FORM

INDIAN INCOME TAX RETURN VERIFICATION FORM

Assessment Year

[Where the data of the Return of Income in Benefits in Form (ITR-1 (SAHAJ), ITR-2, ITR-3,

ITR-V

ITR-4, ITR-4S (SUGAM), ITR-5, ITR-6 transmitted electronically without digital signature]

2013 - 14

(Please see Rule 12 of the Income-tax Rules, 1962)

PERSONAL INFORMATION AND THE

DATE OF ELECTRONIC
TRANSMISSION

Name
AMIT GIRIDHAR BHUYAR

ANLPB4235C
Flat/Door/Block No
MANAKARNA NAGAR

Name Of Premises/Building/Village

Road/Street/Post Office
CHAINTANYA COLONY

Area/Locality
AMRAVATI

Town/City/District

State

Form No. which

has been
electronically
transmitted

Status

Pin

MAHARASHTRA

ITR-1

Individual

AMRAVATI
444606
Original or Revised

Designation of AO (Ward / Circle) ITO WD-1, AMT

E-filing Acknowledgement Number

COMPUTATION OF INCOME
AND TAX THEREON

PAN

553256050310315

Date(DD-MM-YYYY)

ORIGINAL
31-03-2015

Gross Total Income

50000

2
3

Deductions under Chapter-VI-A

Total Income
a
Current Year loss, if any
Net Tax Payable
Interest Payable

2
3
3a
4
5

0
50000
0
0

Total Tax and Interest Payable

Taxes Paid
a
Advance Tax

5
6
7

8
9

7a
7b
7c

TDS

c
TCS
d
Self Assessment Tax
e
Total Taxes Paid (7a+7b+7c +7d)
Tax Payable (6-7e)
Refund (7e-6)

7d

0
0

0
0
0
0
7e
8
9

0
0
0

VERIFICATION
I, AMIT GIRIDHAR BHUYAR

son/ daughter of GIRIDHAR MAHADEORAO, BHUYAR

holding permanent account number

ANLPB4235C

solemnly declare to the best of my knowledge and belief, the information given in the return and the schedules thereto which have been transmitted
electronically by me vide acknowledgement number mentioned above is correct and complete and that the amount of total income/ fringe benefits
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 and
fringe benefits chargeable to income-tax for the previous year relevant to the assessment year 2013-14. I further declare that I am making this return
in my capacity as
and I am also competent to make this return and verify it.
Date 31-03-2015

Sign here

Place Amravati

If the return has been prepared by a Tax Return Preparer (TRP) give further details as below:
Identification No. of TRP

For Office Use Only

Receipt No

Counter Signature of TRP

Name of TRP

Filed from IP address

115.111.107.30

Date
Seal and signature of
receiving official

ANLPB4235C01553256050310315ED804B8AF42EF562F269865E7EEB092D6AA71F34

Please furnish Form ITR-V to Income Tax Department - CPC, Post Bag No - 1, Electronic City Post Office, Bengaluru - 560100,
Karnataka, by ORDINARY POST OR SPEED POST ONLY, within 120 days from date of transmitting the data electronically. Form ITR-V
shall not be received in any other office of the Income-tax Department or in any other manner. The receipt of this ITR-V at ITD-CPC will be sent to
you at e-mail address amitgbhuyar@gmail.com