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INDIAN INCOME TAX RETURN

Assessment
FORM

ITR-1
SAHAJ [For individuals being a resident other than not ordinarily resident having Income from Salaries, one house property, other Year
sources (Interest etc.) and having total income upto Rs.50 lakh] (Refer instructions for eligibility) 2 0 18 - 1 9

First Name Middle Name Last Name PAN

Aadhaar Number [12 Digits]


[Please enter the Aadhaar Number which is linked for your PAN in e-Filing portal]
PART A GENERAL INFORMATION

Aadhaar Enrolment Id [28 Digits]


[Note: If Aadhaar Number is not yet allotted, then Aadhaar Enrolment Id is required. All the digits in enrolment ID & Date and time of
enrolment to be entered continuously. For example Enrolment ID: 1234/12345/12345 & Date/Time of enrollment: 01/12/2016 11:50:22 to
be entered as 1234123451234501122016115022]

Flat / Door / Block No. Name of Premises / Building / Village Date of Birth

Road / Street/ Post Office Area / Locality Town/ City/ District

State Country Pincode No Zip Code Zip Code

(Select) (Select)
Email Address Mobile No. Employer Category Return filed

(Select) (Select)
Are you Person governed by Portuguese Civil Code as per section 5A ? Yes, fill PAN of the Whether Original or
No Revised return? (Select)
Spouse

If Revised/Defective, then Enter Receipt Number of


Date of Filing Original Return
Original Return
Notice No (Where the Original Return filed was If filed in response to a notice u/s
defective and a notice is issued to the assessee to file a 139(9)/142(1)/148/153A/153C
fresh return Sec 139(9) enter date of such notice

i Salary (excluding all allowances, perquisites and profit in lieu of salary)


SALARY / PENSION

ii Allowances not exempt

iii Value of perquisites


1
iv Profits in lieu of salary

v Deduction u/s 16

vi Income chargeable under the Head ‘Salaries’ (i+ii+iii+iv-v) 0

Type of House Property (Select)

i Gross rent received/ receivable/ letable value


HOUSE PROPERTY

ii Tax paid to local authorities

iii Annual Value (i – ii) 0


2
iv 30% of Annual Value 0

v Interest payable on borrowed capital

Income chargeable under the head ‘House Property’ (iii – iv – v)


vi 0
Note : Maximum Loss from House property that can be set-off is INR 2,00,000.

3 Income from Other Sources (Ensure to Fill "Sch TDS2")

Gross Total Income (If loss, put the figure in negative) (1+2+3)
4 0
Note: To avail the benefit of carry forward and set off of loss, please use ITR-2
5 Deductions under Chapter VI A (Section) System Calculated
80 C - Life insurance premia, deferred annuity, contributions to
a provident fund, subscription to certain equity shares or 5a 0
debentures, etc.
b 80 CCC - Payment in respect Pension Fund 5b 0
80 CCD (1) - Contribution to pension scheme of Central
c Government 5c 0
80 CCD(1B) - Contribution to pension scheme of Central
d 5d 0
Government by employee
80 CCD (2) - Contribution to pension scheme of Central
e Government by employer 5e 0

f 80 CCG - Investment made under an equity savings scheme 5f 0

80 D - Health insurance
g (Select) 5g 0
premium
80 DD - Maintenance
including medical
treatment of a
DEDUCTIONS

h (Select) 5h 0
dependant who is a
person with disability

80 DDB - Medical
i treatment of specified (Select) 5i 0
disease
j 80 E - Interest on loan taken for higher education 5j 0
k 80 EE - Interest on loan taken for residential house property 5k 0
l 80 G - Donations to certain funds, charitable institutions, etc 5l 0 0
m 80 GG - Rent paid 5m 0
80 GGA - Certain donations for scientific research or rural
n 5n 0
development
o 80 GGC - Donation to Political party 5o 0
p 80 QQB - Royalty income of authors of certain books. 5p 0
q 80 RRB - Royalty on patents 5q 0
r 80 TTA - Income from Interest on saving bank Accounts 5r 0
80 U - In case of a
s person with disability. (Select) 5s 0

6 Total Deductions (Total of 5a to 5s) 6 0 6 0


7 Total Income (4 - 6) 7 0
8 Tax Payable on Total Income 8 0
9 Rebate u/s 87A 9 0
10 Tax Payable After Rebate (8-9) 10 0
11 Cess on (10) 11 0
12 Total Tax and Cess (10+11) 12 0
13 Relief u/s 89(1) (Please ensure to submit Form 10E) 13
14 Balance Tax after Relief (12-13) 14 0
a Interest u/s 234 A 15a 0
b Interest u/s 234 B 15b 0
15
c Interest u/s 234 C 15c 0
d Fee u/s 234F 15d 0
16 Total Interest Payable (15a + 15b + 15c+15d) 16 0

17 Total Tax , Fee and Interest (14 + 16) 17 0


18 Details of Tax Deducted at Source from SALARY [As per FORM 16 issued by Employer(s)]
TDS1

Tax Deduction
Income chargeable
SI.No Account Number Name of Deductor Total Tax Deducted
under Salaries
(TAN) of the Deductor

(1) (2) (3) (4)


1
2
3
4
Total 0 0
(Do Not Delete Blank Rows)

19 Details of Tax Deducted at Source from Income OTHER THAN Salary [As per FORM 16 A issued by Deductor(s)]
TDS2
SI.No
Tax Deduction
Amount which is Year of tax Amount out of (5) claimed
Account Number Name of the Deductor Tax Deducted
subject to tax deduction deduction this Year
(TAN) of the Deductor

(1) (2) (3) (4) (5) (6)


1 (Select)
2 (Select)
3 (Select)
4 (Select)
Total 0
(Do Not Delete Blank Rows)

20 Details of Tax Deducted at Source [As per 26QC furnised by the Deductor(s)]
TDS3
SI.No
Permanent Account
Amount which is Year of tax Amount out of (5) claimed
Number (PAN) of the Name of the Tenant Tax Deducted
subject to tax deduction Deduction this Year
Tenant

(1) (2) (3) (4) (5) (6)


1 (Select)
2 (Select)
3 (Select)
4 (Select)
0
Total
(Do Not Delete Blank Rows)

21 IT Details of Advance Tax and Self Assessment Tax


Date of Deposit Serial Number of
BSR Code Tax Paid
Sl.No (DD/MM/YYYY) Challan
(1) (2) (3) (4)
1
2
3
4
Total 0
(Do Not Delete Blank Rows)
22
DETAILS OF TAX COLLECTED AT SOURCE [AS PER FORM 27D ISSUED BY THE COLLECTOR(S)]
TCS
Amount which is
Tax Collection Account Year of tax
SI.No Name of the Collector subject to tax
Number of the Collector Collection
collection

(1) (2) (3) (4)


1 (Select)
2 (Select)
3 (Select)
4 (Select)
5 (Select)
TOTAL
LLECTOR(S)]

Amount out of (5) being


Tax Collected
claimed this Year

(5) (6)

0
Total Taxes Paid
23 PLEASE NOTE THAT CALCULATED FIELDS (IN WHITE) ARE PICKED UP FROM OTHER SCHEDULES AND ARE NOT TO BE ENTERED. For ex :
The taxes paid figures below will get filled up when the Schedules linked to them are filled.
a Total Advance Tax Paid (from item 21) 0
TAXES PAID

b Total TDS Claimed (Total from item 18 + item 19 + item 20) 0

c Total TCS Claimed (Total from item 22) 0

d Total Self Assessment Tax Paid (from item 21) 0


24 Total Taxes Paid (22a+22b+22c+22d) 0
25 Amount Payable (17-24) (if 17 is greater than 24) 0
26 Refund (24-17) (if 24 is greater than 17) 0
27 Exempt income (For reporting Purposes)
a Sec.10(38) (Exempted Long term Capital Gains)
b Sec.10(34) (Exempted Dividend Income)
c Agriculture Income (≤ Rs.5000)
d Others
Sl.No Nature of Income Description ( If 'Any Other' selected) Amount
1 (Select) NA
2 (Select) NA
3 (Select) NA

(Do Not Delete Blank Rows)

e Total Amount 0
(i) Details of all Bank Accounts held in India at any time during the previous year (excluding dormant accounts)
a) Bank Account in which refund, if any, shall be credited
E- OTHER INFORMATION

Account Number
Sl.No IFS Code of the Bank Name of the Bank

1
PART E- OTHER INFORMA

b) Other Bank account details

Account Number
Sl.No IFS Code of the Bank Name of the Bank

2
3
4

(Do Not Delete Blank Rows)

VERIFICATION
I, son/daughter of
solemnly declare that to the best of my knowledge and belief, the information given in the return is correct and complete and is in accordance with the provisions
of the Income-tax Act, 1961. I further declare that I am making this return in my capacity as and I am also competent to make
this return and verify it. I am holding permanent account number

Place Date

28 If the return has been prepared by a Tax Return Preparer (TRP) give further details below:
Identification No. of TRP
Name of TRP
If TRP is entitled for any reimbursement from the Government, amount thereof
Details of donations entitled for deduction under section 80G (PLEASE READ NOTE BELOW)
Schedule 80G
(Instructions for correct calculation of 80G)

Donations entitled for 100% deduction without qualifying limit


A
If no entry is made in Name of Donee, then for such rows, any value entered in other columns will be ignored from 80GA to 80GD
City or Town or Eligible Amount
Name of donee Address State Code Pincode PAN of Donee Amount of donation
District of Donation
1 (Select) 0
2 (Select) 0
3 (Select) 0
4 (Select) 0

Total 80GA 0 0

(Do Not Delete Blank Rows)

B Donations entitled for 50% deduction without qualifying limit

City or Town or Eligible Amount


Name of donee Address State Code Pincode PAN of Donee Amount of donation
District of Donation
1 (Select) 0
2 (Select) 0
3 (Select) 0
4 (Select) 0

Total 80GB : 0 0

(Do Not Delete Blank Rows)

C Donations entitled for 100% deduction subject to qualifying limit

City Or Town Eligible Amount


Name of donee Address State Code Pincode PAN of Donee Amount of donation
Or District of Donation
1 (Select) 0
2 (Select) 0
3 (Select) 0
4 (Select) 0

Total 80GC : 0 0

(Do Not Delete Blank Rows)

D Donations entitled for 50% deduction subject to qualifying limit


City Or Town Eligible Amount
Name of donee Address State Code Pincode PAN of Donee Amount of donation
Or District of Donation
1 (Select) 0
2 (Select) 0
3 (Select) 0
4 (Select) 0

Total 80GD 0 0

(Do Not Delete Blank Rows)

E Donations (A + B + C + D) 0 0

NOTE : IN CASE OF DONEE FUNDS SETUP BY GOVERNMENT AS DESCRIBED IN SECTION 80G(2),


PLEASE USE PAN AS "GGGGG0000G".

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