2016 Itr4 PR7

S.
NO Schedule Name
1 PART A - General
2 Nature Of Business
3 Part A - BS
4 Profit and Loss
5 Part A - OI
6 Quantitative Details
7 Part B - TI TTI
8 IT
9 TDS
10 Schedule S
11 House Property
12 BP
13 DPM - DOA
14 DEP_DCG
15 ESR
16 CG
17 OS
18 CYLA - BFLA
19 CFL
20 Unabsorbed Depreciation
21 ICDS
22 10A
23 80_
24 VI-A
25 80G
26 SPI - SI - IF
27 AMT
28 AMTC
29 EI
30 PTI
31 FSI
32 TR_FA
33 Sch 5A
34 AL
Assesment Year 2016-17
Schedules for filing Income Tax Return
Personal Info., Filing Status, Audit Info
NatureOfBusiness
PartA-BS
PartA-P & L
PartA -OI
PartA-QD
PartB-TI,PartB-TTI,Verification
Tax Payments
Tax Payments(TDS1, TDS2, TDS3)

Schedule S
Schedule HP
Schedule BP
Schedule DPM, Schedule DOA
Schedule DEP, Schedule DCG

Schedule ESR
Schedule CG
Schedule OS
Schedule CYLA, Schedule BFLA

ScheduleCFL
Schedule UD
Schedule ICDS
Schedule 10A, 10AA, 10B,10BA
Schedule80-IA,IB,IC
Schedule VIA
Schedule 80G
Schedule SPI, Schedule SI, Schedule IF

Schedule AMT
Schedule AMTC
Schedule EI
Schedule PTI
Schedule FSI
Schedule TR,Schedule FA
Schedule 5A
Schedule AL
Assesment Year 2016-17
Description
Click on applicable links to navigate to the respective sheet / schedule.
Details of Personal Information and filing status
Nature of business or profession, if more than one tradenames please specify upto 3 tradenames
BALANCE SHEET AS ON 31ST DAY OF MARCH, 2016(fill items 1 to 5 in a case where

regular books of accounts are maintained, otherwise fill item 6)
Profit and Loss Account for the previous year 2016-17(fill items 1 to 52 in a case where regular
books of accounts are maintained, otherwise fill item 53)
Other Information (optional in a case not liable for audit under section 44AB)
Quantitative details (optional in a case not liable for audit under section 44AB)
Computation of total income
Details of payments of Advance Tax and Self-Assessment Tax
Details of Tax Deducted at Source from SALARY, Details of Tax Collected at Source
Details of Salary
Details of Income from House Property
Computation of income from business or profession
Depreciation on Plant and Machinery , Depreciation on other assets
Summary of depreciation on assets, Deemed Capital Gains on sale of depreciable assets

Deduction under section 35
Capital Gains
Income from other sources
Details of Income after set-off of current years losses, Details of Income after Set off of Brought
Forward Losses of earlier years
Details of Losses to be carried forward to future Years
Unabsorbed depreciation and allowance under section 35(4)
Effect of Income Computation Disclosure Standards on profit
Deduction under section 10A, Deduction under section 10AA
Deductions under section 80-IA, Deductions under section 80-IB, Deductions under section 80-
IC
Deductions under Chapter VI-A
Details of donations entitled for deduction under section 80G
Income of specified persons(spouse, minor child etc) includable in income of the assessee ,
Income chargeable to Income tax at special rates IB, Information regarding partnership firms in
which you are partner
Computation of Alternate Minimum Tax payable under section 115JC
Computation of tax credit under section 115JD
Details of Exempt Income (Income not to be included in Total Income)
Pass Through Income details from business trust or investment fund as per section 115UA,
115UB
Details of Income from outside India and tax relief
Summary of tax relief claimed for taxes paid outside India, Schedule FA Details of foreign assets
Information regarding apportionment of income between spouses governed by Portuguese Civil
Code
Asset and Liability at the end of the year (other than those included in Part A BS)
Select Applicable sheets below Select Sheets to print and
by choosing Y/N and click on click on apply
apply
Y Y
Y Y
Y Y
Y Y
Y Y
Y Y
Y Y
Y Y
Y Y
Y Y
Y Y
Y Y
Y Y
Y Y
Y Y
Y Y
Y Y
Y Y
Y Y
Y Y
Y Y
Y Y
Y Y
Y Y
Y Y
Y Y
Y Y
Y Y
Y Y
Y Y
Y Y
Y Y
Y Y
Y Y
INDIAN INCOME TAX RETURN Asse
FORM
[For indls and HUFs having income from a proprietory business or profession]
ITR-4
(Please see Rule 12 of the Income Tax-Rules,1962) 2
(Also see attached Instructions)
First Name Middle Name Last Name PA
VENKATESAN GOMATHI BCXPG9360F
PERSONAL INFORMATION
Flat / Door / Block No Name of Premises / Building / Village Status (I-Individual,H-H

17 / 19 I-INDIVIDUAL
Road / Street / Post Office Area / Locality Date of birth (DD/MM/Y

PALANIAPPA NAGAR (in case of individual)
22/04/1980
Town/City/District State Country Pin Code
PALLIPALAYAM 29-TAMILNADU 91-INDIA 638006
Email Address-1 (self) Email Address - 2 Mobile No 1 (Std code) Residential/Office Phone Mobile No-2
cachandhiran@gmail.com 7092224479
Income Tax Ward/Circle Return filed under Section
12 - AfterDueDt 139(4).
Whether original or revised return? Original
If revised, defective, Modified then Enter Receipt No Date of filing of Original
Return
Notice No (Where the original return filed was defective and a notice is issued to the assessee to file If filed, in response to a notice u/s 139(9)/
a fresh return Sec 139(9) 142(1)/ 148/ 153A/ 153C enter dt of such
notice, or u/s 92CD enter dt of advance pricing
agreement
FILING STATUS
Whether any transaction has been made with a person located in a jurisdiction notified u/s 94A of he Act? No Residential Status
Whether you have Aadhaar Number? (Select) If Yes, then please provide your Aadhaar
Number
Are you governed by Portuguese Civil Code? No
FILING
Passport No. (Individual) (If available)

In case of non-resident, is there a permanent extablishment (PE) in India?
Whether this return is being filed by a representative assessee? If yes, please furnish following information N -No
a Name of the representative assessee

b Address of the representative assessee
c PAN of the representative assessee
Are you liable to maintain accounts as per section 44AA? (Select) No
Are you liable for audit under section 44AB? N -No
If liable for audit u/s 44AB, whether the accounts have been audited by an accountant? If yes, furnish the following information below
AUDIT INFORMATION
a Date of furnishing of the audit (DD/MM/YYYY)

report.
b Name of the auditor signing the tax audit report
c Membership no.of the auditor
d Name of the auditor (proprietorship/ firm)
e Permanent Account Number (PAN) of the proprietorship/ firm
f Date of audit report. (DD/MM/YYYY)
Mention other Section Code in which liable to furnish a report and the Date of Furnishing the Report in dd/mm/yyyy format (if liable to furnish the report, date is compulsory) in the table b
S.NO Section Code Date DD/MM/YYYY

1 (Select)
2 (Select)
3 (Select)
4 (Select)
5 (Select)
6 (Select)
7 (Select)
Assessment Year
2016 -17
PAN
BCXPG9360F
Status (I-Individual,H-HUF)
I-INDIVIDUAL
Date of birth (DD/MM/YYYY)

(in case of individual)
22/04/1980
Pin Code Sex (Select)
638006 F-Female
Employer Category
NA
Return filed under Section
12 - AfterDueDt 139(4).
RES - Resident
N -No
N -No
/MM/YYYY)
/MM/YYYY)
mat (if liable to furnish the report, date is compulsory) in the table below .
NATURE OF BUSINESS OR PROFESSION, IF MORE THAN ONE BUSINESS OR PROFESSION
NATURE OF BUSINESS
INDICATE THE THREE MAIN ACTIVITIES/ PRODUCTS

S.No. Code Trade name of the Trade name of the proprietorship, if any Trade name of the
[Please see instruction proprietorship, if any proprietorship, if any
No.7(i)]
1 1001-Other Sector
2 (Select)
3 (Select)
BALANCE SHEET AS ON 31ST DAY OF MARCH, 2016 OF THE PROPRIETORY BUSINESS OR PROFESSION (fill items in a case
Part A-BS where regular books of accounts are maintained, otherwise fill item 6)
1 Proprietors fund
a Proprietors capital a 1073827
b Reserves and Surplus
i Revaluation Reserve bi
ii Capital Reserve bii
iii Statutory Reserve biii
iv Any other Reserve biv
v Total (bi + bii + biii + biv) bv 0
SOURCES OF FUNDS
c Total proprietors fund (a + bv) 1c 1073827

2 Loan funds
a Secured loans
i Foreign Currency Loans ai
ii Rupee Loans
A From Banks iiA
B From others iiB
C Total ( iiA + iiB) iiC 0
iii Total (ai + iiC) aiii 0
b Unsecured loans (including deposits)
i From Banks bi
ii From others bii
iii Total (bi + bii) biii 0
c Total Loan Funds (aiii + biii) 2c 0
3 Deferred tax liability 3
4 Sources of funds (1c + 2c +3) 4 1073827
1 Fixed assets
a Gross: Block 1a 45000
b Depreciation 1b
c Net Block (a b) 1c 45000
d Capital work-in-progress 1d
e Total (1c + 1d) 1e 45000
2 Investments
a Long-term investments
i Government and other Securities - Quoted ai
ii Government and other Securities Unquoted aii
iii Total (ai + aii) aiii 0
b Short-Term investments
bi
i Equity Shares, including share application money
ii Preference Shares bii
iii Debenture biii
iv Total (bi + bii + biii) biv 0
c Total investments (aiii + biv) 2c 0
3 Current assets, loans and advances
a Current assets
i Inventories
A Stores/consumables including packing iA
material
B Raw materials iB
C Stock-in-process iC
D Finished Goods/Traded Goods iD
E Total (iA + iB + iC + iD) iE 0
ii Sundry Debtors aii 356007
APPLICATION OF FUNDS
iii Cash and Bank Balances

A Cash-in-hand iiiA 93745
B Balance with bank iiiB 1181
C Total (iiiA + iiiB) iiiC 94926
iv Other Current Assets aiv 18930
v Total current assets (iE + aii + iiiC + aiv) av 469863
b Loans and advances
Advances recoverable in cash or in kind or for value to bi
i be received
bii 558964
ii Deposits, loans and advances to corporates and others
iii Balance with Revenue Authorities biii
iv Total (bi + bii + biii) biv 558964
c Total of current assets, loans and advances (av + biv) 3c 1028827
d Current liabilities and provisions
i Current liabilities
A Sundry Creditors iA
B Liability for Leased Assets iB
C Interest Accrued on above iC
D Interest accrued but not due on loans iD
E Total (iA + iB + iC + iD) iE 0
ii Provisions
A Provision for Income Tax iiA
B Provision for Wealth Tax iiB
C Provision for Leave iiC
encashment/Superannuation/Gratuity
D Other Provisions iiD

E Total (iiA + iiB + iiC + iiD ) iiE 0
iii Total (iE + iiE) diii 0
e Net current assets (3c diii) 3e 1028827
4 a Miscellaneous expenditure not written off or adjusted 4a
b Deferred tax asset 4b
c Profit and loss account / Accumulated balance 4c
d Total (4a + 4b + 4c) 4d 0
5 Total, application of funds (1e + 2c + 3e +4d) 5 1073827
In a case where regular books of account of business or profession are not maintained -furnish the
NO ACCOUNT
following information as on 31st day of March, 2016, in respect of business or profession)

