Income Tax Preparation(Quarterly/Annualy) FOR Financial YEAR 2010-11

This Calculation sheet Only for West Bengal Govt. Employees

Prepared by Pranab Banerjee,Kalisthanpara,
Jiaganj,Murshidabad,W.B.,
or 9474316768, 8906279547,
FIRST NAME
MIDDLE NAME
LAST NAME
Note:-If any discrepency is arise
about calculation of income Tax,I am
not responsible for that, Pranab
DESIGNATION
Banerjee Permanent A/C No.(PAN NO)
pranab.banerjee83@gmail.com
Pranab
New I T R -I ,For Assessment Year 2011-2012,which
Kumar
recent published by the MINISTRY OF FINANCE(Deptt.of
Banerjee Revenue)Central Board of Taxes,New Delhi. Notification
Dated 23/04/2010 in the Gazette of India
U.D.A. Extraordinary,Part-II, Section 3,(Sub Sec(ii)]
AAQQ 5565 A

Gender ( Male or Female ) Male If Handicapped Employee Pl.

put "Yes" If General put "No" No
DATE OF BIRTH 1/4/1963

EMPLOYEE'S RESIDENTIAL ADDRESS

25D
Flat/Door/Block No.
Village Kalisthanpara

Post Office: Jiaganj This Auto Income Tax Calculation Software

Area/Locality: Jiaganj only for West Bengal Govt Employees. As
If you live in Metro City Type Yes ,else Type No No
the D.A. is not mached with other State or
Central Govt Employees.(In this Software
District: Murshidabad Prepared Salary Statement+Form-16 + ITR-
PIN CODE: 742255 I + Form 10E)
State: West Bengal

Designation of Assessing Officer ( Ward/Circle) 11

Date of Submit this RETURN 25/6/2011

Office Address
B.L.L.R.O., Bhagwangola- First Fill the Pay Sheet
I, Murshidabad

STATUS- Govt/PSU/Others Govt

 Pravat Kr. Das,C/o-
Name & Address of the Deductor SDLLRO,Lalbagh,Murshi Pan No. of Deductor
dabad

Name & Address of the Employer Tan No. of Employer A Q 5544

PARTICULARS OF SALARY
Gross Income from Salary (Salary+H.R.A.+Bonus+Arrear if
345840 This Cell is Auto filled( The Data Comes from Pay Sheet)
any+Int.Bank/NSC+House Property)

Total Income from Salary( This Cell Auto filled) 343440 This Cell is Auto filled (The Data comes from Pay Sheet)

Total income of financial year 2008-09 (Col-11) of Form No. 16

For Calculation of Arrears Relief U/s 89(1).
( For Financial Year 2008-2009) + Two Instlmnt which already
125000 Put your Total Income of 2008-2009 +Two
Instlmnt. Which received as ROPA-Arrears.
received previous year As Arrears. For Calculating Form 10E,

Deduction under chapter VI-A (LIC,PF,Tuition Fees,H.B.Principal):80C (Maximum Deposit Rs.1,00,000)+20,000/- Flixible Bond

1 a) G.P.F. 12000

2 b) P.P.F 0

3 c) L.I.C. 20000

4 d) N.S.C. 5000

5 e) H.B. Loan Principal 0 DEDUCTION ONLY U/S 80C, 80CC (MAXIMUM LIMIT
NOT EXCCEED RS.1,20,000/- including New Tax Savings
6 f) GROUP INSURANCE (G.I.) 480 Bond(Max Rs.20000/-)
7 ULIP 20000

8 g)New Flexible Tax Savings Bond ( Maximum Rs. 20,000/-) 0

9 h)Equity linked savings scheme/tax savings bond etc. 2000

10 i) Tuition Fees 50000

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
11
12 Income from Bank Interest/N.S.C/Others Source 0

13 Income from House Property 0

14 80G 0 Donation in Charitable Fund Maximum 100% of donation)
 Premium in health insurance of
15 80D 5000 self,spouse,children,dependent,Maximum Rs 15000/-

16 80E 0 For Higher Education Loan

17 80DD 0 Medical treatment for self or dependent as Handicapped

18
19 80DDB
80CC 0 Medical Treatment for self or dependent for sever desease
0 Deposit in Pension Fund (Maximum Rs. 1,00,000/-
21 House Rent Paid 0 For Rented House. Must Submit the receipt of House Rent.

