SUGAM

FORM

ITR-4S

INDIAN INCOME TAX RETURN

[PRESUMPTIVE BUSINESS INCOME TAX RETURN]

Assessment
Year

2012-13

FILING STATUS

PERSONAL INFORMATION

(Please see rule 12 of the Income-tax Rules,1962) (Also see attached instructions)

First Name
KARTHIKEYAN

INCOME & DEDUCTIONS

Last Name
MAHESHWARI

PAN
CJEPM2576G

Flat / Door / Building

4/313A

Status
I - Individual

Road / Street
VELANKADU, KALIYANOOR POST

Area / Locality
PALLIPALAYAM

Town/City/District
ERODE

State
29-TAMILNADU

Email Address
samaadhu@gmail.com
Income Tax Ward / Circle

Mobile no (Std code) Phone No

Employer Category (if in
9943739035
employment) OTH
Return filed under section
[Pl see Form Instruction] 12-AfterDueDt
O-Original

Whether original or revised return?

Date of birth (DD/MM/YYYY)

09/05/1985
Pin Code
638008

If revised, enter Original Ack no / Date

If u/s 139(9)-defective return , enter
Original Ack No

Sex (Select)
F-Female

Date

If u/s 139(9)-defective return , enter Notice

If u/s 139(9)No (Enter the full No beginning with CPC/
defective return ,
)
enter Notice Date
RES - Resident
Residential Status
Income from Business (E6 of Sch BP) (Note : This value will be filled automatically
1
1
from ch BP in Next Sheet. Do not enter the value here.
2 Income from Salary / Pension (Ensure to fill Sch TDS1)
2
Income from one House Property
3
3
4

TAX COMPUTATION

Middle Name

Income from Other Sources (Ensure to fill Sch TDS2)

5 Gross Total Income (1+2+3+4)

6 Deductions under Chapter VI A (Section)
6a
a 80 C
6b
b 80 CCC
6c(i)
c(i) 80 CCD (Employers Contribution)
80 CCD (Employees / Self Employed
6c(ii)
c(ii)
Contribution)
6d
d 80 CCF
6e
e 80 D
6f
f 80 DD
6g
g 80 DDB
6h
h 80 E
6i
i 80 G
6j
j 80 GG
6k
k 80 GGA
6l
l 80 GGC
6m
m 80 U
7
7 Deductions (Total of 6a to 6m)
8 Total Income (5 - 7)
9 Tax payable on Total Income
10 Education Cess, including secondary and higher secondary cess on 9
11 Total Tax, Surcharge and Education Cess (Payable) (9 + 10)
11
12 Relief under Section 89
12
13 Relief under Section 90/91
14 Balance Tax Payable (11 - 12 - 13)
15 Total Interest payable
16 Total Tax and Interest Payable (14 + 15)

176,690
0
0

176,690
System Calculated
0
0
0

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0 7
8
9
10
11
0
0
12
14
15

0
0
0
0
0
0
0
0
0
0
0
0
176,690
0
0
0

0
0
0

Calculation of Profits and gains of Business

of plying,hiring,or leasing goods carriages u/s 44AE
1) Heavy Vehicles
Serial No Period of Income per
Deemed Income
holding Vehicle (MUST be
(in
>= Rs 5000 p.m.
months) per vehicle)
(A)
(B)
( C) = (A)*(B)
1
0
2
0
3
0
4
0
5
0
6
0
7
0
8
0
9
0
10
0
0
Total : Presumptive Income From Heavy
Vehicles (E3 in Sheet NOB_BP)

2) Light Vehicles
Serial No Period of
holding
(as full
months)

Income per
Deemed Income
Vehicle (MUST be
>= Rs 4,500 p.m.
per vehicle)

(A)
(B)
1
2
3
4
5
6
7
8
9
10
Total : Presumptive Income From Light
Vehicles (E4 in Sheet NOB_BP)
GRAND TOTAL (E5 in Sheet NOB_BP)

( C) = (A)*(B)
0
0
0
0
0
0
0
0
0
0
0

Nature of business or profession, if more than

S.No.
Code
Tradename Tradename Tradename
[Please see
instruction
No.9(ii)]
(i)

0202KANIKA
Retailers TRADERS

(ii)
(iii)

Computation of income from business or profession

PRESUMPTIVE INCOME UNDER 44AD
1711050
E1
Gross Turnover or Gross Receipts
COMPUTATION - PRESUMPTIVE INCOME

BP

E2

Total Presumptive income under

44AD (>= 8% of E1)

176690

Note : If income is less tha 8% of Gross Receipts, it is mandatory to have a tax audit
under 44AB and Regular ITR 4 form has to be filled and not this form
PRESUMPTIVE INCOME UNDER 44AE
E3
Presumptive Income From Heavy
Vehicles (From 44AE Calculation
Sheet)
E4
Presumptive Income From Other
Vehicles (From 44AE Calculation
Sheet)

0
Total Presumptive Income under 44AE (E3 +
E5
E4)
Note : If the profits are lower than prescribed under S.44AE or the number of
vehicles owned at any time exceel 10 then the regular ITR 4 form has to be filled
and not this form
176690
E6
Income Chargeable under Business (E2 + E5)
E6
E5

FINANCIAL
PARTICULAR
S

Financial Particulars of the Business

Note : For E7 to E10 furnish the information as on 31st day of March, 2012
E7
Amount of Total Sundry Debtors
E8
Amount of Total Sundry
E9
Amount of Total Stock-in-Trade
E10
Amount of the cash Balance

24

Details of Tax Deducted at Source from SALARY

[As per FORM 16 issued by Employer(s)]
Tax Deduction
Name of the
Account Number
SI.No
Employer
(TAN) of the
Employer
(3)
(1)
(2)
1
2
3

Income charg
eable under the
head Salaries

Total tax
Deducted

(4)

(5)

(Click + to add more rows to 23) TDS on Salary above. Do not delete blank rows. )
TDS Details of Tax Deducted at Source on Income OTHER THAN SALARY
2 [As per FORM 16 A issued by Deductor(s)]

SI.No

(1)
1
2
3
4

Tax Deduction
Account Number
(TAN) of the
Deductor

Name of the
Deductor

Unique TDS
Certificate No.

Deducted
Year

Total tax
Deducted

(2)

(3)

(4)

(5)

(6)

(Click + to add more rows ) TDS other than Salary above. Do not delete blank rows. )

TCS

Details of Tax Collected at Source

SI.No

Tax Collection
Account Number

Name of the
Collector

Total tax
Collected

(1)
(2)
(3)
(4)
1
2
3
4
(Click + to add more rows ) TCS above. Do not delete blank rows. )

Amount out
of
(4) claimed
for
this year
(5)

Amount
out of
(6)
claimed
for
this year
(7)

25
Sl No

Details of Advance Tax and Self Assessment Tax Payments

BSR Code

Date of Credit into

Govt Account
(DD/MM/YYYY)

Serial
Number of
Challan

Amount (Rs)

1
2
3
4
5
6
(Click '+' to add more rows ) Tax Payments. Do not delete blank rows. )

REFUND

TAXES PAID

17 Taxes Paid PLEASE NOTE THAT CALCULATED FIELDS (IN WHITE) ARE PICKED UP FROM
OTHER SCHEDULES AND ARE NOT TO BE ENTERED. For ex : The taxes paid figures below will
get filled up when the Schedules linked to them are filled.

18
19
20
21

a Advance Tax (from item 25)

b TDS

17a
17b

c TCS

17c

0
0
0

0
d Self Assessment Tax (item 25)
17d
Total Taxes Paid (17a+17b+17c+17d)
Tax Payable (16-18) (if 16 is greater than 18)
Refund (18-16) if 18 is greater than 16
1654135.3510
Enter your Bank Account number

18
19
20

No
22 Select Yes if you want your refund by direct deposit into your bank account,
Select No if you want refund by Cheque
23 In case of direct deposit to your bank account give additional details
123456789
Savings
MICR Code
Type of Account(As applicable)
26 Exempt income for reporting purposes only
VERIFICATION
KARTHIKEYAN
son/daughter of SUBRAMANI
MAHESHWARI
I,
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 2012-13
Place
Date 02/02/2014
Sign here ->
PALLIPALAYAM
CJEPM2576G
PAN
27 If the return has been prepared by a Tax Return Preparer (TRP) give further details as below:
Identification No of TRP
Name of TRP

28

If TRP is entitled for any reimbursement from the Government, amount thereof (to be
filled by TRP)

0
0
0

Schedule 80G
Details of donations entitled for deduction under section 80G
Donations entitled for 100% deduction without qualifying limit ('IN
CASE OF DONEE FUNDS SETUP BY GOVERNMENT AS
DESCRIBED IN SECTION 80G(2), PLEASE USE PAN AS
"GGGGG0000G".)
Name of Address
City or Town or State Code
PinCode PAN of Donee Amount of Eligible
donee
District
donation Amount of
Donation
1
2
3
4
Total 80GA

Donations entitled for 50% deduction without qualifying limit

Name of Address
City or Town or State Code
donee
District

PinCode

PAN of Donee Amount of Eligible

donation Amount of
Donation
0
0
0
0

1
2
3
4
Total 80GB :

0
0
0
0

Donations entitled for 100% deduction subject to qualifying limit

Name of Address
City Or Town Or State Code
donee
District

PinCode

PAN of Donee Amount of Eligible

donation Amount of
Donation
0
0
0
0

1
2
3
4
Total 80GC :

Donations entitled for 50% deduction subject to qualifying limit

Name of Address
City Or Town Or State Code
donee
District

PinCode

PAN of Donee Amount of Eligible

donation Amount of
Donation
0
0
0
0

1
2
3
4
Total 80GD

Donations (A + B + C + D)

Validate data before generating XML No of entries Amount

TDS on Salary
0
TDS on Interest
0
TCS
0
Tax Payments
0

VERIFICATION
Full Name
Son/daughter of
Place
Date
PAN

KARTHIKEYAN MAHESHWARI
SUBRAMANI
PALLIPALAYAM
02/02/2014
CJEPM2576G

1. Validate against each schedule the

3. In case this count does not match to

count of no of entries.

the entered number of entries, you may

recheck the schedules, refer to
instructions for filling up tables, and
ensure that all entries are valid and
completely entered.

0
0
0
0

2. This is required to confirm that the 4. Once this sheet is validated, you
total no of entries entered per schedule
is valid and being generated in the final
XML

may click on Save XML to generate the

XML file

If the no of entries are 0

In a schedule, there are mandatory fields
For a row to be valid, these must be
filled in.
Also, do not skip blank rows