6
CASE
a Amount of total sundry debtors 6a

b Amount of total sundry creditors 6b
c Amount of total stock-in-trade 6c
d Amount of the cash balance 6d
Part A-P& L Profit and Loss Account for the financial year 2015-16 (fill items 1 to 52 in a case where regular books of accounts are maintained, otherwise fill
item 53)
1 Revenue from operations
A Sales/ Gross receipts of business (net of returns and refunds and duty or tax, if any
i Sale of goods i
ii Sale of Services ii
iii Other operating revenues (specify nature and
amount) Nature Amount
a DYEING COOLY RECEIPTS iiia 844236
b WEAVING COOLY RECEIPTS iiib 1048760
c iiic
d iiid
e Total (iiia + iiib + iiic + iiid) iiie 1892996
iv Total (i + ii + iiie) Aiv 1892996
B Duties, taxes and cess, received or receivable, in respect of goods and services sold or supplied
i Union Excise duties i

ii Service tax ii
CREDITS TO PROFIT AND LOSS ACCOUNT
iii VAT/ Sales tax iii

iv Any other duty, tax and cess iv
v Total (i+ii+iii+iv) Bv 0
C Total Revenue from operations (Aiv + Bv) 1C 1892996
2 Other income
i Rent i
ii Commission ii 38420
iii Dividend income iii
iv Interest income iv 42695
v Profit on sale of fixed assets v
vi Profit on sale of investment being securities chargeable to Securities vi
Transaction Tax (STT)
vii Profit on sale of other investment vii
viii Profit on account of currency fluctuation viii
CREDITS
ix Agriculture income ix
x Any other income (specify nature and amount)
Nature Amount
a a
b b
c c
d d
e Total (xa + xb + xc + xd) e 0
xi Total of other income (i + ii + iii + iv + v + vi + vii + viii + ix + xe) 2xi 81115
3 Closing Stock
i Raw Material i
ii Work - in - process ii
iii Finished Goods iii
Total (3i + 3ii + 3iii) 3iv 0
4 Total of credits to profit and loss account (1C + 2xi + 3iv) 4 1974111
5 Opening Stock
i Raw Material i
ii Work - in - process ii
iii Finished Goods iii
Total (5i + 5ii + 5iii) 5iv 0
6 Purchases (net of refunds and duty or tax, if any) 6
7 Duties and taxes, paid or payable, in respect of goods and services purchased
i Custom duty 7i
ii Counter veiling duty 7ii
iii Special additional duty 7iii
iv Union excise duty 7iv
v Service tax 7v
vi VAT/ Sales tax 7vi
vii Any other tax, paid or payable 7vii
viii Total (7i+7ii+7iii+7iv+7v+7vi+7vii) 7viii 0
8 Freight 8
9 Consumption of stores and spare parts 9
10 Power and fuel 10
11 Rents 11
12 Repairs to building 12
13 Repairs to machinery 13
14 Compensation to employees
i Salaries and wages 14i
ii Bonus 14ii
iii Reimbursement of medical expenses 14iii
iv Leave encashment 14iv
v Leave travel benefits 14v
vi Contribution to approved superannuation fund 14vi
vii Contribution to recognised provident fund 14vii
viii Contribution to recognised gratuity fund 14viii
ix Contribution to any other fund 14ix
x Any other benefit to employees in respect of which an expenditure 14x
has been incurred
xi Total compensation to employees
(14i +14ii+14iii+14iv+14v+14vi+14vii+14viii+14ix+14x) 14xi
0
xii Whether any compensation, included in 14xi, paid to xiia
non-residents N
If Yes, amount paid to non-residents xiib
15 Insurance
i Medical Insurance 15i
DEBITS TO PROFIT AND LOSS ACCOUNT
ii Life Insurance 15ii

iii Keymans Insurance 15iii
iv 15iv
Other Insurance including factory, office, car, goods,etc.
v Total expenditure on insurance (15i+15ii+15iii+15iv) 15v 0
16 Workmen and staff welfare expenses 16
17 Entertainment 17
18 Hospitality 18
19 Conference 19
20 Sales promotion including publicity (other than advertisement) 20
DEBITS TO PROFIT
21 Advertisement 21
22 Commission
i Paid outside India, or paid in India to a non-resident other than a i
company or a foreign company
ii To others ii
iii Total (i + ii) 22iii 0
23 Royalty
i Paid outside India, or paid in India to a non-resident other than a
company or a foreign company i
ii To others ii
24 Professional / Consultancy fees / Fee for technical services
ii To others ii
25 Hotel , boarding and Lodging 25
26 Traveling expenses other than on foreign traveling 26
27 Foreign travelling expenses 27
28 Conveyance expenses 28
29 Telephone expenses 29
30 Guest House expenses 30
31 Club expenses 31
32 Festival celebration expenses 32
33 Scholarship 33
34 Gift 34
35 Donation 35
Rates and taxes, paid or payable to Government or any local body (excluding taxes on income)
36
i Union excise duty 36i
ii Service tax 36ii
iii VAT/ Sales tax 36iii
iv Cess 36iv
v Any other rate, tax, duty or cess including STT and CTT 36v
vi Total rates and taxes paid or payable (36i+36ii+36iii+36iv+36v) 36vi 0

37 Audit fee 37
38 Other expenses (Specify nature and amount)
Nature Amount
a DYEING COOLY a 758112
b WEAVING COOLY b 935942
c c
d d
e Total 38 1694054
Bad debts (specify PAN of the person, if available, for whom Bad Debt for amount
39 of Rs. 1 lakh or more is claimed and amount)
PAN Amount
PAN
PAN
PAN
PAN
PAN
PAN
PAN
ii Others (more than Rs. 1 lakh) where PAN is not available ii
iii Others (amounts less than Rs. 1 lakh) iii

iv Total Bad Debt (39i (All PAN) + 39ii + 39iii) 39iv 0
40 Provision for bad and doubtful debts 40
41 Other provisions 41
42 Profit before interest, depreciation and taxes [4 (5iv + 6 + 7viii + 8 to 13 + 14xi + 15v + 16 to 21 + 22iii + 23iii + 280057
42
24iii + 25 to 35 + 36vi + 37 + 38 + 39iv + 40 + 41)]
43 Interest
ii To others ii
44 Depreciation and amortization 44
45 Profit before taxes (42 43iii 44) 45 280057
APPROPRIATION 46 Provision for current tax 46
FOR TAX AND
47 Provision for Deferred Tax and deferred Liability 47

PROVISIONS
48 Profit after tax (45 46 47) 48 280057

49 Balance brought forward from previous year 49
S
50 Amount available for appropriation (48 + 49) 50 280057

51 Transferred to reserves and surplus 51
52 Balance carried to balance sheet in proprietors account (50 51) 52 280057
53 In a case where regular books of account of business or profession are not maintained, furnish the following
NO ACCOUNT
information for previous year 2015-16 in respect of business or profession

CASE
a Gross receipts 53a

b Gross profit 53b
c Expenses 53c
d Net profit 53d 0
Part A- OI Other Information (optional in a case not liable for audit under section 44AB)
1 Method of accounting employed in the previous year 1 Mercantile
2 Is there any change in method of accounting 2 No
3 Effect on the profit because of deviation, if any, as per Income Computation Disclosure Standards notified under section 145(2) [column 3
11(iii) of Schedule ICDS] 0
4 Method of valuation of closing stock employed in the previous year
a Raw Material (if at cost or market rates whichever is less write 1, if at cost write 2, if at market rate write 3) 4a (Select)
b Finished goods (if at cost or market rates whichever is less write 1, if at cost write 2, if at market rate write 3) 4b (Select)
c Is there any change in stock valuation method (Select) 4c No

d Effect on the profit or loss because of deviation, if any, from the method of valuation prescribed under section 145A 4d
5 Amounts not credited to the profit and loss account, being

a the items falling within the scope of section 28 5a
b The proforma credits, drawbacks, refund of duty of customs or excise or service tax, or refund of 5b
sales tax or value added tax, where such credits, drawbacks or refunds are admitted as due by the
authorities concerned
c escalation claims accepted during the previous year 5c
d Any other item of income 5d
e Capital receipt, if any 5e
f Total of amounts not credited to profit and loss account (5a+5b+5c+5d+5e) 5f 0
6 Amounts debited to the profit and loss account, to the extent disallowable under section 36 due to non-fulfilment of conditions specified in
relevant clauses:-
a Premium paid for insurance against risk of damage or destruction of stocks or store [36(1)(i)] 6a
b Premium paid for insurance on the health of employees [36(1)(ib)] 6b

c Any sum paid to an employee as bonus or commission for services rendered, where such sum was 6c
otherwise payable to him as profits or dividend. [36(1)(ii)]
d Any amount of interest paid in respect of borrowed capital [36(1)(iii)] 6d

e Amount of discount on a zero-coupon bond [36(1)(iiia)] 6e
f Amount of contributions to a recognised provident fund [36(1)(iv)] 6f
g Amount of contributions to an approved superannuation fund [36(1)(iv)] 6g
h Amount of contribution to a pension scheme referred to in section 80CCD [36(1)(iva)] 6h
i Amount of contributions to an approved gratuity [36(1)(v)] 6i
j Amount of contributions to any other fund 6j
k Any sum received from employees as contribution to any provident fund or superannuation fund 6k
or any fund set up under ESI Act or any other fund for the welfare of employees to the extent not
credited to the employees account on or before the due date [36(1)(va)]
l Amount of bad and doubtful debts [36(1)(vii)] 6l

m Provision for bad and doubtful debts [36(1)(viia)] 6m
n Amount transferred to any special reserve [36(1)(viii)] 6n
o Expenditure for the purposes of promoting family planning amongst employees [36(1)(ix)] 6o
p Amount of securities transaction paid in respect of transaction in securities if such income is not 6p
included in business income [36(1)(xv)]
q Any other disallowance 6q
r Total amount disallowable under section 36 (total of 6a to 6q) 6r 0
7 Amounts debited to the profit and loss account, to the extent disallowable under section 37
a Expenditure of capital nature [37(1)] 7a
b Expenditure of personal nature [37(1)] 7b
c Expenditure laid out or expended wholly and exclusively NOT for the purpose of business or 7c
profession [37(1)]
d Expenditure on advertisement in any souvenir, brochure, tract, pamphlet or the like, published 7d
by a political party [37(2B)]
e Expenditure by way of penalty or fine for violation of any law for the time being in force 7e
f Any other penalty or fine 7f

g Expenditure incurred for any purpose which is an offence or which is prohibited by law; 7g
OTHER INFORMATION
h Amount of any liability of a contingent nature 7h

i Any other amount not allowable under section 37 7i
j Total amount disallowable under section 37(total of 7a to 7i) 7j 0
8 A Amounts debited to the profit and loss account, to the extent disallowable under section 40
a Amount disallowable under section 40 (a)(i), on account of non-compliance with the Aa
provisions of Chapter XVII-B
b Amount disallowable under section 40(a)(ia) on account of non-compliance with the Ab
OTHER INF
c Amount disallowable under section 40(a)(iii) on account of non-compliance with the Ac

d Amount of tax or rate levied or assessed on the basis of profits [40(a)(ii)] Ad
e Amount paid as wealth tax [40(a)(iia)] Ae
f Amount paid by way of royalty, license fee, service fee etc. as per section 40(a)(iib) Af
g Amount of interest, salary, bonus, commission or remuneration paid to any partner or Ag

member [40(b)]
h Any other disallowance Ah
i Total amount disallowable under section 40(total of Aa to Ah) 8Ai 0
B Any amount disallowed under section 40 in any preceding previous year but allowable during the previous year
8B
9 Amounts debited to the profit and loss account, to the extent disallowable under section 40A
a Amounts paid to persons specified in section 40A(2)(b) 9a
b Amount in excess of twenty thousand rupees paid to a person in a day otherwise than by account 9b
payee cheque or account payee bank draft under section 40A(3) 100% disallowable
c Provision for payment of gratuity [40A(7)] 9c

d any sum paid by the assessee as an employer for setting up or as contribution to any fund, trust, 9d
company, AOP, or BOI or society or any other institution;[40A(9)]
e Any other disallowance 9e

f Total amount disallowable under section 40A (Total of 9a to 9e) 9f 0
10 Any amount disallowed under section 43B in any preceding previous year but allowable during the previous year
a Any sum in the nature of tax, duty, cess or fee under any law 10a
b Any sum payable by way of contribution to any provident fund or superannuation fund or 10b
gratuity fund or any other fund for the welfare of employees
c Any sum payable to an employee as bonus or commission for services rendered 10c
d Any sum payable as interest on any loan or borrowing from any public financial institution or a 10d
State financial corporation or a State Industrial investment corporation
e Any sum payable as interest on any loan or borrowing from any scheduled bank 10e
f Any sum payable towards leave encashment 10f
g Total amount allowable under section 43B (total of 10a to 10f) 10g 0
11 Any amount debited to profit and loss account of the previous year but disallowable under section 43B:-
a Any sum in the nature of tax, duty, cess or fee under any law 11a
b Any sum payable by way of contribution to any provident fund or superannuation fund or 11b
gratuity fund or any other fund for the welfare of employees
c Any sum payable to an employee as bonus or commission for services rendered 11c
d Any sum payable as interest on any loan or borrowing from any public financial institution or a 11d
State financial corporation or a State Industrial investment corporation
e Any sum payable as interest on any loan or borrowing from any scheduled bank 11e
f Any sum payable towards leave encashment 11f

g Total amount disallowable under Section 43B(total of 11a to 11f) 11g 0
12 Amount of credit outstanding in the accounts in respect of
a Union Excise Duty 12a
b Service tax 12b
c VAT/sales tax 12c
d Any other tax 12d
e Total amount outstanding (total of 12a to 12d) 12e 0
13 Amounts deemed to be profits and gains under section 33AB or 33ABA 13
14 Any amount of profit chargeable to tax under section 41 14
15 Amount of income or expenditure of prior period credited or debited to the profit and loss account (net) 15
Quantitative details (optional in a case not liable for audit under section 44AB) (Note : Numeric values not filled will default to zero)
Part A QD
(a) In the case of a trading concern
Item Name Unit Opening stock Purchase during the Sales Qty Closing stock Shortage/ excess, if
previous year any
1 2 3 4 7 8 9
(Select)
(Select)
(Select)
(Select)
(Select)
(Select)
(Select)
(Select)
(Select)
(Select)
(Select)
(Select)
(Select)
(Select)
(Select)
(Select)
(Select)
(Select)
(Select)
(b) In the case of a manufacturing concern - Raw Materials

