2020-21 It

INDIAN INCOME TAX RETURN ACKNOWLEDGEMENT
[Where the data of the Return of Income in Form ITR-1 (SAHAJ), ITR-2, ITR-3, ITR-4(SUGAM), ITR-5, ITR-6, ITR-7
Assessment Year
filed and verified] 2021-22
(Please see Rule 12 of the Income-tax Rules, 1962)
PAN AOSPR0329F
Name SRINIVASAN RAHAVENDHIRAN

OLD NO 236/3NEW NO 86/4 , SOUTH CHITRA STREET , Srirangam H.O , Srirangam , TIRUCHIRAPPALLI , 29-Tamil Nadu ,
Address
91-India , 620006
Status Individual Form Number ITR-3
Filed u/s 139(4) Belated- Return filed after due date e-Filing Acknowledgement Number 452532380280322
Current Year business loss, if any 1 0
Total Income 7,90,320
Book Profit under MAT, where applicable 2 0
Adjusted Total Income under AMT, where applicable 3 7,90,320
Net tax payable 4 73,387
Interest and Fee Payable 5 5,000
Total tax, interest and Fee payable 6 78,387
Taxes Paid 7 78,387
(+)Tax Payable /(-)Refundable (6-7) 8 0
Dividend Tax Payable 9 0
Interest Payable 10 0
Total Dividend tax and interest payable 11 0
Taxes Paid 12 0
Accreted Income as per section 115TD 14 0
Additional Tax payable u/s 115TD 15 0
Interest payable u/s 115TE 16 0
Additional Tax and interest payable 17 0
Tax and interest paid 18 0
This return has been digitally signed by SRINIVASAN RAHAVENDHIRAN in the capacity of Self having PAN AOSPR0329F from IP address
110.172.187.181 on 28-03-2022 16:15:19
DSC Sl. No. & Issuer 6444665 & 22320515CN=e-Mudhra Sub CA for Class 3 Individual 2014,OU=Certifying Authority,O=eMudhra Consumer
Services Limited,C=IN
System Generated
Barcode/QR Code
AOSPR0329F03452532380280322611A14171832603822449C51B7999BCA432F009D
DO NOT SEND THIS ACKNOWLEDGEMENT TO CPC, BENGALURU

Sree Laxmee Traders Prop: Rahavendhiran
2/164, South Chitra Street, Srirangam, Trichy 620006
Balance Sheet as on 31.03.2021
Liabilities Amount Assets Amount

Propreitor Capital account Fixed Assets 6,40,123
Rahavendhiran 11,94,944
Current Asset
Secured loans 7,86,615 Closing Stock 20,24,236
Rental Advances 2,60,000
Unsecured loans 8,64,995 Sundry Debtors 2,28,411
Cash at Bank 2,27,059
Current Liablities Cash in hand 53,459
Sundry Creditors 5,52,592 GST input credit 57,444
GST Payable 91,586
34,90,732 34,90,732
For M R N R & Associates

Chartered Accounts
FRN - 016705S
R Natarajan
Partner
Trichy Membership No.022998
28-Mar-22 UDIN: 22022998AFTSLW6959
Sree Laxmee Traders Prop: Rahavendhiran
2/164, South Chitra Street, Srirangam, Trichy 620006
Profit and Loss A/c for the year ended 31.03.2021
Particulars Amount Particulars Amount
Opening Stock 5,81,950 Sales 1,51,98,692
Purchase 1,45,50,150 Closing Stock 20,24,236
Gross Profit 20,90,828
1,72,22,928 1,72,22,928
Rent 1,20,000 Gross Profit 20,90,828
Salary 3,62,150 Discount received 8,867
Conveyance expenses 70,650 Interest received 461
Rates and taxes 500
Electricity Charges 1,15,616
Insurance 25,218
Transport Charges 1,13,016
Shop expenses 68,190
Other expenses 6,708
Interest and finance charges 1,99,010
Depreciation 1,30,468
Net Profit 8,88,630
21,00,156 21,00,156
For M R N R & Associates

Chartered Accounts
FRN - 016705S
R Natarajan
Partner
Trichy Membership No.022998
28-Mar-22 UDIN: 22022998AFTSLW6959
Name : RAHAVENDHIRAN Assessment year 2021-22
Father's Name : SRINIVASAN Previous year 2020-21
Date of birth : 22-Jul-79 PAN AOSPR0329F
Address: : 2/164, South Chitra Street,

Srirangam
Trichy 620006
Computation of income
Income from Business Sree Laxmee Traders

-
Profit as per profit and loss account 888630
Less: SB interest income -461 8,88,169
Income from Salary

SB interest 461
-
Gross total income 8,88,630
Less: Deduction under Chapter VI-A
80C 97,847
80D -
80TTA 461
Total deductions 98,308
Taxable income 7,90,322

Tax on income 70,564
Rebate -
Cess @ 4% 2,823
234F fees 5,000
Total tax payable 78,387

TDS 76,561
Self assessment tax paid on 28-03-2022 1,826
Balance tax payable -
Acknowledgement Receipt of
Income Tax Forms
(Other Than Income Tax Return)
e-Filing Acknowledgement Number / Quarterly Statement Receipt Number Date of e-Filing

452128560280322 28-Mar-2022
Name : SRINIVASAN RAHAVENDHIRAN
PAN/TAN : AOSPR0329F
Address : OLD NO 236/3NEW NO 86/4, , Srirangam, TIRUCHIRAPPALLI,

Srirangam H.O, Tamil Nadu, 620006
Form No. : Form 3CB-3CD
Form Description : Audit report under section 44AB of the Income-tax Act, 1961, in
the case of a person referred to in clause (b) of sub-rule (1) of rule
6G
Assessment Year : 2021-22
Financial Year : -
Month : -
Quarter : -
Filing Type : Original
Capacity : Chartered Accountant
Verified By : 022998
(This is a computer generated Acknowledgement Receipt and needs no signature)

Acknowledgement Number : 452532380280322
INDIAN INCOME TAX RETURN Assessment Year

(For individuals and HUFs having income from profits
ITR-3 and gains of business or profession)
(Please see Rule 12 of the Income-tax Rules,1962) 2 0 2 1 - 2 2
(Please refer instructions)
Part A-GEN GENERAL

First Name Last Name PAN
Middle Name
SRINIVASAN RAHAVENDHIRAN AOSPR0329F
Status (Tick) ✔
Flat/Door/Block No. Name Of Premises/Building/Village
✔ Individual
OLD NO 236/3NEW NO 86/4 SOUTH CHITRA STREET HUF
Road/Street/Post Office Date of Birth/ Formation (DD/MMM/YYYY)

Srirangam H.O 22-Jul-1979
Area/locality Aadhaar Number (12 digit)/ Aadhaar Enrolment Id (28 digit) (if eligible for Aadhaar)
Srirangam 9xxx xxxx 7826 /
State
Town/City/District 29-Tamil Nadu PIN code/ZIP code
TIRUCHIRAPPALLI Country 620006
91-India
Residential/Office Phone Number with STD code/Mobile No. 1

Mobile No. 2
91 9944283942
Email Address-1 (self)

Email Address-2
camsnoffice5@gmail.com
139(1)-On or Before due date,

✔ 139(4)-After due date,
Filed u/s (Tick) [Please see instruction] 139(5)-Revised Return,
92CD-Modified return,
(a) 119(2)(b)-after condonation of delay.
139(9),
Or Filed in response to notice u/s 142(1),
148
Are you opting for new tax regime u/s 115BAC ?

Yes
✔ No
If yes, please furnish date of filing of form 10-IE along with Acknowledgment number
Date of filing of form 10-IE Acknowledgment Number
Are you filing return of income under Seventh proviso to Section 139(1) - (Tick) Yes ✔ No
If yes, please furnish following information
(b)
[Note: To be filled only if a person is not required to furnish a return of income under section 139(1) but filing return of income due
to fulfilling one or more conditions mentioned in the seventh proviso to section 139(1)]
Have you deposited amount or aggregate of amounts exceeding Rs. 1 Crore in one or
(bi) Amount (Rs) (If Yes) 0
more current account during the previous year? (Yes/No)
Have you incurred expenditure of an amount or aggregate of amount exceeding Rs. 2

(bii) Amount (Rs) (If Yes) 0
lakhs for travel to a foreign country for yourself or for any other person
Have you incurred expenditure of amount or aggregate of amount exceeding Rs. 1 lakh
(biii) Amount (Rs) (If Yes) 0
on consumption of electricity during the previous year? (Yes/No)
If revised/Defective/Modified, then enter Receipt

(c) No. and Date of filing original return (DD-MMM-
YYYY)
(d) If filed, in response to a notice u/s 139(9)/142(1)/148 or order u/s 119(2)(b), enter Unique (Unique Number)
Number/Document Identification Number and date of such notice/order, or if filed u/s
92CD enter date of advance pricing agreement
✔ You were in India for 182 days or more during the previous year [section 6(1)
(a)]
A. Resident You were in India for 60 days or more during the previous year, and have
been in India for 365 days or more within the 4 preceding years [section (6)(1)
(c)] [where Explanation 1 is not applicable]
You have been a non-resident in India in 9 out of 10 preceding years [section

6(6)(a)]
You have been in India for 729 days or less during the 7 preceding years
[section 6(6)(a)]
You are a citizen of India or person of Indian origin, being outside India, who
comes on a visit to India, and has total income other than the income from
Residential B. Resident but not Ordinarily foreign sources exceeding Rs. 15 lakh and been in India for a period or periods
Status in Resident amounting in all to 120 days or more but less than 182 days during the previous
India (for year [section 6(6)(c)]
individuals)
(Tick You are a citizen of India, who is not resident under clause (1) of section 6
applicable and who is deemed to be resident in India under clause (1A) of section 6,
(e) option) having total income other than the income from foreign sources exceeding Rs.
15 lakh during the previous year and not liable to tax in any other country or
territory by reason of your domicile or residence or any other criteria of similar
nature [section 6(6)(d)]
You were a non-resident during the previous year.

