Income Tax Calculator

2010-2011
Entries Results

Personal IT Stat.

Pay Data

Particulars
IT Data 0

* This programme is suitable to salaried class individuals without Other Source of Income
i.e. Agricultural Income, Business, Capital gains etc.

VERSION 1.1
 Results

IT Stat.

ITR

Particulars of
0

e of Income
 Enter the Details
* Use Tab to fill details.

Name

Designation

Office Address

Pincode

PAN No Residential Address

Professional Tax

Date of Birth

Tuition Fees

Phone No.

Cell No.

Bank AC No.

Bank Branch

Gender M

HBA Interest HBA Principal

House rent paid

monthly
Housing loan
taken after
1.4.1999 Y/N
 Income from
other
source(Family
Pension)

Income from
Deposit Interest
Donation to
State or Central Donation to
Govt other
Medical Insurance institution
Prem. Paid for For
Assesse Family Parents
Expenses for
handicapped
dependant

Expenses for Medical

Treatment

Interest paid to
educational loan
Permanent
physical
disability
Infrastructure
Development
Bond

PARTICULARS OF INSURANCE PREMIUM PAID

SNO POLICY NO NAME OF COMPANY NAME OF POLICY

1
2
3
4
5

PARTICULARS OF POSTAL DEPOSITS

SNO POST OFFICE ISSUE NUMBER NSC NUMBER

1
 2
3
4
5
6

PARTICULARS OF MUTUAL FUND/ NOTIFIED FIXED DEPOSIT

SNO NAME OF INSTITUTION NAME OF PLAN

1
2
3
4
5

DETAILS TOWARDS JEEVAN SURAKSHA & ICICI LIFE TIME PENSION

NATURE OF DEPOSIT ACCOUNT NO. DATE OF DEPO

DETAILS OF INTEREST ACCRUED ON N.S.C. (VIII ISSUE)

NSC & NAME OF POST OFFICE DATE OF PURCHASE

DETAILS OF INFRASTRUCTURE BONDS

NAME OF DEPOSIT ACCOUNT NO. DATE OF DEPOSIT

e Details

ential Address
 Is parent is a
senior citizen

OF POLICY AMOUNT PREMIUM

AMOUNT
 AMOUNT

ME PENSION

DATE OF DEPOSIT PLACE OF DEPOSIT AMOUNT

RATE OF INTEREST (%) AMOUNT

PLACE OF DEPOSIT Amount

 Salary Drawn During The Period From 1.3.2010 To 28.2.2011
Non-
Taxable Grass
Month Pay GP DA HRA MA RA Allow. tax.
Salary
Allow.
March-10 0
April-10 0 0 0 0 0 0 0 0
May-10 0 0 0 0 0 0 0 0
June-10 0 0 0 0 0 0 0 0
July-10 0 0 0 0 0 0 0 0
August-10 0 0 0 0 0 0 0 0
September-10 0 0 0 0 0 0 0 0
October-10 0 0 0 0 0 0 0 0
November-10 0 0 0 0 0 0 0 0
December-10 0 0 0 0 0 0 0 0
January-11 0 0 0 0 0 0 0 0
February-11 0 0 0 0 0 0 0 0
Surrender 0 0
DA Arrear 1 0
DA Arrear 2 0
Pongal Bonus 0
Pay Com. Arrear 0
SG Arrear 0
Total 0 0 0 0 0 0 0 0 0

Click here after filling or every correction in above table →

Hai ! Your payable tax is Rs.
0
o 28.2.2011

Net
GPF HF FBF SPF IT Salary
0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0
0
0
0
0
0
0 0 0 0 0 0
 Data For ITR Form
* Use Tab to fill details

Father Name

Flat/Door/Block No.

Name of Premises / Building / Village

Road/Street/Post Office

Area / Locality

Town/City/District

State

Pincode

ITR Assessing Officer (Ward / Circle)

Email Address

Phone No. STD No No.

Date of Birth (DD/MM/YYYY) / /

Employee Status

Employee Category

Sex

Residential Status

Return filed under Section

Whether Original or Revised return?

 If revised, original return's Receipt No.

Date / /
Name of Employer or Pay Drawing Officer

Son of

Details of Tax Deducted at Source on Salary [As per Form 16 issued by Emp
Tax Deduction Account Number
Sl. Name and address of the Employer
(TAN) of the Employer
No (2) (3)
i

Details of Advance Tax and Self Assessment Tax Payments

Sl.
Name of Bank & Branch BSR Code
No
i
ii
iii
iv
v

Details Of Tax Deducted And Deposited Into Central Government Account

(The Employer is to provide transaction-wise details of tax deducted and deposited)

Total tax Date on which Transfer voucher/

Cheque/DD BSR Code of
deposited tax deposited Challan
No. (if any) Bank branch Identification No.
Rs. (dd/mm/yy)
16 issued by Employer(s)]
of the Employer

Date of Deposit Serial Number

Code Amount (Rs.)
DD/MM/YYYY of Challan

nment Account
ed and deposited)

fer voucher/
Challan
fication No.
 INCOME TAX CALCULATION STATEMENT FOR THE FINANCIAL
YEAR 2010-2011 (ASST. YEAR 2011-2012)

Name :
Designation : PAN :
Print it in Legal
Office Address:
Sheet, 2Pages,
double side
Phone No. : Cell No.: Pin :
Rs. Rs.
1. GROSS SALARY INCOME (Including all allowances) 0
2. LESS
HRA exempted under I.T. Rules under Section 10 (13A)
a. Actual rent paid
b. 10% of salary (Pay + DA)
c. Difference (excess over 10% pay + DA) i.e. (a-b)
d. H.R.A received 0
e. 40% of salary (Pay + DA)
HRA exempted c (or) d (or) e whichever is less 0
3. GROSS INCOME (1-2) 0
4. Taxable perquisites

5. Gross Salary Income (3) + (4) 0

6. Less : Deduction U/S 16
i Entertainment allowance 0
ii Tax on employment (Professional Tax) 0
7. NET SALARY INCOME (5 - 6) 0
8. a. Add Income/Loss from House Property as per Annexure 0
b. Add Income from other source 0
Accrued interest from NSC 0
Other deposit interest 0
9. GROSS TOTAL INCOME (7 + 8) 0
10. LESS DEDUCTIONS : UNDER CHAPTER VI
a. 1. 80-CCC-LIC Jeevan Suraksha ICICI Life Time Pension 0
2. GPF Contribution 0
3. FBF, SPF & HF 0
4. LIC (or) PLI Premium paid 0
5. Tuition fee paid to any School / College 0
6. NSC Deposits 0
7. LIC Mutual fund/ Notified Fixed Deposits with Bank
8. Housing Loan Repayment 0
9. Infrastructure Development Bonds (us/ 80C) (limited to Rs.20,000) 0
Total 1 to 9 (Subject to maximum of Rs.1,00,000/- or Rs.1,20,000/-) 0 0
b. 80-D upto Rs.15,000/- (Mediclaim)
Health Insurance 0
c. 80-DD upto Rs.50,000/- (Medical treatment- Handicapped dependant)
(Rs.1,00,000/- in case of severe disability) 0
d. 80-DDB upto Rs.40,000/- (Medical treatment-individual,
dependant relative) 0
e. 80-E (Repayment of Loan for Higher Studies) 0
f. 80-G (Donations to Chief Minister, Prime Minister Relief Fund)
(or) such other funds 0
g. 80-U upto Rs.50,000/- (Permanent physical disability cases)
 (Rs. 75,000/- in case of severe disability 0
11. TAXABLE INCOME (9 - 10) (rounded to nearest ten rupees) 0
12. TAX ON TOTAL INCOME (FOR COL.11) (rounded to nearest ten rupees)
A. Female
1. On the first (Rs.1,90,000) 1,90,000 Nil
2. On the next (Rs.1,90,001 to Rs.5,00,000) @ 10% 0 0
3. On the next (Rs.5,00,001 to Rs.8,00,000) @ 20% 0 0
4. On the balance (Above Rs.8,00,000) @ 30% 0 0
TOTAL (2+3+4) 0
B.Male
1. On the first (Rs.1,60,000) 1,60,000 Nil
2. On the next (Rs.1,60,001 to Rs.5,00,000) @ 10% 0 0
3. On the next (Rs.3,00,001 to Rs.8,00,000) @ 20% 0 0
4. On the balance (Above Rs.8,00,000) @ 30% 0 0
TOTAL (2+3+4) 0
C. Senior Citizen above 65 years Male & Female
1. On the first (Rs.2,40,000) 2,40,000 Nil
2. On the next (Rs.2,40,001 to Rs.5,00,000) @ 10% 0 0
3. On the next (Rs.3,00,001 to Rs.8,00,000) @ 20% 0 0
4. On the balance (Above Rs.8,00,000) @ 30% 0 0
TOTAL (2+3+4) 0
13. Tax Payable for the 2010-2011 0
14. Education cess @ 3% on col. No. 13 0
15. Tax & Education cess total (13 + 14) 0
16. Tax Relief under section 89(1) as per annexure (Form No. 10E)
17. Tax & Education cess Payable (15 - 16) 0
18. So for deducted 0
19. Balance of Income Tax to be deducted (17 - 18) 0
CERTIFICATE
1. Certified that I am occupying house alloted by the Accomodation controller/PWD/TNHB on payment of rent.
2. Certified that I am occupying rental house and paying monthly rent of Rs.
3. Certified that I am paying a sum of Rs. towards LIC Premium and the policies are kept alive.

Counter Signed

Head of Office. Signature of Employee with Designation

IMPORTANT NOTE
1. The salary bill for February - 2011 shall be presented along with the pre-checked income tax statement of this office salary
bill for Feb. 2011 with income statement without precheck by this office will be returned with a request to present on or after March 2011.
2. Basic exemption limit for Ladies Rs.1,90,000/-.
3. 80- D Medical Insurance Premium
i. Premium paid for assessee / spouse / Dependent Parents / Children.
ii. Premium should be paid by cheque.
iii. Quantum of Deduction- Actuals or Rs.15,000/- (incase of Senior Citizen Rs.20,000/-) whichever is less.
4. 80- DDB Medical Treatment
i. Medical expediture actually incurred or Rs.40,000/- (Rs.60,000/- for Senior Citizens) whichever is less. Copy of the bills
& Statement of expenditure to be enclosed.
ii. Doctor Certificate in Form No. 10-1 should be furnished.
iii. Any claim from Insurance Company / Employer shall be reduced from the deduction allowable.
5. 80-E Repayment of Loan for Higher Studies
i. Applicable for Full Time Course in Engineering / Medicine etc.
ii. Entire Amount of interest paid during the year shall be deducted from Income.
iii. Principal repayment shall be allowed to deduct in eight years beginning from the year in which payment of interest on the loan begins.
6. 80-G Donation
i. 100% deduction is allowable towards Donation to Prime Minister National Relief Fund. National Defence Fund etc.
ii. 50% of qualifying amount of deductiion is allowable in other Donations (Approved)
Particulars of details towards Jeevan Suraksha ICICI Life Time Pension during the financial
Print it in Legal
year 2010-2011 Sheet, 1Page,
front side
Nature of deposit Account No. Date of deposit Place of deposit Amount
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
Total 0

PARTICULARS OF INSURANCE PREMIUM PAID DURING 2010-2011

S. Amount Prem. Per

Policy No Name Of Company Name Of Policy
No Insured Annum
1 0 0 0 0 0
2 0 0 0 0 0
3 0 0 0 0 0
4 0 0 0 0 0
5 0 0 0 0 0
Total 0 0

PARTICULARS OF NSC DEPOSITS DURING 2010-2011

S.No Post Office Issue Number NSC Number Amount
1 0 0 0 0
2 0 0 0 0
3 0 0 0 0
4 0 0 0 0
5 0 0 0 0
6 0 0 0 0
Total 0

PARTICULARS OF MUTUAL FUND/ NOTIFIED FIXED DEPOSIT DURING 2010-2011

SN0 Name Of Institution Name Of Plan Amount
1 0 0 0
2 0 0 0
3 0 0 0
4 0 0 0
5 0 0 0
Total

DETAILS OF INTEREST ACCRUED ON N.S.C. (VIII ISSUE)

NSC & Name of Post Office Date of purchase Rate of Interest (%) Amount
0 0 0% 0
0 0 0% 0
0 0 0% 0
0 0 0% 0
0 0 0% 0
Total 0

PARTICULARS OF DETAILS TOWARDS INFRASTRUCTURE BONDS

Name of deposit Account No. Date of deposit Place of deposit Amount

0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
Total 0
 Statement Showing Salary Drawn During The Period From 1.3.2010 To 28.2.2011

Name : PAN No : Residential Address : HOME

Date of Birth : Print it in Legal Bank AC No :
Phone No. : Sheet, 1Page, Bank & Branch
, :
backside

Taxable Non-tax.
Month Pay DP DA HRA MA RA Allow Allowan. GA GPF HF FBF SPF IT
March-10 0 0 0 0 0 0 0 0 0 0 0 0 0 0
April-10 0 0 0 0 0 0 0 0 0 0 0 0 0 0
May-10 0 0 0 0 0 0 0 0 0 0 0 0 0 0
June-10 0 0 0 0 0 0 0 0 0 0 0 0 0 0
July-10 0 0 0 0 0 0 0 0 0 0 0 0 0 0
August-10 0 0 0 0 0 0 0 0 0 0 0 0 0 0
September-10 0 0 0 0 0 0 0 0 0 0 0 0 0 0
October-10 0 0 0 0 0 0 0 0 0 0 0 0 0 0
November-10 0 0 0 0 0 0 0 0 0 0 0 0 0 0
December-10 0 0 0 0 0 0 0 0 0 0 0 0 0 0
January-11 0 0 0 0 0 0 0 0 0 0 0 0 0 0
February-11 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Surrender 0 0 0 0 0 0 0 0 0 0 0 0 0 0
DA Arrear 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0
DA Arrear 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Pongal Bonus 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Pay Com. Arrear 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
Total 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Profession Tax : 0 Insurance Premium : 0
ITR
GPF/PPF : 0 : NSC Deposit : 0
HF : 0 Mutual Fund/ F.D :
FBF : 0
Total : 0
1 ITR 1

2 ITR 2 (For those have House Loan)

 ITR-1

Print it in A4
Sheet, 1Page,
Single side

ACKNOWLEDGEMENT

Received with thanks from a return of income and / or return of

fringe benefits in Form No. ITR.. For assessment year 2011-2012, having the following particulars.
Name PAN
PERSONAL INFORMATION

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)

1 Gross total income 1 0
0
COMPUTATION OF INCOME AND TAX THEREON

2 Deductions under Chapter VI-A 2

3 Total Income 3 0
3a Current Year loss (if any) 3a
4 Net tax payable 4 0
5 Interest payable 5
6 Total tax and interest payable 6 0
7 Taxes Paid
a Advance Tax 7a
b TDS 7b 0
c TCS 7c
d Self Assessment Tax 7d
e Total Taxes Paid (7a+7b+7c+7d) 7e 0
8 Tax Payable (6-7d) 8 0
9 Refund (7e-6) 9
10 Value of Fringe Benefits 10
11 Total fringe benefit tax liability 11
COMPUTATION OF FRINGE
BENEFITS AND THEREON

12 Total interest payable 12

13 Total tax and interest payable 13
14 Taxes Paid
a Advance Tax 14a
b Self Assessment Tax 14b
c Total Taxes Paid (14a+14b) 14c
15 Tax Payable (13-14) 15
16 Refund (14c-13) 16
Receipt No. Seal and Signature of receiving Official
Date
 INDIAN INCOME TAX RETURN Print it in A4 Assessment Year
FORM

(For Individuals having Income from Salary / Pension / family pension & Interest) Sheet, 2Pages,
ITR-1 double side 2 0 1 1 - 1 2
(Please see Rule 12 of the Income-tax Rules, 1962) (Also see attached instructions)

First Name Middle Name Last Name PAN

PERSONAL INFORMATION

Flat/ Door/ Block No. Name of Premises / Building / Village Date of Birth (DD/MM/YYYY)
/ /
Road / Street / Post Office Area / Locality Employee Category

Town/ City/ District State Pin Code Sex

Email Address0 STD - Phone No. 0

Designation of Assessing Officer (Ward/Circle) Return filed under Section - (Please see instruction number 9 (i))
FILING STATUS

0 0
Whether Original or Revised return? 0
If revised,enter original return's
Receipt No. Date / /
Residential Status 0
1 Income chargeable under the Head 'Salaries' (Salary/Pension) 1 0
2 Income chargeable under the Head 'Other Sources'
a Family Pension 2a 0
b Interest 2b 0
c Total (2a+2b) 2c 0
INCOME & DEDUCTIONS

3 Gross Total Income (1+2c) 3 0

4 Deductions under chapter VI A (Section)
a 80C 0 e 80DD 0 i 80GG
b 80CCC 0 f 80DDB 0 j 80GGA
c 80CCD 0 g 80E 0 k 80GGC
d 80D 0 h 80G 0 l 80U 0
m Deductions (Total of a to l) 4m 0
5 Total Income (3-4m) 5 0
6 Net Agricultural Income (Enter only if greater than Rs.5,000) 6
7 Aggregate Income' (5+6) 7 0
8 a Tax Payable on 'Aggregate Income' 8a 0
b Rebate in respect of Net Agricultural Income 8b
9 a Tax Payable on Total Income (8a-8b) 9a 0
TAX COMPUTATION

b Surcharge on 9a 9b
c Education cess, including secondary and higher 9c
secondary cess on (9a+9b) 0
d Total Tax, Surcharge and Education Cess Payable (9a+9b+9c) 9d 0
10 Relief under Section 89 10
11 Relief under Section 90/91 11
12 Balance Tax Payable (9d-10-11) 12 0
Do not write or stamp in this area (Space for bar code) 13 a Interest Payable U/s 234A 13a
b Interest Payable U/s 234B 13b
c Interest Payable U/s 234C 13c
d Total Interest Payable 13d
(13a+13b+13c) 0
14 Total Tax and Interest Payable 14
(12+13d) 0
For Office Use Only

Seal and Signature of receiving Official

Receipt No.

Date
 15 Taxes Paid
a Advance Tax (from item 23) 15a
TAXES PAID

b TDS (column 7 of item 21+column 7 of item 22) 15b

c Self Assessment Tax (from item 23) 15c
d Total Taxes paid ( 15a+15b+15c) 15d
16 Tax Payable (14-15d) (Enter if 14 is greater than 15d, else leave blank) 16
17 Refund (15d-14) (Enter if 15d is greater than 14, also give Bank Account details below) 17
18 Enter your bank account number (mandatory in case of refund)
REFUND

19 Do you want your refund by

20 In case of direct deposit to your bank account give additional details
MICR Code Type of Account
21 Details of Tax Deducted at Source on Salary [As per Form 16 issued by Employer(s)]
Tax Deduction Account Income chargeable Tax payable
Sl. Deduction under Total tax Tax payable
Number (TAN) of the Name and address of the Employer under the head (incl.surch. And
No Chapter VI-A deducted refundable
Employer Salaries edn.cess)
(2) (3) (4) (5) (6) (7) (8)
TDS ON SALARY

0 0 0 0 0
ii

22 Details of Tax Deducted at Source from Interest [As per Form 16A issued by Deductor(s)]
Tax Deduction Account Amount out of (6)
Sl. Amount paid / Date of Payment / Total tax
Number (TAN) of the Name and address of the Deductor claimed for this
No credited Credit deducted
Deductor year
(1) (2) (3) (4) (5) (6) (7)
TDS ON INTEREST

ii

iii

NOTE Enter the totals of column (7) of 21 and column (7) of 22 in Sl. No. 15b of TAXES PAID
23 Details of Advance Tax and Self Assessment Tax Payments
Sl.
No
Name of Bank & Branch BSR Code Date of Deposit DD/MM/YYYY Serial Number of Amount (Rs.)
Challan
TAX PAYMENTS

i 0 0 0
ii 0 0 0
iii 0 0 0
iv 0 0 0
v 0 0 0
NOTE Enter the totals of Advance tax and Self Assessment tax in Sl. No. 15a and 15c of TAXES PAID
24 Other Information (transactions reported through Annual Information Return) ( Please see instruction number-9(ii) for code)
Sl Code Amount (Rs.) Sl Code Amount (Rs.) Sl Code Amount (Rs.)
a 001 d 004 g 007
b 002 e 005 h 008
c 003 f 006
25 Tax-exempt interest income ( for reporting purpose only ) 25

VERIFICATION
I son of solemnly declare that to the best of my knowledge and belief, the information given
in the return 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 2011-12.

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

If TRP is entitled for any reimbursement from the Government, amount thereof (to be filled by TRP) 27
 (See rule 31 (1) (a) of the Income Tax Rules, 1962)
Form No. 16 CERTIFICATE UNDER SECTION 203 OF THE INCOME TAX ACT,1961 FOR TAX
DEDUCTED AT SOURCE FROM INCOME CHARGEABLE UNDER THE HEAD "SALARIES"
NAME AND ADDRESS OF THE EMPLOYER NAME AND DESIGNATION OF THE EMPLOYEE

Print it in A4
Sheet, 2Pages,
double side
PAN No. of the Deductor TAN No. of the Deductor PAN No. of the Employee

Acknowledgement No.s of all quarterly statements of TDS under sub-section PERIOD

ASSESSMENT YEAR
(3) of Section 200 as provided by TIN Facilitation / Centre or NSDL web-site FROM TO
Quarter Acknowledgement No.

1.4.2010 31.3.2011 2011-2012

DETAILS OF SALARY PAID AND ANY OTHER INCOME AND TAX DEDUCTED
1. Gross Salary
(a) Salary as per provisions contained in Section 17(1) Rs.0
(b) Value of perquisites under Section 17(2)
(as per Form No.12 BA, wherever applicable) Rs.
(c) Profits in lieu of salary under Section 17(3)
( as per Form No.12 BA, wherever applicable) Rs.
(d) TOTAL Rs. 0
2. Less: Allowance to the extent exempt under Section 10
Allowance Rs.
HRA 0
3. BALANCE (1-2) Rs. 0
4. DEDUCTIONS:
(a) Risk Allowance Rs. 0
(b) Tax on Employment Rs. 0
5. Aggregate of 4 (a) and (b) Rs.0
6. Income chargeable under the head 'Salaries' (3-5) Rs.0
7. Add: Any other income reported by the Employee:
Rs.
0 Rs.0
8. GROSS TOTAL INCOME (6+7) Rs.
9. DEDUCTIONS UNDER CHAPTER VI-A GROSS DEDUCTIBLE
(A) Section 80C, 80CCC and 80CCD AMOUNT AMOUNT
(a) SECTION 80C
(i) Rs. 0
(ii) Rs. 0
(iii) Rs. 0
(iv) Rs. 0
(v) Rs. 0
(vi) Rs. 0
(vii) Rs. 0
(viii) Rs. 0 Rs. 0
(b) SECTION 80CCC Rs. 0 Rs. 0
(c) SECTION 80CCD Rs. Rs. Rs. 0
Note: 1. Aggregate amount deductible under section 80C shall not exceed one lakh rupees.
 2. Aggregate amount deductible under the three sections, i.e., 80C, 80CCC and 80CCD, shall not exceed one lakh rupees.
(B) OTHER SECTION (FOR e.g. 80E, GROSS QUALIFYING DEDUCTIBLE
80G ETC.) UNDER CHAPTER VI-A AMOUNT AMOUNT AMOUNT
(a) Section Rs. 0 Rs. 0 Rs. 0
(b) Section Rs. 0 Rs. 0 Rs. 0
(c) Section Rs. 0 Rs. 0 Rs. 0
(d) Section Rs. 0 Rs. 0 Rs. 0
(e) Section Rs. 0 Rs. 0 Rs. 0
(f) Section Rs. 0 Rs. 0 Rs. 0
10. Aggregate of deductible amount under Chapter VI-A Rs. 0
11. TOTAL INCOME (8-10) Rs. 0
12. TAX ON TOTAL INCOME Rs. 0
13. Surcharge (on tax computed at S.No. 12) Rs.
14. Education Cess @ 3% on
(tax at S.No. 12 and surcharge at S.No. 13) Rs. 0
15. Tax payable (12+13+14) Rs. 0
16. Relief under Section 89 (attach details) Rs.
17. Tax payable (15-16) Rs. 0
18. Less: (a) Tax deducted at source u/s 192(1) Rs. Rs. 0
(b) Tax paid by the employer on
behalf of the employee u/s
192(1A) on perquisites U/s 17 (2) Rs. Rs.
19. Tax payable / Refundable (17-18) Rs. 0

DETAILS OF TAX DEDUCTED AND DEPOSITED INTO CENTRAL GOVERNMENT ACCOUNT

(The Employer is to provide transaction-wise details of tax deducted and deposited)
Date on
Education Total tax BSR Code Transfer voucher/
Sl. TDS Surcharg Cheque/DD No. which tax
cess deposited of Bank Challan
No Rs. e Rs. (if any) deposited
Rs. Rs. branch Identification No.
(dd/mm/yy)
0 0 00 0 0 0
00 0 0 0
00 0 0 0
00 0 0 0
00 0 0 0
00 0 0 0
00 0 0 0
00 0 0 0
00 0 0 0
00 0 0 0
00 0 0 0
00 0 0 0
00 0 0 0
I Son of working in the capacity of
,, do hereby certify that a sum of
Rs. 0 [ Rupees hasOnly]
been deducted
at source and paid to the credit of the Central Government. I further certify that the information given above is
true and correct based o the books of account, documents and other available records.

Place :
Date : Signature of the person responsible for deduction of tax

Full Name: Designation :

 INDIAN INCOME TAX RETURN Assessment Year
ITR-2 [For Individuals and HUFs not having Income from Business or Profession]
[Please see Rule 12 of the Income-tax Rules, 1962] Print
[Also it ininstructions]
see attached A4 2 0 1 1- 1
Sheet,
Part A-GEN GENERAL 6Pages,
First name Middle name double side
Last name PAN
PERSONAL INFORMATION

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

0 0 0
Road/Street/Post Office Area/locality Date of Birth (DD/MM/YYYY)
0 0 / /
Town/City/District State Pin code Sex (in case of individual)
0 0
Email Address (STD code) - Phone Number Employer Category
0 ( 0 ) 0 0
Designation of Assessing Officer (Ward/ Circle) Return filed under section
0 [Please see instruction number-9(i)]
Whether Original or Revised return 0
FILING STATUS

If revised, then enter Receipt No and Date of filing

original return (DD/MM/YYYY) / /
Residential Status 0
Whether this return is being filed by a representative assessee?
If yes, please furnish following information
a Name of the representative
b Address of the representative
c Permanent Account Number (PAN) of the representative

PART - B
Part B-TI Computation of total income
1 Salaries (6 of Schedule S) 1
2 Income from house property (3c of Schedule HP) (enter nil if loss) 2
TOTAL INCOME

3 Capital gains
a Short term
i Short term (u/s 111A) (A5 of Schedule CG) 3ai
ii Short term (others) (A6 of Schedule CG) 3aii
iii Total Short-term (3ai+3aii) (enter nil if loss) 3aiii
b Long-term (B5 of Schedule CG) (enter nil if loss) 3b
c Total capital gains (3aiii + 3b) 3c
Do not write or stamp in this area (Space for bar code) For Office Use Only

Receipt No

Date

Seal and Signature of receiving official

 4 Income from other sources
a from sources other than from owning race horses (3of Schedule OS) (enter nil if loss) 4a
b from owning race horses (4c of Schedule OS) (enter nil if loss) 4b
c Total (a+b) 4c
5 Total (1+2+3c+4c) 5
6 Losses of current year set off against 5 (total of 2vi and 3vi of Schedule CYLA) 6
7 Balance after set off current year losses (5-6) (also total of column 4 of Schedule CYLA) 7
8 Brought forward losses set off against 7 (2vi of Schedule 3 BFLA) 8
9 Gross Total income (7-8) (also 3vii of Schedule BFLA) 9
10 Deductions under Chapter VI-A (n of Schedule VIA) 10
11 Total income (9-10) 11
12 Net agricultural income/any other income for rate purpose (4 of Schedule EI) 12
13 'Aggregate income' (11+12) 13
14 Losses of current year to be carried forward (total of row xi of Schedule CFL) 14

Part B- TTI Computation of tax liability on total income

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

2 Surcharge on 1c 2
3 Education Cess on (1c+2) 3
4 Gross tax liability (1c+2+3) 4
5 Tax relief
a Section 89 5a
b Section 90 5b
c Section 91 5c
d Total (5a+5b+5c) 5d
6 Net tax liability (4-5d) 6
7 Interest payable
a For default in furnishing the return (section 234A) 7a
b For default in payment of advance tax (section 234B) 7b
c For deferment of advance tax (section 234C) 7c
d Total Interest Payable (7a+7b+7c) 7d
8 Aggregate liability (6+7d) 8
9 Taxes Paid
a Advance Tax (from Schedule-IT) 9a
TAXES PAID

b TDS (total of column 7 of Schedule-TDS1 and column 7 9b

of Schedule- TDS2)
c Self Assessment Tax 9from Schedule-IT) 9c
d Total Taxes Paid (9a+9b+9c) 9d
10 Amount payable (Enter if 8 is greater than 9d, else enter 0) 10
11 Refund (If 9d is greater than 8,also give Bank Account details below) 11
12 Enter your bank account number (mandatory in case of refund)
REFUND

13 Do you want your refund by cheque or deposited directly into your bank account?
14 In case of direct deposit to your bank account give additional details
MICR code Type of Account

15 E-filing Acknowledgement Number Date (DD/MM/YYYY) - -

VERIFICATION
I son of solemnly declare that to the best of my knowledge and belief,
the information given in the return and schedules therto 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 2011-2012.
Place Date Sign here →

16 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 17
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 & profit 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
Schedule HP Details of Income from House Property
1 Address of property 1 Town / City State PIN code
,, 0 0
(Tick) if let out Name of Tenant PAN of Tenant (optional)

a Annual letable value/ rent received or receivable (higher if let out for whole of the year,
lower if let out for part of the year) 1a
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 0
h Total (1f+1g) 1h 0
HOUSE PROPERTY

i Income from house property 1 (1e-1h) 1i 0

2 Address of property 2 Town / City State PIN code

(Tick) if let out Name of Tenant PAN of Tenant (optional)

a Annual letable value/ rent received or receivable (higher if let out for whole of the year,
lower if let out for part of the year) 2a
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 1e 2f
g Interest payable on borrowed capital 2g
h Total (2f+2g) 2h
i Income from house property 2 (2e-2h) 2i
3 Income under the head "Income from house property"
a Rent of earlier years realized under section 25A/AA 3a
b Arrears of rent received during the year under section 25B after deducting 30% 3b
c Total (3a+3b+1i+2i) 3c
Note Please include the income of the specified persons referred to in Schedule SPI while computing the income under this head

Schedule CG Capital Gains

A Short-term capital gain
1 From assets in case of non-resident to which first proviso to section 48 applicable 1
CAPITAL GAINS

2 From other assets

a Full value of consideration 2a
b Deductions under section 48
 CAPITAL GAI i Cost of acquisition bi
ii Cost of Improvement bii
iii Expenditure on transfer biii

iv Total (i+ii+iii) biv

c Balance (3a-b iv) 2c
d Loss, if any, to be ignored under section 94(7) or 94(8) 2d
e Exemption under section 54/54B/54D/54EC/54F 2e
f Short-term capital gain (2c-2d-2e) 2f
3 Amont deemed to be short term capital gains under sections 54/54B/54D/54EC/54F 3
4 Total Short term capital gain (1+2f+3+4) 4
5 Short term capital gain under section 111A included in 4 A5
6 Short term capital gain other than referred to in section 111A (4-5) A6
B Long term capital gain
1 Asset in case of non-resident to which first proviso to section 48 applicable 1
2 Other assets where proviso to section 112(1) not applicable
a Full value of consideration 2a
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 (2a-biv) 2c
d Deductions under section 54/54B/54D/54EC/54F 2d
e Net balance (2c-2d) 2e
3 Other assets where proviso to section 112(1) is applicable
a Full value of consideration 3a
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 (3a-biv) 3c
d Deductions under section 54/54B/54D/54EC/54F 3d
e Net balance (3c-3d) 3e
4 Amount deemed to be long term capital gains under sections 54/54B/54D/54EC/54ED/54F 4
5 Total long term capital gain (1+2e+3e+4) B5
C Income chargeable under the head "CAPITAL GAINS" (A4+B5) C
D Information about accrual/ receipt of capital gain
Date Upto 15/9 16/9 to 15/2 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

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 1d
e Total (1a+1b+1c+1d) 1e
f Deductions under section 57
OTHER SOURCES

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) 3
4 Income from owning and maintaining race horses
 O a Receipts 4a
b Deductions under section 57 in relation to (4) 4b
c Balance (4a-4b) 4c
5 Income chargeable under the head "Income from other sources" (1g+2+3+4c) 5
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/Sources Income of current House property loss of the current Other sources loss (other than Current years
No. of Income year year set off loss from race horses) of the Income
(Fill this column only current year set off remaining
CURRENT YEAR LOSS ADJUSTMENT

if income is zero or Total loss Total loss after set off

positive (3c of Schedule- (3 of Schedule-
HP) OS)
1 2 3 4=1-2-3
i Salaries
ii House property 0 0
iii Short-term capital
gain
iv Long term capital
gain
v Other sources
(incl profit from
owning race horse)
vi Total loss set off
vii Loss remaining after set-off out of 2&3 0
Schedule BFLA Details of Income after Set off of Brought Forward Losses of earlier years
Income after set off, if any, of
Brought forward loss set Current year's income
Sl. current year's losses as per 4 of
off remaining after set off
BROUGHT FORWARD LOSS

Head/ Source of Income Schedule CYLA

No
1 2 3
ADJUSTMENT

i Salaries
ii House property
iiiShort-term capital gain
iv Long term capital gain
v Other sources (including profit from
owning race horses)
vi Total of brought forward loss set off
vii Current year's income remaining after set off Total (i3+ii3+iii3+iv3+v3)
Schedule CFL Details of Losses to be carried forward to future years
Other sources loss
Date of Filling House Short-term Long-term Other sources loss
Sl. Assessment Year (other than loss (from owning race
(DD/MM/YYYY) property loss Capital loss Capital loss horses)
No from race horses)
i 2002-03
CARRY FORWARD OF LOSS

ii 2003-04
iii2004-05
iv 2005-06
v 2006-07
vi 2007-08
vii 2008-09
viii2009-10
ix Total of earlier year losses
x Adjustment of above losses in
Schedule BFLA
xi 2010-11(Current year losses)
xii Total loss Carried Forward
to future years
Schedule VIA Deductions under Chapter VI-A (Section)
a 80C h 80G
EDUCTIONS
 TOTAL DEDUCTIONS b 80CCC i 80GG
c 80CCD j 80GGA
d 80D k 80GGC
e 80DD l 80RRB
f 80DDB m 80U
g 80E
n Total deductions (total of a to m) n

Schedule SPI Income of specified persons (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 (Please see instruction No.9(iii) for section code and rate of tax)
Sl. Section Special rate Income Tax thereon Sl. Section Special rate Income Tax thereon
No Code % i ii No Code % i ii
SPECIAL RATE

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

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 from transactions on which Securities Transaction Tax is paid 3
4 Net Agriculture income/any other income for rate 4
5 Others 5
6 Total (1+2+3+4+5) 6

Schedule AIR Other Information (transactions reported through Annual Information Return) (Please see instruction number-9(ii) for code)
Sl Code of Transaction Amount (Rs) Sl 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 Date of Deposit Serial Number Amount (Rs)
Name of Bank & Branch BSR Code
TAX PAYMENTS

No (DD/MM/YYYY) of Challan
i
ii
iii
iv
v
Note Enter the totals of Advance tax and Self Assessment tax in Sl. No. 9a & 9c of Part B-TTI

Schedule TDS1 Details of Advance Tax and Self Assessment Tax Payments of Income-Tax

Tax Deduction Account Income Deduction Tax payable Tax

Sl Total tax
Number (TAN) of the Name and address of the Employer chargeable under (incl. surch. payable/
TDS ON SALARY

No under Chapter And edn. Cess) deposited

Deductor refundable
Salaries VI-A
(1) (2) (3) (4) (5) (6) (7) (8)
i

ii

Schedule TDS2 Details of Tax Deducted at Source on Income [As per Form 16A issued by Deductor(s)]
 Tax Deduction Account Date of Total tax Amount out of (6)
TDS ON OTHER INCOME
Sl
Number (TAN) of the Name and address of the Deductor Amount paid Payment /
No deposited claimed for this
Deductor Credit year
(1) (2) (3) (4) (5) (6) (7)

Note Please enter total ofcolumn 7 of Schedule - TDSI and column 7 of Schedule-TDS2 in 9(b) of Part B-TTI
ment Year

ving official
0
0
rrent years

's income
ter set off

sources loss
owning race
horses)
ount (Rs.)

x thereon

Tax
payable/
refundable
(8)
nt out of (6)
ed for this
year
(7)