
DETAILS OF
DONATIONS

Name and address of donee Amount of donation

i Ai
ii Aii
iii Aiii
iv Aiv

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 v Av
vi Total Avi
Donations entitled for 50% deduction where donee not required to be approved under section
B
80G(5) (vi)
Name and address of donee Amount of donation
i Bi
ii Bii
iii Biii
iv Biv
v Bv
vi Total Bvi
Donations entitled for 50% deduction where donee is required to be approved under section
C
80G(5) (vi)
Name and address of donee PAN of donee Amount of donation
i Ci
ii Cii
iii Ciii
iv Civ
v Cv
vi Total Cvi
D Total donations (Avi + Bvi + Cvi) D

Schedule 80-IA Deduction under section 80-IA

Deduction in respect of profits of an enterprise referred to in
a a
section 80-IA(4)(i) [Infrastructure facility]

b
Deduction in respect of profits of an undertaking referred to in b
section 80-IA(4)(ii) [Telecommunication services]
DEDUCTION U/S 80-IA

Deduction in respect of profits of an undertaking referred to in

c c
section 80-IA(4)(iii) [Industrial park and SEZs]
Deduction in respect of profits of an undertaking referred to in
d d
section 80-IA(4)(iv) [Power]

Deduction in respect of profits of an undertaking referred to in

section 80-IA(4)(v) [Revival of power generating plant] and
e e
deduction in respect of profits of an undertaking referred to in
section 80-IA(4)(vi) [Cross-country natural gas distribution network]

f Total deduction under section 80-IA (a + b + c + d + e) f

Schedule 80-IB Deduction under section 80-IB

Deduction in respect of industrial undertaking referred to in
a a
section 80-IB (3) [Small-scale industry]
Deduction in respect of industrial undertaking located in Jammu &
b b
Kashmir [Section 80-IB (4)]
Deduction in respect of industrial undertaking located in
c industrially backward states specified in Eighth Schedule [Section c
80-IB (4)]
Deduction in respect of industrial undertaking located in
d d
industrially backward districts [Section 80-IB (5)]
DEDUCTION U/S 80-IB

e Deduction in the case of multiplex theatre [Section 80-IB(7A)] e

f Deduction in the case of convention centre [Section 80-IB(7B)] f
Deduction in the case of company carrying on scientific research
g g
[Section80-IB (8A)]
Deduction in the case of an undertaking which begins commercial
h h
production of refining of mineral oil [Section 80-IB (9)]
Deduction in the case of an undertaking developing and building
i i
housing projects [Section 80-IB (10)]
Deduction in the case of an undertaking operating a cold chain
j j
facility [Section 80-IB (11)]
Deduction in the case of an undertaking engaged in processing,
k packaging and preservation of fruits and vegetables [Section 80-IB k
(11A)]

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 Deduction in the case of an undertaking engaged in integrated
l business of handling storage and transportation of food grains l
[Section 80-IB (11A)]

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 m
Deduction in the case of an undertaking engaged in operating and m
maintaining a rural hospital [Section 80-IB (11B)]
n Total deduction under section 80-IB (Total of a to m) n

Schedule 80-IC or 80-IE Deduction under section 80-IC or 80-IE

1 Deduction in respect of industrial undertaking located in Sikkim 1
2 Deduction in respect of industrial undertaking located in Himachal Pradesh 2
3 Deduction in respect of industrial undertaking located in Uttranchal 3
DEDUCTION U/S 80-IC

4 Deduction in respect of industrial undertaking located in North East

a Assam 4a
b Arunachal Pradesh 4b
c Manipur 4c
ib Mizoram 4d
e Meghalaya 4e
f Nagaland 4f
g Tripura 4g
h Total of deduction for undertakings located in North-east (Total of 4a to 4g) 4h
5 Total deduction under section 80-IC or 80-IE (1 + 2 + 3 + 4h) 5

Schedule VI-A Deductions under chapter VI-A (Section)

a 80C j 80GGC
80IA (f of Schedule
b 80CCC k
80-IA)
TOTAL DEDUCTIONS

c 80CCD l 80IAB
80IB (n of Schedule
d 80D m
80-IB)
80IC/ 80-IE (5 of
e 80DD n
Schedule 80-IC/ 80-IE)
f 80DDB o 80ID/ 80JJA
g 80E p 80QQB
h 80G q 80RRB
i 80GG/GGA r 80U
s Total deductions under Chapter VI-A(total of a to r) s

Schedule SPI Income of specified person (spouse, minor child etc.) includable in income of the assessee
Sl. No. Name of person PAN of person (optional) Relationship Nature of Income Amount (Rs.)
1
2

Schedule SI Income chargeable to income tax at special rates IB (Please see instruction No. 9(iii) for section code and rate of tax)
Sl Section Special Income Tax thereon Sl Section Special Income Tax thereon
No. Code rate (%) i ii No. Code rate (%) i ii
SPECIAL RATE

1 6
2 7
3 8
4 9
5 10
11 Total (1ii to 10ii)

Schedule IF Information regarding partnership firms in which you are partner

Number of firms in which you are partner
FIRMS IN WHICH PARTNER

Name of the Firm PAN of the firm Percentage Amount of share in Capital balance on
Share in the the profit 31stMarch in the firm
profit of the
firm
i ii
1
2
3
4
5
6 Total

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Schedule EI Details of Exempt Income (Income not to be included in Total Income)
1 Interest Income 1
EXEMPT INCOME

2 Dividend Income 2
3 Long-term capital gains on which Securities Transaction Tax is paid 3
4 Net agricultural income (other than income to be excluded under rule 7, 7A, 7B or 8) 4
5 Share in the profit of firm/AOP etc. 5
6 Others, including exempt income of minor child 6
7 Total (1 + 2 + 3 + 4 + 5 + 6) 7

Schedule AIR Other information (Information relating to Annual Information Return) (Please see instruction No. 9(iv) for code)

Sl. No. Code of Transaction Amount (Rs.) Sl. No. Code of Transaction Amount (Rs.)

1 001 5 005
2 002 6 006
3 003 7 007
4 004 8 008

Schedule IT Details of Advance Tax and Self Assessment Tax Payments of Income tax
Sl. Name of Bank & Branch BSR Code Date of Deposit Serial Number of Amount (Rs.)
No. (DD/MM/YYYY) Challan
TAX PAYMENTS

i
ii
iii
iv
v
NOTE ► Enter the total of Advance Tax and Self Assessment tax in Sl. No.119a and 11d of Part B-TTI

Schedule TDS1 Details of Tax Deducted at Source from Salary [As per Form 16 issued by Employer(s)]
Sl Tax Deduction Unique Name and address Income Deduction Tax Payable Total tax Tax payable/
No. Account Number Transaction of the Employer chargeable under (incl. surch. and deducted refundable
TDS ON SALARY

(TAN) of the No. (UTN) under the head Chapter edu. cess)
Employer Salaries VI-A

(1) (2) (9) (3) (4) (5) (6) (7) (8)

ii

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Schedule TDS2 Details of Tax Deducted at Source on Income [As per Form 16 A issued by Deductor(s)]
Sl Tax Deduction Account Unique Name and address of the Amount Paid/ Date of Total tax Amount out of (6)
No. Number (TAN) of the Transaction Deductor Credited Payment/ Credit deducted claimed for this year
Deductor No. (UTN)
TDS ON OTHER INCOME

(1) (2) (8) (3) (4) (5) (6) (7)

ii

iii

NOTE ► Please enter the total of column 7 of Schedule TDS1 and column 7 of schedule-TDS2 in 11(b) of Part B-TTI

Schedule TCS Details of Tax Collected at Source [As per Form 27D issued by Collector(s)]
Sl Tax Deduction and Unique Name and address of the Amount Date of Total tax Amount out of (6) to
No. Tax Collection Transaction Collector Received/debited Receipt/debit deducted be allowed as credit
Account Number of No. (UTN) during the year
TDS ON INCOME

the Collector

(1) (2) (8) (3) (4) (5) (6) (7)

ii

NOTE ► Enter the total of column 7 in Sl. No. 11(c) of Part B-TTI

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