(i) Please specify the jurisdiction(s) of residence during the previous year -
S.No Jurisdiction of residence Taxpayer Identification Number
C. Non-resident (ii) In case you are a Citizen of India or a Person of Indian Origin (POI), please
specify -
Total period of stay in India during the Total period of stay in India during the
previous year (in days) 4 preceding years (in days)
Residential
Status in D.
India (for Resident
HUF) (Tick Resident but not Ordinarily Resident
applicable Non-resident
option)
Yes
(f) Do you want to claim the benefit under section 115H? (applicable in case of resident) ✔ No
Are you governed by Portuguese Civil Code as per section 5A? (Tick) ✔
Yes
(g) ✔ No
(If ?YES? please fill Schedule 5A)
Whether this return is being filed by a representative assessee? (Tick) ✔

Yes
(h) ✔ No
If yes, furnish following information -
(1) Name of the representative
(2) Capacity of the Representative (drop down to be provided)
(3) Address of the representative
(4) Permanent Account Number (PAN) / Aadhaar No. of the representative /
Whether you were Director in a company at any time during the previous year? (Tick) ✔ Yes ✔ No
(i)
If yes, please furnish following information -
Name of Company Type of company PAN Whether its shares are listed Director Identification
or unlisted Number (DIN)
(j) Whether you are Partner in a firm? (Tick) ✔ Yes ✔ No If yes, please furnish following information -
Name of Firm PAN
Whether you have held unlisted equity shares at any time during the previous year? (Tick) ✔ Yes ✔ No
(k)
If yes, please furnish following information in respect of equity shares
Name of Type of PAN Opening balance Shares acquired during the year Shares transferred during Closing balance
Company company the year
No. of Cost of No. of Date of subscription Face value Issue price per share (in case Purchase price per share (in case of purchase No. of Sale No. of Cost of
shares acquisition shares / purchase per share of fresh issue) from existing shareholder) shares consideration shares acquisition
1a 1b 2 3 4 5 6 7 8 9 10 11 12 13
(l) In case of non-resident, is there a permanent establishment (PE) in India? (Tick) ✔ Yes No
Whether assessee is located in an International Financial Services Centre and derives income solely in convertible foreign
exchange?
(m)
Yes
✔ No
(a1) Are you liable to maintain accounts as per section 44AA? (Tick) ✔ ✔ Yes No
(a2) Whether assessee is declaring income only under section 44AE/44B/44BB/44AD/44ADA/44BBA/44BBB Yes ✔ No
If No , Whether during the year Total sales/turnover/gross receipts of business exceeds Rs. 1 crores but does not exceed Rs. 10
crores?
a2i ✔ Yes
No
If Yes is selected at a2i, whether aggregate of all amounts received including amount received for sales, turnover or gross receipt s
or on capital account like capital contributions, loans etc. during the previous year, in cash, does not exceed five per cent of said
a2ii amount?
Yes
✔ No
If Yes is selected at a2i, whether aggregate of all payments made including amount incurred for expenditure or on capital account
such as asset acquisition, repayment of loans etc., in cash, during the previous year does not exceed five per cent of the said
a2ii payment?
Yes
✔ No
(b) Are you liable for audit under section 44AB? (Tick) ✔ ✔ Yes No
If (b) is Yes, whether the accounts have been audited by an accountant? (Tick) ✔ ✔ Yes No
(c)
If Yes, furnish the following information below
(1) Date of furnishing of the audit report (DD-MMM-YYYY) 28-Mar-2022

(2) Name of the auditor signing the tax audit report NATARAJAN R
(3) Membership No. of the auditor 022998
(4) Name of the auditor (proprietorship/ firm) M R N R AND ASSOCIATES
(5) Proprietorship/firm registration number 0016705S
Permanent Permanent Account Number (PAN)/Aadhaar No. of the
(6)
proprietorship/ firm
ABIFM9703D /
(7) Date of report of the audit 28-Mar-2022

(di) Are you liable for Audit u/s 92E? Yes ✔ No Date of furnishing audit report? DD-MMM-YYYY
(dii) If liable to furnish other audit report, mention the date of furnishing the audit report? (DD/MM/YY) (Please see Instruction)
SL. No. Section Code Whether have you furnished such other audit report? Date of furnishing of the audit report
(e) If liable to audit under any Act other than the Income-tax act, mention the Act, section and date of furnishing the audit report?
SL. Act Section Have you got audited Date of furnishing of the
No. under the selected Act audit report
other than the Income-tax
Act?
NATURE NATURE OF BUSINESS OR PROFESSION, IF MORE THAN ONE BUSINESS OR PROFESSION

OF INDICATE THE THREE MAIN ACTIVITIES/ PRODUCTS (OTHER THAN THOSE DECLARING INCOME
BUSINESS UNDER SECTIONS 44AD, 44ADA AND 44AE)
S. Code Trade name of the proprietorship, if Description
No. [Please see instruction] any
1 09028 -Retail sale of other products n.e. SREE LAXMI TRADERS