22 Conveyance Allowances U/s 10(14)(i) 0 Maximum Rs. 9600 P.A.

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

TOTAL DEDUCTION CHAPTER VI-A Rs. 105000 TOTAL DEDUCTION CHAPTER VI-A Rs.

24 Arrear Received if any 15000 Auto Filled Cell [the Data Comes Pay Sheet]

25 Relief under Section 89(1) 1,545 Auto Filled Cell [the Data Comes 10E ]
sthanpara,
banerjee83@gmail.com

ssment Year 2011-2012,which

MINISTRY OF FINANCE(Deptt.of
of Taxes,New Delhi. Notification
0 in the Gazette of India
t-II, Section 3,(Sub Sec(ii)]

Tax Calculation Software

al Govt Employees. As
hed with other State or
oyees.(In this Software
atement+Form-16 + ITR-

Pay Sheet
 A Q 5544

a Comes from Pay Sheet)

a comes from Pay Sheet)

328440

- Flixible Bond

C, 80CC (MAXIMUM LIMIT

including New Tax Savings
Rs.20000/-)

x.limit 1,00,000/-) + 20,000/-

Bond

mum 100% of donation)

 ximum Rs 15000/-

dent as Handicapped

ndent for sever desease

m Rs. 1,00,000/-
e receipt of House Rent.

dnes as handicapped(Max

R VI-A Rs.

Comes Pay Sheet]

 TOTAL

Pay Calculation Sheet for -Income Tax Calculation ,for the financial year 2010-2011, Assessment Year 2011-12
Govt Employees

Travelling Arrears
Grade Put D.A.
MONTH Alwnc/ Educ. Spl. Arrer DA Put HRA Received Arr.
Basic Pay Pay/ D.A. Rate of H.R.A. M.A. Bonus (ExcludingB G.P.F. P.Tax
&Year Conveyance Allwanc Allwnc IF ANY Rate of % as 6th Pay GPF
D.Pay % onus+
Allownce Comm.

Mar-10 12840 4200 0 0 0 5964 35% 0 2556 15% 300 1000 15000 25860 1000 0 200

Apr-10 12840 4200 0 0 0 5964 35% 0 2556 15% 300 25860 1000 200

Prepared by Pranab Banerjee, Kalisthanpara,Jiaganj,

May-10 12840 4200 0 0 0 5964 35% 0 2556 15% 300 25860 1000 200
Arrears)
Jun-10 12840 4200 0 0 0 5964 35% 0 2556 15% 300 25860 1000 200

Murshidabad, West Bengal

Jul-10 13,300 4200 0 0 0 7875 45% 0 2625 15% 300 28300 1000 200

Aug-10 13,300 4200 0 0 0 7875 45% 0 2625 15% 300 28300 1000 200

Sep-10 13,300 4200 0 0 0 7875 45% 0 2625 15% 300 28300 1000 200

Oct-10 13,300 4200 0 0 0 7875 45% 0 2625 15% 300 28300 1000 200

Nov-10 13,300 4200 0 0 0 7875 45% 0 2625 15% 300 28300 1000 200

Dec-10 13,300 4200 0 0 0 7875 45% 0 2625 15% 300 28300 1000 200

Jan-11 13,300 4200 0 0 0 7875 45% 0 2625 15% 300 28300 1000 200

Feb-11 13,300 4200 0 0 0 7875 45% 0 2625 15% 300 28300 1000 200

TOTAL 157760 50400 0 0 0 86856 0 31224 3600 1000 15000 329840 12000 2400

Total Earning for this Year excluding Bonus & Arrear 279440 Total Deduction Excluding TDS 14880

Total Earning for this Year Including Bonus & Arrear 295440 Total Deduction Including TDS 24320
 Only For West Bengal

Deposite
H.B.
Arr. P. G.I.S./
Loan.
H.B.Int d as
Tax GISL Paid monthly
Princpl
TDS

0 40 0 0 500

0 40 0 500
0

0 40 0 500
0

0 40 0 500
0

0 40 0 500
0

0 40 0 500
0

0 40 0 500
0

0 40 0 500
0

0 40 0 500
0

0 40 0 500
0

0 40 0 500
0

0 40 0 0 3940

0 480 0 0 9440
 INCOME TAX STATEMENT FOR THE FINANCIAL YEAR 2010-2011
ASSESSMENT YEAR 2011-2012
A. Name & Designation of the Assesses Pranab Kumar Banerjee U.D.A.
B. Residential Address Kalisthanpara Jiaganj Murshidabad Pin Code No. 742255
C. Pan Card No. AAQQ 5565 A
1 a) Salary income with allowance excluding H.R.A.:-…………………………… Rs. 298616
b) House Rent Allowance :-…………………………………………………………… Rs. 31224
c) Bonus :-………………………………………………………………………………… Rs. 1000
d) Arrear,if any :-………………………………………………………………………….. Rs. 15000
2 Any other income as stated by the Assesses :-
a) Income from N.S.C./Bank interest etc:-…………………………………………. Rs. 0
b) Income from House Property:-……………………………………………………. Rs. 0
3 Gross Income(Col.1 + 2 ) :-……………………………………………………………… Rs. 345840
4 Interest paid as H.B.Loan (1.5 Lacks maximum) U/S 24(B):-………………………. Rs. 0
5 Professional Tax U/S 16(iii) :-………………………………………………………… Rs. 2400
6 Exemption of Conveyance Allowances U/s 10(14)(i)[Max.Rs 9600/-P.A. 0
7 Exemption U/S 10(13A) :- ###
a) H.R.A.Received :-………………………………………… Rs. -
b) House Rent paid :-…………………………………………………… Rs. - ###
c) Expenditure on rent in excess of
50% of B.Pay In Metropol City ors 40%............................. 63,104 Rs. -
10% of B.Pay ………………………………………………… -15,776 Rs. -
e) Amount exempted (Least of a,c):- -15,776 Rs. - Rs. -
8 Total Income(Col.3-4-5-6-7) :-………………………………………………………. Rs. 343440
9 Deduction U/S 80 C (Maximum Rs.1,20,000/- including T.Svngs Bond) ###
a) Contribution to G.P.F.:- ……………………………………………. Rs. 12000 ###
b) Contribution to P.P.F…………………………………………………… Rs. 0
b) Group Insurance Savings Scheme :-………….. Rs. 480 ###
c) L.I.C./Premium paid(including Notified Pension Scheme 20000 Charg of H.R
d)Purchase of N.S.C. :-………………………………………….. Rs. 5000
ULIP……………………………………………………………………. Rs. 20000
e) Amount paid as excluisively tuition fees to any
University/College/School for maximum of two
Children( 2 )Maximum Rs.1,00,000/-)………………………………… Rs. 50000
f) Payment of H.B.Loan (Principal) :- Rs. 0
g) New Flexible Bond Max Rs. 20,000/-)………………………………… Rs. 0
g) Equity linked savings scheme/tax savings bond etc.{Max-20000/-) Rs. 2000 ###
h) Others, if any as notified :- 80DDB 0 ii)80G 0 ###
80U 0 iii)80DD 0 iv)80D 5000 v)80E 0 5000 ###
10 Total Amount Deducted (a to h) :-……………………………………….. Rs. 114480 Rs. 105000
11 Taxable Income (8-10) :-[Rouned to the next 10]……………….. Rs. 238440
12 i) Upto Rs.1,60,000/- Tax Nil, (ii)Rs.1,60,001/-to 5,00,000/-Tax 10%(iii) 500000 -80000
20%, iv)Rs.8,00,001/-to Onwards Tax 30%, For Female Up to 190000/- Tax NIL
13 Total Tax :-……………………………………………………………………… Rs. 7,844
14 3% Educational cess on tax :-…………………………………………………… Rs. 235
15 Tax Payable including educational cess(Col.13+14) :-………………….. Rs. 8,079
16 Relief U/S 89(1)[Arrears Relief from Salary] Rs. 1,545
17 Net Tax Payable ( 15-16) Rs. 6,534
18 Tax Paid from Salary Anually or Monthwise……………………………………………… 9440
19 Balance Tax Payable/Refundable……………….. ………………………………….. Rs. -2,906
###
Date:- Signature of the employee
Designation
Pranab Banerjee,Jiaganj,Msd
 Salary Statement for the Year 2010-2011(From March 10 to Feb 2011)
Salary Statement of Sri Pranab Kumar Banerjee U.D.A.

Travelling
H.B. Deposited
MONTH Grade Pay/ Alwnc/ Educ. Spl. G.I.S./G H.B.Int
Basic Pay D.A. H.R.A. M.A. G.P.F. P.Tax Loan. as monthly
&Year D.Pay Conveyance Allwanc Allwnc ISL Paid
Princpl TDS
Allownce

Mar-10 12840 4200 0 0 0 5964 2556 300 1000 200 40 0 0 500

Apr-10 12840 4200 0 0 0 5964 2556 300 1000 200 40 0 0 500

May-10 12840 4200 0 0 0 5964 2556 300 1000 200 40 0 0 500

Jun-10 12840 4200 0 0 0 5964 2556 300 1000 200 40 0 0 500

Jul-10 13300 4200 0 0 0 7875 2625 300 1000 200 40 0 0 500

Aug-10 13300 4200 0 0 0 7875 2625 300 1000 200 40 0 0 500

Sep-10 13300 4200 0 0 0 7875 2625 300 1000 200 40 0 0 500

Oct-10 13300 4200 0 0 0 7875 2625 300 1000 200 40 0 0 500

Nov-10 13300 4200 0 0 0 7875 2625 300 1000 200 40 0 0 500

Dec-10 13300 4200 0 0 0 7875 2625 300 1000 200 40 0 0 500

Jan-11 13300 4200 0 0 0 7875 2625 300 1000 200 40 0 0 500

Feb-11 13300 4200 0 0 0 7875 2625 300 1000 200 40 0 0 3940

TOTAL 157760 50400 0 0 0 86856 31224 3600 12000 2400 480 0 0 9440

Total Arrears Received from March 10 to Feb 2011 Rs. 15,000 Total Earning Rs. 329840

Bonus Received From March 2010 to Feb 2011 Rs. 1,000

Dated:- Signature of Employee

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

Name and address of the Employer Name and designation of the employee
Pravat Kr. Das,C/o-
Pranab Kumar Banerjee U.D.A.
SDLLRO,Lalbagh,Murshidabad
PAN NO.of
TAN No.of the Deductor PAN NO. of the Employee
Deductor
- A Q 5544 AAQQ 5565 A
CIT (TDS) Period
Assessment Year
Address Central Income Tax Office,Berhampore From To
Murshidabad, West Bengal 2011 2012 1/4/2010 31/3/2011
City Berhampore Pin Code 775,566
Receipt Numbers of original statements Amount of tax deposited
Amount of tax deducted in respect
Quarter of TDS under sub-section (3) of section remitted in respect of the
of the employee
200 employee
Q1 5 1,500 1,500
Q2 7 1,500 1,500
Q3 9 1,500 1,500
Q4 10 4,940 4,940
TOTAL 9,440 9,440
PART B (Refer Note )
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. 345,840
Value of perquisites under section
(b) 17(2)(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)
(d) TOTAL Rs. 345840
2 Less: Allowance to the extent exempt u/s 10
Allowance Rs.
HRA Exempt( U/s
10(13A)
0
Conv.Alw.exempt(U/s
10(14)(i)
0 0
3 Balance(1-2) Rs. 345840
4 Deductions :
H.B.Loan Int.(Max-
(a) 1,50,000/-) u/s 0
24(B)
(b) Tax on employment 2400
5 Aggregate of 4(a) to (b)
Income chargeable under the head 'salaries'
Rs. 2,400
6 Rs. 343440
(3-5)
Add: Any other income reported by the
7
employee ###
a)Income form N.S.C./Bank int.etc. Rs. 0 ###
8 Gross total income (6+7) Rs. 343440
 9 Deductions under Chapter VIA
U/s 80C (Aggregate amount Gross
A
Max.Rs.1,20,000/-) Amount
Deductible Amount Rs.

(a)(i)Sec.80C-G.P.F. Rs. 12000

(ii)P.P.F. Rs. 0
(ii) G.I.S. Rs. 480
(iii) U L I P Rs. 20000
(iv) Tution Fees Rs. 50000
(v) New Flexible Bond (Max Rs 20,000/-)U/s
80CCF
0 ###
(vi) N.S.C. 5000 lic
(vii) L I C Premium Rs. 20000
(viii) Equity Links Savings Bond
Rs.
2000
(ix) H.B.L.(Principal) Rs. 0 109480 Rs. 100,000
Qulfy
B Other sections e.g.,80E,80G,etc under chapter VI Gross Amount amount
Deductible Amount Rs.

(a) Section 80 E Rs. 0 0

(b) Section 80 G Rs. 0 0
© Section 80U Rs. 0 0
(d) Section 80DD Rs. 0 0
(e) Section 80D Rs. 5000 5000
f) Section 80CC Rs. 0 0
G) Section 80DDB Rs. 0 0
Aggregate of deductible amount under
10
Chap. VIA
Rs. 105,000
11 Total Income (8-10) Rs. 238,440
12 Tax on total income Rs. 7,844
13 Surcharge on col.12 Rs. 0
14 Education & cess @3% on col.no.12 Rs. 235
15 Tax payable (12+13+14) Rs. 8,079
16 Relief U/s 89(1) Rs. 1,545
Tax payable/refundable
17
(15-16)
Rs. 6,534
18 Less (a) Tax deducted at source Rs. 9,440
Net Tax col.No.
19
17-18)
Refundable - Rs. 2,906
Verification
I 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
Designatio
Full Name:-
n
Note:-
1 If an assessee is employed under more than one employer during the year, each of the employers shall is
A 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

Sl.No Book Identification Number (BIN)
of the employee (Rs.

Date on
DDO Sequence Number in the
Receipt Numbers of Form which tax
Book Adjustment Mini
No 24G deposited
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 Challan
Sl.No
of the employee (Rs.) Date on which tax deposited
BSR Code of the Bank Branch Serial
(dd/mm/yy)
Number

1 500 Treasury Lalbagh 1/4/2010 3

2 500 Treasury Lalbagh 31/4/2010 4
3 500 Treasury Lalbagh 28/5/10 5
4 500 Treasury Lalbagh 28/6/10 6
5 500 Treasury Lalbagh 28/7/10 7
6 500 Treasury Lalbagh 28/8/2010 8
7 500 Treasury Lalbagh 28/9/10 9
8 500 Treasury Lalbagh 28/10/10 10
9 500 Treasury Lalbagh 28/11/10 11
10 500 Treasury Lalbagh 28/12/10 12
11 500 Treasury Lalbagh 28/01/11 13
12 3,940 Treasury Lalbagh 12/30/1899 14
Total 9,440 -

1 In the Column for TDS, give total amount for TDS, Surcharge(if applicable) and education cess
 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
Pranab Kumar Banerjee AAQQ 5565 A
PERSONAL INFORMATION

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

25D Kalisthanpara 1/4/1963

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

Jiaganj Jiaganj √ Govt. PSU Others
Town/City/District State Pin code Employer Category
Murshidabad West Bengal 742,255 √ 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) 25/6/2011
Residential Status (Tick)√ √ Resident Non-Resident Resident but not ordinarily Residen
Rs.
1 Income chargeable under the Head 'Salaries',Pension 343,440 1
2 Income chargeable under the Head 'House Property'(enter-ve sign in case2ofRs. 0 if any)
loss,
Income chargeable under the Head 'Other Sources' (enter-ve sign in
INCOME & DEDUCTIONS

3 case
GrossofTotal
loss,Income
if any) 3 Rs. Rs.
0
4 (1+2+3) 4 343,440
5 Deductions under chapter VIA (Section
a 80C ### e 80DD Rs. 0 I 80GG Rs. 0
b 80CCC Rs. 0 f 80DDB Rs. 0 j 80GGA Rs. 0
c 80CCD Rs. 0 g 80E Rs. 0 k 80GGC Rs. 0
d 80D Rs. 5,000 h 80G Rs. 0 l 80U Rs. 0 Rs.
6 Deductions (Total of 5a to5i) 6 105,000
Rs.
7 Total Income (4-6) 7 238,440
8 Tax Payable on 'Aggregate Income' 8 Rs. 7,844 ###
9 Rs. 235
TAX COMPUTATION

9 Education Cess on (on 8)

### Total Tax, Surcharge and Education cess payable (8+9) Rs. 8,079
###
### Relief under Section 89 ###
Rs. 1,545 ###
### Relief under Section 90/91 ###
Rs. 0
### Balance Tax Payable (10-11-12) Rs. 6,534
###
14 Total interest payable u/s 234A/234B/234C 14 Rs. 0
### Total Tax and Interest payable (12+13) 15 Rs. 6,534
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 Rs. 0
TAXES PAID

b TDS (column 7 of item23+column 7 of item 24) 16b Rs. 9,440

c Self Assessment Tax (from item 25) 16c Rs. 0
17 Total Taxes paid (16a+16b+16c) 17 Rs. 9,440
18 Tax payable(15-17)(enter if 15 is greater than 17, else leave blank) 18 Rs. 0 ###
19 Refund (18-17) (enter if 15d is greater than 14, also give Bank account details below)
19 Rs. 2,906
REFUND

20 Enter your bank account chequnumber (mandatory in case of refund) 0

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 0 Type of Account (tick as applicable) √ Savings
23 Details of Tax Deducted at Source from Salary [As per Form 16 issued by Employer(s)]
Tax TAX
TDS ON SALARY

Tax Deduction Deduction

Name and Income payable -
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) (2) (3) (4) (5) (6) (7) (8)
Rs. Rs.
A Q 5544 - Rs. 343,440 Rs. 6,534 Rs. 9,440
105,000 2,906
24 Details of Tax Deducted at 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)
- -
-
-
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 PAID-
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

2
 If TRP is entitled for any reimbursement from the Government, amount thereof (to be
29 29
filled by TRP)

2
 Government of India

INCOME TAX DEPARTMENT

ACKNOWLEDGEMENT

Received with thanks form: Pranab Kumar Banerjee 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

Pranab Kumar Banerjee AAQQ 5565 A

Flat/Door/Block No: Name of Premises/Building/Village:
25D Kalisthanpara
Road/Street/Post Office: Area/Locality:
Jiaganj Jiaganj
Town/City/District: State: Status(fill the code)
Murshidabad West Bengal Govt 11
Designation of Assessing Officer Original/Revised Original
Fringe Benefits & Tax Thereon COMPUTATION OF INCOME & TAX THEREON

1 Gross total income 1 Rs. 343,440

2 Deduction under Chapter-VI-A 2 Rs. 105,000
3 Total Income 3 Rs. 238,440
4 Net tax payable 4 Rs. 6,534
5 Interest payable 5 Rs. 0
6 Total tax and interest payable 6 Rs. 6,534
7 Taxes paid
a Advance Tax 7a Rs. 0
b TDS 7b Rs. 9,440
c TCS 7c Rs. 0
d Self Assessment Tax 7d Rs. 0
e Total Taxes paid (7a+7b+7c+7d) 7e Rs. 9,440
8 Tax payable (6-7e) 8 Rs. 0 ###
9 Refund (7e-6) 9 Rs. 2,906 ###
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 Pranab Banerjee
2 Permanent account number AAQQ 5565 A

Residential status PERMANENT RESIDENT

3

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. Rs. 15,000
(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) Rs. 223,440
2 Salary received in arrears or advance Rs. 15,000
Total income (as increased by salary received in arrears or advance)
3
[Add item 1 and item 2] Rs. 238,440
4 Tax on total income [as per item 3] Rs. 8,079 ###
5 Tax on total income [as per item 1] Rs. 6,534 ###
Tax on salary received in arrears or advance
6
[Difference of item 4 and item 5] Rs. 1,545
Tax computed in accordance with Table "A"
7
[Brought from column 7 of Table A] Rs. 0
Relief under Section 89(1) [Indicate difference between the amounts mentioned against
8
item 6 and item 7] Rs. 1,545

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

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

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

2008-09 Rs. 125,000 Rs. 15,000 Rs. 140,000 Rs. 0 Rs. 0 Rs. 0 ###

###

Signature:

Place: Name:

Date: Designation:
Dept: