National Board of Revenue IT-11GA (2023)
www.nbr.gov.bd
For Office Use
Serial No. of Return Register FORM OF RETURN OF
INCOME
Volume No. of Return Register
FOR INDIVIDUAL PERSON
Date of Return Submission
1. Name of the Taxpayer: ……..................................................................................................
2. National ID No. / Passport No. (If No NID): .............................................................................
TIN: 1 2 3 4 5 6 7 8 9 0 1 2
4. (a) Circle: ..................................... (b) Taxes Zone:............................................
5. Assessment Year: 2024-25 Residental Status: Resident ✔ / Non-Resident
....................
7. Taxpayer’s Status: Individual ... Firm ... Hindu Undivided Family ... Others ...
8. Tick on the box for getting special benefit:
A gazette war-wounded freedom fighter Female Third gender
Disable person Aged 65 years or more A parent of a person with disability
9. Date of Birth (DD MM YYYY):
10. Wife/Husband's Name:…………………………………………………………………...
TIN (if spouse is a Taxpayer): ……………………………………………………………
11. Address: ........................................................................................................
........................................................................................................
Mobile: E-mail:
12. If employed, employer’s name (latest employer’s name in case of multiple employment):
13.(a) Name of Organization:
(b) Business Identification number (BIN):
14. Name and TIN of Partners / Members in case of Firm / Association of Persons:
Statement of Income and Tax during the Income Year ended on 2024-25
Name of the Taxpayer:
TIN: 1 2 3 4 5 6 7 8 9 0 1 2
Particulars of Income Amount in Taka
1. Income from Employment (annex Schedule 1) 883,184
2. Income from Rent (annex Schedule 2) 0
3. Income from Agriculture (annex Schedule 3) 0
4. Income from Business (annex Schedule 4) 0
5. Income from Capital Gain 0
6. Income from Financial Assets 0
(Bank Interest, Dividend, Securities Profit etc)
7. Income from Other Sources 0
(Royalty, License Fees, Honorarium, Govt. Incentive
etc.)
8. Share of Income from Firm or AoP 0
9. Income of Minor or Spouse (if not Taxpayer) 0
10. Taxable Income from Abroad 0
11. Total Income (Aggregate of Serial 1 to 10) 883,184
Tax Computation Amount in Taka
12. Gross Tax on Taxable Income 54,978
13. Tax Rebate (annex Schedule 5) 0
14. Net Tax after Rebate (12 – 13) 54,978
15. Minimum Tax 5,000
16. Tax Payable (Higher of 14 and 15) 54,978
17. (a) Net Wealth Surcharge (if applicable) 0
(b) Environmental Surcharge (if applicable)
18. Delay Interest, Penalty or any other amount
Under Income Tax Act (if any)
19. Total Amount Payable (16 + 17 + 18) 54,978
List of Documents Furnished with this Return
Verification
I father / husband
TIN: 123456789012 Solemnly declare that to the best of my knowledge and belief the information
given in this return and statements and documents annexed herewith is correct and complete.
Place: .................................
Date: ................................
Schedule 1
This part is applicable for employees other than employees receiving salary under government
pay scale.
Name of the Taxpayer:
TIN: 1 2 3 4 5 6 7 8 9 0 1 2
Particulars Income Income (Taka)
(Taka)
1. Basic pay 50,000
2. Allowances 650,000
3. Advance / Arrear Salary 565,888
4. Gratuity, Annuity, Pension or similar benefit 58,888
5. Perquisites 0
6. Receipt in lieu of or in addition to Salary or Wages 0
7. Income from Employee’s Share Scheme 0
8. Accommodation Facility 0
9. Transport Facility 0
10. Any other Facility provided by Employer 0
11. Employer’s Contribution to Recognized Provident Fund 0
12. Others, if any (provide detail) 0
13. Total Salary Received (aggregate of 1 to 12) 1,324,776
14. Exempted Amount (as per Part 1 of 6th Schedule) 441,592
15. Total Income from Salary (13 – 14) 883,184
Schedule 2
(Particulars of Income from Rent)
Name of the Taxpayer:
TIN: 1 2 3 4 5 6 7 8 9 0 1 2
Location, description and Amount Amount
Total Rental Income Computation
ownership proportion of (Taka) (Taka)
property
1. Rent Received or Annual Value 0
(whichever is higher)
2. Advance Rent Received 0
3. Value of any Benefit in addition to 1 & 0
2
4. Adjusted Advance Rent 0
5. Vacancy Allowance 0
6. Total Rental Value (1 + 2 + 3 – 4 – 5) 0
7. Allowable Deduction:
(a) Repair, Collection etc. 0
(b) Municipal or Local Tax 0
(c) Land Revenue 0
(d) Interest Paid on Loan / Mortgage / 0
Capital Charge
(e) Insurance Premium Paid 0
(f) Others, if any
8. Total Admissible Deduction 0
9. Net Income (6 – 8) 0
10. Taxpayer’s Share, if applicable
Schedule 3
(Particulars of Income from Agriculture)
Name of the Taxpayer:
TIN: 1 2 3 4 5 6 7 8 9 0 1 2
Summary of Income Amount in Taka
1. Sales / Turnover / Receipt 0
2. Gross Profit 0
3. General Expenses, Selling Expenses, Land Revenue,Loan Interest,Other 0
Expenses
4. Net Profit ( 1 – 3) 0
Schedule 4
(Particulars of Income from Business)
Name of the Taxpayer:
TIN: 1 2 3 4 5 6 7 8 9 0 1 2
Name of Business:
Nature of Business:
Address of Business:
Summary of Income Amount in Taka
1. Sales / Turnover / Receipt 0
2. Gross Profit 0
3. General Expenses, Selling Expenses, Land 0
Revenue, Rates, Loan Interest, Insurance
Premium and Other Expenses
4. Bad Debt Expense 0
5. Net Profit ( 2 – 3) 0
Summary of Balance Sheet Amount in Taka
6. Cash and Bank Balance 0
7. Inventory 0
8. Fixed Assets 0
9. Other Assets 0
10. Total Assets ( 6 + 7 + 8 + 9) 0
11. Opening Capital 0
12. Net Profit 0
13. Drawing during the Income Year 0
14. Closing Capital (11 + 12 – 13) 0
15. Liabilities 0
16. Total Capital & Liabilities (14 + 15) 0
Schedule 5
(Particulars of Investment Tax Credit)
Name of the Taxpayer:
TIN: 1 2 3 4 5 6 7 8 9 0 1 2
Particulars of Rebatable Investment
Summary of Income Amount in Taka
1. Life Insurance Premium or Contractual Deferred Annuity Paid in 0
Bangladesh
2. Contribution to Deposit Pension Scheme 0
3. Investment in Government Securities, Unit Certificate, Mutual 0
Fund, ETF or Joint
Investment Scheme Unit Certificate
4. Investment in Securities listed with Approved Stock Exchange 0
5. Contribution to Provident Fund to which Provident Fund Act, 1925 0
applies
6. Self & Employer’s Contribution to Recognized Provident Fund 0
7. Contribution to Super Annuation Fund 0
8. Contribution to Benevolent Fund / Group Insurance Premium 0
9. Contribution to Zakat Fund 0
10. Others, if any (provide detail) 0
11. Total Investment (aggregate of 1 to 10) 0
12. Amount of Tax Rebate 0
Instructions to fill up the Return Form
Instructions:
(1) This Return of Income shall be Signed and Verified by the Taxpayer or his Authorized
Representative as prescribed in the Income Tax Act, 2023.
(2)Enclose where applicable:
(a) Salary statement for salary; Bank statement for interest; Certificate for interest on savings
instruments; Rent agreement, receipts of municipal tax & land revenue, statement of house
property loan interest, insurance premium for house property income; Statement of Professional
income as per IT Rule-8; Copy of assessment/ income statement & balance sheet for partnership
income; Documents of capital gain; Dividend warrant for dividend income; Statement of other
income; Documents in support of investments in savings certificates, LIP, DPS, Zakat,
stock/share etc.
(b) Depreciation Chart claiming depreciation as per the Income Tax Act, 2023;
(c) Computation of Income according to the Income Tax Act, 2023.
(3)Enclose Separate Statement for:
(a) any income of the spouse of the Taxpayer (if she/he is not an Taxpayer), minor children and
dependent;
(b) Tax exempted / Tax free Income.
(c) Income Exempted from Tax declared under Part 1 of the Sixth Schedule of the Income Tax
Act, 2023.
(4)Documents furnished to support the declaration should be signed by the Taxpayer or his/her
authorized representative.
(5)Furnish the following information:
(a) Name, address & TIN of the partners if the Taxpayer is a firm;
(b) Name of firm, address & TIN if the Taxpayer is a partner;
(c) Name of the company, address & TIN if the Taxpayer is a director.
(6) Assets and liabilities of self, spouse (if she/he is not a Taxpayer), minor children and
dependant(s) to be shown in the IT-10B (2023).
(7) Signature is mandatory for all Taxpayer or his / her authorized representative.
(8) For Individual Person, signature is also mandatory in IT-10B (2023) & IT-10BB (2023).
(9) If needed, please use separate sheet.
