Download - Income Tax Return 2016
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FORM OF RETURN OF INCOME UNDER THE INCOME-tax ORDIN(XXXVI OF 1984)
Unive !a" #e"$%N& 'a" ON FOR THE #A ARIED INDIVIDUA
[Put tick (√) where applicable]
A!!e!!'ent ea * + 1 -+ 1.1. Name of the Assessee: M / A"a'
2. T N:
!. Natio"al # No:
$. #ate of %irth: 1 1 9 8 &mail:'. pouse s T N or Name : *
+. (a) ,ircle: (b) Ta-es o"e: /. 0esi e"tial tatus: 0esi e"t. Name a" a ress of the emplo3er: *
1*. Prese"t A ress: *
11. Telepho"e: 45ce 6obile:
Statement of income during the income year ended on 30/0#e ia" n&/ Hea0! &$ In &'e
1 alaries : u7s 212 "come from house propert3: u7s 2$! A8ricultural i"come: u7s 2'$ ,apital 9ai": u7s !1
"come from other sources: u7s !!' Total i"come+ Ta- le;iable o" total i"come/ Ta- rebate: u7s $$(2)(b)
Ta- pa3able ( i
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&"closures: i8"(Na
Na'e &$ t e A!!e!!ee* M / A"a'"come Bear: 2*1$?2*1
Assessme"t Bear: 2*1 ?2*1'C&'67tati&n &$ In &'e Tax ia i"it
3a ti 7"a ! &$ T&ta" In &'e A'&7nt in T
A/ In &'e $ &' #a"a * U%#-++1 %asic alar3 1**=**2 Couse 0e"t !'*=**
@ess: &-emptio"? Taka 2 =*** per mo"th 3earl3 2 =***D12 !**=**or= *E of basic salar3 '**=**Fhiche;er is lower !**=**
! ,o";e3a"ce Allowa"ce@ess: &-emptio" ma-imum !*=**
$ ,o";e3a"ce acilit3 (%asic alar3D E)6e ical Allowa"ce@ess: &-empte 6a-. Tk.12*=***. 12*=**
' @ea;e are Allowa"ce+ @ea;e &"cashme"t/ "ce"ti;e %o"us
esti;al %o"us1* &mplo3erGs ,o"tributio" to 0P H1*E of basic salar311 "terest o" 0P (&mplo3ee a" &mplo3erGs i"terest)
@ess: &-emptio"?i"terest o" 0P H1$. *E= or4"e thir of basic salar3 $**=**Fhiche;er is lower
T&ta" In &'e $ &' #a"a;/ In &'e $ &' H&7!e 3 &6e t * U%#-+4 (i$ an )
C/ A5 i 7"t7 a" In &'e* U%#-+. (i$ an )D/ Ca6ita"
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$
Ta- #e ucte at ource o" #0 Ta- #e ucte at ource o" #P Ta- #e ucte at ource o" #i;i e"A ;a"ce "come Ta- Pa3me"t for alar3 b3 the emplo3er
Net Tax ia i"it % (Re$7n0)
Signature of the Asse
#tate'ent &$ a!!et! an0 "ia i"itie! $& #a"a ie0 6e !&n (a! &n1/ Na'e &$ t e A!!e!!ee* M / A"a'+/ TIN*
1/ N&n-A5 i 7"t7 a" 3 &6e t (at &!t ?it "e5a" ex6en!e! ) *@a" 7Couse propert3 (#escriptio" a" locatio" of propert3)
+/ A5 i 7"t7 a" 3 &6e t (at &!t ?it "e5a" ex6en!e!) *@a" (Total la" a" locatio" of la" propert3) 2.'' ecimal la"
=/ Inve!t'ent!* A'&7nt in T(a) hares7#ebe"tures 1**=**(b) a;i"8 ,ertiOcate7I"it ,ertiOcate7%o"
**=**( ) @oa"s 8i;e"(e) 4ther ";estme"tT&ta"4/ M&t& Ve i "e! (at &!t) *
T3pe of motor ;ehicle a" 0e8istratio" "umber/ Be?e""e ( 7antit an0 &!t) 8 ;& i
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(ii) Ta- e-empte 7Ta- free "come !**=**(iii) 4ther receipts (%a"k loa" recei;e i" this i"come 3ear)
Total source of u"1@/ Di e en e (;et?een !e ia" 1 an0 1.)
Name si8"atu#ate:
DPlease pro;i e ocume"ts a" use separate sheet= if "ee e .
In!t 7 ti&n! t& 2"" 76 t e Ret7 n F& '
In!t 7 ti&n!*
(2) &"close where applicable:(i) alar3 stateme"t for salar3 i"comeQ(ii) #ee or re"tal a8reeme"t (if a"3) for house propert3 i"comeQ(iii) #ocume"ts i" support of a"3 other i"come or liabilities show"Q
(i;) #ocume"ts i" support of i";estme"ts ma e i" a"3 formQ(;) ,omputatio" of i"come accor i"8 to "come?ta- 4r i"a"ce= 1 /$Q(;i) Pro;i e e;i e"ce i" support of ta- pa3me"t.
( ) f "ee e = please use separate sheet.
(') Please ;isit N%0 s website www."br?b .or8 for further i"formatio".
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A :n&?"e05e'ent Re ei6t &$ In &'e Tax Ret7 n
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< &!! ea"t ! &?n* 1$=21*=***.** Net ea"t ! &?n *
#ate of receipt of retur": erial No. i" 0etur" 0e8iste
0etur" submitte u" er sectio" /2%%7Normal
#i5nat7 e &$ Re eivin5
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IT-11UMA
NCE, 1984
No"?resi e"t
*
/2015A'&7nt in Ta:a
1=!/*=***.**=***.**12=***.**
?!*=***.**
1=$++=***.**1/*=$**.**
!'=***.**1$$=$**.**
$=***.**
!=***.***.**
?1$1=$**.**!**=***.**
&5 a6 &$ t e A!!e!!ee
[to be atteste o" thephoto8raph]
l3 eclare that to the bestume"ts a""e-e herewith
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ture of the assesseee a" seal)
:a A'&7nt in Ta:a
*.** 1=2**=***.***.**
'*=***.**
*.***.***.**
??*.**
? ??
?*.**?
???
12*=***.**?
?
?*.**
?1=!/*=***.**
=***.**
12=***.**?
7nt =***.**.**
.** 22= **.**
.** 2= **.**? ?-
?-!*=***.**
1=$++=***.**
Pls i"put 3earl3
"put 3earl3 house re"t.
Please i"p
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re of the Assessee
:a A'&7nt in Ta:a
*.**2$*=***.***.**
???
-?-
??*.**
??*.**?
2$*=***.**
$*+=1**.**1 =***=***.**
$*+=1**.**2$*=***.**
e Tax ia i"it
*.** ?
*.** $*=***.***.** + =***.***.** ' =$**.**
? ?? ?
/ 18 ,4 /*.** !'=***.**
1$$=$**.**?
1$$=$**.**$=***.**
1$$=$**.****.**
s
ust "p
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1*
2=2 *.**2 *.**
???
1$1=$**.**
see
IT-1 ;;; % .%+ 1 )
A'&7nt in Ta:a
1*=***=***.**
/**=***.**:a
'**=***.**
*.**?
*.**??
1=2**=***.**$**=***.**2**=***.**1 *=***.**
:a
/'*=***.**
*.***.**
?
?14,+1 , /
!**=***.**
??
*.**?
1=,91 , /, , //= 1*=***.**
1= **=***.**1*=$1*=***.**:a
*.**
Pls i"put T# e u
Pls i"put Ta- paita- toke" feeR las
Pls i"putsubmit re
Bear "co
Pls i"put famil3 e-Jero #e ia" NO/ 1
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*.**
1=+++=***.**?
/='!!=***.**
e of the Assessee
LLLLLLLLLLLLLLLLL..
nt ea * + 1 -+ 1.
!=***.**
i" this form is correct a"
pe" a"t(s) to be show" i"
o" as prescribe u7s + of
see or his7her authoriJe
epe" a"t(s) to be show"
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1!= 1*=***.**
r:
O e ?it !ea"/