Prepare Income Tax , With Salary Statement, ITR-I, Form 16, FOR Financial YEAR 2010-11.

This Calculation sheet for Private concern Employees

For Contact :- pranab.banerjee83@gmail.com, bpranab78@yahoo.com OR Contact No. 9474316768 ,
8906279547 This Software's Cost Rs. 525/-
if any discripency is arise for FIRST NAME
calculation of income tax by This New I T R - I(SARAL II),For Assessment Year 2011-
this software,I am not MIDDLE NAME Kumar
2012,which recent published by the MINISTRY OF
responisible for that LAST NAME Bandyopadhyay FINANCE(Deptt.of Revenue)Central Board of Taxes,New
Delhi. Notification Dated 23/04/2010 in the Gazette of India
pranab banerjee DESIGNATION Snr.Accountant Extraordinary,Part-II, Section 3,(Sub Sec(ii)]
Employee's Permanent A/C No.(PAN NO) JKLK0555 K

Gender ( Male or Female ) Male

If you Handicapped Employee Pl.
No
DATE OF BIRTH 1/1/1963 put "Yes" If General put "No"

EMPLOYEE'S RESIDENTIAL ADDRESS

Flat/Door/Block No.
This Software's Cost Village Kualalampur

Rs. 525/- Post Office: Kualalampur First your Fill the Pay Sheet ,
Area/Locality: Kualalampur
If you live in Rented house of Metro City OR Othrs City Type
No
Yes ,else Type No After
District: Utta Dinazpur you fill this Bio Data Sheet
UPDATE

PIN CODE:
CLICK DON'T
742125

State: West Bengal

Designation of Assessing Officer( Ward/Circle) 11

Date of Submit this RETURN 31/3/2010

Office Address
STATUS- Govt/PSU/Others PSU
Full Name of Deductor/D.D.O. D.N.Sinha Pan No. of Deductor 00558

G.M.,Sam Eletronics, 45
Name & Address of the Employer Bibekananda Rd, Tan No. of Employer 556688
Kualalmpur
 PARTICULARS OF SALARY
Taxable income of previous year (Col-11) Form No. 16 of If you could not Got any Arrears Salary Amount Please Leave
0
PREVIOUS YEAR,[For Arrears Relief U/s 89(1)] Blank this Cell (Put 0 )

1 Deduction under chapter VI-A (LIC,PF,Tuition Fees,H.B.Principal):80C (Maximum Deposit Rs.1,00,000)

2 a) G.P.F/EPF/PF 67090

3 b) L.I.C. 50000

c) U.LIP 500

4 d) N.S.C. 500 DEDUCTION ONLY U/S 80C, 80CC (MAXIMUM

LIMIT NOT EXCCEED RS.1,20,000/- including New
5 e) H.B. Loan Principal 500 Tax Savings Bond(Max Rs.20000/-)
6 f) GROUP INSURANCE (G.I./GISL/CGEIS) 720

7 g)New Flexible Bond ( Maximum Rs. 20,000/-) 0

8 h) Tuition Fees (Max.Rs.1,00,000) 20000

TOTAL DEDUCTION U/S 80C Max. Rs 1,00,000/- + 20,000 Total Deduction U/S 80C (Max.limit 1,00,000/-) + 20,000/-
Infrustructure Bond, Total Rs.1,20,000/- 100000 New declared Infrustructure Bond
9
Interest From Bank 200 Income From Bank interest
10 Income from N.S.C 1000 Interest from N.S.C.