Item Name Unit of measure Opening stock Purchase during the Consumption during Sales during the Closing stock Yield Finished Products
previous year the previous year previous year
1 2 3 4 5 6 7 8
(Select)
(Select)
(Select)
(Select)
(Select)
(Select)
(Select)
(Select)
(Select)
(Select)
(Select)
(Select)
(Select)
(Select)
(Select)
(Select)
(Select)
(Select)
(Select)
(Select)
(C) In the case of a manufacturing concern -Finished Products/By-products

Item Name Unit Opening stock Purchase during the Finished goods Sales during the Closing stock Shortage/ excess, if any
previous year manufactured previous year
1 2 3 4 5 6 7 8
(Select)
(Select)
(Select)
(Select)
(Select)
(Select)
(Select)
(Select)
(Select)
(Select)
(Select)
(Select)
(Select)
(Select)
(Select)
(Select)
(Select)
(Select)
(Select)
(Select)
%age of yield Shortage/
excess, if any
9 10
Computation of total income PLEASE NOTE THAT CALCULATED FIELDS (IN WHITE) ARE PICKED UP FROM OTHER SCHEDULES AND ARE NO
Part B - TI
The Income figures below will get filled up when the Schedules linked to them are filled.
1 Salaries (7 of Schedule S) 1
2 Income from house property (C of Schedule-HP) (enter nil if loss) 2
TOTAL INCOME
3 Profits and gains from business or profession

i Profit and gains from business other than speculative business and specified business 3i 280057
(A37 of Schedule-BP) (enter nil if loss)
ii Profit and gains from speculative business (B41 of Schedule BP) (enter nil if loss and take 3ii 0
the figure to schedule CFL)
iii Profit and gains from specified business (C47 of Schedule BP) (enter nil if loss and take 3iii 0
the figure to schedule CFL)
iv Total (3i + 3ii + 3iii) (enter nil if 3iv is a loss) 3iv
4 Capital gains
a Short term
i Short-term chargeable @ 15% (7ii of item E of schedule CG) 4ai 0
ii Short-term chargeable @ 30% (7iii of item E of schedule CG) 4aii 0
iii Short-term chargeable at applicable rate (7iv of item E of schedule CG) 4aiii 0
iv Total short-term (4ai + 4aii + 4aiii) 4aiv 0

b Long term
i Long-term chargeable @ 10% (7v of item E of schedule CG) 4bi 0
ii Long-term chargeable @ 20% (7vi of item E of schedule CG) 4bii 0
iii Total Long-Term (4b(i) + 4b(ii)) (enter nil if loss) 4biii 0
c Total capital gains (4aiv + 4biii) (take the figure adjusted to Schedule CYLA)(In case of negative figure enter nil and take the figure under respective head 4c
to schedule CFL)
5 Income from other sources
a from sources other than from owning race horses and income chargeable to tax at special 5a 784
rate ( 1i of Schedule OS) (enter nil if loss)
b Income chargeable to tax at special rate (1fiv of Schedule OS) 5b 0
c from the activity of owning and maintaining race horses (3c of Schedule OS) (enter nil if 5c 0
loss)
d Total (5a + 5b + 5c) 5d
6 Total (1 + 2 + 3iv +4c +5d) 6
7 Losses of current year to be set off against 6 (total of 2xii,3xii and 4xii of Schedule CYLA) 7
8 Balance after set off current year losses (6 7) (total of column 5 of Schedule CYLA+5b) 8
9 Brought forward losses to be set off against 8 (total of 2xiii, 3xiii and 4xiii of Schedule BFLA) 9
10 Gross Total income (8-9) (5xiv of Schedule BFLA+ 5b) 10
11 Income chargeable to tax at special rate under section 111A, 112 etc. included in 10 11
12 Deduction u/s 10A or 10AA (c of Sch. 10A + c of Sch. 10AA) 12
13 Deductions under Chapter VI-A
a Part-B, CA and D of Chapter VI-A [(1 + 3) of Schedule VI-A and limited upto (10-11) a 784
b Part-C of Chapter VI-A [(2 of Schedule VI-A and limited upto (10-11-3iii) b 0
c Total (13a + 13b) [limited upto (10-11)] 13c

14 Total income (10 - 12 - 13c) 14
15 Income which is included in 14 and chargeable to tax at special rates (total of (i) of schedule SI) 15
16 Net agricultural income/ any other income for rate purpose (4 of Schedule EI) 16
17 Aggregate income (14-15+16) [applicable if (14-15) exceeds maximum amount not chargeable to tax] 17
18 Losses of current year to be carried forward (total of row xi of Schedule CFL) 18
Part B - TTI Computation of tax liability on total income

1 a Tax payable on deemed total income under section 115JC (4 of Schedule AMT) 1a
b Surcharge on (a) (applicable if 3 of schedule AMT exceeds 1 crore) 1b
c Education Cess, including secondary and higher education cess on (1a+1b) above 1c
d Total Tax Payable on deemed total income (1a+1b+1c) 1d
2 Tax payable on total income
a Tax at normal rates on 17 of Part B-TI 2a 3006
b Tax at special rates (total of (ii) of Schedule-SI) 2b #VALUE!
Rebate on agricultural income [applicable if (14-15) of Part B-TI exceeds maximum 2c 0
c
amount not chargeable to tax]
COMPUTATION OF TAX LIABILITY
d Tax Payable on Total Income (2a + 2b-2c) 2d

e Rebate under section 87A (applicable if 14 of Part B-TI does not exceed 5 lakh) 2e
f Tax payable after rebate (2d 2e) 2f
g Surcharge on 2f (applicable if 14 of Part B-TI exceeds 1 crore 2g
h Education cess, including secondary and higher education cess on (2f + 2g) 2h
i Gross tax liability (2f + 2g + 2h) 2i
3 Gross tax payable (higher of 1d and 2i) 3
4 Credit under section 115JD of tax paid in earlier years (applicable if 2i is more than 1d) (5 of Schedule AMTC) 4
5 Tax payable after credit under section 115JD (3 - 4) 5
6 Tax relief
a Section 89 6a
b Section 90/ 90A ( 2 of Schedule TR) 6b 0
COMPUTAT
c Section 91 ( 3 of Schedule TR) 6c 0

d Total (6a + 6b + 6c) 6d
7 Net tax liability (5 6d) (Enter 0 if negative) 7
8 Interest payable
a For default in furnishing the return (section 234A) 8a 0
b For default in payment of advance tax (section 234B) 8b 0
c For deferment of advance tax (section 234C) 8c 0
d Total Interest Payable (8a+8b+8c) 8d
9 Aggregate liability (7 + 8d) 9
10 Taxes Paid
TAXES PAID
a Advance Tax (from column 5 of 18A ) 10a 0

b TDS (total of column 5 of 18B and column 8 of 18C) 10b 18930
c TCS (column 7 of 18D) 10c 0
d Self-Assessment Tax (from column 5 of 18A) 10d 0
e Total Taxes Paid (10a+10b+10c + 10d) 10e
11 Amount payable (Enter if 9 is greater than 10e, else enter 0) 11
12 Refund (If 10e is greater than 9) 12
13 Details of all Bank Accounts held in India at any time during the previous year (excluding dormant accounts)
Total number of savings and current bank accounts held by you at any time during the previous year (excluding dormant accounts). Provide the details below.
a. Bank Account in which refund, if any, shall be credited

Sl.No IFS Code of the Name of the Bank Account Number Type of Account
Bank
1 UTBI0PPM820 United Bank of India 1002010103059 Savings
b. Other Bank account details
Sl.No IFS Code of the Name of the Bank Account Number Type of Account
Bank
2 (Select)
3 (Select)
14 Do you at any time during the previous year,-
(i) hold, as beneficial owner, beneficiary or otherwise, any asset (including financial interest in any entity) located outside India; or
(ii) have signing authority in any account located outside India; or
(iii) have income from any source outside India? 14
[applicable only in case of a resident] [Ensure Schedule FA is filled up if the answer is Yes ]
VERIFICATION
I, (full name in block letters), VENKATESAN GOMATHI son/ daughter of ANANDHAN
solemnly declare that to the best of my knowledge and belief, the information given in the return and schedules thereto is correct and complete and that the amount of total income and other particul
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 2016-17.
Place PALLIPALAYAM Sign here

PAN BCXPG9360F 08/04/2017 (Date)
16 If the return has been prepared by a Tax Return Preparer (TRP) give further details below:
Identification No. of TRP Counter Signature of TRP
Name of TRP
If TRP is entitled for any reimbursement from the Government, amount thereof 17
HITE) ARE PICKED UP FROM OTHER SCHEDULES AND ARE NOT TO BE ENTERED. For ex :
d.
0
0
280057
784
280841
0
280841
0
280841
0
0
784
280060
#VALUE!
0
#VALUE!
0
0
0
0
0
#VALUE!
#VALUE!
#VALUE!
0
30
#VALUE!
#VALUE!
#VALUE!
#VALUE!
0
#VALUE!
0
#VALUE!
18930
#VALUE!
#VALUE!
1
No
ANANDHAN
and complete and that the amount of total income and other particulars shown therein are truly
he previous year relevant to the Assessment Year 2016-17.
18A Tax Payments
A Details of payments of Advance Tax and Self-Assessment Tax
BSR Code
Date of Deposit Serial Number of
SI NO Must be filled to include the
(DD/MM/YYYY) Challan
payment in the Total
1 1 2 3
1
2
3
4
Total
Note Enter the totals of Advance tax and Self-Assessment tax in Sl No. 10a & 10d of Part B-TTI
Amount (Rs)
0
10a & 10d of Part B-TTI
18B Details of Tax Deducted at Source from SALARY [As per FORM 16 issued by Employer(s)]
Tax Deduction Account

Income chargeable Total tax
Sl No Number (TAN) of the Name of Employer
under Salaries deducted
Deductor
2
If no entry is made in this column,
1 3 4 5
then columns (3) to (5) will not be
considered for that row
1
2
3
4
Total 0 0
18C1 Details of Tax Deducted at Source on Income [As per FORM 16 A issued by Deductor(s)]
Tax Deduction Account

Unique TDS Unclaimed TDS
Sl No Number (TAN) of the Name of Deductor TDS Of Current Fin Year
Certificate Number brought forward (b/f)
Deductor
2
Financial Year in which TDS
If no entry is made in this column, Amount b/f
1 3 4 is deducted 7
then columns (3) to (7) will not be 6
5
VINAYAKA
1 CMBV05681E (Select) 18930
MOORTHY VIJAYA
2 (Select)
3 (Select)
4 (Select)
Total
18D Details of Tax Collected at Source [As per Form 27D issued by the Collector(s)]
Amount out of (6) being claimed

Tax Deduction and Tax
TCS of the current this Year (only if corresponding
SI.No Collection Account Number of Name of the Collector Unclaimed TCS brought forward (b/f)
Fin. Year income is being offered for tax
the collector
this year)
(2)
Fin. Year in which
If no entry is made in this Unclaimed TCS Brought
collected
(1) column, then columns (3) to (5) (3) Forward (6) (7)
will not be considered for that (5)
(4)
row
1 (Select)
2 (Select)
3 (Select)
4 (Select)
Total 0
18C2 Details of Tax Deducted at Source (TDS) on Sale of Immovable Property u/s 194IA (For seller of property) or Form 26QB]
Sl Unique TDS Unclaimed TDS
PAN of the buyer Name of the buyer TDS of the current fin. Year
No Certificate Number brought forward (b/f)
2
Financial Year in which TDS
If no entry is made in this column, Amount b/f
1 3 4 is deducted 7
then columns (3) to (7) will not be 6
5
1 (Select)
2 (Select)
3 (Select)
4 (Select)
Total
Amount out of (6) or
Amount out of (6) or (7) being claimed this Year (only if
(7) being carried
corresponding income is being offered for tax this year)
forward
In the hands of
In own hands spouse, if section 5A
10
8 is applicable
9
18930
0
0
0
0
18930
Amount out of (5) or (6) being

carried forwared
(8)
0
0
0
0
Amount out of (6) or (7) being claimed this Year (only if
corresponding income is being offered for tax this year) Amount out of (6) or
(7) being carried
forward
In the hands of
In own hands spouse, if section 5A
10
8 is applicable
9
0
0
0
0
0
Schedule S Details of Income from Salary (Fields marked in RED must not be left Blank. Empty numeric values treated as
Name of Employer
Address of employer
State (Select)
1 Salary (Excluding all exempt/ non-exempt allowances, perquisites & profit in lieu of salary as they are shown se
2 Allowances exempt under section 10 (Not to be included in 7 below)
i Travel concession/assistance received [(sec. 10(5)]
ii Tax paid by employer on non-monetary perquisite [(sec. 10(10CC)]
iii Allowance to meet expenditure incurred on house rent [(sec. 10(13A)]
iv Other allowances
3 Allowances not exempt (refer Form 16 from employer)
4 Value of perquisites (refer Form 16 from employer)
5 Profits in lieu of salary (refer Form 16 from employer)
6 Deduction u/s 16 (Entertainment allowance by Government and tax on employment)
7 Income chargeable under the Head Salaries (1+3+4+5-6)
numeric values treated as zeroes)
PAN of Employer (optional)
Town/City Pin code
salary as they are shown separately below) 1
i
ii
iii
iv
3
4
5
6
7 0
Total 0
SCH HP Details of Income from House Property (Fields marked in RED must not be left Blank)
ADDRESS OF PROPERTY (NOTE :

Town/ City State
DO NOT LEAVE ADDRESS BLANK )
(Select)
Is the property co-owned? (Select) Your percentage of share in the
property.
NAME OF CO-OWNER (TO ADD MORE COOWNERS,

S.No PAN of Co-owner
PLEASE CLICK ON "ADD COOWNERS" BUTTON AT THE BOTTOM
1
2
3
4
5
6
7
Type Of House Property? (Select)
S.No Name(s) of Tenant PAN(s) of Tenant (optional)
1
2
3
a Annual letable value or rent received or receivable (higher of the two, if let out for whole of the year, lower of the two if let out for part of the year)
b The amount of rent which cannot be realized

c Tax paid to local authorities
d Total (b + c)
e Annual value (a d) (nil, if self -occupied etc. as per section 23(2)of the Act)
f Annual value of the property owned (own percentage share x e)
g 30% of f
h Interest payable on borrowed capital Cannot exceed 2 lacs if not let
out
i Total (g + h)
j Income from house property (f i)
ADDRESS OF PROPERTY (NOTE :

Town/ City State
DO NOT LEAVE ADDRESS BLANK )
(Select)
Is the property co-owned? (Select) Your percentage of share in the
property.
NAME OF CO-OWNER (TO ADD MORE COOWNERS,

S.No PAN of Co-owner
PLEASE CLICK ON "ADD COOWNERS" BUTTON AT THE BOTTOM
1
2
3
4
5
6
7
Type Of House Property? (Select)
S.No Name(s) of Tenant PAN(s) of Tenant (optional)
1
2
3
a Annual letable value or rent received or receivable (higher of the two, if let out for whole of the year, lower of the two if let out for part of the year)
b The amount of rent which cannot be realized

c Tax paid to local authorities
d Total (b + c)
e Annual value (a d) (nil, if self -occupied etc. as per section 23(2)of the Act)
f Annual value of the property owned (own percentage share x e)
g 30% of f
h Interest payable on borrowed capital Cannot exceed 2 lacs if not let
out
i Total (g + h)
j Income from house property (f i)
Income under the head Income from house property
A Rent of earlier years realized under section 25A/AA
B Arrears of rent received during the year under section 25B after deducting 30%
C Total (1j + 2j + 3a + 3b ) (if negative take the figure to 2i of schedule CYLA)
PIN Code
0.00
Percentage Share in
Property
wer of the two if let out for part of the year) a
0
e 0
f 0
0
i 0
j 0
PIN Code
0.00
Percentage Share in
Property
wer of the two if let out for part of the year) a
0
e 0
f 0
0
i 0
j 0
A
B
C 0
Schedule BP Computation of income from business or profession
A From business or profession other than speculative business or specified business
1 Profit before tax as per profit and loss account (item 45 and 53d of Part A-P&L) 1 280057
2a Net profit or loss from speculative business included in 1 (Enter -ve sign in 2a
case of loss)
2b Net profit or Loss from Specified Business u/s 35AD included in 1 (enter 2b
ve sign in case of loss)
3 Income/ receipts credited to profit and loss account considered under other heads of income
a Salary 3a
b House Propery 3b
c Capital Gains 3c
d Other Sources 3d
4 Profit or loss included in 1, which is referred to in Section . 44AD/ 4 0
44AE/44B/ 44BB/ 44BBA/ 44BBB/ 44D/ 44DA Chapter-XII-G/ First
Schedule of Income Tax Act
5 Income credited to Profit and Loss account (included in 1) which is exempt, in point(d)
a share of income from firm(s) 5a
b Share of income from AOP/ BOI 5b
c Any other exempt income
NAME Amount
i i
ii ii
iii iii
Total (ci + cii + ciii) 5c 0
d Total exempt income (5a+5b+5c) 5d 0
6 Balance (1 2a 2b - 3a -3b -3c -3d 4 5d) 6 280057
7 Expenses debited to profit and loss account considered under other heads of income
a Salary 7a
b House Propery 7b
c Capital Gains 7c
d Other Sources 7d
8 Expenses debited to profit and loss account which relate to exempt income 8
9 Total (7a + 7b + 7c + 7d + 8) 9 0
10 Adjusted profit or loss (6+9) 10 280057
11 Depreciation and amoritisation debited to profit and loss account 11 0
12 Depreciation allowable under Income-tax Act
i Depreciation allowable under section 32(1)(ii) and 32(1)(iia) (item 6 12i
of Schedule-DEP) 0
ii Depreciation allowable under section 32(1)(i) (Make your own 12ii
computation refer Appendix IA of IncomeTax Rules)
iii Total (12i + 12ii) 12iii 0

13 Profit or loss after adjustment for depreciation (10 +11 - 12iii) 13 280057
14 Amounts debited to the profit and loss account, to the extent disallowable 14 0
under section 36 (6r of Part-OI)
under section 37 (7j of Part-OI)
under section 40 (8Ai of Part-OI)
under section 40A (9f of Part-OI)
18 Any amount debited to profit and loss account of the previous year but 18 0
disallowable under section 43B (11g of Part-OI)
19 Interest disallowable under section 23 of the Micro, Small and Medium 19

Enterprises Development Act,2006
20 Deemed income under section 41 20
21 Deemed income under section 21
32AD/33AB/33ABA/35ABB/40A(3A)/72A/80HHD/80-IA
22 Deemed income under section 43CA 22
23 Any other item or items of addition under section 28 to 44DA 23
FROM BUSINESS OR PROFESSION
24 Any other income not included in profit and loss account/any other 24
expense not allowable (including income from salaary, commission, bonus
and interest from firms in which an individual/ HUF/ Prop. concern is a
partner)
25 Total (14 + 15 +16 +17 +18 +19 + 20 +21 + 22 + 23 + 24) 25 0

26 Deduction allowable under section 32(1)(iii) 26
INCOME FROM BUSINESS OR P
27 Deduction allowable under section 32AD 27
28 Amount of deduction under section 35 or 35CCC or 35CCD in excess of 28 0
the amount debited to profit and loss account (item X(4) of Schedule ESR)
(if amount deductible under section 35 or 35CCC or 35CCD is lower than
amount debited to P&L account, it will go to item 24)
29 Any amount disallowed under section 40 in any preceding previous year 29 0

but allowable during the previous year(8Bof Part-OI)
30 Any amount disallowed under section 43B in any preceding previous year 30 0
but allowable during the previous year(10g of Part-OI)
31 Deduction under section 35AC

a Amount, if any, debited to profit and loss account 31a
b Amount allowable as deduction 31b
c Excess amount allowable as deduction (31b 31a) 31c 0
32 Any other amount allowable as deduction 32
33 Total (26 + 27+ 28 +29 +30+31c + 32) 33 0
34 Income (13 + 25 33) 34 280057
35 Profits and gains of business or profession deemed to be under -
i Section 44AD i
ii Section 44AE ii
iii Section 44B iii
iv Section 44BB iv
v Section 44BBA v
vi Section 44BBB vi
vii Section 44D vii
viii Section 44DA viii
ix First Schedule of Income-tax Act ix
x Total (35i to 35ix) 35x 0
36 Net profit or loss from business or profession other than speculative and specified business (33 + 34x) 36 280057
37 Net Profit or loss from business or profession other than speculative A37 A37 280057
business and specified business, after applying rule 7A,7Bor 8, if
applicable (if rule 7A,7B or 8 is not applicable, enter same figure as in 36)
(if loss take the figure to 2i of item E)
B Computation of income from speculative business
38 Net profit or loss from speculative business as per profit or loss account 38 0
39 Additions in accordance with section 28 to 44DA 39
40 Deductions in accordance with section 28 to 44DA 40
41 Income from speculative business (38+ 39- 40) (if loss, take the figure of 6xi of schedule CFL) B41 0
C Computation of income from specified business under section 35AD

42 Net profit or loss from specified business as per profit or loss account 42 0
43 Additions in accordance with section 28 to 44DA 43
44 Deductions in accordance with section 28 to 44DA (other than deduction under section,- (i) 35AD, (ii)32 or 35 on 44
which deduction u/s 35AD is claimed)
45 Profit or loss from specified business (42+43-44) 45 0
46 Deductions in accordance with section 35AD(1) or 35AD(1A) 46
47 Income from Specified Business (45-46) (if loss, take the figure to 7xi of schedule CFL) C47 0
D Income chargeable under the head Profits and gains from Business or profession (A37+B41+C47) D 280057
E Intra head set off of business loss of current year

Type of business Income of current year (Fill this column only if figure is zero or Business loss set off (2) Business income remaining
positive) (1) after set off (3) = (1)-(2)
(i) Loss to be set off

(Fill this row only if
figure is negative)
0
(ii) Income from
speculative business
0 0 0
(iii) Income from
specified business
0 0 0
(iv) Total loss set off
0
(ii + iii)
(v) Loss remaining
after set off (i iv)
0
Note : Please include the income of the specified persons referred to in Schedule SPI while computing the income under this head
Schedule
DPM Depreciation on Plant and Machinery (Other than assets on which full capital expenditure is allowable as deduction under any other section)
1 Block of assets Plant and machinery
2 Rate (%) 15 30 40 50 60
(i) (ii) (iii) (iv) (v)
3 Written down value on the first day of previous
year
4 Additions for a period of 180 days or more in the
previous year
5 Consideration or other realization during the
DEPRECIATION ON PLANT AND MACHINERY
previous year out of 3 or 4
6 Amount on which depreciation at full rate to be

allowed (3 + 4 -5) (Enter 0, if result is negative)
0 0 0 0 0
7 Additions for a period of less than 180 days in the
previous year
8 Consideration or other realizations during the year
out of 7
9 Amount on which depreciation at half rate to be
allowed (7 8) (Enter 0, if result is negative)
0 0 0 0 0
10 Depreciation on 6 at full rate 0 0 0 0 0
11 Depreciation on 9 at half rate 0 0 0 0 0
12 Additional depreciation, if any, on 4 0 0
13 Additional depreciation, if any, on 7 0 0
14 Total depreciation (10+11+12+13) 0 0 0 0 0
15 Expenditure incurred in connection with transfer
of asset/ assets
16 Capital gains/ loss under section 50 (5 + 8 -3-4 -7
-15) (Enter negative only if block ceases to exist)
17 Written down value on the last day of previous

year (6+ 9 -14) (enter 0 if result is negative)
0 0 0 0 0
Schedule
Depreciation on other assets(Other than assets on which full capital expenditure is allowable as deduction)
DOA
1 Block of assets
Building Furniture and fittings Intangible
2 Rate (%) 5 10 100 10 25

(i) (ii) (iii) (iv) (v)
3 Written down value on the first day of previous
year
4 Additions for a period of 180 days or more in the
previous year
5 Consideration or other realization during the
previous year out of 3 or 4
DEPRECIATION ON OTHER ASSETS
6 Amount on which depreciation at full rate to be

allowed (3 + 4 -5) (Enter 0, if result is negative)
0 0 0 0 0
7 Additions for a period of less than 180 days in the
previous year
8 Consideration or other realizations during the year
out of 7
9 Amount on which depreciation at half rate to be
allowed (7-8) (Enter 0, if result is negative)
0 0 0 0 0
10 Depreciation on 6 at full rate 0 0 0 0 0
11 Depreciation on 9 at half rate 0 0 0 0 0
12 Additional depreciation, if any, on 4
13 Additional depreciation, if any, on 7
14 Total depreciation (10+11+12+13) 0 0 0 0 0
15 Expenditure incurred in connection with transfer
of asset/ assets
16 Capital gains/ loss under section 50 (5 + 8 -3-4 -7
-15) (Enter negative only if block ceases to exist)
17 Written down value on the last day of previous

year (6+ 9 -14) (enter 0 if result is negative)
0 0 0 0 0
n under any other section)
Plant and machinery
80 100
(vi) (vii)
0 0
0 0
0 0
0 0
0 0
0 0
Ships
20
(vi)
0
0
0
0
Summary of depreciation on assets (Other than assets on which full capital expenditure is allowable as deduction under any
Sch DEP other section)
1 Plant and machinery
Block entitled for depreciation @ 15 per cent ( Schedule
a 1a
DPM - 14 i) 0
b 1b
DPM - 14 ii) 0
c 1c
DPM - 14 iii) 0
SUMMARY OF DEPRECIATION ON ASSETS

d 1d
DPM - 14 iv) 0
e 1e
DPM - 14 v) 0
f 1f
DPM 14 vi) 0
g 1g
DPM - 14 vii) 0
h Total depreciation on plant and machinery ( 1a+1b+1c+1d+1e+1f+1g) 1h 0
2 Building
Block entitled for depreciation @ 5 per cent (Schedule
a 2a
DOA- 14i) 0
b 2b
DOA- 14ii) 0
c 2c
DOA- 14iii) 0
d Total depreciation on building (2a+2b+2c) 2d 0
3 Furniture and fittings (Schedule DOA- 14 iv) 3 0
4 Intangible assets (Schedule DOA- 14 v) 4 0
5 Ships (Schedule DOA- 14 vi) 5 0
6 Total depreciation ( 1h+2d+3+4+5) 6 0
Sch DCG Deemed Capital Gains on sale of depreciable assets

1 Plant and machinery
a 1a 0
DPM - 16i)
b 1b 0
DPM 16ii)
c 1c 0
DPM - 16iii)
d 1d 0
DPM - 16iv)
e 1e 0
DPM 16v)
f 1f 0
DPM 16vi)
g 1g 0
DPM 16vii)
h Total ( 1a +1b + 1c + 1d + 1e + 1f + 1g) 1h 0
2 Building
a 2a
DOA- 16i) 0
b 2b
DOA- 16ii) 0
c 2c
DOA- 16iii) 0
d Total ( 2a + 2b + 2c) 2d 0
3 Furniture and fittings ( Schedule DOA- 16iv) 3 0
4 Intangible assets (Schedule DOA- 16v) 4 0
5 Ships (Schedule DOA- 16vi) 5 0
6 Total ( 1h+2d+3+4+5) 6 0
Schedule ESR Deduction under section 35 or 35CCC or 35CCD
Amount of deduction in excess of the
Expenditure of the nature referred Amount, if any, debited to profit Amount of deduction allowable
Sl No amount debited to profit and loss account
to in section (1) and loss account (2) (3)
(4) = (3) - (2)
i 35(1)(i) 0
ii 35(1)(ii) 0
iii 35(1)(iia) 0
iv 35(1)(iii) 0
v 35(1)(iv) 0
vi 35(2AA) 0
vii 35(2AB) 0
viii 35CCC 0
ix 35CCD 0
x Total 0 0 0
Schedule CG Capital Gains
A Short-term Capital Gains (STCG) (Items 4 , 5 & 8 are not applicable for residents)
1 From sale of land or building or both
a i Full value of consideration received/receivable
ii Value of property as per stamp valuation authority
iii Full value of consideration adopted as per section 50C for the purpose of Capital Gains (ai or aii)
b Deductions under section 48
i Cost of acquisition without indexation
ii Cost of Improvement without indexation
CAPITAL GAINS
iii Expenditure wholly and exclusively in connection with transfer

iv Total (bi + bii + biii)
c Balance (aiii biv)
di Deduction under section 54B(Specify details in item Dbelow)
dii Deduction under section 54D(Specify details in item Dbelow)
diii Deduction under section 54G(Specify details in item Dbelow)
div Deduction under section 54GA(Specify details in item Dbelow)
d Total Deduction under section 54B/54D/54G/54GA
e Short-term Capital Gains on Immovable property (1c - 1d)
2 From Slump sale
a Full value of consideration
b Net worth of the under taking or division
c Short term capital gains from slump sale (2a-2b)
3 (i) From sale of equity share or unit of equity oriented Mutual Fund (MF) or unit of a business trust on which STT is paid u/s 111A [for others]
ia Full value of consideration
ib Deductions under section 48
iv Total ( i + ii + iii)
ic Balance (3ia 3ibiv)
id Loss to be disallowed u/s 94(7) or 94(8)- for example if asset bought/acquired within 3 months prior to record date and dividend/income/bonus units are received, then loss
arising out of sale of such asset to be ignored (Enter positive value only)
ie Short-term capital gain on equity share or equity oriented MF or unit of a business trust (STT paid) u/s 111A [for others] (3ic +3id)
(ii) From sale of equity share or unit of equity oriented Mutual Fund (MF) or unit of a business trust on which STT is paid u/s 115AD(1)(b)(ii) [for FII]
iia Full value of consideration
iib Deductions under section 48
iv Total ( i + ii + iii)
iic Balance (3a 3biv)
iid Loss to be disallowed u/s 94(7) or 94(8)- for example if asset bought/acquired within 3 months prior to record date and dividend/income/bonus units are received, then loss
arising out of sale of such asset to be ignored (Enter positive value only)
iie Short-term capital gain on equity share or equity oriented MF or unit of a business trust (STT paid) u/s 115AD(1)(b)(ii) [for FII] (3iic +3iid)
6 From sale of assets other than at A1 or A2 or A3 or A4 or A5 above
iv Total (i + ii + iii)
c Balance (6a biv)
d In case of asset (security/unit)loss to be disallowed u/s 94(7) or 94(8)- for example if asset bought/acquired within 3 months prior to record date and dividend/income/bonus
units are received, then loss arising out of sale of such asset to be under (Enter positive value only)
e Deemed short term capital gains on depreciable assets (6 of schedule- DCG)

fi Deduction under section 54D (Specify details in item Dbelow)
fii Deduction under section 54G (Specify details in item Dbelow)
fiii Deduction under section 54GA (Specify details in item Dbelow)
f Deduction under section 54D/G/GA
g STCG on assets other than at A1 or A2 or A3 or A4 or A5 above (6c + 6d + 6e-6f)
7 Amount deemed to be short-term capital gains
a Whether any amount of unutilized capital gain on asset transferred during the previous years shown below was deposited in the Capital Gains Accounts Scheme within due date for
that year? If yes, then provide the details below
Previous year Section under which New asset acquired/constructed Amount not used for
in which asset deduction claimed in new asset or remained
transferred that year unutilized in Capital
gains account (X)
Sl.
Previous year Section under which Amount not used for
in which asset deduction claimed in new asset or remained
transferred that year Year in which asset Amount utilised out of unutilized in Capital
acquired/constructe Capital Gains account gains account (X)
d
Sl.
i 1 2012-13
ii 4 2013-14 54B
b Amount deemed to be short term capital gains, other than at a

Total amount deemed to be short term capital gains (Xi + Xii + b)
9 Total Short-term Capital Gain (A1e +A2c +A3ie +A3iie +A4a +A4b +A5e +A6g +A7 -A8)
B Long-term capital gain (LTCG) (Items 5, 6, 7 & 10 are not applicable for residents)
1 From sale of land or building or both
Long-term Capital Gains
a i Full value of consideration received/receivable

ii Value of property as per stamp valuation authority
iii Full value of consideration adopted as per section 50C for the purpose of Capital Gains
b (ai orunder
Deductions aii) section 48
i Cost of acquisition with indexation
ii Cost of Improvement with indexation
iv Total (bi + bii + biii)
c Balance (aiii biv)
di Deduction under section 54 (Specify details in item D below)
dii Deduction under section 54B (Specify details in item D below)
diii Deduction under section 54D (Specify details in item D below)
div Deduction under section 54EC (Specify details in item D below)
dv Deduction under section 54F (Specify details in item D below)
dvi Deduction under section 54G (Specify details in item D below)
dvii Deduction under section 54GA (Specify details in item D below)
dviii Deduction under section 54GB (Specify details in item D below)
d Total Deduction under section 54/54B/54D/54EC/54F/54G/54GA/54GB (Specify details in item D below)
e Long-term Capital Gains on Immovable property (1c - 1d)
2 From Slump sale
2
b Net worth of the under taking or division

c Balance (2a - 2b)
di Deduction u/s 54EC (Specify details in item D below)
dii Deduction u/s 54F (Specify details in item D below)
d Total Deduction u/s 54EC/54F
e Long term capital gains from slump sale (2c-2d)
3 From sale of bonds or debenture (other than capital indexed bonds issued by Government)
ii Cost of improvement without indexation
iv Total (bi + bii +biii)
c Balance (3a biv)
di Deduction under sections 54EC (Specify details in item D below)
dii Deduction under sections 54F(Specify details in item D below)
d Deduction under sections 54EC/54F(Specify details in item D below)
e LTCG on bonds or debenture (3c 3d)
4 From sale of, (i) listed securities (other than a unit) or zero coupon bonds where proviso under section 112(1) is applicable
ia Full value of consideration
ib Deductions under section 48
ic Balance (4a biv)
di Deduction under sections 54EC(Specify details in item D below)
id Deduction under sections 54EC/54F(Specify details in item D below)
ie Long-term Capital Gains on assets at B3 above (4c 4d)
From sale of GDR of an Indian company referred in sec. 115ACA
b

c Balance (4a biv)
di Deduction under sections 54EC(Specify details in item D below)
d Deduction under sections 54EC/54F(Specify details in item D below)
e Long-term Capital Gains on assets at B4 above (4c 4d)
8 From sale of assets where B1 to B7 above are not applicable
i Cost of acquisition with indexation
ii Cost of improvement with indexation
c Balance (8a biv)
di Deduction under sections 54D (Specify details in item D below)
dii Deduction under sections 54EC (Specify details in item D below)
diii Deduction under sections 54F (Specify details in item D below)
div Deduction under sections 54G (Specify details in item D below)
dv Deduction under sections 54GA (Specify details in item D below)
d Deduction under sections 54D/54EC/54F/54G/54GA (Specify details in item D below)
e Long-term Capital Gains on assets at B8 above (8c-8d)
9 Amount deemed to be long-term capital gains
a Whether any amount of unutilized capital gain on asset transferred during the previous years shown below was deposited in the Capital Gains Accounts Scheme within due date for
that year? If yes, then provide the details below
Sl. Previous year Section under which New asset acquired/constructed Amount not used for
in which asset deduction claimed in Year in which asset Amount utilised out of new asset or remained
transferred that year acquired/constructe Capital Gains account unutilized in Capital
d gains account (X)
i 1 2012-13
ii 3 2013-14 54B
b Amount deemed to be long-term capital gains, other than at a

Total amount deemed to be long-term capital gains (Xi + Xii + b)
11
Total long term capital gain [B1e +B2e +B3e +B4ie +B4iie +B5d +B5e +B6ie +B6iie +B6iiie +B7c + B7f + B8e+B9-B10] (In case of loss take the figure to 9xi of schedule CFL)
C Income chargeable under the head CAPITAL GAINS (A9 + B11) (take B11 as nil, if loss)
D Information about deduction claimed
1 In case of deduction u/s 54/54B/54D/54EC/54F/54G/54GA/54GB/115F give following details
Section Amount of Deduction Cost of New Asset Date of its acquisition/ Amount deposited in
construction Capital Gains Accounts
Scheme before due date
1 (Select)
2 (Select)
3 (Select)
4 (Select)
5 (Select)
6 (Select)
7 (Select)
8 (Select)
c Total deduction claimed 1c 0

2 In case of deduction u/s 54GB, furnish PAN of the company
E Set-off of current year capital losses with current year capital gains (excluding amounts included in A8 & B10 which is chargeable under DTAA)
SI. Gain of current year Short term capital loss set off Long term capital loss set off
(Fill this column only if
computed figure is
Type of Capital Gain positive) 15% 30% applicable rate 10% 20%
1 2 3 4 5 6
i Loss to be set off (Fill this row if
figure computed is negative) 0 0 0 0 0
------>
ii 15% 0 0 0
iii Short term 30% 0 0 0
capital gain
Short term
iv capital gain
0 0 0
applicable rate
v 10% 0 0 0 0 0
Long term
vi capital gain
20% 0 0 0 0 0
vii Total loss set off 0 0 0 0 0

(ii + iii + iv + v + vi)
viii Loss remaining after set off 0 0 0 0 0
(i vii)
F Information about accrual/receipt of capital gain
Upto 15/9 16/9 to 15/12
Type of Capital gain / Date
(i) (ii)
1 Short-term capital gains taxable at the rate of 15%. Enter value from item 5vi of schedule BFLA, if any.
2 Short-term capital gains taxable at the rate of 30%. Enter value from item 5vii of schedule BFLA, if any.
3 Short-term capital gains taxable at applicable rates. Enter value from item 5viii of schedule BFLA, if any.
4 Long- term capital gains taxable at the rate of 10%. Enter value from item 5ix of schedule BFLA, if any.
5 Long- term capital gains taxable at the rate of 20%. Enter value from item 5xi of schedule BFLA, if any.
NOTE Please include the income of the specified persons referred to in Schedule SPI while computing the income under this head
ai
aii
aiii
bi
bii
biii
biv 0
1c 0
di
dii
diii
div
1d 0
A1e 0
2a
2b
A2c 0
1A [for others]
3ia
bi
bii
biii
ibiv 0
3ic 0
3id
A3ie 0
15AD(1)(b)(ii) [for FII]
3iia
bi
bii
biii
iibiv 0
3iic 0
3iid
for FII] (3iic +3iid) A3iie 0
6a
bi
bii
biii
biv 0
6c 0
6d
e 0
fi
fii
fiii
6f 0
A6g 0
(Select)
7b
A7 0
A9 0
ai
aii
aiii
bi
bii
biii
biv 0
1c 0
di
dii
diii
div
dv
dvi
dvii
dviii
1d 0
B1e 0
2a
2b
2c 0
di
dii
d 0
B2e 0
3a
bi
bii
biii
biv 0
2c 0
di
dii
2d 0
B3e 0
4ia
bi
bii
biii
ibiv 0
4ic 0
di
dii
3id 0
B4ie 0
4iia
bi
bii
biii
iibiv 0
4iic 0
di
dii
4iid 0
B4iie 0
8a
bi
bii
biii
biv 0
8c 0
di
di
dii
dii
dii
8d 0
B8e 0
(Select)
9b
B9 0
B11
loss take the figure to 9xi of schedule CFL) 0
C 0
Current years capital gains

remaining after set off
(7= 1-2-3-4-5-6)
0
0
0
16/9 to 15/12 16/12 to 15/3 16/3 to 31/3

(ii) (iii) (iv)
Sch OS Income from other Sources
1 Income other than from owning race horse(s):-
OTHER SOURCES
a Dividends, Gross 1a 0
b Interest, Gross 1b 784
c Rental income from machinery, plants, buildings, etc., Gross 1c 0
d Others, Gross (Fill up the Source and the Income Below).
Note: For source other than the available Section Codes in Sl no 3 dropdown and Sl no1, Pl enter description in Sl no 2
Source Income
below. (i) (2)
5BB-Winnings
1 without selecting
Note: Do not enter amount Section from lotteries,Description.
Code/Filling crossword puzzles etc. is mandatory.
1st coumn
2
3
4
5
6
1d Total 0
e Total (1a + 1b + 1c + 1d)

f Income included in 1e chargeable to tax at special rate (to be taken to schedule SI)
i Winnings from lotteries, crossword puzzles, races, games, gambling, betting etc (u/s 115BB) 1fi 0
ii Any other income chargeable to tax at the rate specified under chapter XII/XII-A 1fii 0
iv Income included in 1e chargeable to tax at special rate (1fi +1fii+1fiii) 1fiv 0
g Gross amount chargeable to tax at normal applicable rates (1e-1fiv) 1g 784
h Deductions under section 57 (other than those relating to income under 1fi, 1fii & 1fiii for non-residents)
i Expenses / Deductions hi
ii Depreciation hii
iii Total hiii 0
i Income from other sources (other than from owning race horses and amount chargeable to tax at special rate) (1g hiii) (If negative take the figure to 4i of
schedule CYLA)
2 Income from other sources (other than from owning and maintaining race horses) (1fiv + 1i) (enter 1i as nil if negative)
3 Income from the activity of owning and maintaining race horses
a Receipts 3a
b Deductions under section 57 in relation to (3) 3b
c Balance (3a 3b) (if negative take the figure to 10xi of Schedule CFL)
4 Income under the head Income from other sources (2 + 3c) (take 3c as nil if negative)
NOTE Please include the income of the specified persons referred to in Schedule SPI while computing the income under this head
1e 784
1i
784
2 784
3c 0
4 784
under this head
Schedule CYLA Details of Income after set-off of current years losses
Business Loss Other sources loss (other

Income of current
(other than speculation than loss from owning
year (Fill this column House property loss of
Sl.No Head/ Source of Income loss or specified business loss) of the race horses) of the
only if income is zero the current year set off
current year current year set off
or positive)
set off
Total loss Total loss

Total loss (2v of item E of Schedule BP) (1i of Schedule-OS)
Loss to be setoff -> (3c of Schedule HP)
0 0 0
1 2 3 4
i Salaries 0 0 0
ii House property 0 0 0
Business Income
iii
(excluding speculation
profit and income from
specified business) 280057 0 0
CURRENT YEAR LOSS ADJUSTMENT
iv
Speculative Income 0 0 0
v Specified Business
Income 0 0 0
vi Short-term capital gain

taxable @ 15% 0 0 0 0
vii Short-term capital gain

taxable @ 30% 0 0 0 0
Short-term capital gain
viii taxable @ applicable
rates 0 0 0 0
CURR ix Long term capital gain
taxable @ 10% 0 0 0 0
x Long term capital gain

taxable @ 20% 0 0 0 0
Other sources (excluding
profit from owning race
horses and amount
xi chargeable to special rate
of tax)
784 0 0
Profit from owning and
xii maintaining race horses
0 0 0 0
xiii Total loss set-off 0 0 0
xiv Loss remaining after set-off 0 0 0
Schedule BFLA Details of Income after Set off of Brought Forward Losses of earlier years
Income after set off, if

Brought forward
any, of current years Brought forward loss Brought forward
allowance under section
Sl. losses as per 5 of set off depreciation set off
Head/ Source of Income 35(4) set off
No. Schedule CYLA)
1 2 3 4
i Salaries 0
ii House property 0 0 0 0
Business Income
iii (excluding speculation
profit and income from
specified business) 280057 0 0 0
TMENT
iv
BROUGHT FORWARD LOSS ADJUSTMENT Speculative Income 0 0 0 0
v Specified Business
Income 0 0 0 0
vi Short-term capital gain

taxable @ 15% 0 0 0 0
vii Short-term capital gain

taxable @ 30% 0 0 0 0
Short-term capital gain
viii taxable @ applicable
rates 0 0 0 0
ix Long term capital gain

taxable @ 10% 0 0 0 0
x Long term capital gain

taxable @ 20% 0 0 0 0
Other sources income

xi (excluding profit from
owning and maintaining
race horses and amount
chargeable to special rate
of tax) 784 0 0
xii Profit from owning and

maintaining race horses 0 0 0 0
xiii Total of brought forward loss set off (ii2 + iii2 +

iv2 + v2+vi2+vii2+viii2+ix2+x2+xii2) 0 0 0
xiv
Current years income remaining after set off Total (i5 + ii5 + iii5 + iv5+v5 + vi5 + vii5 + viii5 + ix5 + x5 + xi5 +xii5)
Current years
Income remaining
after set off
5=1-2-3-4
0
0
280057
0
0
784
s of earlier years
Current years
income remaining
after set off
5
0
0
280057
0
784
280841
Schedule CFL Details of Losses to be carried forward to future Years
Sl. Assessment Year Date of House Loss from business other Loss from Loss from Specified Short-term Long-term
No. Filing property loss than loss from speculative business business capital loss Capital loss
(DD/MM/ speculative business and
YYYY) specified business
i 2008-09
CARRY FORWARD OF LOSS
ii 2009-10
iii 2010-11
iv 2011-12
v 2012-13
vi 2013-14
vii 2014-15
viii 2015-16
Total of earlier year
ix 0 0 0 0 0 0
losses b/f
Adjustment of above
x losses in Schedule 0 0 0 0 0 0
BFLA
2016-17 (Current
xi 0 0 0 0 0 0
year losses)
Total loss Carried
xii Forward to future 0 0 0 0 0 0
years
Loss
from owning
and maintaining
race horses
0
Schedule UD Unabsorbed depreciation and allowance under section 35(4)
Depreciation Allowance und

SrNo Assessment Year (2) Amount of brought Amount of depreciation set-off Balance Carried forward to the Amount of brought forward
(1) forward unabsorbed against the current year next year unabsorbed allowance
depreciation income (5) (6)
(3) (4)
1 2016-17
2 0
3 0
4 0
5 0
6 0
7 0
8 0
9 0
Total 0 0 0 0
Allowance under section 35(4)
Amount of allowance set-off Balance Carried forward to the
against the current year income next year
(7) (8)
0
0
0
0
0
0
0
0
0 0
Schedule ICDS Effect of Income Computation Disclosure Standards on profit
Sl. No. ICDS

(i) (ii)
I Accounting Policies
II Valuation of Inventories
III Construction Contracts
IV Revenue Recognition
V Tangible Fixed Assets
VI Changes in Foreign Exchange Rates
VII Government Grants
VIII Securities
IX Borrowing Costs
X Provisions, Contingent Liabilities and Contingent Assets
XI Total Net effect (I+II+III+IV+V+VI+VII+VIII+IX+X)

isclosure Standards on profit
Amount
(iii)
0
Schedule 10A Deduction under section 10A
1 Deductions in respect of units located in Special Economic Zone
Assessment Year Assessment year in which unit begins to Amount of
manufacture/produce deduction
1 Undertaking No.1 (Select)
Total Deductions under Section 10A 0
Schedule 10AA Deduction under section 10AA

DEDUCTION
U/S 10AA
1 Deductions in respect of units located in Special Economic Zone

Assessment year in which unit begins to manufacture/produce Amount of
deduction
Total Deduction Under Section 10AA 0
(Note: If no entry is made in first row then other rows will not be considered)
Schedule 80-IA Deductions under section 80-IA
a Deduction in respect of profits of an undertaking referred to in section 80-IA(4)(ii) [Telecommunication services]
1 Undertaking 1
2 Undertaking 2
b Deduction in respect of profits of an undertaking referred to in section 80-IA(4)(iii) [Industrial park and SEZs]
1 Undertaking 1
2 Undertaking 2
c Deduction in respect of profits of an undertaking referred to in section 80-IA(4)(iv) [Power]
1 Undertaking 1
2 Undertaking 2
d Deduction in respect of profits of an undertaking referred to in section 80-IA(4)(v) [Revival of power generating plant]
and deduction in respect of profits of an undertaking referred to in section 80-IA(4)(vi) [Cross-country natural gas
distribution network]
1 Undertaking 1
2 Undertaking 2
e Total deductions under section 80-IA (a + b + c + d + e) 0
Schedule 80-IB Deductions under section 80-IB
a Deduction in respect of industrial undertaking located in Jammu & Kashmir [Section 80-IB(4)]
1 Undertaking 1
2 Undertaking 2
b Deduction in respect of industrial undertaking located in industrially backward states specified in Eighth Schedule
[Section 80-IB(4)]
1 Undertaking 1
2 Undertaking 2
c Deduction in respect of industrial undertaking located in industrially backward districts [Section 80-IB(5)]
1 Undertaking 1
2 Undertaking 2
d Deduction in the case of multiplex theatre [Section 80-IB(7A)]
1 Undertaking 1
2 Undertaking 2
e Deduction in the case of convention centre [Section 80-IB(7B)]
1 Undertaking 1
2 Undertaking 2
f Deduction in the case of undertaking which begins commercial production or refining of mineral oil [Section 80-IB(9)]
1 Undertaking 1
2 Undertaking 2
g Deduction in the case of an undertaking developing and building housing projects

[Section 80-IB(10)]
1 Undertaking 1
2 Undertaking 2
h Deduction in the case of an undertaking operating a cold chain facility

[Section 80-IB(11)]
1 Undertaking 1
2 Undertaking 2
i Deduction in the case of an undertaking engaged in processing, preservation

and packaging of fruits and vegetables [Section 80-IB(11A)]
1 Undertaking 1
2 Undertaking 2
j Deduction in the case of an undertaking engaged in integrated business of handling, storage and transportation of
foodgrains [Section 80-IB(11A)]
1 Undertaking 1
2 Undertaking 2
k Deduction in the case of an undertaking engaged in operating and maintaining a rural hospital [Section 80-IB(11B)]
1 Undertaking 1
2 Undertaking 2
l Deduction in the case of an undertaking engaged in operating and maintaining a hospital in any area, other than
excluded area [Section 80-IB(11C)
1 Undertaking 1
2 Undertaking 2
m Total deduction under section 80-IB (Total of a to l) 0
Schedule 80-IC or 80-IE Deductions under section 80-IC or 80-IE

1 Deduction in respect of industrial undertaking located in Sikkim
1 Undertaking 1
2 Undertaking 2
2 Deduction in respect of industrial undertaking located in

Himachal Pradesh
1 Undertaking 1
2 Undertaking 2
3 Deduction in respect of industrial undertaking located in Uttaranchal
1 Undertaking 1
2 Undertaking 2
4 Deduction in respect of industrial undertaking located in North-East
a Assam
1 Undertaking 1
2 Undertaking 2
b Arunachal Pradesh
1 Undertaking 1
2 Undertaking 2
c Manipur
1 Undertaking 1
2 Undertaking 2
d Mizoram
1 Undertaking 1
2 Undertaking 2
e Meghalaya
1 Undertaking 1
2 Undertaking 2
f Nagaland
1 Undertaking 1
2 Undertaking 2
g Tripura
1 Undertaking 1
2 Undertaking 2
Total of deduction for undertakings located in North-east (Total of 4a to 4g)

h 0
5 Total deduction under section 80-IC or 80 IE (1 + 2 + 3 + 4h) 0

Schedule VI-A Deductions under Chapter VI-A
1. Part B- Deduction in respect of certain payments System Calculated
a 80C a 0
b 80CCC b 0
c 80CCD(1) c 0
d 80CCD(1B) d 0
e 80CCD(2) e 0
f 80CCG f 0
g 80D g 0
h 80DD h 0
i 80DDB i 0
j 80E j 0
k 80G k 0 0
l 80GG l 0
m 80GGC m 0
DEDUCTIONS
Total Deduction under Part B (total of a to m) 1 0 0

TOTAL
2. Part C- Deduction in respect of certain incomes

n 80IA (e of Schedule80-IA) n 0 0
o 80IAB o 0
p 80IB (m of Schedule 80-IB p 0 0
q 80IC / 80-IE (e of Schedule 80-IC/ 80-IE) q 0 0
r 80ID r 0
s 80JJA s 0
t 80JJAA t 0
u 80QQB u 0
v 80RRB v 0
Total Deduction under Part C (total of n to v) 2 0 0
3. Part CA and D Deduction in respect of certain incomes / other Deductions
w 80TTA w 784 784
x 80U x 0
Total Deduction under Part CA and D (total of w to x) 3 784 784
4 Total Deductions under Chapter VI-A (1 + 2 + 3) 4 784 784
Schedule 80G Details of donations entitled for deduction under section 80G (Please read NOTE below)
A Donations entitled for 100% deduction without qualifying limit
Name of donee Address City or Town or State Code PinCode PAN of Donee Amount of donation
District
1 (SELECT)
2 (SELECT)
3 (SELECT)
4 (SELECT)
Total 80GA 0
B Donations entitled for 50% deduction without qualifying limit

Name of donee Address City or Town or State Code PinCode PAN of Donee Amount of donation
District
1 (SELECT)
2 (SELECT)
3 (SELECT)
4 (SELECT)
Total 80GB : 0
C Donations entitled for 100% deduction subject to qualifying limit

Name of donee Address City Or Town Or State Code PinCode PAN of Donee Amount of donation
District
1 (SELECT)
2 (SELECT)
3 (SELECT)
4 (SELECT)
Total 80GC : 0
D Donations entitled for 50% deduction subject to qualifying limit

Name of donee Address City Or Town Or State Code PinCode PAN of Donee Amount of donation
District
1 (SELECT)
2 (SELECT)
3 (SELECT)
4 (SELECT)
Total 80GD 0
E TOTAL ELIGIBLE AMOUNT OF DONATIONS (AIII + BIII + CIII + DIII) 0
NOTE : IN CASE OF DONEE FUNDS SETUP BY GOVERNMENT AS DESCRIBED IN SECTION 80G(2),

PLEASE USE PAN AS "GGGGG0000G"
Name of Donee must be filled to include the donation in the Total
0G (Please read NOTE below)
Eligible Amount of Donation
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
Schedule SPI Income of specified persons(spouse, minor child etc) includable in income of the assessee (income of the minor child, in excess of Rs. 1,500 per child, to be included)
(income of the minor child, in excess of Rs. 1,500 per child, to be included)
PAN of person
Sl No Name of person Relationship Nature of Income Amount (Rs)
(optional)
1
2
3
4
5
6
0
Please clilck on Recalculate initially, and also subsequently if Gender, Date of Birth , Residential Status or Assessee Status (Indl / HUF etc) is changed (Note "Recalculate button is provided in Sheet P
Schedule SI Income chargeable to Income tax at special rates IB [Please see instruction Number-9 for section code and rate of tax]
Sl Section Special rate Income Taxable Income after System calculated tax
No code (Serial nos other than Sl no 1,2 are autofilled) (%) i adjusting for Min thereon
Chargeable to Tax
111 - Tax on accumulated balance of recognised PF

1
1 0 0 0
2 Chargeable under DTAA rate 1 0 0 0
3 111A (STCG on shares where STT paid) 15 0 #VALUE! #VALUE!
SPECIAL RATE
115AD(1)(b)(ii)- Short term capital gains referred to in

4 section 111A 15 0 0 0
5 112 (LTCG on others) 20 0 #VALUE! #VALUE!
112 proviso (LTCG on listed securities/ units without
6 indexation) 10 0 #VALUE! #VALUE!
SPECIAL
112(1)(c)(iii)(LTCG on unlisted securities in case of non-

7 residents) 10 0 0 0
115A(1)(a)(i)- Dividends interest and income from units
8 purchase in foreign currency 20 0 0 0
115A(1)(a)(ii)- Interest received from govt/Indian Concerns
recived in Foreign Currency
9 20 0 0 0
115A(1) (a)(iia) -Interest from Infrastructure Debt Fund
10 5 0 0 0
11 115A(1) (a)(iiaa) -Interest as per Sec. 194LC 5 0 0 0
12 115A(1) (a)(iiab) -Interest as per Sec. 194LD 5 0 0 0
13 115A(1) (a)(iiac) -Interest as per Sec. 194LBA 5 0 0 0
115A(1) (a)(iii) - Income received in respect of units of UTI
14 purchased in Foreign Currency 20 0 0 0
Para E II of Part I of Ist Sch of FA - Income from royalty or
technical services - Non-domestic company
15 50 0 0 0
115A(1)(b)(A)- Income from royalty & technical services
15 10 0 0 0
115A(1)(b)(B) Income from royalty & technical services
16 10 0 0 0
115AC(1)(a & b) - Income from bonds or GDR purchased in
17 foreign currency - non-resident 10 0 0 0
115AC(1)(c) -LTCG arising from the transfer of bonds or
GDR purchased in foreign currency - non-resident
18 10 0 0 0
115ACA(1)(a) - Income from GDR purchased in foreign
19 currency -resident 10 0 0 0
115ACA(1)(b) - LTCG arising from the transfer of GDR
purchased in foreign currency -resident
20 10 0 0 0
115AD(1)(i) -Income received by an FII in respect of
securities (other than units as per Sec 115AB)
21 20 0 0 0
115AD(1)(i) -Income received by an FII in respect of bonds
or government securities as per Sec 194LD
22 5 0 0 0
115AD(1)(ii) -STCG (other than on equity share or equity
oriented mutual fund referred to in section 111A) by an FII
23 30 0 0 0
24 115AD(1)(iii)-Long term capital gains by an FII 10 0 0 0
115BB (Winnings from lotteries, puzzles, races, games etc.)
25 30 0 0 0
115BBA - Tax on non-residents sportsmen or sports
26 associations 20 0 0 0
27 115BBC - Anonymous donations 30 0 0 0
115BBE - Tax on income referred to in sections 68 or 69 or
28 69A or 69B or 69C or 69D 30 0 0 0
29 115E(a) - Investment income 20 0 0 0
115E(a)-LTCG on any asset other than a specified asset-non
30 resident Indian 20 0 0 0
31 115E(b) - Income by way of long term capital gains 10 0 0 0
Tax at Spl Rate #VALUE!
Schedule IF Information regarding partnership firms in which you are partner

Details of firms in which you are partner
FIRMS IN WHICH
Sl no Name of the Firm PAN of the firm Whether firm is Liable for Whether section 92E is
PARTNER
Audit? (Yes/ No) applicable to firm? (Yes/

No)
1 (Select) (Select)
2 (Select) (Select)
3 (Select) (Select)
4 (Select) (Select)
5 (Select) (Select)
6 (Select) (Select)
is changed (Note "Recalculate button is provided in Sheet PART B - TI - TTI)
Please Click on
Compute Tax button in
Part B TI to re
calculate Tax at
Normal Rate and Tax
at Special Rate
Percentage Amount of Capital balance
Share in the share on 31st March in
profit of the firm in the profit the firm
1 ii
0 0
Schedule AMT Computation of Alternate Minimum Tax payable under section 115JC
1 Total Income as per item 14 of PART-B-TI 280060
2 Adjustment as per section 115JC(2)
ALTERNATE MINIMUM TAX
a Deduction Claimed under any section included in 2a 0

Chapter VI-A under the heading C.Deductions
in respect of certain incomes
b Deduction Claimed u/s 10AA 2b 0

Deduction claimed u/s 35AD as reduced by the
c amount of depreciation on assets on which such 2c
deduction is claimed
d Total Adjustment (2a+ 2b+2c) 2d 0
3 Adjusted Total Income under section 115JC(1) (1+2d) 3 280060
4 Tax payable under section 115JC [18.5% of (3)] (if 3 is greater than 20 lacs) 4 0
Schedule AMTC Computation of tax credit under section 115JD
1 Tax under section 115JC in assessment year 2016-17 (1d of Part-B-TTI) 1
2 Tax under other provisions of the Act in assessment year 2016-17 (2i of Part-B-TTI) 2
3 Amount of tax against which credit is available [enter (2 1) if 2 is greater than 1, otherwise enter 0] 3
4 Utilisation of AMT credit Available (Sum of AMT credit utilized during the current year is subject to maximum of amount mentioned in 3 above and cannot exceed the sum
Brought Forward
S.No Assessment Year AMT Credit Gross AMT Credit Set off in earlier AMT Credit Brought AMT Credit Utilised Balance AMT Credit
(A) (B1) years Forward during the Current Year Carried Forward
AMT CREDIT
(B2) (B3 = B1-B2) (C) (D)= (B3) (C)
i 2013-14 0
ii 2014-15 0
iii 2015-16 0
iv Current AY (enter 1 -2,
if 1>2 else enter 0
v Total 0 0 0 0
5 Amount of tax credit under section 115JD utilised during the year [total of item no 4 (C)] 5
6 Amount of AMT liability available for credit in subsequent assessment years [total of 4 (D)] 6
0
#VALUE!
#VALUE!
ct to maximum of amount mentioned in 3 above and cannot exceed the sum of AMT Credit
Balance AMT Credit

Carried Forward
(D)= (B3) (C)
0
0
0
0
0
0
0
Schedule EI Details of Exempt Income (Income not to be included in Total Income)
1 Interest income 1
2 Dividend income 2
3 Long-term capital gains from transactions on which Securities Transaction Tax is paid 3
EXEMPT INCOME
4 i Gross Agricultural receipts (other than income to be excluded under rule 7A, 7B i
or 8 of I.T. Rules)
ii Expenditure incurred on agriculture ii
iii Unabsorbed agricultural loss of previous eight assessment years iii
iv Net Agricultural income for the year (i ii iii) (enter nil if loss) 4 0
5 Others, (including exempt income of minor child) 5
6 Total (1+2+3+4+5) 6 0
Schedule PTI Pass Through Income details from business trust or investment fund as per section 115UA, 115UB
Name of business trust/ PAN of the business trust/
Sl. Sl. Head of income
investment fund investment fund
1 i House property
ii Capital Gains
a
b
iii Other Sources
iv Income claimed to be exempt
a
b
c
2 i House property
ii Capital Gains
a
b
iii Other Sources
iv Income claimed to be exempt
a
b
c
NOTE Please refer to the instructions for filling out this schedule.
er section 115UA, 115UB
ead of income Amount of income
ouse property
apital Gains
Short term
Long term
her Sources
come claimed to be exempt
u/s 10(23FBB)
u/s
u/s
ouse property
apital Gains
Short term
Long term
her Sources
come claimed to be exempt
u/s 10(23FBB)
u/s
u/s
TDS on such amount, if any
FSI Details of Income from outside India and tax relief
Sr No Country Code Taxpayer Identification Sr No Head of Income
(Note : If no entry is number
made in this column,
then other columns will
not be considered for
that row)
(a)
1 (Select) i Salary
ii House Property
iii Business Income
iv Capital Gains
v Other Sources
Total
2 (Select) i Salary
ii House Property
iii Business Income
iv Capital Gains
v Other Sources
Total
3 (Select) i Salary
ii House Property
iii Business Income
iv Capital Gains
v Other Sources
Total
Income from Tax paid outside Tax payable on Tax relief available Relevant article of
outside India India such income under in India DTAA if relief
(included in PART normal provisions (e=lower of c and claimed u/s 90 or
B-TI) in India d) 90A
(d) (e )
(b) (c) (f)
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
(Note : If no entry is made in the Country Code column, then other columns will not be considered for that row)
Schedule TR Summary of tax relief claimed for taxes paid outside India
1 Details of Tax relief claimed
Country Code Tax Identification number Total taxes paid outside Total tax relief available
India (total of (e) of Schedule FSI in
(total of (c) of Schedule FSI respect of each country)
in
(b) respect of each country) (d)
(a) (c)
0 0
2 Total Tax relief available in respect of country where DTAA is applicable (section 90/90A) (Part of total of 1(d))
3 Total Tax relief available in respect of country where DTAA is not applicable (section 91) (Part of total of 1(d))
4 Whether any tax paid outside India, on which tax relief was allowed in India, has been refunded/credited by the foreign tax authority during the y
a details
Amountbelow
of tax refunded b) Assessment year in which tax relief allowed in India
Schedule FA Details of Foreign Assets and Income from any source outside India
NOTE : This Schedule is not Applicable for NRI \(Non Resident Indians) as per Reseidential Status
A Details of Foreign Bank Accounts held (including any beneficial interest) at any time during the previous year
Sr No Country Name & Code Name of the Bank Address of the Bank Account Holder Name
(1) (2) (3) (4)
1
2
3
4
5
6
B Details of Financial Interest in any Entity held (including any beneficial interest) at any time during the previous year
Sr No Country Name and Code Nature of entity Name of the Entity Address of the Entity
(1) (2) (3) (3)
1
2
3
4
5
6
C Details of Immovable Property held (including any beneficial interest) at any time during the previous year
Sr No Country Name & Code Address of the Property Ownership- Date of acquisition
Direct/ Beneficial owner/
Beneficiary
(2)
(1) (3) (4)
1
2
3
4
5
6
D Details of any other Capital Asset held (including any beneficial interest) at any time during the previous year
Sr No Country Name & Code Nature of Asset Ownership- Date of acquisition
Direct/ Beneficial owner/
Beneficiary
(1) (2) (3) (4)
1
2
3
4
5
6
E Details of account(s) in which you have signing authority held (including any beneficial interest) at any time during the previous year and which has not been include
Sr No Name of the Institution in which the Address of the Institution Name of the Account Account Number
account is held Holder
(Note : If no entry is made in this
column, then other columns will not be
considered for that row)
(1) (2)
(3) (4)
Sr No Name of the Institution in which the Address of the Institution Name of the Account Account Number
account is held Holder
(Note : If no entry is made in this
column, then other columns will not be
considered for that row)
(1) (2)
(3) (4)
1
2
3
4
5
6
F Details of trusts, created under the laws of a country outside India, in which you are a trustee, beneficiary or settlor
Sr No Country Name & Code Name of the trust Address of the trust Name of Other trustees
(1) (2) (3) (4)
1
2
3
4
5
6
G Details of any other income derived from any source outside India which is not included in,- (i) items A to F above and, (ii) income under the head business or profess
Sr No Country Name & Code Name of the Person Address of the Person Income derived
(3)
(1) (2) (4)
1
2
3
4
5
6
Please refer to instructions for filling out this schedule. In case of an individual, not being an Indian citizen, who is in India on a business, employment or student visa
NOTE
schedule if no income is derived from that asset during the current previous year.
Section under which
relief claimed
(specify 90, 90A or 91)
(e)
0
0
ax authority during the year? If yes, provide the (Select)
Status- Account Number Account opening date Peak Balance Interest accrued in Interest taxable and offered in this return
Owner/ Beneficial owner/ Beneficiary during the year (in the account
Rupees) Amount Schedule where
offered
(5) (7) (8) (9)
(6) (10) (11)
Nature of Interest- Date since held Total Investment (at cost) Income accrued Nature of Income Income taxable and offered in this return
Direct/ Beneficial owner/ Beneficiary (in rupees) from such Interest Amount Schedule where
offered
(4) (7) (8)
(5) (6) (9) (10)
Total Investment (at cost) (in rupees) Income derived from the Nature of Income Income taxable and offered in this return
property Amount Schedule where Item number of
offered schedule
(5)
(6) (7) (8) (9) (10)
Total Investment (at cost) (in rupees) Income derived from the Nature of Income Income taxable and offered in this return
asset Amount Schedule where Item number of
offered schedule
(5)
(6) (7) (8) (9) (10)
hich has not been included in A to D above.

Peak Balance/Investment during the Whether income accrued is If (6) is yes, Income If (6) is yes, Income offered in this return
year (in rupees) taxable in your hands? accrued in the account
(6) (7)
(5)
Peak Balance/Investment during the Whether income accrued is If (6) is yes, Income
year (in rupees) taxable in your hands? accrued in the account Amount Schedule where Item number of
offered schedule
(6) (7)
(5) (8) (9) (10)
Address of Other trustees Name of Settlor Address of Settlor Name of Address of Date since position Whether income
Beneficiaries Beneficiaries held derived is taxable in
your hands?
(5) (6) (7) (8) (9) (10) (11)

head business or profession
Nature of income Whether taxable in your If (6) is yes, Income offered in this return
hands? Amount Schedule where Item number of
offered schedule
(5) (6) (7) (8) (9)
mployment or student visa, an asset acquired during any previous year in which he was non-resident is not mandatory to be reported in this
Interest taxable and offered in this return
Item number of
schedule
(12)
Income taxable and offered in this return
Item number of
schedule
(11)
If (11) is yes, If (11) is yes, Income offered in this return
Income derived
from the trust
Amount Schedule Item number
where offered of schedule
(12)
Schedule 5A Information regarding apportionment of income between spouses governed by Portuguese Civil Code
Name of the Spouse
PAN of the Spouse
Heads of Income Income received under the head Amount apportioned in the Amount of TDS deducted on
(i) hands of the spouse income at (ii)
(ii) (iii)
1 House Property 1
2 Business or profession 2
3 Capital Gains 3
4 Other Sources 4
5 Total (1+2+3+4) 5 0 0 0
uguese Civil Code
TDS Apportioned In the hands of

spouse
(ii)
0
Schedule AL Asset and Liability at the end of the year (other than those included in Part A BS) (Applicable in a case where total income exceeds Rs. 50 lakh)
A Particulars of Asset Amount (Cost) (Rs.)

1 Immovable Asset
a Land 1a
DETAILS OF ASSET AND LIABILTY
b Building 1b
2 Movable Asset
a Financial Asset
i Bank (including all deposits) 2ai
ii Shares and securities 2aii
iii Insurance policies 2aiii
iv Loans and Advances given 2aiv
v Cash in hand 2av
b Jewellery, bullion etc. 2b
Archaeological collections, drawings, painting, sculpture or any work of 2c
c
art
d Vehicles, yachts, boats and aircrafts 2d
3 Total 3 0
B Liability in relation to Assets at A B
Schedule No of entries
QUANTITATIVE_DETAILS-a 0
QUANTITATIVE_DETAILS-b 0
QUANTITATIVE_DETAILS-c 0
SCHEDULE S 0
HOUSE_PROPERTY 0
10A 0
10AA 0
TDS1 0
TDS2 1
TDS3 0
Please verify the following schedules / sheets whichever showing up as empty, whether they are optional, not filled, or are they actua
Nature of Business Filled
Schedule DPM Empty
Schedule DOA Empty
Schedule ESR Empty
Tax payment Amount Verification

Schedule Amount
IT 0
TDS1 0
TDS2 18930
TDS3 0
TCS 0
VERIFICATION DETAILS
Name VENKATESAN GOMATHI
Son / daughter of ANANDHAN
Place 0
Date 08/04/2017
PAN BCXPG9360F
Schedule No of entries
80G-A 0
80G-B 0
80G-C 0
80G-D 0 1. Validate against each schedule the count of no of
SI 0 entries.
IF 0
IT 0
TCS 0 2. This is required to confirm that the total no of entries
SPI 0 entered per schedule is valid and being generated in the
final XML
y are optional, not filled, or are they actually empty

Schedule CFL Empty
Schedule 80 IA Empty 3. In case this count does not match to the entered
Schedule 80 IB Empty number of entries, you may recheck the schedules, refer
to instructions for filling up tables, and ensure that all
Schedule 80 IC Empty entries are valid and completely entered.
Schedule EI Empty
4. Once this sheet is validated, you 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
Do not leave blank rows in between
Even when a sheet/schedule is filled

the status reflects as 'Empty"
Certain schedules are optional.
Hence users may not fill them and
the utility reflects them as Empty
Even optional schedules, if applicable
have rules for filling.
The mandatory fields required
for an optional schedule cannot be left
blank.

2016 Itr4 PR7

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S.

4 Profit and Loss

Schedules for filing Income Tax Return

Personal Info., Filing Status, Audit Info

Tax Payments(TDS1, TDS2, TDS3)

Schedule DEP, Schedule DCG

Schedule CYLA, Schedule BFLA

Schedule SPI, Schedule SI, Schedule IF

Details of Personal Information and filing status

BALANCE SHEET AS ON 31ST DAY OF MARCH, 2016(fill items 1 to 5 in a case where

Summary of depreciation on assets, Deemed Capital Gains on sale of depreciable assets

Flat / Door / Block No Name of Premises / Building / Village Status (I-Individual,H-H

Road / Street / Post Office Area / Locality Date of birth (DD/MM/Y

Passport No. (Individual) (If available)

a Name of the representative assessee

a Date of furnishing of the audit (DD/MM/YYYY)

S.NO Section Code Date DD/MM/YYYY

Date of birth (DD/MM/YYYY)

INDICATE THE THREE MAIN ACTIVITIES/ PRODUCTS

c Total proprietors fund (a + bv) 1c 1073827

iii Cash and Bank Balances

D Other Provisions iiD

following information as on 31st day of March, 2016, in respect of business or profession)

a Amount of total sundry debtors 6a

i Union Excise duties i

iii VAT/ Sales tax iii

ii Life Insurance 15ii

vi Total rates and taxes paid or payable (36i+36ii+36iii+36iv+36v) 36vi 0

iii Others (amounts less than Rs. 1 lakh) iii

47 Provision for Deferred Tax and deferred Liability 47

48 Profit after tax (45 46 47) 48 280057

50 Amount available for appropriation (48 + 49) 50 280057

information for previous year 2015-16 in respect of business or profession

a Gross receipts 53a

c Is there any change in stock valuation method (Select) 4c No

5 Amounts not credited to the profit and loss account, being

b Premium paid for insurance on the health of employees [36(1)(ib)] 6b

d Any amount of interest paid in respect of borrowed capital [36(1)(iii)] 6d

l Amount of bad and doubtful debts [36(1)(vii)] 6l

f Any other penalty or fine 7f

h Amount of any liability of a contingent nature 7h

c Amount disallowable under section 40(a)(iii) on account of non-compliance with the Ac

g Amount of interest, salary, bonus, commission or remuneration paid to any partner or Ag

c Provision for payment of gratuity [40A(7)] 9c

e Any other disallowance 9e

f Any sum payable towards leave encashment 11f

(b) In the case of a manufacturing concern - Raw Materials

(C) In the case of a manufacturing concern -Finished Products/By-products

3 Profits and gains from business or profession

iv Total short-term (4ai + 4aii + 4aiii) 4aiv 0

c Total (13a + 13b) [limited upto (10-11)] 13c

Part B - TTI Computation of tax liability on total income

d Tax Payable on Total Income (2a + 2b-2c) 2d

c Section 91 ( 3 of Schedule TR) 6c 0

a Advance Tax (from column 5 of 18A ) 10a 0

a. Bank Account in which refund, if any, shall be credited

Place PALLIPALAYAM Sign here

Tax Deduction Account

Tax Deduction Account

Amount out of (6) being claimed

Amount out of (5) or (6) being

salary as they are shown separately below) 1

ADDRESS OF PROPERTY (NOTE :