Name Mujeeb ur RehmanMobile No 9911400178Place New Delhi

In case you are facing any problem in using this file, feel free to contact me.

9 (ii) - Codes for special rates of tax , Schedule SI

S. No Particulars

1 Tax on accumulated balance of recognised provident fund 2 Short term capital gains 3 Long term capital gains (with indexing) 4 Long term capital gains (without indexing) 5 Dividends, interest and income from units purchase in foreign currency

6

7 Income from royalty & technical services

8 Income from royalty & technical services

9 Income from royalty & technical services

10 Income received in respect of units purchase in foreign currency by a off-shore fund

11

12

13

14 Profits and gains of life insurance business

15

16 Tax on non-residents sportsmen or sports associations

17

18 Anonymous donations 19 Investment income 20 Income by way of long term capital gains 21 Double Taxation Agreement

7. Codes for filling this Return Form

Sl.No How the return is filed

i. Voluntarily before the due date under section 139

ii. Voluntarily after the due date under section 139

iii. In response to notice under section 142(1)

iv. In response to notice under section 148

v. In response to notice under section 153A/153C

9. Codes for filling out this Form

Sl.No Nature of transaction

Income from royalty or technical services where agreement entered between 31.3.1961 to 31.3.1976 in case of royalty and between 29.2.1964 and 31.3.1976, and agreement is approved by the Central Government.

Income by way of long-term capital gains arising from the transfer of units purchase in foreign currency by a off-shore fund

Income from bonds or GDR purchases in foreign currency or capital gains arising from their transfer in case of a non-resident

Income from GDR purchased in foreign currency or capital gains arising from their transfer in case of a resident

Winnings from lotteries, crosswords puzzles, races including horse races, card games and other games of any sort or gambling or betting of any form or nature whatsoever

Tax on income from units of an open – ended equity oriented fund of the Unit Trust of India or of Mutual Funds

1.

2.

3.

4.

5.

6.

7.

8.

Cash deposits aggregating to ten lakh rupees or more in a year in any savings accounmaintained in a banking company to which the Banking Regulation Act, 1949 (10 of 1949), applied (including any bank or banking institution referred to in section 51 of the Act.Payment made by you against bills raised in respect of a credit card aggregating tomore in a year.Payment made by you of an amount of two lakh rupees or more for purchase of units of Mutual Fund.Payment made by you of an amount of five lakh rupees or more for acquiring bonds or debentures issued by a company or institution.Payment made by you of an amount of one lakh rupees or more for acquiring sharescompany.Purchase by you of any immovable property valued at thirty lakh rupees or more.

Sale by you of any immovable property valued at thirty lakh rupees or more.Payment made by you of an amount of five lakh rupees or more in a year for investment in issued by Reserve Bank of India.

9 (ii) - Codes for special rates of tax , Schedule SI

Section Rate of Tax

111 1111A 1A 15112 21 20112 22 10

115A(1)(a) 5A1a 20

FA 50

5A1b1 30

5A1b2 20

5A1b3 10

115AB(1)(a) 5AB1a 10

115AB(1)(b) 5AB1b 10

115AC(1) 5AC 10

115ACA(1) 5ACA 10

115B 5B 12.5

115BB 5BB 30

115BBA 5BBA 10

115BBB 5BBB 10

115BBC 5BBC 30115E(a) 5Ea 20115E(b) 5Eb 10

DTAA

How the return is filed Code

Voluntarily before the due date under section 139 11

Voluntarily after the due date under section 139 12

In response to notice under section 142(1) 13

In response to notice under section 148 14

In response to notice under section 153A/153C 15

Nature of transaction Code

Section Code To be computed in

accordance with rule 9(1) of Part A of

fourth Schedule

Paragraph EII of Part I of first schedule of

Finance Act

115A(1)(b) if agreement is entered on or before 31.5.1997

115A(1)(b) if agreement is entered on or after 31.5.1997 but before 1.6.2005

115A(1)(b)if agreement is on or after 1.6.2005

001

002

003

004

005

006

007

008

savings account by you maintained in a banking company to which the Banking Regulation Act, 1949 (10 of 1949), applied (including any bank or banking institution referred to in section 51 of the Act.aggregating to two lakh rupees or

for purchase of units of Mutual Fund. or more for acquiring bonds or debentures

more for acquiring shares issued by a

immovable property valued at thirty lakh rupees or more.

immovable property valued at thirty lakh rupees or more.or more in a year for investment in bonds

INPUT SHEET - [ ITR - 2 ] A.Y. 2010 - 2011

1. Name of the Assessee Name

PAN of the Assessee

Whether Senior Citizen or not No

2. Date of Birth

3. Father's Name

4. Select Gender of the Assessee Male

5. Address Flat/Door No./Block No.

Name of premises/Building/Village `Road / Street / Post Office

Area/ Locality

Town / City /Municipality

State

Pin Code

E-mail ID

6. Phone No (STD Code)

7. Designation of Assessing Officer (Ward/Circle)

8. Status of the Assessee (Individual/HUF) Individual

9. Name of the Employer

9a. Select the Cateogory of Employer Others

9b. PAN/TAN of Employer TAN

9c. Address of the employer Address

Town/City

State

Pin Code

10. Type of Return (Original/Revised) Original

10a. Return Filed under Section 139(1)/139(4) Before Due Date u/s 139(1)

11. Select Residential Status Resident

12. If this return is filed by a representative Assessee, Select Yes or No No

HEADS OF INCOME

13. INCOME FROM SALARY

Salary (Excluding all allowances & perquisites) -

Allowances Exempt u/s 10 -

Allowances not exempt u/s 10 -

Value of Perquisites u/s 17(2)

INCOME CHARGEABLE UNDER THE HEAD SALARIES

14. INCOME FROM HOUSE PROPERTY

HOUSE PROPERTY-1 HOUSE PROPERTY-2

Address :

Door No.

Town/City

State

PIN Code

Select Let Out/Self Occupied - -

Name of Tenant

Gross Annual Value

Less: Amount of Rent which cannot be realised -

Less: Municipal Taxes -

Net Annual Value -

Less: Deduction U/s 24

a) Standard Deduction @ 30% -

b) Interest on borrowed capital

Income from House Property -

INCOME CHARGEABLE UNDER THE HEAD HOUSE PROPERTY

15. INCOME FROM CAPITAL GAINS

A. Short Term Capital Gains: On Shares & Mutual Funds

a. Full Value of Consideration -

Less: Deduction u/s 48

i. Cost of acquisition - -

ii. Cost of Improvement - -

iii Expenditure on transfer - -

b. Balance -

c. Loss, if any to be ignored under Section 94(7) or 94(8)

d. Short Term Capital Gains -

e. Exemption u/s 54B/54D -

f. Income from Short Term Capital Gains -

Income from Short Term Capital Gains Chargeable at Special Rates u/s 111A

B. Long Term Capital Gains

Other assets where proviso under section 112(1) is not applicable

a. Full Value of consideration Less: Deduction u/s 48

i. Indexed cost of acquisition

ii. Indexed cost of Improvement -

iii. Expenditure on Transfer -

On Other than Shares & Mutual Funds

b. Long Term Capital Gains -

c. Exemption u/s 54/54B/54D/54EC/54ED/54F -

Income from Long Term Capital Gains -

Other assets where proviso under section 112(1) is applicable

a. Full Value of consideration - Less: Deduction u/s 48

i. Cost of acquisition without acquisition -

ii. Cost of Improvement without Indexation -

iii. Expenditure on Transfer -

b. Long Term Capital Gains -

c. Exemption u/s 54/54B/54D/54EC/54ED/54F -

Income from Long Term Capital Gains -

d. Income from Long Term Capital Gains

INCOME CHARGEABLE UNDER THE HEAD CAPITAL GAINS

16. INFORMATION ABOUT RECEIPT/ACCRUAL OF CAPITAL GAIN:

S.NO DATE UPTO 15/9/2009

1

- - - -

2

- - - -

3

- - - -

4

- - - -

17. INCOME CHARGEABLE TO INCOME TAX AT SPECIAL RATES:

S. NO SECTION CODE SPECIAL RATE INCOME TAX THEREON

16/09/2009 TO 15/12/2009

16/12/2009 TO 15/03/2010

16/03/2010 TO 31/03/2010

Long-term where proviso under Section 112(1) is exercised (Without indexation)-Code in SI Schedule is 22, Tax Rate is 10%;Enter only positive value from item B3e of Schedule CG AFTER loss adjustment under this category in Schedule CYLA and BFLA, if any.

Long-term where proviso under Section 112(1) is NOT exercised (With indexation)-Code in SI Schedule is 21, Tax Rate is 20%;Enter only positive value from item (B5-B3e) of Schedule CG AFTER loss adjustment under this category in Schedule CYLA and BFLA, if any.

Short-term under 111A-Code in SI Schedule is 1A, Tax Rate is 15%;Enter only positive value from item A7 of Schedule CG AFTER loss adjustment under this category in Schedule CYLA and BFLA, if any.

Short-term OTHERS-Tax at normal rates;Enter only positive value from item A8 of Schedule CG AFTER loss adjustment under this category in Schedule CYLA and BFLA, if any.

1 1A 15% -

2 22 10% -

3 21 20% -

4 5BB 30% -

TOTAL -

18. INCOME FROM OTHER SOURCES

A. Income other than from owning race horse(s):-

a. Dividends, Gross -

b. Interest, Gross

c. Other Income

Income other than from owning race horse(s):- -

INCOME CHARGEABLE UNDER THE HEAD OTHER SOURCES

19. BROUGHT FORWARD LOSS SET OFF

PARTICULARS

a. House Property -

b. Short-term Capital Gain -

c. Long term Capital Gain -

d. -

19. LOSS TO BE CARRIED FORWARD TO FUTURE YEARS

ASSESSMENT YEAR

2002-03

2003-04

2004-05

2005-06

2006-07

2007-08

2008-09

2009-10

20. DEDUCTIONS UNDER CHAPTER - VIA

a. Deduction U/s 80C -

b. Deduction U/s 80CCC -

c. Deduction U/s 80CCD -

BROUGHT FORWARD LOSSES OF EARLEIR YEARS

Other sources(profit from owning race horses but excluding winnings from Lottery)

DATE OF FILING ROI

HOUSE PROPERTY LOSS

SHORT TERM CAPITAL LOSS

LONG TERM CAPITAL LOSS

d. Deduction U/s 80D -

e. Deduction U/s 80G -

TOTAL OF DEDUCTION UNDER CHAPTER VIA

21.

S. NO NAME OF PERSON RELATIONSHIP

1

2

22. SCHEDULE ANNUAL INFORMATION RETURN:

S. NO CODE OF TRANSACTION AMOUNT

1 001

2 002

3 003

4 004

6 005

7 006

8 007

9 008

COMPUTATION OF NET TAX PAYABLE

23. Tax at normal rates -

24. Tax at special rates -

25. Tax Payable on total Income -

25. Education Cess -

26. Interest Payable U/s 234

a) U/s 234 A - -

b) U/s 234 B -

c) U/s 234 C -

27. Taxes Paid

a) Advance Tax Paid and Self Assessment Tax Paid

Name of Bank & Branch BSR Code Amount

1 - Input adv tax on or before 15.09.09

2 - Input adv tax on or before 15.12.09

3 Input adv tax on or before 15.03.10

4

TOTAL : -

b) Tax Deducted At Source (As per Form No. 16 issued by the employer)

INCOME OF SPECIFIED PERSONS INCLUDIBLE IN TOTAL INCOME OF THE ASSESSEE (INCOME OF MINOR CHILD TO BE INCLUDED AFTER RS. 1500 PER CHILD

PAN OF THE PERSON

NATURE OF INCOME

Sl.No

Date of Deposit(DD/MM/YYYY

Serial No. of Challan

0

0

- - - - -

TOTAL : -

b) Tax Deducted At Source (As per Form No. 16A issued by the deductee)

Total Taxes paid

28. BANK DETAILS

a. Name of the Bank

b. Select Type of account (Saving/Current) Saving

c. Bank Account Number

d. MICR Code

e. Do You Want Refund by Cheque or Directly deposit into your Account Direct Deposit into Account

29. DETAILS OF EXEMPT INCOME

a. Interest income

b. Dividend income

c.

d Others,including exempt income of minor child

Total

0

TAN of the

Employer

Name and address of the Employer

Income Chargeable u/h Salaries

Deduction under

Chapter VI-A

Tax Payable (including E

Cess)

Total tax deducted

Tax Payable/ refundable

TAN of the

Deductor

Name and address of the deductor

Amount Paid/ Credit

Date of Payment/ Credit

Total tax Deducted

Amount claimed for this year

Long-term capital gains on which Securities Transaction Tax is paid

INPUT SHEET - [ ITR - 2 ] A.Y. 2010 - 2011

`

PAN

Resident

-

-

-

-

-

On Shares & Mutual Funds

-

-

-

-

-

-

-

-

-

-

-

16/03/2010 TO 31/03/2010

-

OTHER SOURCES LOSS

-

AMOUNT

-

-

-

-

-

-

Input adv tax on or before 15.09.09

Input adv tax on or before 15.12.09

Input adv tax on or before 15.03.10

INCOME OF SPECIFIED PERSONS INCLUDIBLE IN TOTAL INCOME OF THE ASSESSEE (INCOME OF MINOR CHILD TO BE INCLUDED AFTER RS. 1500

-

-

PER

SO

NA

L I

NFO

RM

ATIO

N

Name

0Flat/Door/Block No

0Road/Street/Post Office

0Town/City/District

0

Designation of Assessing Officer (Ward/Circle)

CO

MP

UTA

TIO

N O

F I

NC

OM

E A

ND

TA

X T

HER

EO

N

1 Gross Total Income

2 Deductions Under Chapter VI-A

3 Total Income

3a Current Year Loss, (if any)

4 Net tax payable

5 Interest payable

6 Total tax and interest payable

7 Taxes paid

a Advance Tax

b TDS

c TCS

d Self Assessment Tax

e Total Taxes Paid (7a+7b+7c+

8 Tax Payable (6-7e)

9 Refund (7e-6)

Receipt No

Date

FO

RM

ITR-2

INDIAN INCOME TAX RETURN Assessment Year

[For Individuals and HUFs not having Income from Business or Profession]

2 0 1 0 - 1 1(Please see Rule 12 of the Income-tax Rules, 1962)

(Also see attached instructions)

Part A-GEN GENERAL 1 0

PER

SO

NA

L I

NFO

RM

ATIO

N

First Name Middle Name Last Name PAN

0 0

Flat /Door/Block No. Name of Premises/building/Village Status (Tick) √

0 0 √ Individual HUF

Road/Street/Post Office Area/Locality Date of Birth (DD/MM/YYYY)(in case of individual

0 0 30-Dec-99

Town/City/District State Pin Code Sex(in case of individual) (Tick) √

0 0 0 √ Male Female

Email Address (STD Code) - Phone Number Employer Category (if in employment)

0 0 Govt. PSU √ Others

FIL

ING

STA

TU

S

Designation of Assessing Officer (Ward/Circle) Return Filed Under Section 11

0 [Please see instruction number-9(I)]

Whether original or Revised return? (Tick) √ √ Original Revised

Residential Status (Tick) √ Resident Non-Resident Resident but not ordinarily Resident

Whether this return is being filed by a representative assessee? (Tick) Yes √ NoIf Yes, please furnish following information:-a Name of the representativeb Address of the representativec Permanent Account Number (PAN) of the representati

PART - BPart B - TI Computation of total income

TO

TA

L I

NC

OM

E

1 1 -

2 2 -

3 Capital gains

a Short Term

(i) 3ai -

(ii) 3aii -

(iii) 3aiii -

b 3b -

c 3c -

4 Income from other sources

a 4a -

b 4b -

c 4c -

5 Total (1+2+3c+4c) 5 -

Do not write or stamp in this area (Space for bar code) For Office Use only

Receipt No.

Date

Seal and Signature of receiving official

If revised, enter Receipt No and Date of filing original return

(DD/MM/YYYY)

Salaries (6 of Schedule S)

Income from house property (3c of Schedule HP) (enter nil if loss)

Short-term (u/s 111A) (enter nil, if loss) (A5 of Schedule CG)

Short-term (others) (A6 of Schedule CG)

Total Short-term (3ai +3aii) (A4 of Schedule CG)

Long-term (B5 of Schedule CG) (enter nil if loss)

Total capital gains (3aiii + 3b) (enter nil if 3c is a loss)

From sources other than from owning race horses and Winnings from Lottery (3 of Schedule OS)

from owning race horses (4c of Schedule OS) (enter nil if loss)

Total (a + b) (enter nil, if 4c is a loss)

6 6 -

7 7 -

8 8 - 9 9 -

10 10 - 11 11 - 12 12 -

13 13 -

14 14 -

Part B - TTI

CO

MP

UTA

TIO

N O

F T

AX

LIA

BIL

ITY

1 Tax payable on total incomea Tax at normal rates 1a - b 1b - c 1c -

2 2 - 3 3 - 4 Tax relief

a Section 89 4a - b Section 90 4b - c Section 91 4c -

d Total (4a + 4b + 4c) 4d - 5 Net tax liability (3 - 4d) 5 - 6 Interest Payable

a For default in furnishing the return (section 234A) 6a - b For default in payment of advance tax (section 234B) 6b - c For deferment of advance tax (section 234C) 6c - d Total Interest Payable (6a + 6b + 6c) 6d -

7 Aggregate liability (5 + 6d) 7 -

TA

XES

PA

ID

8 Taxes paida Advance Tax (from Schedule - IT) 8a - b

8b -

c Self Assessment Tax (from Schedule - IT) 8c d Total Taxes paid (8a + 8b + 8c) 8d -

9 Amount payable (enter if 7 is greater than 8d, else enter 0) 9 -

REFU

ND

10 Refund (if 8d is greater than 7, also give bank account details below) 10 -

11 Enter your bank account number (mandatory in case of refund) 0

12 Do you want your refund by Cheque, or √ deposited directly into your bank account ? (tick as applicable)

13 Give Additional Details of your bank account 0

MICR Code 0 Type of account (tick as applicable ) √ Savings Current

VERIFICATION

I, 0 Son of 0 holding permanent

account number 0 solemnly declare that to the best of my knowledge and belief, the information given in the

Place NEW DELHI Date Sign here

14 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 15

Schedule S Details of Income from Salary

SA

LA

RIE

S

Name of Employer PAN of Employer (optional)

0 0

Address of employer Town/City State Pin Code

Lossess of current year set off against 5 (total of 2vi and 3vi of schedulce CYLA)

Balance after set off current year losses (5-6) (also total of column 4 of Schedule CYLA)

Brought forward losses set off against 7 (2vi of Schedule BFLA)

Gross Total income (7-8) (also 3vii of Schedule BFLA)

Deductions under Chapter VI-A (n of Schedule VIA)

Total income (9-10)

Net agricultural income / any other income for rate purpose (4 of Schedule EI)

Aggregate income' (11 + 12)

Losses of current year to be carried forward (total of row xi of Schedule CFL)

Computation of tax liability on total income

Tax at special rates (11 of Schedule SI)Tax payable on total income (1a + 1b)

Education Cess including Secondary & Higher Education Cess on 1cGross tax liability (1c + 2 )

TDS (total of column 7 of Schedule - TDSI and column 7 of schedule - TDS2

return and schedules thereto is correct and complete and that the amount of total income/fringe benefits and other particulars shown there are truly stated and are in accordance with the provisions of the Income Tax Act, 1961, in respect of, income & fringe benefits chargeable to Income tax for the previous year relevant to Assessment Year 2010-2011

SA

LA

RIE

S

0 0 0 0

11 -

2 2 -

3 3 -

4 4 -

5 5 -

6 Income chargeable under the Head 'Salaries' (1+3+4+5) 6 -

Schedule HP

HO

US

E P

RO

PER

TY

1 Address of property 1 Town / City State PIN Code

0 0 0 0

(Tick) If let out Name of Tenant PAN of Tenant (optional)

a1a

-

b The amount of rent which cannot be realized 1b -

c Tax paid to local authorities 1c -

d Total (1b + 1c) 1d -

e Balance (1a - 1d) 1e -

f 30% of 1e 1f -

g Interest payable on borrowed capital 1g -

h Total (1f + 1g) 1h -

i Income from house property 1 (1e-1h) 1i -

2 Address of property 2 Town / City State PIN Code

0 0 0 0

(Tick) If let out Name of Tenant PAN of Tenant (optional)

0

a2a

-

b The amount of rent which cannot be realized 2b - c Tax paid to local authorities 2c -

d Total (2b + 2c) 2d -

e Balance (2a - 2d) 2e -

f 30% of 2e 2f -

g Interest payable on borrowed capital 2g -

h Total (2f + 2g) 2h -

i Income from house property 2 (2e-2h) 2i -

3 Income under the head "Income from house property"

a Rent of earlier years realized under section 25A/AA 3a -

b Arrears of rent received during the year under section 25B after deducting 30% 3b -

c Total (3a + 3b + 1i + 2i) 3c - NOTE Please including the income of the specified persons referred to in schedule SPI while computing the income under this head

Schedule CG Capital Gains

CA

PIT

AL G

AIN

S

A Short-term capital gain

1 From assets in case of non-resident to which first proviso to section 48 applicable 1 2 From assets in case of others

a Full value of consideration 2a - b Deductions under section 48

i Cost of acquisition bi - ii Cost of Improvement bii - iii Expenditure on transfer biii - iv Total (i+ii+iii) biv -

c Balance (2a - biv) 2c -

d2d -

e Deduction under section 54B/54D 2e -

f Short-term capital gain (2c + 2d - 2e) 2f -

3A3 -

4 Total short term capital gain (1+2f+A3) A4 -

5 Short term capital gain under section 111A included in 4 A5 -

6 Short term capital gain other than referred to in section 111A (A4-A5) A6 - B Long term capital gain

1 Asset in case of non-resident to which first proviso to section 48 is applicable 1 -

Salary (Exculding all exempt/non-exempt allowances, perquisites & profit in lieu of salary as they are shown separately below)

Allowances exempt under section 10 (Not to be included in 6 below)

Allowances not exempt (refer Form 16 from employer)

Value of perquisites (refer Form 16 from employer)

Profits in lieu of salary (refer Form 16 from employer)

Details of Income from House Property (Please refer to instructions)

Annual letable value/rent received or receivable (higher if let out for whole of the year, lower if let out for part of the year)

Annual letable value/rent received or receivable (higher if let out for whole of

the year, lower if let out for part of the year

Loss, if any, to be ignored u/s. 94(7) or 94(8) (enter positive values only)

Amount deemed to be short term capital gains under sections 54B/54D/54EC/54ED/54G/ 54GA

CA

PIT

AL G

AIN

S2 Assets in case of others where proviso to section 112(1) is not exercised

a Full value of consideration 2a - b Deductions under section 48

i Cost of acquisition after indexation bi -

ii Cost of Improvement after indexation bii - iii Expenditure on transfer biii - iv Total (bi+bii+biii) biv -

c Balance (2a - biv) 2c -

d

2d - e Net balance (2c - 2d) 2e -

3 Assets in case of others where proviso under section 112(1) is exerciseda Full value of consideration 3a -

b Deductions under section 48

i Cost of acquisition without indexation bi -

ii Cost of Improvement without indexation bii -

iii Expenditure on transfer biii - iv Total (bi+bii+biii) biv -

c Balance (3a - biv) 3c - d Deductions under sections 54/54B/54D/54EC/54F 3d -

e Net balance (3c - 3d) 3e -

4 Amount deemed to be long term capital gains under sections 54/54B/54D/54EC/54ED/5 B4 -

5 B5 -

C C - D Information about accrual / receipt of capital gain

Date Upto 15/9 16/9 to 15/12 16/12 to 15/3 16/3 to 31/3

(i) (ii) (iii) (iv)

1

- - - -

2

- - - -

3

- - - -

4

- - - -

NOTE: Please include the income of the specified persons referred to in schedule SPI while computing the income under this head

Schedule OS Income from Other Sources

INC

OM

E F

RO

M O

TH

ER

SO

UR

CES

1 Income

a Dividends, Gross 1a -

b Interest, Gross 1b -

c Rental income from machinery, plants, buildings, 1c - d 1d -

e Total (1a + 1b + 1c + 1d) 1e -

f Deductions under section 57:-

i Expenses/Deduction fi -

ii Depreciation fii -

iii Total fiii - g Balance (1e - fiii) 1g -

2 Winnings from lotteries, crossword puzzles, races, etc., 2 -

3 3

- 4 Income from owning and maintaining race horses

a Receipts 4a -

b Deductions under section 57 in relation to (4) 4b -

c Balance (4a - 4b) 4c -

5 5 -

Deductions under sections 54/54B/54D/54EC/54F/ 54G/ 54GA

Total long term capital gain [(1+2e (enter 2e as nil if loss) + 3e (enter 3e as nil if loss) + 4)]

Income chargeable under the Head "CAPITAL GAINS" (A4 + B5) (enter B5 as nil if loss)

Long-term where proviso under Section 112(1) is exercised (Without indexation)-Code in SI Schedule is 22, Tax Rate is 10%;Enter only positive value from item B3e of Schedule CG AFTER loss adjustment under this category in Schedule CYLA and BFLA, if any.

Long-term where proviso under Section 112(1) is NOT exercised (With indexation)-Code in SI Schedule is 21, Tax Rate is 20%;Enter only positive value from item (B5-B3e) of Schedule CG AFTER loss adjustment under this category in Schedule CYLA and BFLA, if any.

Short-term under 111A-Code in SI Schedule is 1A, Tax Rate is 15%;Enter only positive value from item A7 of Schedule CG AFTER loss adjustment under this category in Schedule CYLA and BFLA, if any.

Short-term OTHERS-Tax at normal rates;Enter only positive value from item A8 of Schedule CG AFTER loss adjustment under this category in Schedule CYLA and BFLA, if any.

Others, Gross (excluding income from owning race horses)

Income from other sources (other than from owning race horses and winnings from Lottery) (1g+2) (enter 1g as nil, if loss)

Income chargeable under the head "income from other sources: (3+4c) (enter 4c as nil if loss and take 4c loss figure to Schedule CFL)

INC

OM

E F

RO

M O

TH

ER

SO

UR

CES

5 5 -

NOTE: Please include the income of the specified persons referred to in schedule SPI while computing the income under this head

Schedule CYLA Details of Income after Set off of current year losses

CU

RR

EN

T Y

EA

R L

OS

S A

DJU

STM

EN

T

Head/Source of income

Total loss (3 of Schedule-OS)

1 2 3 4=1-2-3Loss to be adjusted

i Salaries - - - - ii House Property - - - iii Short-term Capital gain - - - -

iv Long term Capital gain - - - - v

- - -

vi Total loss set off - -

vii Loss remaining after set-off out of 2 & 3 - -

Schedule BFLA Details of Income after set off of Brought Forward Losses of earlier years

BR

OU

GH

T F

OR

WA

RD

LO

SS

AD

JUS

TM

EN

T

Head/Source of Income Brought forward loss set off

1 2 3i Salaries - - -

ii House Property - - - iii Short-term Capital Gain - - - iv Long term Capital Gain - - - v

- - -

vi Total of brought forward loss set off -

vii Current year's income remaining after set off total (i3 + ii3 + iii3 + iv3 + v3) -

Schedule CFL Details of Losses to be carried forward to future years

CA

RR

Y F

OR

WA

RD

OF L

OS

S

Assessment year House property loss

(DD/MM/YYYY)

i 2002-03 30-Dec-99 - - - ii 2003-04 30-Dec-99 - - - iii 2004-05 30-Dec-99 - - -

iv 2005-06 30-Dec-99 - - - v 2006-07 30-Dec-99 - - - - vi 2007-08 30-Dec-99 - - - - vii 2008-09 30-Dec-99 - - - - viii 2009-10 30-Dec-99 - - - - ix Total of earlier year

- - - -

lossesx Adjustment of above

- - - -

losses in schedule BFLAxi 2010-11 (current

- - - -

year losses)xii Total loss carried

- - - - forward to futureyears

Schedule VIA Deductions under Chapter VI-A (Section)

TO

TA

L D

ED

UC

TIO

NS

a 80C - h 80G -

b 80CCC - I 80GG -

c 80CCD - j 80GGA -

d 80D - k 80GGC -

e 80DD - l 80RRB -

f 80DDB - m 80U -

g 80E

n Total deductions (total of a to m) n -

Schedule SPI Income of specified persons (spouse, minor child etc) includable in income of the assessee ( income of minor child to be included after Rs 1,500 per child )

Income chargeable under the head "income from other sources: (3+4c) (enter 4c as nil if loss and take 4c loss figure to Schedule CFL)

Sl No.

Income of current year

(Fill this column only if income

is zero or positive)

House property loss of the current year set off

Other sources loss (other than loss from race

horses) of the current year set off

Current year's Income remaining after set off

Total loss (3c of Schedule - HP)

Other sources(incl profit from owning race horses but excluding winnings from lottery)

Sl No

Income after set off, if any, of current year's losses as per 4 of Schedule CYLA

Current year's Income remaining after set off

Other sources( profit from owning race horsesbut excluding winnings from Lottery)

Date of Filing Short-term Capital loss

Long Term Capital loss

Other sources loss (from owning race

horses)

Sl. No. Name of person PAN of person (optional) Relationship Nature of Income Amount(Rs.)

1 0 0 0 0 -

2 0 0 0 0 -

Schedule SI

SP

EC

IAL R

ATE

Section CodeSpecial rate (%)

1 1A 15 - - 6

2 22 10 - - 7 3 21 20 - - 8 4 5BB 30 - - 9

5 10

11 Total (1 ii to 10 ii) - 1 0 0 0 0 0 0 0 0 0

Schedule EI Details of Exempt Income (Income not to be included in Total Income)

EX

EM

PT I

NC

OM

E 1 Interest income 1 -

2 Dividend Income 2 - 3 Long-term capital gains on which Securities Transaction Tax is paid 3 - 4 Net Agriculture income/any other Income for rate purpose 4 -

5 Others, including exempt income of minor child 5 -

6 Total (1+2+3+4+5) 6 -

Schedule AIRSl Code of Transaction Amount (Rs.) Sl No Code of Transaction Amount(Rs.)1 001 - 5 005 - 2 002 - 6 006 - 3 003 - 7 007 - 4 004 - 8 008 -

0 0 0 0

Schedule IT Details of advance Tax and Self assessment Tax payments of Income-tax

TA

X P

AY

MEN

TS Name of Bank & Branch BSR Code Amount (Rs.)

(i) 0 0 30-Dec-99 0 -

(ii) 0 0 30-Dec-99 0 - (iii) 0 0 30-Dec-99 0 - (iv) 0 0 30-Dec-99 0 - Note: Enter the totals of Advance tax and Self Assessment Tax in Sl. No. 8a & 8c of Part B-TTI

Schedule TDS1 Details of Tax deducted at source from Salary [As per Form 16 issued by Employer(s)]

TD

S O

N S

ALA

RY

Name and address of the Employer

(1) (2) (3) (4) (5) (6) (7) (8)

(i)

0

0

- - - - -

(ii)

Schedule TDS2 Details of Tax Deducted at Source on Interest [As per Form 16A issued by Deductor(s)]

TD

S O

N O

TH

ER

IN

CO

ME

Name and Address of the Deductor Amount paid

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

0

0

- 30-Dec-99 - - 0

(ii)0

0

- 30-Dec-99 - - 0

(iii)

0

0

- 30-Dec-99 - - 0

(iv)

0

0

- 30-Dec-99 - - 0

Note: Please Enter the total of column 7 of Schedule - TDS1 and column 7 of Schedule - TDS2 in 8(b) of Part B-TTI

Income chargeable to Income tax at special rates [Please see instruction No.9(iii) for section code and rate of tax]Sl No.

Special rate (%)

Income i

Tax thereon ii

Sl No

Section Code

Income i

Tax thereon ii

Other Information (transactions reported through Annual Information Return) [Please see instruction No-9(ii) for code]

Sl No

Date of Deposit (DD/MM/YYYY)

Serial Number of Challan

Sl No

Tax Deduction Account Number

(TAN) of the Employer

Income Chargeable under the

head Salaries

Duduction under

Chapter VI-A

Tax payable (including education

cess)

Total Tax Deducted

Tax payable/ refundabl

e

Sl No

Tax Deduction Account Number(TAN) of the

Deductor

Date of Payment /

Credit

Total Tax Deducted

Amount out of (6) claimed for this

year