11 Income from House Property 1000 Income From House Property if any
12 80G 0 Donation in Charitable Fund Maximum 100% of donation)
Premium in health insurance of
13 80D 0 self,spouse,children,dependent,Maximum Rs 15000/-

14 80E 0 For Higher Education Loan Maximum No Limit

15 80DD 0 Medical treatment for self or dependent as Handicapped

16 80DDB 0 Medical Treatment for self or dependent for sever desease

Permanent disability including blindnes as handicapped(Max
18 80U 0 Rs.75000/-)

20
21 House Rent Paid 0 For Rented House. Must Submit the receipt of House Rent.
Transport OR Conveyance Allowances U/s 10(14)(i) 2400 Maximum Rs. 9600 P.A.
24 Leave Travel Allowances U/s 10(5) 0 Actual Expenses will be given.
 Submit herewith your actual Medical Bills up to Rs.
Medical Reimbursment Max 15000 P.A 0
15000/-
26

TOTAL DEDUCTION CHAPTER VI-A Rs. 100000 TOTAL DEDUCTION CHAPTER VI-A Rs.
Advance Income Tax Paid
 No. 9474316768 ,

Assessment Year 2011-

d by the MINISTRY OF
ntral Board of Taxes,New
010 in the Gazette of India
tion 3,(Sub Sec(ii)]

Pay Sheet ,

After
Data Sheet

00558

556688
 y Amount Please Leave
t0)

00,000)

C, 80CC (MAXIMUM
20,000/- including New
Max Rs.20000/-)

1,00,000/-) + 20,000/-

% of donation)

Rs 15000/-
mit

Handicapped
sever desease
handicapped(Max

receipt of House Rent.

l Bills up to Rs.

VI-A Rs.
Pay Calculation Sheet for -Income Tax Calculation , Double Click
for the on the Yellow
financial year 2010-2011, Assessment Year 2011-12 cell and Put
A Name & Designation of the Assesses - Kumar Bandyopadhyay the Password
"pranab" and
Conv
Spl.
Leave
Put Arrear Put Intertn Allwn./
TOTAL
G.P.F./ Edit
H.B. the
H.B.Lyellow
MONTH Basic Travel Othrs Madical (2+3+4+5+6 G.I.S./ TDS/
Alwn if D.A. D.A. D.A. if H.R.A. H.R.A. ment Transp Bonus E.P.F./P P.Tax Pr. Cell
Int
&Year Pay Allown/ Allwn Allown +7+8+9+10+ GISL I .Tax
any Rate of any Alwnc ort .F. Paid Paid
L.T.C. Rate of 11+12)
% Allwnc
%

1 2 3 4 5 6 7 8 9 10 11 TOTAL 16 17 18 19 20 21
Mar-10 18190 0 5000 0 35% 6367 0 2% 364 200 1000 200 10000 31321 4620 150 60 0 0 500
Apr-10 18190 0 0 35% 6867 500 2% 364 200 1000 200 26821 4912 150 60 0 0 500
May-10 18190 0 0 35% 6367 0 2% 364 200 1000 200 26321 4912 150 60 0 0 500
Jun-10 18190 0 0 35% 6367 0 2% 364 200 1000 200 This 26321 4912 150 60 0 0 500
Jul-10 18740 0 0 35% 7059 500 2% 375 200 1000 200
Sheet 27574 5060 150 60 0 500
0
is not
Aug-10 18740 0 0 35% 6559 0 2% 375 200 1000 200 Printab 27074 5060 150 60 0 0 500
Sep-10 18740 0 0 45% 8433 0 2% 375 200 1000 200 le. 28948 5434 150 60 0 0 500
Oct-10 18740 0 0 45% 8433 0 2% 375 200 1000 200 Only 28948 6436 150 60 0 0 500
Data
Nov-10 18740 0 0 45% 8933 500 2% 375 200 1000 200 29448 6436 150 60 0 0 500
Entry
Dec-10 18740 0 45% 8433 0 2% 375 200 1000 200 Sheet 28948 6436 150 60 0 0 500
Jan-11 18740 0 0 45% 8433 0 2% 375 200 1000 200 28948 6436 150 60 0 0 500
Feb-11 18740 0 0 45% 8433 0 2% 375 200 1000 200 28948 6436 150 60 0 0 3257
TOTAL 222680 0 5000 0 90684 4456 2400 12000 2400 339620 67090 1800 720 0 0 8757
 INCOME TAX STATEMENT FOR THE FINANCIAL YEAR 2010-2011
ASSESSMENT YEAR 2011-2012
A. Name & Designation of the Assesses - Kumar Bandyopadhyay Snr.Accountant
B. Residential Address Kualalampur Kualalampur Utta Dinazpur Pin Code No. 742125
C. Pan Card No JKLK0555 K
1 Salary income with all allowance ( Except Medical allowances)…………………. Rs. 339620
3 Bonus :-………………………………………………………………………………… Rs. 10000
5 Medical Allowances Received………………………………………………. 2400
6 Income From Bank (Interest)……………………………………………………….. 200
7 Income from N.S.C.( interest )…………………………………………………. Rs. 1000
8 Income from House Property:-……………………………………………………. Rs. 1000
9 Gross Income(Col.1 + 2+3+4+5+6+7+8 ) :-………………………………… Rs. 354220
10 Interest paid as H.B.Loan (1.5 Lacks maximum) U/S 24(B):-………………………. Rs. 0
11 Professional Tax U/S 16(iii) :-(For Handcpd employees are exempt from P.tax) Rs. 1800
12 Exemption of Conveyance Allowances/Transport Allwn/ U/s 10(14)(i)[Max.Rs 9600/-P.A. 2400
13 Exemption U/S 10(13A) :- ###
a) House Rent Received……………. Rs. 0 b)House Rent Paid Rs. - ###
c)Expenditure on house rent in excess of 50% in Metro Pol City
-
others 40% & 10% of B.Pay .
c) Amount exempted (which is less of a , b ,c):-………………………. Rs. - Rs. 0
14 Exemption of Medical Reimbursment Max Rs. 15000/-P.A. 0
15 Intertenment Allowances U/s 16(ii) Max.Rs. 5000/- P.A……………….. 5000
16 Exemption of Leave Travel allowances(Actual Expenses)[ U/s 10(5) Rs. 5000
17 Total Income(Col.9-10-11-12-13-14-15-16)…………………………………….. Rs. 345020
18 Deduction U/S 80 C (Maximum Rs.1,20,000/- including Infrastru. Bond) ###
a) Contribution to G.P.F./E.P.F. ………………………………………. Rs. 67090
c) Group Insurance Savings Scheme :- …………………. Rs. 720 ###
d) L.I.C.(Yearly Basis)………………………………………………………. 50000 ###
e) U.LIP (As Yearly Basis)……………………………………………. Rs. 500
f)Purchase of N.S.C. :- ……………………………………. Rs. 500
g) Amount paid as excluisively tuition fees to any
University/College/School for maximum of two
Children( 2 )Maximum Rs1,00,000/-………………………… Rs. 20000
h) Payment of H.B.Loan (Principal) :-………………………… Rs. 500
i) New Insfruc. bond{Max-20000/-}……………………. Rs. 0 ###
j) Others, if any as notified :- 80DDB 0 80G 0 Hnd ca
i) 80U 0 ii)80DD 0 iii)80D 0 80E 0 Rs. 0 ###
k) Total Amount Deducted (a to j) :-………………………. Rs. 139310 Rs. 100000
19 Taxable Income (18-19) :-[Rounded off to the next 10]………………… Rs. 245020
20 i) Upto Rs.1,60,000/- Tax Nil, (ii)Rs.1,60,001/-to 5,00,000/-Tax 10%
iii) Rs.5,00,0001/- to 8,00,000/- Tax 20%, iv)Rs.8,00,001/-to Onwards Tax 30%
v) For Women employee upto Rs.1,90,000/- Tax Nil
21 Total Tax Computed………………………………………………………… Rs. 8,502
22 3% Educational cess on tax :-…………………………………………………… Rs. 255
23 Tax Payable including Education & Cess(Col.21+22)………………… Rs. 8,757
24 Relief U/S 89(1)[Arrears Relief from Salary]……………………………… Rs. -
25 Net Tax Payable ( 23-24)…………………………………………………….. Rs. 8,757
26 Tax already deducted from source :-…………………………………………. Rs. 8,757
27 Balance Tax :- Refundable Payable …………………………….. Rs. -
###
Dated:- Signature of the Employees with Designation
 Pay Statement For the Year 2010-2011
Name of the Employee - Kumar Bandyopadhyay

Leave
Madica Intertnm Conv./ G.P.F./
MONTH Spl. Alwn Travel Othrs G.I.S./ H.B. Pr. H.B.L TDS/
Basic Pay D.A. H.R.A. l ent Transport E.P.F./P.F P.Tax
&Year if any Allown/L Allwn GISL Paid Int Paid I .Tax
Allown Alwnc Allowanc .
.T.C.

Mar-10 18190 0 5000 6367 364 200 1000 0 200 4620 150 60 0 0 500

Apr-10 18190 0 6867 364 200 1000 0 200 4912 150 60 0 0 500

May-10 18190 0 6367 364 200 1000 0 200 4912 150 60 0 0 500

Jun-10 18190 0 6367 364 200 1000 0 200 4912 150 60 0 0 500

Jul-10 18740 0 7059 375 200 1000 0 200 5060 150 60 0 0 500

Aug-10 18740 0 6559 375 200 1000 0 200 5060 150 60 0 0 500

Sep-10 18740 0 8433 375 200 1000 0 200 5434 150 60 0 0 500

Oct-10 18740 0 8433 375 200 1000 0 200 6436 150 60 0 0 500

Nov-10 18740 0 8933 375 200 1000 0 200 6436 150 60 0 0 500

Dec-10 18740 0 8433 375 200 1000 0 200 6436 150 60 0 0 500

Jan-11 18740 0 8433 375 200 1000 0 200 6436 150 60 0 0 500

Feb-11 18740 0 8433 375 200 1000 0 200 6436 150 60 0 0 3257

TOTAL 222680 0 5000 90684 4456 2400 12000 0 2400 67090 1800 720 0 0 8757

Total Arrears Received during this Period 0

Signature of the Employee

Date:-
Designation:-
 FORM NO.16
[See rule 31(1)(a)]
Certificate under section 203 of the Income-tax Act, 1961 for Tax deducted at source on Salary

PART- A
Name and address of the Employer Name and designation of the employee
G.M.,Sam Eletronics, 45 Bibekananda Rd,
- Kumar Bandyopadhyay Snr.Accountant
Kualalmpur
TAN No.of the
PAN NO.of Deductor PAN NO. of the Employee To
Deductor From
00558 556688 JKLK0555 K
CIT (TDS) Assessment Year Period
Address Central Income Tax Departmment, Cochin
2011 2012
- 1/4/2010 31/3/2011
City Cochin Pin Code 556,644
Summary of tax deducted at source
Receipt Numbers of original statements of Amount of tax deducted in respect Amount of tax deposited remitted
Quarter TDS under sub-section (3) of section 200 of the employee in respect of the employee
Q1 22 1,500 1,500
Q2 25 1,500 1,500
Q3 55 1,500 1,500
Q4 52 4,257 4,257
TOTAL Rs. 8,757 8,757
PART- B (Refer Note 1)
Details of Salary paid and any other income and tax deducted
1 Gross Salary IN RUPEES IN RUPEES IN RUPEES
Salary as per provisions contained in
(a) section 17(1) Rs. 354,220
Value of perquisites under section 17(2)
(b) (as per Form No. 12BA,wherever Rs. 0
applicable)
Profits in lieu of salary under section
(c) 17(3) (as per Form No. 12BA, wherever Rs. 0
applicable)
Rs.
(d) TOTAL…………………………………………….
354,220
2 Less: Exempted Allowance u/s 10 Ed
Allowance Rs. ###
(i) H.R.A Exemption 0 Rs. 0
Convences Allowances
(ii)
Exemp
2400
Medical Reimbursment
(v)
Exemp
0
Rs.
3 Balance(1-2) Rs. ###
351,820
4 Deductions :
H.B.Loan Int.(Max-1,50,000/-)
(a) u/s 24(B) 0
(b) Tax on employment 1800
(e) Leave Travel Allowances 5000
(f) Intertainment Allowances 5000
5 Aggregate of 4(a) tounder
Income chargeable (f) the head 'salaries' Rs. 11,800
6 Rs. 340,020
Add: Any other income reported by the
(3-5)
7
employee
a)Income form N.S.C./Bank int.etc. Rs. 1000
8 Gross total income (6+7) Rs. 341020
 1

9 Deductions under Chapter VIA

U/s 80C (Aggregate amount Gross
A Deductible Amount Rs.
Max.Rs.1,20,000/-) Amount
(a)(i)Sec.80C-G.P.F………………. Rs. 67090
(ii) G.I.S……………………………. Rs. 720
(iii) U.LIP…………………………… Rs. 500
(iv) Tuition
Rs. 20000
Fees………………….
(v) N.S.C…………………………. Rs. 500
(vi) L.I.C. Rs. 50000
(vii) H.B.LOAN(PRINCIPAL) Rs. 500 Rs. 139,310 Rs. 100,000
B Other sections e.g.,80E,80G,etc under chapter VI A Gross Amount Qulfy amount Deductible Amount Rs.

(a) Section 80 E Rs. 0 Rs. 0

(b) Section 80 G Rs. 0 Rs. 0
( c ) Section 80U Rs. 0 Rs. 0
(d) Section 80DD Rs. 0 Rs. 0
(e) Section 80D Rs. 0 Rs. 0
f) Section 80CC Rs. 0 Rs. 0
G) Section 80DDB Rs. 0 Rs. 0
Aggregate of deductible amount under Chap.
10
VIA
Rs. 100,000
11 Total Income (8-10) Rs. 241,020
12 Tax on total income Rs. 8,502
13 Education & cess @3% on col.no.12 Rs. 255
14 Tax payable (12+13+14) Rs. 8,757
15 Less Relief U/s 89(1)(attach dtls Rs. 0
16 Tax payable/refundable (15-16) Rs. 8,757
17 Less (a) Tax deducted at source Rs. 8,757
Net Tax col.No.17-
18
18)
Refundable Tax payable Rs. 0
Verification
son/daughter of

working in the capacity of(designation do hereby certify that a sum of Rs [Rs.

(in words)] has been deducted and deposited to the credit of the Central Governement.

I further certifify that the information given about is true, complete and correct and is based on the books of account,

documents,TDS,statement ,TDS deposited and other available records.

Place:-

Date:- Signature of person responsible for deduction of tax

Designation Full Name:-
Note:-
1 If an assessee is employed under more than one employer during the year, each of the employers shall issue
of the certificate in Form No. 16 pertaining to the period for which such assessee was employed with each
of the employers. Part B may be issued by each of the employers or the last employer at the option of the
assessee.
2 Government deductors to enclose Annexure-A if tax is paid without production of an income-tax
challan and Annexure-B if tax is paid accomanied by an income-tax challan.

3 Non-Government deducto5rs to enclose Annexure-B

 4 The deductor shall furnish the address of the Commissioner of Income-tax(TDS) having jurisdiction
as regards TDS statements of the assesee.
5 This Form shall be applicable only in respect of tax deducted on or after 1st day of April, 2010.

ANNEXURE-A
DETAILS OF TAX DEDUCTED AND DEPOSITED IN THE CENT5RAL GOVERNMENT ACCOUNT THROUGH BOOK ENTRY
(The Employer to provide payment wise details of tax deducted and deposited with respect to the employee)
Tax Deposited in respefct on of
Sl.No Book Identification Number (BIN)
the employee (Rs.

DDO Sequence Number in the Date on which

Receipt Numbers of
Book Adjustment Mini tax deposited
Form No 24G
Statement (dd/mm/yy)

Note:-
1. In the column for TDS, give total amount for TDS,Surcharge(if applicable) and education cess.

ANNEXURE-B
DETAILS OF TAX DEDUCTED AND DEPOSITED IN THE CENTRAL GOVERNMENT ACCOUNT THROUGH CHALLAN
(The Employer to provide payment wise details of tax deducted and deposited with respect to employee)

Challan Identification Number ( C I N )

Tax Deposited in respect on of the
Sl.No
employee (Rs.) BSR Code of the Bank Date on which tax deposited Challan Serial
Branch (dd/mm/yy) Number

1 500 0555 31/3/2010 5

2 500 0555 28/4/2010 6
3 500 0555 28/5/2010 7
4 500 0555 28/6/2010 8
5 500 0555 29/7/2010 9
6 500 0555 28/8/2010 10
7 500 0555 28/9/2010 11
8 500 0555 28/10/2010 12
9 500 0555 28/11/2010 13
10 500 0555 28/12/2010 14
11 500 0555 28/1/2011 15
12 3,257 0555 28/2/2011 16
Total 8,757

1 In the column for TDS, GIVE TOTAL AMOUNT FOR TDS, Surcharge(if applicable) and Education Cess
3
 INDIAN INCOME TAX RETURN Assessment Year
[For Individual having Income from Salary/Pension/income from One
FORM

SARAL-II House Property(Excluding loss brought forward from previous

(ITR-I) years)/Income from Other Sources (Excluding Winning from Lottery and 2 0 1 1 - 1 2
income from Race Horses)]

(Please see Rule 12 of the Income-tax Rules, 1962)(Also see attached instuctions)
First name Middle name Last Name Pan No
- Kumar Bandyopadhyay JKLK0555 K
PERSONAL INFORMATION

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

- Kualalampur 1/1/1963

Road/Street/Post Office Area/Locality Employer Category √

Kualalampur Kualalampur √ PSU PSU Others
Town/City/District State Pin code Employer Category
Utta Dinazpur West Bengal 742125 √ Male √ -
Email Addrs. (STD Code) - Phone Number
Designation of Assessing Officer (Ward/Circle) Return Filed Under Section- 1 1
FILING STATUS

11 [Please see instruction number-9(i)]

Whether original or Revised return? (Tick)
√ √ Original Revised
If revised, enter Receipt No and Date of ORIGINAL
filing original return (DD/MM/YYYY)
Original return(DD/MM/YYYY) 31/3/2010
Residential Status (Tick)√ √ Resident Non-Resident Resident but not ordinarily Reside
1 Income chargeable under the Head 'Salaries',Pension 345020 1
2 Income chargeable under the Head 'House Property'(enter-ve sign in case2of loss,0if any)
Income chargeable under the Head 'Other Sources' (enter-ve sign in
INCOME & DEDUCTIONS

3 case 0
GrossofTotal
loss,Income
if any) 3
4 (1+2+3) 4 345020
5 Deductions under chapter VIA (Section
a 80C 100000 e 80DD 0 I 80GG 0
b 80CCC 0 f 80DDB 0 j 80GGA 0
c 80CCD 0 g 80E 0 k 80GGC 0
d 80D 0 h 80G 0 l 80U 0
6 Deductions (Total of 5a to5i) 6 100,000
7 Total Income (4-6) 7 245020
8 Tax Payable on 'Aggregate Income' 8 8502 ###
255
TAX COMPUTATION

9 Education Cess on (on 8) 9

### Total Tax, Surcharge and Education cess payable (8+9) ### 8757
### Relief under Section 89 ### 0 ###
### Relief under Section 90/91 ### 0
### Balance Tax Payable (10-11-12) ### 8757
14 Total interest payable u/s 234A/234B/234C 14 0
### Total Tax and Interest payable (12+13) 15 8757
Do not write or stamp in this areas for office Seal and signature of receiving official
use only

Receipt No.

Date

1
1
 16 Taxes Paid
a Advance Tax (from item 25) 16a 0
TAXES PAID

b TDS (column 7 of item23+column 7 of item 24) 16b 8757

c Self Assessment Tax (from item 25) 16c 0
17 Total Taxes paid (16a+16b+16c) 17 8757
18 Tax payable(15-17)(enter if 15 is greater than 17, else leave blank) 18 0 ###
19 Refund (18-17) (enter if 15d is greater than 14, also give Bank account details below)
19 0
REFUND

20 Enter your bank account chequnumber (mandatory in case of refund) 501

21 Do you want your refund bye or deposited directly into your bank account? (tick as applicable
√
22 Give additional details of your bank account
MICR Code 000558 Type of Account (tick as applicable) √ Savings
23 Details of Tax Deducted at Source from Salary [As per Form 16 issued by Employer(s)]
TDS ON SALARY

Tax TAX
Tax Deduction Deduction
Name and Income payable Payble
Sl Account under Total tax
No Number(TAN) of the
address of the chargeable under (incl.
Chapter VI- deposited
Employer the head salaries surch. And Refundabl
Employer A
edn. Cess) e
(1) G.M.,Sam
(2)(3) (4) (5) (6) (7) (8)
Eletronics, 45
556688 345,020 100,000 8,757 8,757 0
Bibekananda
24 Details of Tax Deducted
Rd,atKualalmpur
Source other than salary
Amount
Tax Deduction Namee and out of
TDS ON INTEREST

Sl Account Amount paid/ Date of Total tax

No Number(TAN) of the address of the (6) claim
credited Payment /Credit deposited
Deductor Deductor for this
year
(1) (2) (3) (4) (5) (6) (7)
- 0
0
0
NOTE Enter the total of column (7) of 23and column (7) of 17 of TAXES PAID
25 Details of Advance Tax and Self Assessment Tax Payments
Sl Name of Bank & Date of Deposit Serial Number of
No BSR Code Amount (Rs.)
Branch (DD/MM/YYYY) Challan
TAX PAYMENTS

(i)
(ii)
(iii)
(iv)
NOTE Enter the total of Advance tax and Self Assessmen tax in Sl.No.17 of TAXES PAID0
26 Other Information (Transactions reported through Annual Information Return) (Please see instruction number-9(ii)
Sl. Code Amount (Rs.) Sl. Code Amount (Rs.) Sl. Code Amount (Rs.)
a 001 e 004 h 007
b 002 f 005 i 008
c 003 g 006 j
27 Exempt income only for reporting purposes(from Dividend, Capital gains 27 etc)
VERIFICATION
I, son/ daughter of solemnly
declare that to the best of my knwledge and belief, the information given in the return thereto is correct and
complete and that the amount of total income and other particulars shown therein are truly stated and 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 2010-11

Place Date Sign here

28 If the return has been prepared by a Tax Return Preparer (TRP) give further details as below :
Identification No. of TRP Name of TRP Counter Signature of TRP
 If TRP is entitled for any reimbursement from the Government, amount thereof
29 (to be filled by TRP) ###
 Government of India

INCOME TAX DEPARTMENT

ACKNOWLEDGEMENT

Received with thanks form: - Kumar Bandyopadhyay a return of income

&/return of fringe benefits in Form No ITR - 1 for assessment year 20011-2012, having the following particulars:

Name PAN NO
PERSONAL INFORMATION

- Kumar Bandyopadhyay JKLK0555 K

Flat/Door/Block No: Name of Premises/Building/Village:
- Kualalampur
Road/Street/Post Office: Area/Locality:
Kualalampur Kualalampur
Town/City/District: State: Status(fill the code)
Utta Dinazpur West Bengal PSU 11
Designation of Assessing Officer Original/Revised Original
Fringe Benefits & Tax Thereon COMPUTATION OF INCOME & TAX THEREON

1 Gross total income 1 345020

2 Deduction under Chapter-VI-A 2 100000
3 Total Income 3 245020
4 Net tax payable 4 8757
5 Interest payable 5 0
6 Total tax and interest payable 6 8757
7 Taxes paid
a Advance Tax 7a -
b TDS 7b 8,757
c TCS 7c -
d Self Assessment Tax 7d -
e Total Taxes paid (7a+7b+7c+7d) 7e 8757
8 Tax payable (6-7e) 8 0 ###
9 Refund (7e-6) 9 0 ###
10 Value of Fringe Benefits 10 NA
Computation of Income &

11 Total fringe benefit tax liability 11 NA

12 Total interest payable 12 NA
13 Total tax and interest payable 13 NA
14 Taxes paid NA
a Advance Tax 14a
b Self Assessment Tax 14b
c Total Taxes paid (14a+14b) 14c NA
15 Tax payable (13-14c) 15 NA
16 Refund (14c-13) 16 NA
Receipt No. Seal and Signature of receiving official:
Date:
 FORM NO.10 E
[See rule 21AA]

Form for furnishing particulars of income under section 192(2A) for the year ending 31 st March, 2011 for claiming
relief under section 89(1) by a Government servant or an employee in a 2[company,co-operative society,local
authority ,university, instituty
1 Name and address of the employee - Kumar Bandyopadhyay
2 Permanent account number JKLK0555 K

3 Residential status PERMANENT RESIDENT

Particulars of income referred to in rule 21A of the Income-tax Rules, 1962,during the previous year relevant to
assessment year 2011-12

1 (a) Salary received in arrears or in advance in accordance with the provisions of sub-rule (2)
of rule 21A. -
(b)
Payment in the nature of gratuity in respect of past services, extending over a period of not
less than 5 years in accordance with the provisions of sub-rule (3) of rule 21A. Not Applicable

(c)
Payment in the nature of compensation from the employer or former employer at or in
connection with termination of employment after continuous service of not less than 3 Not Applicable
years or where the unexpired portion of term of employment is also not less than 3 ye

(d) Payment in commutation of pension in accordance with the provisions of sub-rule (5) of
rule 21A Not Applicable
2 Detailed particulars of payments referred to above may be given in Annexure I,II,IIA,III,
or IV as the case may be. ANNEX-I

…………………………………………..
Signature of the employee

Verification
I, _______,do hereby declare that what is stated above
is true to the best of my knowledge and belief.
Verified today, the Day of

Place: …………………….
………………………………………
Date:…………………… Signature of the employee
 ANNEXURE-I
[See item 2 of Form No.10E]
Arrears or advance salary
Sl No. Particulars Amount (Rs.)
1 Total income (excluding salary received in arrears or advance) 245,020
2 Salary received in arrears or advance 0
Total income (as increased by salary received in arrears or advance)
3
[Add item 1 and item 2] 245,020
4 Tax on total income [as per item 3] 8,757 ###
5 Tax on total income [as per item 1] 8,757 ###
Tax on salary received in arrears or advance
6 [Difference of item 4 and item 0
5]
Tax computed in accordance with Table "A"
7 [Brought from column 7 of 0
Table A]
Relief under Section 89(1) [Indicate difference between the amounts mentioned
8
against item 6 and item 7] 0

TABLE "A"
[See item 7 of Annexure 1]

Total income Salary received Total income (as Tax on total Tax on total Difference in tax
of the in arrears or increased by income [as per income[as per [Amount under
relevent advance salary received in column (2)-After column (4) column (6)
previous year relating to the arrears or Rebate and After Rebate minus amount
(Rs.) relevent advance) of the including Edn and including under column
previous year relevent previous Cess and Edn Cess and (5)] (Rs.)
as mentioned year mentioned in Surcharge] Surcharge]
Previous year
in column (1) column (1) [add (Rs.) (Rs.)
(Rs.) colmn 2 & 3]
(Rs.)

(1) (2) (3) (4) (5) (6) (7)

0 0 0 0 0 0 ###

###

Signature:

Place: Name:

Date: Designation:
Dept: