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FIRST NAME Pranab
MIDDLE NAME Kumar
LAST NAME Banerjee
DESIGNATION U.D.A.
Permanent A/C No.(PAN NO) AAQQ 5565 A
Gender ( Male or Female ) MaleNo
DATE OF BIRTH 1/4/1963
EMPLOYEE'S RESIDENTIAL ADDRESS
Flat/Door/Block No. 25D
Village Kalisthanpara
Post Office: Jiaganj
Area/Locality: Jiaganj
If you live in Metro City Type Yes ,else Type No No
District: Murshidabad
PIN CODE: 742255
State: West Bengal
Designation of Assessing Officer ( Ward/Circle) 11
Date of Submit this RETURN 25/6/2011
First Fill the Pay Sheet Office Address
STATUS- Govt/PSU/Others Govt
Income Tax Preparation(Quarterly/Annualy) FOR Financial YEAR 2010-11 This Calculation sheet Only for West Bengal Govt. Employees Prepared by Pranab Banerjee,Kalisthanpara, Jiaganj,Murshidabad,W.B., pranab.banerjee83@gmail.com or 9474316768, 8906279547,
Note:-If any discrepency is arise about calculation of income Tax,I am
not responsible for that, Pranab Banerjee
New I T R -I ,For Assessment Year 2011-2012,which recent published by the MINISTRY OF FINANCE(Deptt.of Revenue)Central Board of Taxes,New Delhi. Notification
Dated 23/04/2010 in the Gazette of India Extraordinary,Part-II, Section 3,(Sub Sec(ii)]
If Handicapped Employee Pl. put "Yes" If General put "No"
This Auto Income Tax Calculation Software only for West Bengal Govt Employees. As the D.A. is not mached with other State or Central Govt Employees.(In this Software Prepared Salary Statement+Form-16 + ITR-I + Form 10E)
B.L.L.R.O., Bhagwangola-I,
Murshidabad
Name & Address of the Deductor Pan No. of Deductor
Name & Address of the Employer Tan No. of Employer A Q 5544
PARTICULARS OF SALARY
345840 This Cell is Auto filled( The Data Comes from Pay Sheet)
Total Income from Salary( This Cell Auto filled) 343440 This Cell is Auto filled (The Data comes from Pay Sheet)
125000
Deduction under chapter VI-A (LIC,PF,Tuition Fees,H.B.Principal):80C (Maximum Deposit Rs.1,00,000)+20,000/- Flixible Bond
1 a) G.P.F. 12000
2 b) P.P.F 0
3 c) L.I.C. 20000
4 d) N.S.C. 5000
5 e) H.B. Loan Principal 0
6 f) GROUP INSURANCE (G.I.) 480
7 ULIP 20000
8 g)New Flexible Tax Savings Bond ( Maximum Rs. 20,000/-) 0
9 h)Equity linked savings scheme/tax savings bond etc. 2000
10 i) Tuition Fees 50000
11100000
12 Income from Bank Interest/N.S.C/Others Source 0
13 Income from House Property 0
14 80G 0 Donation in Charitable Fund Maximum 100% of donation)
Pravat Kr. Das,C/o-SDLLRO,Lalbagh,Murshi
dabad
Gross Income from Salary (Salary+H.R.A.+Bonus+Arrear if any+Int.Bank/NSC+House Property)
Total income of financial year 2008-09 (Col-11) of Form No. 16
( For Financial Year 2008-2009) + Two Instlmnt which already received previous year As Arrears. For Calculating Form 10E,
For Calculation of Arrears Relief U/s 89(1). Put your Total Income of 2008-2009 +Two Instlmnt. Which received as ROPA-Arrears.
DEDUCTION ONLY U/S 80C, 80CC (MAXIMUM LIMIT NOT EXCCEED RS.1,20,000/- including New Tax
Savings Bond(Max Rs.20000/-)
TOTAL DEDUCTION U/S 80C Max. Rs 1,00,000/- + 20,000 Infrustructure Bond, Total Rs.1,20,000/-
Total Deduction U/S 80C (Max.limit 1,00,000/-) + 20,000/- New declared Infrustructure Bond
15 80D 5000
16 80E 0 For Higher Education Loan
17 80DD 0 Medical treatment for self or dependent as Handicapped
18 80DDB 0 Medical Treatment for self or dependent for sever desease 19 80CC0 Deposit in Pension Fund (Maximum Rs. 1,00,000/-
21 House Rent Paid 0 For Rented House. Must Submit the receipt of House Rent.
22 Conveyance Allowances U/s 10(14)(i) 0 Maximum Rs. 9600 P.A.
23 80U 0
TOTAL DEDUCTION CHAPTER VI-A Rs. 105000 TOTAL DEDUCTION CHAPTER VI-A Rs.
24 Arrear Received if any 15000 Auto Filled Cell [the Data Comes Pay Sheet]
25 Relief under Section 89(1) 1,545 Auto Filled Cell [the Data Comes 10E ]
Premium in health insurance of self,spouse,children,dependent,Maximum Rs 15000/-
Permanent disability including blindnes as handicapped(Max Rs.75000/-)
EMPLOYEE'S RESIDENTIAL ADDRESS
First Fill the Pay Sheet
Income Tax Preparation(Quarterly/Annualy) FOR Financial YEAR 2010-11 This Calculation sheet Only for West Bengal Govt. Employees
Prepared by Pranab Banerjee,Kalisthanpara, Jiaganj,Murshidabad,W.B., pranab.banerjee83@gmail.com or 9474316768, 8906279547,
New I T R -I ,For Assessment Year 2011-2012,which recent published by the MINISTRY OF FINANCE(Deptt.of Revenue)Central Board of Taxes,New Delhi. Notification
Dated 23/04/2010 in the Gazette of India Extraordinary,Part-II, Section 3,(Sub Sec(ii)]
This Auto Income Tax Calculation Software only for West Bengal Govt Employees. As the D.A. is not mached with other State or Central Govt Employees.(In this Software Prepared Salary Statement+Form-16 +
A Q 5544
PARTICULARS OF SALARY
This Cell is Auto filled( The Data Comes from Pay Sheet)
This Cell is Auto filled (The Data comes from Pay Sheet)
328440
Deduction under chapter VI-A (LIC,PF,Tuition Fees,H.B.Principal):80C (Maximum Deposit Rs.1,00,000)+20,000/- Flixible Bond
Donation in Charitable Fund Maximum 100% of donation)
DEDUCTION ONLY U/S 80C, 80CC (MAXIMUM LIMIT NOT EXCCEED RS.1,20,000/- including New Tax
Savings Bond(Max Rs.20000/-)
Total Deduction U/S 80C (Max.limit 1,00,000/-) + 20,000/- New declared Infrustructure Bond
For Higher Education Loan
Medical treatment for self or dependent as Handicapped
Medical Treatment for self or dependent for sever desease Deposit in Pension Fund (Maximum Rs. 1,00,000/-For Rented House. Must Submit the receipt of House Rent.
Maximum Rs. 9600 P.A.
TOTAL DEDUCTION CHAPTER VI-A Rs.
Auto Filled Cell [the Data Comes Pay Sheet]
self,spouse,children,dependent,Maximum Rs 15000/-
Permanent disability including blindnes as handicapped(Max
D.A. H.R.A. M.A. Bonus G.P.F. P.Tax
Mar-10 12840 4200 0 0 0 5964 35% 0 2556 15% 300 1000 15000 25860 1000 0 200
Apr-10 12840 4200 0 0 0 5964 35% 0 2556 15% 300 25860 1000 200
May-10 12840 4200 0 0 0 5964 35% 0 2556 15% 300 25860 1000 200
Jun-10 12840 4200 0 0 0 5964 35% 0 2556 15% 300 25860 1000 200
Jul-10 13,300 4200 0 0 0 7875 45% 0 2625 15% 300 28300 1000 200
Aug-10 13,300 4200 0 0 0 7875 45% 0 2625 15% 300 28300 1000 200
Sep-10 13,300 4200 0 0 0 7875 45% 0 2625 15% 300 28300 1000 200
Oct-10 13,300 4200 0 0 0 7875 45% 0 2625 15% 300 28300 1000 200
Nov-10 13,300 4200 0 0 0 7875 45% 0 2625 15% 300 28300 1000 200
Dec-10 13,300 4200 0 0 0 7875 45% 0 2625 15% 300 28300 1000 200
Jan-11 13,300 4200 0 0 0 7875 45% 0 2625 15% 300 28300 1000 200
Feb-11 13,300 4200 0 0 0 7875 45% 0 2625 15% 300 28300 1000 200
TOTAL 157760 50400 0 0 0 86856 0 31224 3600 1000 15000 329840 12000 2400
Total Earning for this Year excluding Bonus & Arrear 279440 Total Deduction Excluding TDS 14880
Total Earning for this Year Including Bonus & Arrear 295440 Total Deduction Including TDS 24320
Pay Calculation Sheet for -Income Tax Calculation ,for the financial year 2010-2011, Assessment Year 2011-12 Only For West Bengal Govt Employees
MONTH &Year
Basic Pay
Grade Pay/
D.Pay
Travelling Alwnc/
Conveyance Allownce
Educ. Allwanc
Spl. Allwnc
Put D.A. Rate of
%
Arrer DA IF ANY
Put HRA Rate of %
Arrears Received as 6th Pay
Comm.
TOTAL
(ExcludingBonus+ Arrears)
Arr. GPF
Pre
par
ed b
y P
ran
ab B
aner
jee,
Kal
isth
anp
ara,
Jiag
anj,
Mu
rsh
idab
ad, W
est
Ben
gal
0 40 0 0 500
0 40 00
500
0 40 00
500
0 40 00
500
0 40 00
500
0 40 00
500
0 40 00
500
0 40 00
500
0 40 00
500
0 40 00
500
0 40 00
500
0 40 0 0 3940
0 480 0 0 9440
Pay Calculation Sheet for -Income Tax Calculation ,for the financial year 2010-2011, Assessment Year 2011-12 Only For West Bengal Govt Employees
Arr. P. Tax
G.I.S./GISL
H.B. Loan. Princpl
H.B.Int Paid
Deposited as
monthly TDS
INCOME TAX STATEMENT FOR THE FINANCIAL YEAR 2010-2011ASSESSMENT YEAR 2011-2012
A. Name & Designation of the Assesses Pranab Kumar Banerjee U.D.A. B. Residential Address Kalisthanpara Jiaganj Murshidabad Pin Code No. 742255C. Pan Card No. AAQQ 5565 A 1 a) Salary income with allowance excluding H.R.A.:-…………………………… Rs. 298616
b) House Rent Allowance :-…………………………………………………………… Rs. 31224
c) Bonus :-………………………………………………………………………………… Rs. 1000
d) Arrear,if any :-…………………………………………………………………………. Rs. 15000
2 Any other income as stated by the Assesses :-
a) Income from N.S.C./Bank interest etc:-…………………………………………. Rs. 0
b) Income from House Property:-……………………………………………………. Rs. 0
3 Gross Income(Col.1 + 2 ) :-…………………………………………………………… Rs. 345840
4 Interest paid as H.B.Loan (1.5 Lacks maximum) U/S 24(B):-…………………… Rs. 0
5 Professional Tax U/S 16(iii) :-………………………………………………………… Rs. 2400
6 Exemption of Conveyance Allowances U/s 10(14)(i)[Max.Rs 9600/-P.A. 0
7 Exemption U/S 10(13A) :- ###
a) H.R.A.Received :-………………………………………… Rs. -
b) House Rent paid :-…………………………………………………… Rs. - ###
c) Expenditure on rent in excess of
50% of B.Pay In Metropol City ors 40%............................. 63,104 Rs. -
10% of B.Pay ………………………………………………… - 15,776 Rs. -
e) Amount exempted (Least of a,c):- - 15,776 Rs. - Rs. -
8 Total Income(Col.3-4-5-6-7) :-………………………………………………………. Rs. 343440
9 Deduction U/S 80 C (Maximum Rs.1,20,000/- including T.Svngs Bond) ###
a) Contribution to G.P.F.:- ……………………………………………. Rs. 12000 ###
b) Contribution to P.P.F…………………………………………………… Rs. 0
b) Group Insurance Savings Scheme :-………….. Rs. 480 ###
c) L.I.C./Premium paid(including Notified Pension Scheme 20000 Charg of H.R.A
d)Purchase of N.S.C. :-………………………………………….. Rs. 5000
ULIP……………………………………………………………………. Rs. 20000
e) Amount paid as excluisively tuition fees to any
University/College/School for maximum of two
Children( 2 )Maximum Rs.1,00,000/-)………………………………… Rs. 50000
f) Payment of H.B.Loan (Principal) :- Rs. 0
g) New Flexible Bond Max Rs. 20,000/-)………………………………… Rs. 0
g) Equity linked savings scheme/tax savings bond etc.{Max-20000/-) Rs. 2000 ###
h) Others, if any as notified :- 80DDB 0 ii)80G 0 ###
80U 0 iii)80DD 0 iv)80D 5000 v)80E 0 5000 ###
10 Total Amount Deducted (a to h) :-……………………………………….. Rs. 114480 Rs. 105000
11 Taxable Income (8-10) :-[Rouned to the next 10]……………….. Rs. 238440
12 i) Upto Rs.1,60,000/- Tax Nil, (ii)Rs.1,60,001/-to 5,00,000/-Tax 10%(iii) 500000 -80000
20%, iv)Rs.8,00,001/-to Onwards Tax 30%, For Female Up to 190000/- Tax NIL
13 Total Tax :-……………………………………………………………………… Rs. 7,844
14 3% Educational cess on tax :-…………………………………………………… Rs. 235
15 Tax Payable including educational cess(Col.13+14) :-………………….. Rs. 8,079
16 Relief U/S 89(1)[Arrears Relief from Salary] Rs. 1,545
17 Net Tax Payable ( 15-16) Rs. 6,534
18 Tax Paid from Salary Anually or Monthwise……………………………………………… 9440
19 Balance Tax Payable/Refundable……………….. ………………………………….. Rs. -2,906
###
Date:- Signature of the employee
Designation
Pranab Banerjee,Jiaganj,Msd
Salary Statement for the Year 2010-2011(From March 10 to Feb 2011)
Salary Statement of Sri Pranab Kumar Banerjee U.D.A.
D.A. H.R.A. M.A. G.P.F. P.Tax
Mar-10 12840 4200 0 0 0 5964 2556 300 1000 200 40 0 0 500
Apr-10 12840 4200 0 0 0 5964 2556 300 1000 200 40 0 0 500
May-10 12840 4200 0 0 0 5964 2556 300 1000 200 40 0 0 500
Jun-10 12840 4200 0 0 0 5964 2556 300 1000 200 40 0 0 500
Jul-10 13300 4200 0 0 0 7875 2625 300 1000 200 40 0 0 500
Aug-10 13300 4200 0 0 0 7875 2625 300 1000 200 40 0 0 500
Sep-10 13300 4200 0 0 0 7875 2625 300 1000 200 40 0 0 500
Oct-10 13300 4200 0 0 0 7875 2625 300 1000 200 40 0 0 500
Nov-10 13300 4200 0 0 0 7875 2625 300 1000 200 40 0 0 500
Dec-10 13300 4200 0 0 0 7875 2625 300 1000 200 40 0 0 500
Jan-11 13300 4200 0 0 0 7875 2625 300 1000 200 40 0 0 500
Feb-11 13300 4200 0 0 0 7875 2625 300 1000 200 40 0 0 3940
TOTAL 157760 50400 0 0 0 86856 31224 3600 12000 2400 480 0 0 9440
Total Arrears Received from March 10 to Feb 2011 Rs. 15,000 Total Earning Rs. 329840
Bonus Received From March 2010 to Feb 2011 Rs. 1,000
Dated:- Signature of Employee
Designation:-
MONTH &Year
Basic Pay
Grade Pay/ D.Pay
Travelling Alwnc/
Conveyance Allownce
Educ. Allwanc
Spl. Allwnc
G.I.S./GISL
H.B. Loan. Princpl
H.B.Int Paid
Deposited as monthly
TDS
FORM NO.16
PRART A
Certificate under section 203 of the Income-tax Act, 1961 for Tax deducted at source from Salary
Name and address of the Employer Name and designation of the employee
Pranab Kumar Banerjee U.D.A.
TAN No.of the Deductor PAN NO. of the Employee
- A Q 5544 AAQQ 5565 A
CIT (TDS)Assessment Year
Period
Address Central Income Tax Office,Berhampore From To
Murshidabad, West Bengal 2011 2012 1/4/2010 31/3/2011
City Berhampore Pin Code 775,566
Quarter
Q 1 5 1,500 1,500 Q 2 7 1,500 1,500 Q 3 9 1,500 1,500
Q 4 10 4,940 4,940
TOTAL 9,440 9,440
PART B (Refer Note )
Details of Salary Paid and any other income and tax deducted
1 Gross Salary IN RUPEES IN RUPEES IN RUPEES
(a) Rs. 345,840
(b) Rs. 0
(c) Rs. 0
(d) TOTAL Rs. 345840
2
Allowance Rs.
0
0 0
3 Balance(1-2) Rs. 3458404 Deductions :
(a) 0
(b) Tax on employment 2400
5 Aggregate of 4(a) to (b) Rs. 2,400
6 Rs. 343440
7 ###
a)Income form N.S.C./Bank int.etc. Rs. 0 ###
8 Gross total income (6+7) Rs. 343440
[See rule 31(1)(a)]
Pravat Kr. Das,C/o-SDLLRO,Lalbagh,Murshidabad
PAN NO.of Deductor
Receipt Numbers of original statements of TDS under sub-section (3) of section
200
Amount of tax deducted in respect of the employee
Amount of tax deposited remitted in respect of the
employee
Salary as per provisions contained in section 17(1)
Value of perquisites under section 17(2)(as per Form No. 12BA,wherever applicable)
Profits in lieu of salary under section 17(3)(as per Form No. 12BA, wherever applicable)
Less: Allowance to the extent exempt u/s 10
HRA Exempt( U/s 10(13A)Conv.Alw.exempt(U/s 10(14)(i)
H.B.Loan Int.(Max-1,50,000/-) u/s 24(B)
Income chargeable under the head 'salaries' (3-5) Add: Any other income reported by the employee
9 Deductions under Chapter VIA
A Deductible Amount Rs.
(a)(i)Sec.80C-G.P.F. Rs. 12000(ii)P.P.F. Rs. 0(ii) G.I.S. Rs. 480
(iii) U L I P Rs. 20000
(iv) Tution Fees Rs. 50000
0 ###
(vi) N.S.C. 5000 lic
(vii) L I C Premium Rs. 200002000
(ix) H.B.L.(Principal) Rs. 0 109480 Rs. 100,000
B Other sections e.g.,80E,80G,etc under chapter VI Gross Amount Deductible Amount Rs.
(a) Section 80 E Rs. 0 0(b) Section 80 G Rs. 0 0© Section 80U Rs. 0 0(d) Section 80DD Rs. 0 0(e) Section 80D Rs. 5000 5000f) Section 80CC Rs. 0 0G) Section 80DDB Rs. 0 0
10 Rs. 105,000
11 Total Income (8-10) Rs. 238,44012 Tax on total income Rs. 7,84413 Surcharge on col.12 Rs. 014 Education & cess @3% on col.no.12 Rs. 23515 Tax payable (12+13+14) Rs. 8,07916 Relief U/s 89(1) Rs. 1,54517 Rs. 6,53418 Less (a) Tax deducted at source Rs. 9,440
19 Refundable - Rs. 2,906
VerificationI son/daughter of
working in the capacity of(designation do hereby certify that a sum of Rs [Rs.
(in words)] has been deducted and deposited to the credit of the Central Governement. I further
certifify that the information given about is true, complete and correct and is based on the books of account, documents, TDS
statement ,TDS deposited and other available records.
Place:-
Date:- Signature of person responsible for deduction of tax
Full Name:-
Note:-
1 If an assessee is employed under more than one employer during the year, each of the employers shall issue Part
A of the certificate in Form No. 16 pertaining to the period for which such assessee was employed with each
of the employers. Part B may be issued by each of the employers or the last employer at the option of the assessee.2 Government deductors to enclose Annexure-A if tax is paid without production of an income-tax
challan and Annexure-B if tax is paid accomanied by an income-tax challan.3 Non-Government deducto5rs to enclose Annexure-B
U/s 80C (Aggregate amount Max.Rs.1,20,000/-)
Gross Amount
(v) New Flexible Bond (Max Rs 20,000/-)U/s 80CCF
(viii) Equity Links Savings Bond Rs.
Qulfy amount
Aggregate of deductible amount under Chap. VIA
Tax payable/refundable (15-16)
Net Tax col.No. 17-18)
Designation
4 The deductor shall furnish the address of the Commissioner of Income-tax(TDS) having jurisdictionas regards TDS statements of the assesee.
5 This Form shall be applicable only in respect of tax deducted on or after 1st day of April, 2010.
ANNEXURE-A
DETAILS OF TAX DEDUCTED AND DEPOSITED IN THE CENT5RAL GOVERNMENT ACCOUNT THROUGH BOOK ENTRY
(The Employer to provide payment wise details of tax deducted and deposited with respect to the employee)
Book Identification Number (BIN)
Note:-1. In the column for TDS, give total amount for TDS,Surcharge(if applicable) and education cess.
ANNEXURE-BDETAILS OF TAX DEDUCTED AND DEPOSITED IN THE CENTRAL GOVERNMENT ACCOUNT THROUGH CHALLAN
(The Employer to provide payment wise details of tax deducted and deposited with respect to employee)
Challan Identification Number ( C I N )
BSR Code of the Bank Branch
1 500 Treasury Lalbagh 1/4/2010 3
2 500 Treasury Lalbagh 31/4/2010 4
3 500 Treasury Lalbagh 28/5/10 5
4 500 Treasury Lalbagh 28/6/10 6
5 500 Treasury Lalbagh 28/7/10 7
6 500 Treasury Lalbagh 28/8/2010 8
7 500 Treasury Lalbagh 28/9/10 9
8 500 Treasury Lalbagh 28/10/10 10
9 500 Treasury Lalbagh 28/11/10 11
10 500 Treasury Lalbagh 28/12/10 12
11 500 Treasury Lalbagh 28/01/11 13
12 3,940 Treasury Lalbagh 12/30/1899 14
Total 9,440 -
1 In the Column for TDS, give total amount for TDS, Surcharge(if applicable) and education cess
Sl.No
Tax Deposited in respefct on of the employee (Rs.
Receipt Numbers of Form No 24G
DDO Sequence Number in the Book Adjustment Mini
Statement
Date on which tax deposited
(dd/mm/yy)
Sl.No
Tax Deposited in respect on of the employee (Rs.) Date on which tax deposited
(dd/mm/yy)
Challan Serial
Number
1
FO
RM
INDIAN INCOME TAX RETURN Assessment Year
2 0 1 1 - 1 2
(Please see Rule 12 of the Income-tax Rules, 1962)(Also see attached instuctions)
PER
SO
NA
L I
NFO
RM
ATIO
N
First name Middle name Last name PAN NO
Pranab Kumar Banerjee AAQQ 5565 A Flat /Door/Block No. Name Of Premises/Building/Village Date of Birth
25D Kalisthanpara 1/4/1963
Road/Street/Post Office Area/Locality Employer Category √
Jiaganj Jiaganj √ Govt. PSU Others
Town/City/District State Pin code Employer Category
Murshidabad West Bengal 742,255 √ male√ -
Email Addrs. (STD Code) - Phone Number
FIL
ING
STA
TU
S
Designation of Assessing Officer (Ward/Circl Return Filed Under Section- 1 1
11 [Please see instruction number-9(i)]
Whether original or Revised return? (Ti √ √ Original Revised
ORIGINAL
Original return(DD/MM/YYYY) 25/6/2011
Residential Status (Tick√ √ Resident Non-Resident Resident but not ordinarily Res
INC
OM
E &
DED
UC
TIO
NS
1 Income chargeable under the Head 'Salaries',Pension 1 ###
2 Income chargeable under the Head 'House Property'(enter-ve sign in case 2 Rs. 0
3 3 Rs. 0
4 4 ###5 Deductions under chapter VIA (Section
a 80C ### e 80DD Rs. 0 I 80GG Rs. 0
b 80CCC Rs. 0 f 80DDB Rs. 0 j 80GGA Rs. 0
c 80CCD Rs. 0 g 80E Rs. 0 k 80GGC Rs. 0
d 80D Rs. 5,000 h 80G Rs. 0 l 80U Rs. 0
6 Deductions (Total of 5a to5i) 6 ###
7 Total Income (4-6) 7 ###
TA
X C
OM
PU
TA
TIO
N
8 Tax Payable on 'Aggregate Income' 8 Rs. 7,844 ###9 Education Cess on (on 8) 9 Rs. 235
### Total Tax, Surcharge and Education cess payable (8 ###Rs. 8,079### Relief under Section 89 ###Rs. 1,545 ###### Relief under Section 90/91 ###Rs. 0
### Balance Tax Payable (10-11-12) ###Rs. 6,53414 Total interest payable u/s 234A/234B/234C ###Rs. 0
### Total Tax and Interest payable (12+13) ###Rs. 6,534Seal and signature of receiving official
Receipt No.
Date
SARAL-II (ITR-I)
[For Individual having Income from Salary/Pension/income from One House Property(Excluding loss brought forward from previous
years)/Income from Other Sources (Excluding Winning from Lottery and income from Race Horses)]
If revised, enter Receipt No and Date of filing original return (DD/MM/YYYY)
Income chargeable under the Head 'Other Sources' (enter-ve sign in case of loss, if any)Gross Total Income (1+2+3)
Do not write or stamp in this areas for office use only
2
TA
XES
PA
ID16 Taxes Paid
a Advance Tax (from item 25) 16a Rs. 0
b TDS (column 7 of item23+column 7 of i 16b Rs. 9,440
c Self Assessment Tax (from item 2 16c Rs. 0
17 Total Taxes paid (16a+16b+16c) 17 Rs. 9,440
18 18 Rs. 0 ###
REFU
ND
19 19 Rs. 2,906
20 Enter your bank account number (mandatory in case o 0
21 Do you want your refund by or √
22 Give additional details of your bank account
MICR Code 0 √ Savings
23 Details of Tax Deducted at Source from Salary [As per Form 16 issued by Employer(s)]
TD
S O
N S
ALA
RY TAX
-
(1) (2) (3) (4) (5) (6) (7) (8)
A Q 5544 - Rs. 343,440 ### Rs. 6,534 ### ###
24 Details of Tax Deducted at Source other than salary
TD
S O
N I
NTER
ES
T
(1) (2) (3) (4) (5) (6) (7)
- -
-
- NOTE Enter the total of column (7) of 23and column (7) of 17 of TAXES PAID
25 Details of Advance Tax and Self Assessment Tax Payments
TA
X P
AY
MEN
TS BSR Code Amount (Rs.)
(i)
(ii)
(iii)
(iv)NOTE Enter the total of Advance tax and Self Assessmen tax in Sl.No.17 of TAX -
26
Sl. Code Amount (Rs.) Sl. Code Amount (Rs.) Sl Code Amount (Rs.)
a 001 e 004 h 007
b 002 f 005 i 008
c 003 g 006 j
27 Exempt income only for reporting purposes(from Dividend, Capital 27
VERIFICATION
I, son/ daughter of solemnly
Place Date Sign here
28 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
Tax payable(15-17)(enter if 15 is greater than 17, else leave blank)
Refund (18-17) (enter if 15d is greater than 14, also give Bank account details below)
cheque deposited directly into your bank account? (tick as applicable
Type of Account (tick as applicable)
Sl No
Tax Deduction Account Number(TAN) of the Employer
Name and address of the
Employer
Income chargeable under the head salaries
Deduction under
Chapter VI-A
Tax payable
(incl. surch. And edn. Cess)
Total tax deposited
Refundable
Sl No
Tax Deduction Account
Number(TAN) of the Deductor
Namee and address of the
Deductor
Amount paid/ credited
Date of Payment /Credit
Total tax deposited
Amount out of
(6) claim for this year
Sl No
Name of Bank & Branch
Date of Deposit (DD/MM/YYYY)
Serial Number of Challan
Other Information (Transactions reported through Annual Information Return) (Please see instruction number-9(ii) for code)
declare that to the best of my knwledge 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 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 2010-11
2
29 29If TRP is entitled for any reimbursement from the Government, amount thereof (to be filled by TRP)
Government of India
INCOME TAX DEPARTMENT ACKNOWLEDGEMENT
Received with thanks form: Pranab Kumar Banerjee a return of income &/return of fringe benefits in Form No ITR - 1 for assessment year 20011-2012, having the following particulars:
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Pranab Kumar Banerjee AAQQ 5565 A
Flat/Door/Block No: Name of Premises/Building/Village:
25D Kalisthanpara
Road/Street/Post Office: Area/Locality:
Jiaganj Jiaganj
Town/City/District: State: Status(fill the code)
Murshidabad West Bengal Govt 11
Designation of Assessing Officer Original/Revised Original
1 Gross total income 1 Rs. 343,440
2 Deduction under Chapter-VI-A 2 Rs. 105,000
3 Total Income 3 Rs. 238,440
4 Net tax payable 4 Rs. 6,534
5 Interest payable 5 Rs. 0
6 Total tax and interest payable 6 Rs. 6,534
7 Taxes paid
a Advance Tax 7a Rs. 0
b TDS 7b Rs. 9,440
c TCS 7c Rs. 0
d Self Assessment Tax 7d Rs. 0
e Total Taxes paid (7a+7b+7c+7d) 7e Rs. 9,440
8 Tax payable (6-7e) 8 Rs. 0 ###
9 Refund (7e-6) 9 Rs. 2,906 ###
10 Value of Fringe Benefits 10 NA
11 Total fringe benefit tax liability 11 NA
12 Total interest payable 12 NA
13 Total tax and interest payable 13 NA
14 Taxes paid NA
a Advance Tax 14a
b Self Assessment Tax 14b
c Total Taxes paid (14a+14b) 14c NA
15 Tax payable (13-14c) 15 NA
16 Refund (14c-13) 16 NA
Receipt No. Seal and Signature of receiving official:
Date:
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FORM NO.10 E[See rule 21AA]
1 Name and address of the employee Pranab Banerjee
2 Permanent account number AAQQ 5565 A
3 Residential status PERMANENT RESIDENT
1 (a) Rs. 15,000(b)
Not Applicable
(c)
Not Applicable
(d)Not Applicable
2ANNEX-I
…………………………………………..Signature of the employee
Verification
I, _______,do hereby declare that what is stated above
is true to the best of my knowledge and belief.Verified today, the Day of
Place: …………………….………………………………………
Date:…………………… Signature of the employee
Form for furnishing particulars of income under section 192(2A) for the year ending 31 st March, 2011 for claiming relief under section 89(1) by a Government servant or an employee in a 2[company,co-operative society,local authority ,university, instituty
Particulars of income referred to in rule 21A of the Income-tax Rules, 1962,during the previous year relevant to assessment year 2011-12
Salary received in arrears or in advance in accordance with the provisions of sub-rule (2) of rule 21A.
Payment in the nature of gratuity in respect of past services, extending over a period of not less than 5 years in accordance with the provisions of sub-rule (3) of rule 21A.
Payment in the nature of compensation from the employer or former employer at or in connection with termination of employment after continuous service of not less than 3 years or where the unexpired portion of term of employment is also not less than 3 ye
Payment in commutation of pension in accordance with the provisions of sub-rule (5) of rule 21A
Detailed particulars of payments referred to above may be given in Annexure I,II,IIA,III, or IV as the case may be.
ANNEXURE-I[See item 2 of Form No.10E]
Arrears or advance salary
Sl No. Particulars Amount (Rs.)
1 Total income (excluding salary received in arrears or advance) Rs. 223,440
2 Salary received in arrears or advance Rs. 15,000
3 Rs. 238,440
4 Tax on total income [as per item 3] Rs. 8,079 ###
5 Tax on total income [as per item 1] Rs. 6,534 ###
6 Rs. 1,545
7 Rs. 0
8 Rs. 1,545
TABLE "A"[See item 7 of Annexure 1]
(1) (2) (3) (4) (5) (6) (7)
2008-09 Rs. 125,000 Rs. 15,000 Rs. 140,000 Rs. 0 Rs. 0 Rs. 0 ###
###
Signature:
Place: Name:
Date: Designation:
Dept:
Total income (as increased by salary received in arrears or advance) [Add item 1 and item 2]
Tax on salary received in arrears or advance [Difference of item 4 and item 5]
Tax computed in accordance with Table "A" [Brought from column 7 of Table A]
Relief under Section 89(1) [Indicate difference between the amounts mentioned against item 6 and item 7]
Previous year
Total income of the relevent
previous year (Rs.)
Salary received in arrears or advance
relating to the relevent
previous year as mentioned
in column (1) (Rs.)
Total income (as increased by
salary received in arrears or
advance) of the relevent previous year mentioned in column (1) [add colmn 2 & 3]
(Rs.)
Tax on total income [as per
column (2)-After Rebate and
including Edn Cess and
Surcharge] (Rs.)
Tax on total income[as per
column (4) After Rebate and including Edn Cess and Surcharge]
(Rs.)
Difference in tax [Amount under
column (6) minus amount under
column (5)] (Rs.)