INDIAN INCOME TAX RETURN

[For individuals being a resident (other than not ordinarily resident) having total income upto Rs.50 lakh, having Income from Salaries, one house property, Assessment
FORM

ITR-1
SAHAJ
other sources (Interest etc.), and agricultural income upto Rs.5 thousand] Year
[Not for an individual who is either Director in a company or has invested in unlisted equity shares]
(Refer instructions for eligibility) 2 0 19 - 20

First Name Middle Name Last Name PAN

Aadhaar Number [12 Digits]

Aadhaar Enrolment Id
PART A GENERAL INFORMATION

[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 enrolment: 01/12/2016 11:50:22 to be entered as 1234123451234501122016115022]

Flat / Door / Block No. Name of Premises / Building / Village Date of Birth (DD/MM/YYYY)

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

State Country Pincode Nature of Employment

(Select) INDIA (Select)
Mobile Number Filed u/s OR Filed in response to notice u/s
Email Address ●

91 139(1)-On or before due date

If revised/defective

Receipt Number Date of Filing Original Return

If filed in response to notice u/s 139(9)/142(1)/148/153A/153C or order u/s 119(2)(b)-

Unique Number Date of such Notice or Order
i Gross Salary (ia + ib + ic) 0
SALARY / PENSION

a Salary as per section 17(1)

b Value of perquisites as per section 17(2)

c Profits in lieu of salary as per section 17(3)

ii Less : Allowances to the extent exempt u/s 10 (Ensure that it is included in salary income u/s 17(1)/17(2)/17(3) ) 0
Sl.No. Nature of Exempt Allowance Description ( If 'Any Other' selected) Amount
 1 1 (Select) Not Applicable

2 (Select) Not Applicable

iii Net Salary (i – ii) 0

iv Deductions u/s 16 (iva + ivb + ivc) 0
a Standard Deduction u/s 16(ia) 0
b Entertainment Allowance u/s 16(ii)
c Professional Tax u/s 16(iii)
v Income chargeable under the Head ‘Salaries’ (iii-iv) 0

Type of House Property (Select)

i Gross rent received/ receivable/ letable value during the year

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

vi Arrears/Unrealized Rent received during the year Less 30%

Income chargeable under the head ‘House Property’ (iii – iv – v )+ vi
vii Note : Maximum Loss from House property that can be set-off is INR 2,00,000. To avail the benefit of carry forward and set off of loss, please use ITR- 0
2"
Income from Other Sources 0

Sl.No. Nature of Income Description ( If 'Any Other' selected) Amount

3 1 (Select) Not Applicable

2 (Select) Not Applicable

Less: Deduction u/s 57(iia) (In case of family pension only)

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 Part C – Deductions and Taxable Total Income (Refer instructions for Deduction limit as per Income-tax Act) Amount System Calculated

80C - Life insurance premia, deferred annuity, contributions to provident

a 5a 0
fund, subscription to certain equity shares or debentures, etc.

b 80CCC - Payment in respect Pension Fund 5b 0

c 80CCD(1) - Contribution to pension scheme of Central Government 5c 0

d 80CCD(1B) - Contribution to pension scheme of Central Government 5d 0

80CCD(2) - Contribution to pension scheme of Central Government by

e 5e 0
employer

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

80D

a) Health insurance
(Select) 5ga 0
premium
g
b) Medical expenditure (Select) 5gb
DEDUCTIONS

c) Preventive health
(Select) 5gc
check-up
80DD - Maintenance
including medical
h treatment of a dependent (Select) 5h 0
who is a person with
disability
80DDB - Medical
i treatment of specified (Select) 5i 0
disease
j 80E - Interest on loan taken for higher education 5j 0
k 80EE - Interest on loan taken for residential house property 5k 0
l 80G - Donations to certain funds, charitable institutions, etc. 5l 0 0
m 80GG - Rent paid 5m 0
0
n 80GGA - Certain donations for scientific research or rural development 5n 0

o 80GGC - Donation to Political party 5o 0

p 80TTA - Interest on deposits in savings Accounts 5p 0
q 80TTB- Interest on deposits in case of senior citizens 5q 0
80U - In case of a person
r (Select) 5r 0
with disability
6 Total Deductions (Total of 5a to 5r) 6 0 6 0
7 Total Income (4 - 6) 7 0
 Exempt Income: For reporting purpose
Sl.No. Nature of Income Description ( If 'Any Other' selected) Amount

1 (Select) Not Applicable

2 (Select) Not Applicable

Total Exempt Income 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 Health and Education Cess @4% on (10) 11 0
12 Total Tax &Cess (10+11) 12 0
13 Relief u/s 89(1) 13
14 Balance Tax after Relief (12-13) 14 0
Interest u/s 234 A 15a 0
Interest u/s 234 B 15b 0
15
Interest u/s 234 C 15c 0
Fee u/s 234F 15d 0
16 Total Interest, Fee 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

19
Details of Tax Deducted at Source from Income OTHER THAN Salary [As per FORM 16 A issued by Deductor(s)]
TDS2

Tax Deduction
Gross receipt which is Year of tax TDS Credit out of (5)
SI.No. Account Number Name of the Deductor Tax Deducted
subject to tax deduction deduction claimed this Year
(TAN) of the Deductor

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

1 (Select)
2 (Select)
3 (Select)
4 (Select)
Total 0
 20
TDS3 Details of Tax Deducted at Source [As per Form 16C furnished by the Payer(s)]

Permanent Account
Gross receipt which is Year of tax TDS Credit out of (5)
SI.No. Number (PAN) of the Name of the Tenant Tax Deducted
subject to tax deduction Deduction claimed this Year
Tenant

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

1 (Select)
2 (Select)
3 (Select)
4 (Select)
Total 0

21 IT Details of Advance tax and Self Assessment tax payments

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
 22
DETAILS OF TAX COLLECTED AT SOURCE [AS PER FORM 27D ISSUED BY THE COLLECTOR(S)]
TCS
Gross payment
Tax Collection Account Year of tax TCS Credit out of (5) being
SI.No. Name of the Collector which is subject to Tax Collected
Number of the Collector Collection claimed this Year
tax collection

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

1 (Select)
2 (Select)
3 (Select)
4 (Select)
Total 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 :
TAXES PAID

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
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 (23a+23b+23c+23d) 0
25 Amount Payable (17-24) (if 17 is greater than 24) 0
26 Refund (24-17) (if 24 is greater than 17) 0
(i) Details of all Bank Accounts held in India at any time during the previous year (excluding dormant accounts)
Sl.No. IFS Code of the Bank Name of the Bank Account Number Select Account for Refund Credit
1
2

NOTE:
1.Minimum one account should be selected for refund credit
2.In case of Refund, multiple accounts are selected for refund credit, then refund will be credited to one of the account decided by CPC after processing the return

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 (Select) and I am also competent to make

this return and verify it. I am holding Permanent Account Number

Date (System Date) 29/07/2019 Place
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
NOTE :
1. Submission date is the system date of e-Filing portal of Income Tax Department. The same is available in the Acknowledgement/ITR-V generated after submission of
return.
2. Verification Date is the date of e-Verification at e-Filing portal of Income Tax Department or the date of receipt of ITR-V at CPC, Bengaluru. The same will be available in
View Returns/Forms option of e-Filing portal. In case of e-Verification, it is available in Acknowledgement
NOTE :
1. Submission date is the system date of e-Filing portal of Income Tax Department. The same is available in the Acknowledgement/ITR-V generated after submission of
return.
2. Verification Date is the date of e-Verification at e-Filing portal of Income Tax Department or the date of receipt of ITR-V at CPC, Bengaluru. The same will be available in
View Returns/Forms option of e-Filing portal. In case of e-Verification, it is available in Acknowledgement
 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
Amount of donation
City or Town or Eligible Amount
Sl.No. Name of donee Address State Code Pincode PAN of Donee Donation in other
District Donation in cash Total Donation of Donation
mode
1 (Select) 0 0
2 (Select) 0 0
3 (Select) 0 0
4 (Select) 0 0

Total A 0 0 0 0

(Do Not Delete Blank Rows)

B Donations entitled for 50% deduction without qualifying limit

Amount of donation
City or Town or
Sl.No. Name of donee Address State Code Pincode PAN of Donee Donation in other Eligible Amount
District Donation in cash Total Donation
mode of Donation
1 (Select) 0 0
2 (Select) 0 0
3 (Select) 0 0
4 (Select) 0 0

Total B 0 0 0 0

(Do Not Delete Blank Rows)

C Donations entitled for 100% deduction subject to qualifying limit
Amount of donation
City Or Town Eligible Amount
Sl.No. Name of donee Address State Code Pincode PAN of Donee Donation in other
Or District Donation in cash Total Donation of Donation
mode
1 (Select) 0 0
2 (Select) 0 0
3 (Select) 0 0
4 (Select) 0 0

Total C 0 0 0 0

(Do Not Delete Blank Rows)

D Donations entitled for 50% deduction subject to qualifying limit

Amount of donation
City Or Town Eligible Amount
Sl.No. Name of donee Address State Code Pincode PAN of Donee Donation in other
Or District Donation in cash Total Donation of Donation
mode
1 (Select) 0 0
2 (Select) 0 0
3 (Select) 0 0
4 (Select) 0 0

Total D 0 0 0 0

(Do Not Delete Blank Rows)

E Donations (A + B + C + D) 0 0 0 0
NOTE : IN CASE OF DONEE FUNDS SETUP BY GOVERNMENT AS DESCRIBED IN SECTION 80G(2),
PLEASE USE PAN AS "GGGGG0000G".
Schedule 80GGA Details of donations for scientific research or rural development
Amount of donation
Relevant Clause under which City or Town Eligible Amount
Sl.No. Name of Donee Address State Code Pincode PAN of donee Donation in
deduction is claimed or District Donation in cash Total Donation of Donation
other mode
1 (Select) 0 0
2 (Select) 0 0
3 (Select) 0 0
4 (Select) 0 0

Total Donation 0 0 0 0

(Do not delete blank rows)