c
BALANCE SHEET AS ON 31ST DAY OF MARCH, 2021 OF THE PROPRIETORY BUSINESS

Part A-BS ORPROFESSION (fill items below in a case where regular books of accounts are maintained, otherwise
fill item 6)
1 Proprietor?s fund
a Proprietor?s capital a 11,94,944
b Reserves and Surplus
i Revaluation Reserve bi 0
ii Capital Reserve bii 0
iii Statutory Reserve biii 0
iv Any other Reserve biv 0
v Total (bi + bii + biii + biv) bv 0
c Total proprietor's fund (a + bv) 1c 11,94,944
2 Loan funds
a Secured loans
i Foreign Currency Loans ai 0
ii Rupee Loans
A From Banks iiA 0
B From others iiB 7,86,615
C Total (iiA + iiB) iiC 7,86,615
iii Total (ai + iiC) aiii 7,86,615
b Unsecured loans (including deposits)
i From Banks bi 0
ii From others bii 8,64,995
iii Total (bi + bii) biii 8,64,995
c Total Loan Funds (aiii + biii) 2c 16,51,610
3 Deferred tax liability 3 0
4 Sources of funds (1c + 2c +3) 4 28,46,554
1 Fixed assets
a Gross: Block 1a 7,70,591
b Depreciation 1b 1,30,468
c Net Block (a ? b) 1c 6,40,123
d Capital work-in-progress 1d 0
e Total (1c + 1d) 1e 6,40,123
2 Investments
a Long-term investments
i Government and other Securities - Quoted ai 0
ii Government and other Securities ? Unquoted aii 0
iii Total (ai + aii) aiii 0
b Short-term investments
Equity Shares, including share application
i bi 0
money
ii Preference Shares bii 0
iii Debentures biii 0
iv Total (bi + bii + biii) biv 0
c Total investments (aiii + biv) 2c 0
3 Current assets, loans and advances
a Current assets
i Inventories
Stores/consumables including packing
A iA 0
material
B Raw materials iB 0
C Stock-in-process iC 0
D Finished Goods/Traded Goods iD 20,24,236
E Total (iA + iB + iC + iD) iE 20,24,236
ii Sundry Debtors aii 2,28,411
iii Cash and Bank Balances
A Cash-in-hand iiiA 53,459
B Balance with banks iiiB 2,27,059
C Total (iiiA + iiiB) iiiC 2,80,518
iv Other Current Assets aiv 0
v Total current assets (iE + aii + iiiC + aiv) av 25,33,165
b Loans and advances
Advances recoverable in cash or in kind or for
i bi 0
value to be received
Deposits, loans and advances to corporates and
ii bii 2,60,000
others
iii Balance with Revenue Authorities biii 57,444
iv Total (bi + bii + biii ) biv 3,17,444
c Total of current assets, loans and advances (av + biv) 3c 28,50,609
d Current liabilities and provisions
i Current liabilities
A Sundry Creditors iA 6,44,178
B Liability for Leased Assets iB 0
C Interest Accrued on above iC 0
D Interest accrued but not due on loans iD 0
E Total (iA + iB + iC + iD) iE 6,44,178
ii Provisions
A Provision for Income Tax iiA 0
Provision for Leave encashment
B iiB 0
/Superannuation/Gratuity
C Other Provisions iiC 0
D Total (iiA + iiB + iiC) iiD 0
iii Total (iE + iiD) diii 6,44,178
e Net current assets (3c ? diii) 3e 22,06,431
4 a Miscellaneous expenditure not written off or adjusted 4a 0
b Deferred tax asset 4b 0
c Profit and loss account/ Accumulated balance 4c 0
d Total (4a + 4b + 4c) 4d 0
5 Total, application of funds (1e + 2c + 3e +4d) 5 28,46,554
In a case where regular books of account of business or profession are not maintained
6 - (furnish the following information as on 31st day of March, 2021, in respect of
business or profession)
a Amount of total sundry debtors 6a 0
b Amount of total sundry creditors 6b 0
c Amount of total stock-in-trade 6c 0
d Amount of the cash balance 6d 0
Part A-
Manufacturing Account for the financial year 2020-21 (fill items 1 to 3 in a case where regular books of
Manufacturing
accounts are maintained, otherwise fill items 61 to 65 as applicable)
Account
1 Debits to manufacturing account
Opening Inventory
i Opening stock of raw-material i 0
A
ii Opening stock of Work in progress ii 0
iii Total (i + ii) Aiii 0
Purchases (net of refunds and duty or tax, if any) (Provide details of top three
B B 0
purchase item)
C Direct wages C 0
D Direct expenses (Di + Dii + Diii) D 0
i Carriage inward i 0
ii Power and fuel ii 0
iii Other direct expenses iii 0
E Factory Overheads
I Indirect wages i 0
II Factory rent and rates ii 0
III Factory Insurance iii 0
IV Factory fuel and power /label> iv 0
V Factory general expenses v 0
Vi Depreciation of factory machinery vi 0
Vii Total (i+ii+iii+iv+v+vi) Evii 0
F Total of Debits to Manufacturing Account (Aiii+B+C+D+Evii) IF 0
2 Closing Stock
i Raw material 2i 0
ii Work-in-progress 2ii 0
Total (2i +2ii) 2 0
3 Cost of Goods Produced ? transferred to Trading Account (1F - 2) 3 0
Part A-Trading Trading Account for the financial year 2020-21 (fill items 4 to 12 in a case where regular books of
Account accounts are maintained, otherwise fill items 61 to 65 as applicable)
4 Revenue from operations
Sales/ Gross receipts of business (net of returns and refunds
A
and duty or tax, if any)
i Sale of goods i 1,51,98,692
ii Sale of services ii 0
iii Other operating revenues (specify nature and amount)
Sl. No. Nature of Revenue Amount
Total Aiii 0
iv Total (i + ii + iiic) Aiv 1,51,98,692
B Gross receipts from Profession B 0
Duties, taxes and cess received or receivable in respect of
C
goods and services sold or supplied
Union Excise
i i 0
duties
ii Service tax ii 0
iii VAT/Sales tax iii 0
Central Goods &
iv Service Tax iv 0
(CGST)
State Goods &
v Services Tax v 0
(SGST)
Integrated Goods
vi & Services Tax vi 0
(IGST)
Union Territory
Goods &
vii vii 0
Services Tax
(UTGST)
Any other duty,
viii viii 0
tax and cess
ix Total (i + ii + iii + iv +v+ vi+vii+viii) Cix 0
D Total Revenue from operations (Aiv + B +Cix) 4D 1,51,98,692
5 Closing Stock of Finished Stocks 5 20,24,236
6 Total of credits to Trading Account (4D + 5) 6 1,72,22,928
7 Opening Stock of Finished Goods 7 5,81,950
8 Purchases (net of refunds and duty or tax, if any) 8 1,45,50,150
9 Direct Expenses (9i + 9ii + 9iii) 9 0
i Carriage inward 9i 0
ii Power and fuel 9ii 0
iii Other direct expenses 9iii 0
Sl.No Nature of Expense Amount
Duties and taxes, paid or payable, in respect of goods and services

10
purchased
i Custom duty 10i 0
ii Counter veiling duty 10ii 0
iii Special additional duty 10iii 0
iv Union excise duty 10iv 0
v Service tax 10v 0
vi VAT/ Sales tax 10vi 0
Central Goods &
vii 10vii 0
Service Tax (CGST)
State Goods &
viii 10viii 0
Services Tax (SGST)
Integrated Goods &
ix 10ix 0
Services Tax (IGST)
Union Territory Goods
x & Services Tax 10x 0
(UTGST)
Any other tax, paid or
xi 10xi 0
payable
Total (10i + 10ii + 10iii + 10iv + 10v + 10vi + 10vii + 10viii +
xii 10xii 0
10ix + 10x + 10xi)
11 Cost of goods produced ? Transferred from Manufacturing Account 11 0
Gross Profit from Business/Profession -
12 transferred to Profit and Loss account (6-7-8-9- 12 20,90,828
10xii-11)
Part A- Profit and Loss Account for the financial year 2020-21 (fill items 13 to 60 in a case where regular books of
P& L accounts are maintained, otherwise fill items 61 to 65 as applicable)
13 Gross profit transferred from Trading Account 13 20,90,828

14 Other income
i Rent i 0
ii Commission ii 0
iii Dividend income iii 0
iv Interest income iv 461
v Profit on sale of fixed assets v 0
Profit on sale of investment being securities chargeable to Securities
vi vi 0
Transaction Tax (STT)
vii Profit on sale of other investment vii 0
viii Gain (loss) on account of foreign exchange fluctuation u/s 43AA viii 0
Profit on conversion of inventory into capital asset u/s 28(via) (Fair Market
ix ix 0
Value of inventory as on the date of conversion)
x Agricultural income x 0
xi Any other income (specify nature and amount) xi 8,867
Sl. No. Nature of Income Amount
1 DISCOUNT RECEIVED 8,867

xii Total of other income (i + ii + iii + iv + v + vi + vii + viii + ix + x + xic) 14xii 9,328
15 Total of credits to profit and loss account (13+14xii) 15 21,00,156
16 Freight outward 16 1,13,016
17 Consumption of stores and spare parts 17 0
18 Power and fuel 18 1,15,616
19 Rents 19 1,20,000
20 Repairs to building 20 0
21 Repairs to machinery 21 0
22 Compensation to employees
i Salaries and wages 22i 3,62,150
ii Bonus 22ii 0
iii Reimbursement of medical expenses 22iii 0
iv Leave encashment 22iv 0
v Leave travel benefits 22v 0
vi Contribution to approved superannuation fund 22vi 0
vii Contribution to recognised provident fund 22vii 0
viii Contribution to recognised gratuity fund 22viii 0
ix Contribution to any other fund 22ix 0
Any other benefit to employees in respect of which an expenditure has been
x 22x 0
incurred
xi Total compensation to employees (total of 22i to 22x) 22xi 3,62,150
xii Whether any compensation, included in 22xi, paid to non-residents xiia N
If Yes, amount paid to non-residents xiib 0
23 Insurance
i Medical Insurance 23i 0
ii Life Insurance 23ii 0
iii Keyman?s Insurance 23iii 0
iv Other Insurance including factory, office, car, goods, etc. 23iv 25,218
v Total expenditure on insurance (23i + 23ii + 23iii + 23iv) 23v 25,218
24 Workmen and staff welfare expenses 24 0
25 Entertainment 25 0
26 Hospitality 26 0
27 Conference 27 0
28 Sales promotion including publicity (other than advertisement) 28 0
29 Advertisement 29 0
30 Commission
Paid outside India, or paid in India to a non-resident other than a
i i 0
company or a foreign company
ii To others ii 0
iii Total (i + ii) 30iii 0
31 Royalty
Paid outside India, or paid in India to a non-resident other than a company
i i 0
or a foreign company
ii To others ii 0
32 Professional / Consultancy Fee / Fee for technical services
i i 0
ii To others ii 0
33 Hotel, boarding and Lodging 33 0
34 Traveling expenses other than foreign traveling 34 0
35 Foreign traveling expenses 35 0
36 Conveyance expenses 36 70,650
37 Telephone expenses 37 0
38 Guest House expenses 38 0
39 Club expenses 39 0
40 Festival celebration expenses 40 0
41 Scholarship 41 0
42 Gift 42 0
43 Donation 43 0
44 Rates or taxes, paid or payable to Government or any local bosy (excluding taxes on income)
i Union excise duty 44i 0
ii Service tax 44ii 0
iii VAT/Sales tax 44iii 0
iv Cess 44iv 0
v Central Goods & Service Tax (CGST) 44v 0
vi State Goods & Service Tax (SGST) 44vi 0
vii Integrated Goods & Service Tax (IGST) 44vii 0
viii Union Territory Goods & Service Tax (UTGST) 44viii 0
ix Any other rate, tax, duty or cess incl STT and CTT 44ix 500
Total rates and taxes paid or payable (44i + 44ii +44iii +44iv + 44v + 44vi +
x 44x 500
44vii + 44viii +44ix)
45 Audit Fee 45 0
46 Other expenses (specify nature and amount)
Sl. No. Nature of Expense Amount
1 SHOP EXPENSES 68190

2 OTHER EXPENSES 6708
iii Total (i + ii) 46iii 74,898
Bad debts (specify PAN/ Aadhaar of the person, if available, for whom Bad Debt
47 47i 0
for amount of Rs. 1 lakh or more is claimed and amount)
Sl. No. PAN of the person Aadhaar Number of the person Amount
Others (more than Rs. 1 lakh) where PAN/ Aadhaar is not available (provide
ii 47ii 0
name and complete address)
Sl. Name Flat / Name of Road/ Area/ Town/ State Country PIN ZIP Amount
No. Door / Premises/ Street/ Locality City/ Code Code
Block No. Building/ Village Post Office District
iii Others (amounts less than Rs. 1 lakh) 47iii 0

iv Total Bad Debt (47i + 47ii + 47iii) 47iv 0
48 Provision for bad and doubtful debts 48 0
49 Other provisions 49 0
Profit before interest, depreciation and taxes [15 ? (16 to 21 + 22xi + 23v + 24 to
50 29 + 30iii + 31iii + 32iii + 33 to 43 + 44x + 45 + 46iii + 47iv + 48 + 49)] 50 12,18,108
51 Interest
i i 0
ii To others ii 1,99,010
iii Total (i + ii) 51iii 1,99,010
52 Depreciation and amortization 52 1,30,468
53 Net profit before taxes (50 ? 51iii ? 52) 53 8,88,630
54 Provision for current tax 54 0
55 Provision for Deferred Tax 55 0
56 Profit after tax (53 - 54 - 55) 56 8,88,630
57 Balance brought forward from previous year 57 0
58 Amount available for appropriation (56 + 57) 58 8,88,630
59 Transferred to reserves and surplus 59 0
60 Balance carried to balance sheet in proprietor?s account (58 ?59) 60 8,88,630
61 COMPUTATION OF PRESUMPTIVE BUSINESS INCOME UNDER SECTION 44AD
Sl. No. Name of Business Business Code Description
(i) Gross Turnover or Gross Receipts (ia + ib) 61i 0

Through a/c payee cheque or a/c payee bank draft or bank electronic
a clearing system received or other prescribed electronic modes before ia 0
specified date
b Any other mode ib 0
(ii) Presumptive Income under section 44AD (iia + iib) 61ii 0
6% of 61ia, or the amount claimed to have been earned, whichever is
a iia 0
higher
8% of 61ib, or the amount claimed to have been earned, whichever is
b iib 0
higher
NOTE?If income is less than the above percentage of Gross Receipts/Turnover, it is mandatory to maintain books of
accounts and have a tax audit under section 44AB
COMPUTATION OF PRESUMPTIVE INCOME FROM PROFESSIONS UNDER
62
SECTION 44ADA
(i) Gross Receipts 62i 0

Presumptive Income under section 44ADA (50% of 62i, or the amount
(ii) 62ii 0
claimed to have been earned, whichever is higher)
NOTE?If income is less than 50% of Gross Receipts, it is mandatory to maintain books of accounts and have a tax
audit under section 44AB
63 COMPUTATION OF PRESUMPTIVE INCOME FROM GOODS CARRIAGES UNDER SECTION 44AE
Registration Whether Tonnage capacity Number of months for which Presumptive income u/s 44AE for
No. of goods owned/ of goods carriage goods carriage was owned/leased the goods carriage (Computed @
carriage leased (in MT) /hired by assessee Rs.1000 per ton per month in case
/hired tonnage exceeds 12MT, or else @
Rs.7500 per month) or the amount
claimed to have been
actuallyearned, whichever is
higher
(i) (1) (2) (3) (4) (5)
Total 0
Total presumptive income from goods carriage u/s 44AE [total of column (5)
(ii) 63(ii) 0
of table 63(i)]
NOTE? If the profits are lower than prescribed under S.44AE or the number of goods carriage owned / leased / hired
at any time during the year exceeds 10, then , it is mandatory to maintain books of accounts and have a tax audit
under section 44AB
IF REGULAR BOOKS OF ACCOUNT OF BUSINESS OR PROFESSION ARE NOT
64 MAINTAINED, furnish the following information for previous year 2020-21 in respect of
business or profession -
(i) FOR ASSESSEE CARRYING ON BUSINESS
A Gross receipts (a1 + a2) ia 0
1 clearing system or other prescribed electronic modes received before a1 0
specified date
2 Any other mode a2 0
B Gross profit ib 0
C Expenses ic 0
D Net profit 64i 0
(ii) FOR ASSESSEE CARRYING ON PROFESSION
a Gross receipts (a1 + a2) Iia 0
1 clearing system or other prescribed electronic modes received before a1 0
specified date
2 Any other mode a2 0
b Gross profit Iib 0
c Expenses iic 0
d Net profit 64ii 0
iii Total profit (64i + 64ii) 64iii 0
65 I Turnover from speculative activity 65i 0
ii Gross Profit 65ii 0
iii Expenditure, if any 65iii 0
iv Net income from speculative activity (65ii-65iii) 65iv 0
Part A- OI Other Information (mandatory if liable for audit under section 44AB, for other fill, if applicable)
Method of accounting employed in the previous year (Tick) ✔
1 ✔ mercantile
cash
Is there any change in method of accounting (Tick)
2 Yes
✔ No
Increase in the profit or decrease in loss because of deviation, if any, as per

3a Income Computation Disclosure Standards notified under section 145(2) [column 3a 0
11a(iii) of Schedule ICDS]
Decrease in the profit or increase in loss because of deviation, if any, as per
3b Income Computation Disclosure Standards notified under section 145(2) [column 3b 0
11b(iii) of Schedule ICDS]
4 Method of valuation of closing stock employed in the previous year
Raw Material (if at cost or market rates whichever is less write 1, if at cost write 2,
a
if at market rate write 3)
Finished goods (if at cost or market rates whichever is less write 1, if at cost write
b
2, if at market rate write 3)
Is there any change in stock valuation method (Tick)
c Yes
No
Increase in the profit or decrease in loss because of deviation, if any, from

d 4d 0
the method of valuation specified under section 145A
Decrease in the profit or increase in loss because of deviation, if any, from
e 4e 0
the method of valuation specified under section 145A
5 Amounts not credited to the profit and loss account, being -
a the items falling within the scope of section 28 5a 0
the proforma credits, drawbacks, refund of
duty of customs or excise or service tax, or
refund of sales tax or value added tax, or
b 5b 0
refund of GST, where such credits, drawbacks
or refunds are admitted as due by the
authorities concerned
escalation claims accepted during the
c 5c 0
previous year
d any other item of income 5d 0
e capital receipt, if any 5e 0
f Total of amounts not credited to profit and loss account (5a+5b+5c+5d+5e) 5f 0
Amounts debited to the profit and loss account, to the extent disallowable under
6
section 36 due to non-fulfilment of conditions specified in relevant clauses
a Premium paid for insurance against risk of 6a 0
damage or destruction of stocks or store [36(1)
(i)]
Premium paid for insurance on the health of
b 6b 0
employees [36(1)(ib)]
Any sum paid to an employee as bonus or
commission for services rendered, where
c 6c 0
such sum was otherwise payable to him as
profits or dividend [36(1)(ii)]
Any amount of interest paid in respect of
d 6d 0
borrowed capital [36(1)(iii)]
Amount of discount on a zero-coupon bond [36
e 6e 0
(1)(iiia)]
Amount of contributions to a recognised
f 6f 0
provident fund [36(1)(iv)]
Amount of contributions to an approved
g 6g 0
superannuation fund [36(1)(iv)]
Amount of contribution to a pension scheme
h 6h 0
referred to in section 80CCD [36(1)(iva)]
Amount of contributions to an approved
i 6i 0
gratuity fund [36(1)(v)]
j Amount of contributions to any other fund 6j 0
Any sum received from employees as
contribution to any provident fund or
superannuation fund or any fund set up under
k ESI Act or any other fund for the welfare of 6k 0
employees to the extent not credited to the
employees account on or before the due date
[36(1)(va)]
l Amount of bad and doubtful debts [36(1)(vii)] 6l 0
Provision for bad and doubtful debts [36(1)
m 6m 0
(viia)]
Amount transferred to any special reserve [36
n 6n 0
(1)(viii)]
Expenditure for the purposes of promoting
o 6o 0
family planning amongst employees [36(1)(ix)]
Amount of securities transaction paid in
respect of transaction in securities if such
p 6p 0
income is not included in business income [36
(1)(xv)]
Marked to market loss or other expected loss
q as computed in accordance with the ICDS 6q 0
notified u/s 145(2) [36(1)(xviii)]
r Any other disallowance 6r 0
s Total amount disallowable under section 36 (total of 6a to 6r) 6s 0
7
section 37
a Expenditure of capital nature [37(1)] 7a 0
b Expenditure of personal nature [37(1)] 7b 0
Expenditure laid out or expended wholly and
c exclusively NOT for the purpose of business 7c 0
or profession [37(1)]
Expenditure on advertisement in any souvenir,
d brochure, tract, pamphlet or the like, published 7d 0
by a political party [37(2B)]
Expenditure by way of penalty or fine for
e 7e 0
violation of any law for the time being in force
f Any other penalty or fine 7f 0
Expenditure incurred for any purpose which is
g 7g 0
an offence or which is prohibited by law
h Amount of any liability of a contingent nature 7h 0
Any other amount not allowable under section
i 7i 0
37
j Total amount disallowable under section 37 (total of 7a to 7i) 7j 0
Amounts debited to the profit and loss account, to the extent disallowable
8 A
under section 40
Amount disallowable under section 40 (a)
a (i), on account of non-compliance with Aa 0
the provisions of Chapter XVII-B
Amount disallowable under section 40(a)
b (ia) on account of non-compliance with Ab 0
(ib), on account of non-compliance with
c Ac 0
the provisions of Chapter VIII of the
Finance Act, 2016
d (iii) on account of non-compliance with Ad 0
Amount of tax or rate levied or assessed
e Ae 0
on the basis of profits [40(a)(ii)]
f Amount paid as wealth tax [40(a)(iia)] Af 0
Amount paid by way of royalty, license
g fee, service fee etc. as per section 40(a) Ag 0
(iib)
Amount of interest, salary, bonus,
commission or remuneration paid to any
h Ah 0
partner or member inadmissible under
section [40(b)/40(ba)]
i Any other disallowance Ai 0
j Total amount disallowable under section 40(total of Aa to Ai) 8Aj 0
Any amount disallowed under section 40 in any preceding previous year but
B 8B 0
allowable during the previous year
9
section 40A
a Amounts paid to persons specified in section 9a 0
40A(2)(b)
Amount paid otherwise than by account payee
cheque or account payee bank draft or use of
electronic clearing system through a bank
b 9b 0
account or through such electronic mode as
may be prescribed, disallowable under section
40A(3)
c Provision for payment of gratuity [40A(7)] 9c 0
Any sum paid by the assessee as an
employer for setting up or as contribution to
d 9d 0
any fund, trust, company, AOP, or BOI or
society or any other institution [40A(9)]
e Any other disallowance 9e 0
f Total amount disallowable under section 40A(total of 9a to 9e) 9f 0
Any amount disallowed under section 43B in any preceding previous year but
10
allowable during the previous year
Any sum in the nature of tax, duty, cess or fee
a 10a 0
under any law
Any sum payable by way of contribution to
any provident fund or superannuation fund or
b 10b 0
gratuity fund or any other fund for the welfare
of employees
Any sum payable to an employee as bonus or
c 10c 0
commission for services rendered
Any sum payable as interest on any loan or
borrowing from any public financial institution
d 10d 0
or a State financial corporation or a State
Industrial investment corporation
borrowing from any scheduled bank or a co-
e operative bank other than a primary 10e 0
agricultural credit or a primary co-operative
agricultural and rural development bank
f Any sum payable towards leave encashment 10f 0
Any sum payable to the Indian Railways for
g 10g 0
the use of railway assets
h Total amount allowable under section 43B (total of 10a to 10g) 10h 0
Any amount debited to profit and loss account of the previous year but
11
disallowable under section 43B
Any sum in the nature of tax, duty, cess or fee
a 11a 0
under any law
Any sum payable by way of contribution to
any provident fund or superannuation fund or
b 11b 0
gratuity fund or any other fund for the welfare
of employees
Any sum payable to an employee as bonus or
c 11c 0
commission for services rendered
d borrowing from any public financial institution 11d 0
or a State financial corporation or a State
Industrial investment corporation
Any sum payable by the assessee as interest
on any loan or borrowing from a deposit taking
non-banking financial company or
da systemically important non-deposit taking 11da 0
nonbanking financial company, in accordance
with the terms and conditions of the
agreement governing such loan or borrowing
borrowing from any scheduled bank or a co-
operative bank other than a primary
e 11e 0
agricultural credit society or a primary co-
operative agricultural and rural development
bank
f Any sum payable towards leave encashment 11f 0
Any sum payable to the Indian Railways for
g 11g 0
the use of railway assets
h Total amount disallowable under Section 43B (total of 11a to 11g) 11h 0
12 Amount of credit outstanding in the accounts in respect of
a Union Excise Duty 12a 0
b Service tax 12b 0
c VAT/sales tax 12c 0
d Central Goods & Service Tax (CGST) 12d 0
e State Goods & Services Tax (SGST) 12e 0
f Integrated Goods & Services Tax (IGST) 12f 0
Union Territory Goods & Services Tax
g 12g 0
(UTGST)
h Any other tax 12h 0
i Total amount outstanding (total of 12a to 12h) 12i 0
13 Amounts deemed to be profits and gains under section 33AB or 33ABA 13 0
13a 33AB 13a 0
13b 33ABA 13b 0
14 Any amount of profit chargeable to tax under section 41 14 0
Amount of income or expenditure of prior period credited or debited to the profit
15 15 0
and loss account (net)
16 Amount of expenditure disallowed u/s 14A 16 0
Whether assessee is exercising option under subsection 2A of section 92CE (Tick)
17 Yes 17
✔ No
[If yes , please fill schedule TPSA]
Part A ? QD Quantitative details (mandatory if liable for audit under section 44AB)
a. In the case of a trading concern
Sl. No. Item Name Unit of Opening Stock Purchase Sales during Closing stock Shortage
measure during the the previous /excess (if any)
previous year year
b. In case of a manufacturing concern - Raw Materials

Sl. Item Unit of Opening Purchase Consumption Sales Closing Yield Percentage Shortage
No. Name measure Stock during the during the during Stock Finished of yield /excess
previous previous year the Products (if any)
year previous
year
c. In case of a manufacturing concern - Finished products/ By-products

Sl. Item Unit of Opening Purchase Quantity Sales during Closing Shortage
No. Name measure Stock during the manufactured the previous stock /excess (if
previous during the year any)
year previous year
SCHEDULES TO THE RETURN FORM (FILL AS APPLICABLE)
Schedule S Details of Income from Salary
TAN of Employer (mandatory if tax is

Name of Employer Nature of employer (Tick)
deducted)
Address of employer Town/City State Pin code/ Zip code
11234566789012 Gross Salary (1a + 1b + 1c) 1 0
a Salary as per section 17(1) 1a 0
b Value of perquisites as per section 17(2) 1b 0
c Profit in lieu of salary as per section 17(3) 1c 0
2 Total Gross Salary (from all employers) 2 0
Less allowances to the extent exempt u/s 10 (drop down to be provided in e-filing utility) (please refer
3 instructions) 3 0
(Note: Ensure that it is included in Total Gross salary in (2) above )
Sl. No. Nature of Exempt Allowance Description Amount
4 Net Salary (2 - 3) 4 0
5 Deduction u/s 16 (5a + 5b + 5c) 5 0
a Standard deduction u/s 16(ia) 5a 0
b Entertainment allowance u/s 16(ii) 5b 0
c Professional tax u/s 16(iii) 5c 0
6 Income chargeable under the Head 'Salaries' (4 - 5) 6 0

Schedule HP Details Of Income From House Property (Please Refer Instructions)

PIN Code/ Zip Code
1 Address of property 1 Town/ City State
/
Is the property co-owned? Yes No (if ?YES? please enter following details)
Your percentage of share in the property (%) undefined
Sl. Name of Co-owner(s) PAN/Aadhaar No. of Co-owner (s) Percentage Share in Property
No
I /
[Tick the
applicable Sl. Name(s) of PAN/ Aadhaar No. of Tenant(s) PAN/TAN of Tenant(s) (if TDS credit is claimed)
option] No. Tenant (if let (Please see note)
Let out out)
Self-occupied
Deemed let I /
out
a Gross rent received or receivable or letable value 1a 0
b The amount of rent which cannot be realized 1b 0
c Tax paid to local authorities 1c 0
d Total ( 1 b + 1 c) 1d 0
Annual value ( 1 a ? 1 d) (nil, if self -occupied etc. as per section 23(2)of
e 1e 0
the Act)
f Annual value of the property owned (own percentage share x 1 e) 1f 0
g 30% of 1 f 1g 0
h Interest payable on borrowed capital 1h 0
i Total ( 1 g + 1 h) 1i 0
j Arrears/Unrealised rent received during the year less 30% 1j 0
k Income from house property 1 ( 1 f ? 1 i + 1 j) 1k 0
3 Pass through income/loss if any * 3 0
Income under the head ?Income from house property? (1k + 2k + 3)
4 4 0
(if negative take the figure to 2i of schedule CYLA)
Please include the income of the specified persons referred to in Schedule SPI and Pass through income referred to
in schedule PTI while computing the income under this head.
Furnishing of PAN/ Aadhaar No. of tenant is mandatory, if tax is deducted under section 194-IB.
Furnishing of TAN of tenant is mandatory, if tax is deducted under section 194-I.
Schedule BP Computation of income from business or profession

From business or profession other than speculative business and specified
A
business
Profit before tax as per profit and loss account (item 53, 61(ii), 62(ii), 63(ii), 64
1 1 8,88,630
(iii) and 65(iv) of P&L )
Net profit or loss from speculative business
included in 1 (enter ?ve sign in case of loss) [Sl.
2a 2a 0
no 65iv of Schedule P&L] (in case of no account
case)]
Net profit or Loss from Specified Business u/s
2b 35AD included in 1 (enter ?ve sign in case of 2b 0
loss)
a Salaries 3a 0
House
b 3b 0
property
Capital
c 3c 0
gains
Other
Income/ receipts credited to d 3d 461
sources
profit and loss account
considered under other heads Dividend
3 di 3di 0
of income/chargeable u/s Income
115BBF/ chargeable u/s
Other
115BBG
than
dii 3dii 461
Dividend
Income
u/s
e 3e 0
115BBF
u/s
f 3f 0
115BBG
Profit or loss included in 1, which is referred to in
4a section 44AD/44ADA/44AE/44B/44BB/44BBA 4a 0
/44DA (drop down to be provided)
Sl.
Section Amount
No
i 44AD 4ai 0
ii 44ADA 4aii 0
iii 44AE 4aiii 0
iv 44B 4aiv 0
v 44BB 4av 0
vi 44BBA 4avi 0
vii 44DA 4avii 0
Profit from activities covered under rule 7, 7A, 7B
4b (1), 7B(1A) and 8 (Dropdown to be provided and 4b 0
capture as individual line item)
Sl.
Section Amount
No
i Profit from activities covered under rule 7 4bi 0
ii Profit from activities covered under rule 7A 4bii 0
Profit from activities covered under rule 7B
iii 4biii 0
(1)
Profit from activities covered under rule 7B
iv 4biv 0
(1A)
v Profit from activities covered under rule 8 4bv 0
5 Income credited to Profit and Loss account (included in 1) which is exempt
Share of income from
a 5a 0
firm(s)
Share of income from
b 5b 0
AOP/ BOI
Any other exempt
c income (specify nature 5c 0
and amount)
Sl. No. Nature of Exempt Income Amount
d Total exempt income (5a + 5b + 5ciii) 5d 0

6 Balance (1 - 2a - 2b - 3a - 3b - 3c - 3d - 3e - 3f - 4a - 4b - 5d) 6 8,88,169
a Salaries 7a 0
House
b 7b 0
property
Expenses debited to profit and Capital

c 7c 0
loss account considered under gains
7 other heads of income/related Other
to income chargeable u/s d 7d 0
sources
115BBF or u/s 115BBG
u/s
e 7e 0
115BBF
u/s
f 7f 0
115BBG
Expenses debited to profit and loss account
8a 8a 0
which relate to exempt income
Expenses debited to profit and loss account
8b which relate to exempt income and disallowed u 8b 0
/s 14A (16 of Part A-OI)
9 Total (7a + 7b + 7c + 7d + 7e + 7f + 8a + 8b) 9 0
10 Adjusted profit or loss (6+9) 10 8,88,169
11 Depreciation and amortisation debited to profit and loss account 11 1,30,468
12 Depreciation allowable under Income-tax Act
Depreciation allowable under section 32(1)
i 12i 1,30,468
(ii) and 32(1)(iia) (item 6 of Schedule-DEP)
Depreciation allowable under section 32(1)
ii (i) (Make your own computation refer 12ii 0
Appendix-IA of IT Rules)
iii Total (12i + 12ii) 12iii 1,30,468
13 Profit or loss after adjustment for depreciation (10 + 11 - 12iii) 13 8,88,169
Amounts debited to the profit and loss account,
14 to the extent disallowable under section 36 (6s 14 0
of PartA-OI)
15 to the extent disallowable under section 37 (7j of 15 0
PartA-OI)
16 to the extent disallowable under section 40 (8Aj 16 0
of PartA-OI)
17 to the extent disallowable under section 40A (9f 17 0
of PartA-OI)
Any amount debited to profit and loss account of
18 the previous year but disallowable under section 18 0
43B (11h of PartA-OI)
Interest disallowable under section 23 of the
19 Micro, Small and Medium Enterprises 19 0
Development Act,2006
20 Deemed income under section 41 20 0
Deemed income under section 32AD/ 33AB/
21 33ABA/ 35ABA /35ABB/ 40A(3A)/ 72A/80HHD/ 21 0
80-IA
a 32AD 21a 0
b 33AB 21b 0
c 33ABA 21c 0
d 35ABA 21d 0
e 35ABB 21e 0
f 40A(3A) 21f 0
g 72A 21g 0
h 80HHD 21h 0
i 80-IA 21i 0
22 Deemed income under section 43CA 22 0
Any other item of addition under section 28 to
23 23 0
44DA
Any other income not included in profit and loss
account/any other expense not allowable
24 (including income from salary, commission, 24 0
bonus and interest from firms in which individual
/HUF/prop. concern is a partner)
a Salary 24a 0
b Bonus 24b 0
c Commission 24c 0
d Commission 24d 0
e Others 24e 0
Increase in profit or decrease in loss on account
of ICDS adjustments and deviation in method of
25 25 0
valuation of stock (Column 3a + 4d of Part A -
OI)
26 Total (14 + 15 + 16 + 17 + 18 + 19 + 20 + 21 + 22 + 23 + 24 + 25) 26 0
27 Deduction allowable under section 32(1)(iii) 27 0
28 Deduction allowable under section 32AD 28 0
Amount of deduction under section 35 or 35CCC
or 35CCD in excess of the amount debited to
profit and loss account (item x(4) of Schedule
29 29 0
ESR) (if amount deductible under section 35 or
35CCC or 35CCD is lower than amount debited
to P&L account, it will go to item 24)
Any amount disallowed under section 40 in any
30 preceding previous year but allowable during the 30 0
previous year(8B of PartA-OI)
Any amount disallowed under section 43B in any
31 preceding previous year but allowable during the 31 0
previous year(10h of PartA-OI)
32 Any other amount allowable as deduction 32 0
Decrease in profit or increase in loss on account
33 of ICDS adjustments and deviation in method of 33 0
valuation of stock (Column 3b + 4e of Part A- OI)
34 Total (27+28+29+30+31+32+33) 34 0
35 Income (13+26-34) 35 8,88,169
36 Profits and gains of business or profession deemed to be under -
i Section 44AD (61(ii) of schedule P&L) 36i 0
ii Section 44ADA (62(ii) of schedule P&L) 36ii 0
iii Section 44AE (63(ii) of schedule P&L) 36iii 0
iv Section 44B 36iv 0
v Section 44BB 36v 0
vi Section 44BBA 36vi 0
vii Section 44DA 36vii 0
viii Total (36i to 36vii) 36viii 0
Net profit or loss from business or profession other than speculative and
37 37 8,88,169
specified business (35 + 36viii)
Net Profit or loss from business or profession other than speculative business
and specified business after applying rule 7A, 7B or 8, if applicable (If rule 7A,
38 7B or 8 is not applicable, enter same figure as in 37) (If loss take the figure to A38 8,88,169
2i of item E) (38a+ 38b + 38c + 38d + 38e + 38f)
a Income chargeable under Rule 7 38a 0
Deemed income chargeable under Rule
b 38b 0
7A
Deemed income chargeable under Rule 7B
c 38c 0
(1)
Deemed income chargeable under Rule 7B
d 38d 0
(1A)
e Deemed income chargeable under Rule 8 38e 0
Income other than Rule 7A, 7B & 8 (Item
f 38f 8,88,169
No. 37)
Balance of income deemed to be from agriculture, after applying Rule 7, 7A,
39 7B(1), 7B(1A) and Rule 8 for the purpose of aggregation of income as per 39 0
Finance Act [4b-(38a+38b+38c+38d+38e)]
B Computation of income from speculative business
Net profit or loss from speculative business as per profit or loss account (Item
40 40 0
No. 2a)
41 Additions in accordance with section 28 to 44DA 41 0
42 Deductions in accordance with section 28 to 44DA 42 0
Income from speculative business (40+ 41 ? 42) (if loss, take the figure to 6xiii
43 B43 0
of schedule CFL)
C Computation of income from specified business under section 35AD
44 Net profit or loss from specified business as per profit or loss account 44 0
45 Additions in accordance with section 28 to 44DA 45 0
Deductions in accordance with section 28 to 44DA (other than deduction
46 46 0
under section,- (i) 35AD, (ii) 32 or 35 on which deduction u/s 35AD is claimed)
47 Profit or loss from specified business (44 + 45 - 46) 47 0
48 Deductions in accordance with section 35AD(1) 48 0
Income from Specified Business (47-48) (if loss, take the figure to 7xiii of
49 C49 0
schedule CFL)
Relevant clause of sub-section (5) of section 35AD which covers the specified
50 C50
business (to be selected from drop down menu)
Income chargeable under the head 'Profits and gains from business or profession'
D D 8,88,169
(A38 + B43 + C49)
E Intra head set off of business loss of current year
Income of current year (Fill this Business income
Business loss
column only if figure is zero or remaining after set
Sl. Type of Business income set off
positive) off
(1) (2) (3) = (1) - (2)
Loss to be set off (Fill this
i row only if figure is 0
negative)
Income from speculative
ii 0 0 0
business
Income from specified
iii 0 0 0
business
iv Total loss set off (ii + iii) 0
v Loss remaining after set off (i ? iv) 0
NOTE - Please include the income of the specified persons referred to in Schedule SPI while computing the
income under this head
FORM ITR-3 and gains of business or profession)
Depreciation on Plant and Machinery (Other than assets on which full capital expenditure is allowable as
Schedule DPM
deduction under any other section)
1 Block of assets Plant and machinery
15 30 40 45
2 Rate (%)
(i) (ii) (iii) (iv)
Written down value on the
3 55,250 0 99,356 0
first day of previous year
Amount as adjusted on
account of opting for
3a 0 0 0
taxation under section
115BAC
Adjusted Written down value
3b on the first day of previous 55,250 0 99,356 0
year (3) + (3a)
Additions for a period of 180
4 days or more in the previous 4,66,630 0 0
year
Consideration or other
5 realization during the 0 0 0 0
previous year out of 3b or 4
Amount on which
depreciation at full rate to be
6 5,21,880 0 99,356 0
allowed (3b + 4 -5) (enter 0,
if result is negative)
Additions for a period of less
7 than 180 days in the 65,814 0 0
previous year
8 realizations during the year 0 0 0
out of 7
Amount on which
depreciation at half rate to
9 65,814 0 0
be allowed (7-8) (enter 0, if
result is negative)
10 Depreciation on 6 at full rate 78,282 0 39,742 0
Depreciation on 9 at half
11 4,936 0 0
rate
Additional depreciation, if
12 0 0 0
any, on 4
Additional depreciation, if
13 0 0 0
any, on 7
Additional depreciation
relating to immediately
14 preceding year' on asset put 0 0 0 0
to use for less than 180
days
Total depreciation
15 83,218 0 39,742 0
(10+11+12+13+14)
Depreciation disallowed
16 under section 38(2) of the I. 0 0 0 0
T. Act (out of column 15)
Net aggregate depreciation
17 83,218 0 39,742 0
(15-16)
Proportionate aggregate
depreciation allowable in the
18 event of succession, 0 0 0 0
amalgamation, demerger
etc. (out of column 17)
Expenditure incurred in
19 connection with transfer of 0 0 0 0
asset/ assets
Capital gains/ loss under
section 50 (5 + 8 -3b - 4 -7
20 0 0 0 0
-19) (enter negative only if
block ceases to exist)
Written down value on the
last day of previous year (6+
21 5,04,476 0 59,614 0
9 -15) (enter 0 if result is
negative)
Depreciation on other assets (Other than assets on which full capital expenditure is allowable as
Schedule DOA
deduction)
Furniture and Intangible
1 Block of assets Land Building (not including land) Ships
fittings assets
Nil 5 10 40 10 25 20
2 Rate (%)
(i) (ii) (iii) (iv) (v) (vi) (vii)
Written down value on

3 the first day of previous 0 0 0 0 34,605 0 0
year
Additions for a period of

4 180 days or more in the 0 0 0 32,000 0 0
previous year
realization during the
5 0 0 0 0 0 0
previous year out of 3 or
4
Amount on which
depreciation at full rate to
6 be allowed (3 + 4 -5) 0 0 0 66,605 0 0
(enter 0, if result is
negative)
Additions for a period of

7 less than 180 days in the 0 0 0 16,936 0 0
previous year
8 realizations during the 0 0 0 0 0 0
year out of 7
Amount on which
depreciation at half rate
9 0 0 0 16,936 0 0
to be allowed (7-8) (enter
0, if result is negative)
Depreciation on 6 at full
10 0 0 0 6,661 0 0
rate
Depreciation on 9 at half
11 0 0 0 847 0 0
rate
Total depreciation
12 0 0 0 7,508 0 0
(10+11)
Depreciation disallowed
13 under section 38(2) of the 0 0 0 0 0 0
I.T. Act (out of column 12)
Net aggregate
14 0 0 0 7,508 0 0
depreciation (12-13)
Proportionate aggregate
depreciation allowable in
15 the event of succession, 0 0 0 0 0 0
amalgamation, demerger
etc. (out of column 14)
Expenditure incurred in
16 connection with transfer 0 0 0 0 0 0
of asset/ assets

section 50 (5 + 8 -3-4 -7
-16) (enter negative only
17 if block ceases to exist) 0 0 0 0 0 0
section 50 (5 + 8 -3-4 -7
-16)
Written down value on

the last day of previous
18 0 0 0 0 76,033 0 0
year (6+ 9 -12) (enter 0 if
result is negative)
Summary of depreciation on assets (Other than assets on which full capital expenditure is allowable as
Schedule DEP
deduction under any other section)
1 Plant and machinery
Block entitled for depreciation
@ 15 percent
a 1a 83,218
(Schedule DPM -17i or 18i as
applicable)
@ 30 percent
b 1b 0
(Schedule DPM - 17ii or 18ii as
applicable)
@ 40 percent
c 1c 39,742
(Schedule DPM - 17iii or 18iii
as applicable)
@ 45 percent
d 1d 0
(Schedule DPM - 17iv or 18iv
as applicable)
e Total depreciation on plant and machinery ( 1a + 1b + 1c + 1d) 1e 1,22,960
2 Building (not including land)
@ 5 percent
a 2a 0
(Schedule DOA- 14ii or 15ii as
applicable)
@ 10 percent
b 2b 0
(Schedule DOA- 14iii or 15iii
as applicable)
@ 40 percent
c 2c 0
(Schedule DOA- 14iv or 15iv
as applicable)
D Total depreciation on building (total of 2a + 2b + 2c) 2d 0
3 Furniture and fittings (Schedule DOA- 14v or 15v as applicable) 3 7,508
4 Intangible assets (Schedule DOA- 14vi or 15vi as applicable) 4 0
5 Ships (Schedule DOA- 14vii or 15vii as applicable) 5 0
6 Total depreciation (1e+2d+3+4+5) 6 1,30,468
Schedule DCG Deemed Capital Gains on sale of depreciable assets

1 Plant and machinery
a @ 15 percent 1a 0
(Schedule DPM - 20i)
b @ 30 percent 1b 0
(Schedule DPM - 20ii)
c @ 40 percent 1c 0
(Schedule DPM - 20iii)
d @ 45 percent 1d 0
(Schedule DPM - 20iv)
e Total ( 1a + 1b + 1c + 1d) 1e 0
2 Building (not including land)
a @ 5 percent 2a 0
(Schedule DOA- 17ii)
b @ 10 percent 1b 0
(Schedule DOA- 17iii)
c @ 40 percent 2c
(Schedule DOA- 17iv)
d Total (2a + 2b + 2c) 2d 0
3 Furniture and fittings (Schedule DOA- 17v) 3 0
4 Intangible assets (Schedule DOA- 17vi) 4 0
5 Ships (Schedule DOA- 17vii) 5 0
6 Total depreciation (1e+2d+3+4+5) 6 0
Schedule ESR Expenditure on scientific Research etc. (Deduction under section 35 or 35CCC or 35CCD)
Amount of deduction in
Expenditure of the nature Amount, if any, debited to Amount of deduction excess of the amount debited
Sl No
referred to in section (1) profit and loss account (2) allowable (3) to profit and loss account (4)
= (3) - (2)
i 35(1)(i) 0 0 0
ii 35(1)(ii) 0 0 0
iii 35(1)(iia) 0 0 0
iv 35(1)(iii) 0 0 0
v 35(1)(iv) 0 0 0
vi 35(2AA) 0 0 0
vii 35(2AB) 0 0 0
viii 35CCC 0 0 0
ix 35CCD 0 0 0
x Total 0 0 0
In case any deduction is claimed under sections 35(1)(ii) or 35(1)(iia) or 35(1)(iii) or 35(2AA), please provide the details as per
NOTE
Schedule RA.
Schedule CG Capital Gains

A Short-term Capital Gains (STCG) (Sub-items 4 and 5 are not applicable for residents)
1i From sale of land or building or both (fill up details separately for each property)
a i Full value of consideration received/receivable Ai 0
ii Value of property as per stamp valuation authority Aii 0
Full value of consideration adopted as per section 50C for the purpose of
iii Capital Gains [in case (aii) does not exceed 1.10 times (ai), take this Aiii 0
figure as (ai), or else take (aii)]
b Deductions under section 48
i Cost of acquisition without indexation Bi 0
ii Cost of Improvement without indexation Bii 0
iii Expenditure wholly and exclusively in connection with transfer Biii 0
iv Total (bi + bii + biii) Biv 0
c Balance (aiii - biv) 1c 0
d Deduction under section 54B/54D/ 54G/54GA (Specify details in item D below) 1d 0
e Short-term Capital Gains on Immovable property (1c - 1d) A1e 0
f In case of transfer of immovable property, please furnish the following details (see note)
Sl. Name of buyer PAN/ Aadhaar No. of buyer Percentage Amount Address of Pin code / Zip
No. (s) (s) share property code
1 / ,,
Furnishing of PAN/ Aadhaar is mandatory, if the tax is deducted under section 194-IA or is quoted by buyer in the
NOTE documents.
In case of more than one buyer, please indicate the respective percentage share and amount.
2 From slump sale
a Full value of consideration 2a 0
b Net worth of the under taking or division 2b 0
c Short term capital gains from slump sale (2a-2b) A2c 0
From sale of equity share or unit of equity oriented Mutual Fund (MF) or unit of a business trust on which STT is paid under
3
section 111A or 115AD(1)(ii) proviso (for FII)
For NON-RESIDENT, not being an FII- from sale of shares or debentures of an Indian company (to be computed
4
with foreign exchange adjustment under first proviso to section 48)
a STCG on transactions on which securities transaction tax (STT) is paid A4a 0
STCG on transactions on which securities transaction tax (STT) is not
b A4b 0
paid
5 For NON-RESIDENTS- from sale of securities (other than those at A3 above) by an FII as per section 115AD
In case securities sold include shares of a company other than quoted
a i
shares, enter the following details
Full value of consideration received/receivable in respect of
a unquoted shares ia 0
Fair market value of unquoted shares determined in the
b ib 0
prescribed manner
Full value of consideration in respect of unquoted shares
c adopted as per section 50CA for the purpose of Capital Gains ic 0
(higher of a or b)
Full value of consideration in respect of securities other than
ii aii 0
unquoted shares
iii Total (ic + ii) aiii 0
i Cost of acquisition without indexation bi 0
ii Cost of improvement without indexation bii 0
iii Expenditure wholly and exclusively in connection with transfer biii 0
iv Total (i + ii + iii) biv 0
c Balance (5aiii - biv) 5c 0
Loss to be disallowed u/s 94(7) or 94(8)- for example if security bought
/acquired within 3 months prior to record date and dividend/income
d 5d 0
/bonus units are received, then loss arising out of sale of such security to
be ignored (Enter positive value only)
Short-term capital gain on sale of securities by an FII (other than those at
e A5e 0
A2) (5c +5d)
6 From sale of assets other than at A1 or A2 or A3 or A4 above
In case assets sold include shares of a company other than quoted shares,
a i
enter the following details
Full value of consideration received/receivable in respect of
a ia 0
unquoted shares
Fair market value of unquoted shares determined in the
b ib 0
prescribed manner
Full value of consideration in respect of unquoted shares
c adopted as per section 50CA for the purpose of Capital Gains ic 0
(higher of a or b)
Full value of consideration in respect of securities other than
ii aii 0
unquoted shares
ii Cost of improvement without indexation bii 0
iv Total (i + ii + iii) biv 0
In case of asset (security/unit) loss to be disallowed u/s 94(7) or 94(8)-
for example if asset bought/acquired within 3 months prior to record date
d 6d 0
and dividend/income/bonus units are received, then loss arising out of
sale of such asset to be ignored (Enter positive value only)
e Deemed short term capital gains on depreciable assets (6 of schedule- A6e 0
DCG)
7 Amount deemed to be short term capital gains
Whether any amount of unutilized capital gain on asset transferred during the previous years shown below was
a deposited in the Capital Gains Accounts Scheme within due date for that year?
yes No Not applicable. If yes, then provide the details below
Sl. Previous year in Section under which New asset acquired/constructed Amount not used for new asset or
No. which asset deduction claimed in that remained unutilized in Capital gains
Year in which asset Amount utilised out of
transferred year account (X)
acquired Capital Gains account
/constructed
Amount deemed to be short term capital gains u/s 54B/54D/54G/54GA, other than
b 0
at 'a'
Total amount deemed to be short term capital gains (Xi + Xii + b) A7 0
Pass Through Income/ Loss in the nature of Short Term Capital Gain, (Fill
8 A8 0
up schedule PTI) (A8a + A8b + A8c)
Pass Through Income/ Loss in the nature of Short Term Capital Gain,
a A8a 0
chargeable @ 15%
b A8b 0
chargeable @ 30%
c A8c 0
chargeable at applicable rates
9 Amount of STCG included in A1-A8 but not chargeable to tax or chargeable at special rates as per DTAA
Sl. Amount Item No. A1 to A7 Country Article Rate as per Whether Section Rate as Applicable rate
No. of above in which name & of Treaty TRC of I.T. per I.T. [lower of (6) or
income included Code DTAA (enter NIL, if obtained Act Act (9)]
not (Y/N)
chargeable
(1) (2) (3) (4) (5) (6) (7) (8) (9) (10)
a Total amount of STCG not chargeable to tax in India as per DTAA A9a 0
b Total amount of STCG chargeable to tax at special rates as per DTAA A9b 0
Total Short-term Capital Gain (A1e+ A2c+ A3e+ A4a+ A4b+ A5e+ A6g+ A7+
10 A10 0
A8? A9a)
B Long-term capital gain (LTCG) (Sub-items, 6 , 7, 8 & 9 are not applicable for residents)
1i From sale of land or building or both (fill up details separately for each property)
a i Full value of consideration received/receivable ai 0
ii Value of property as per stamp valuation authority aii 0
Full value of consideration adopted as per section 50C for the

iii purpose of Capital Gains [in case (aii) does not exceed 1.10 aiii 0
times (ai), take this figure as (ai), or else take (aii)]
i Cost of acquisition with indexation bi 0
ii Cost of Improvement with indexation bii 0
Expenditure wholly and exclusively in connection with

iii biii 0
transfer
iv Total (bi + bii + biii) biv 0

c Balance (aiii 1c 0
- biv)
Deduction
under
section 54
/54B/54D
/54EC/54F
d /54G/54GA 1d 0
/54GB
(Specify
details in
item D
below)
e Long-term Capital Gains on Immovable property (1c - 1d) B1e 0
f In case of transfer of immovable property, please furnish the following details (see note)
Sl.No. Name of buyer(s) PAN/ Aadhaar Percentage share Amount Address of property Pin code / Zip code
1 / ,,
Furnishing of PAN/ Aadhaar is mandatory, if the tax is deducted under section 194-IA or is quoted by buyer in
NOTE the documents.
In case of more than one buyer, please indicate the respective percentage share and amount.
2 From slump sale
b Net worth of the under taking or division 2b 0
c Balance (2a ? 2b) 2c 0
d Deduction u/s 54EC /54F (Specify details in item D below) 2d 0
e Long term capital gains from slump sale (2c-2d) 2e 0
3 From sale of bonds or debenture (other than capital indexed bonds issued by Government)
ii Cost of Improvement without indexation bii 0
iv Total (bi + bii +biii) biv 0
c Balance (2a - biv) 2c 0
d Deduction under sections 54F (Specify details in item D below) 2d 0
e LTCG on bonds or debenture (2c - 2d) B2e 0
From sale of, (i) listed securities (other than a unit) or zero coupon bonds where proviso under section 112(1) is applicable (ii)
4
GDR of an Indian company referred in sec. 115ACA
From sale of equity share in a company or unit of equity oriented fund or unit of a business trust on which STT
5
is paid under section 112A
a LTCG u/s 112A (column 14 of Schedule 112A) 4a 0
b Deduction under sections 54F (Specify details in item D below) 4b 0
c Long-term Capital Gains on sale of capital assets at B4 above (4a - 4b) B4c 0
For NON-RESIDENTS- from sale of shares or debenture of Indian company (to be computed with foreign
6
exchange adjustment under first proviso to section 48)
a LTCG computed without indexation benefit 5a 0
b Deduction under sections 54F (Specify details in item D below) 5b 0
c LTCG on share or debenture (5a-5b) B5c 0
For NON-RESIDENTS- from sale of, (i) unlisted securities as per sec. 112(1)(c), (ii) bonds or GDR as referred
7 in sec. 115AC, (iii) securities by FII as referred to in sec. 115AD (other than securities referred to in section
112A for which column B7 is to be filled up)
For NON-RESIDENTS - From sale of equity share in a company or unit of equity oriented fund or unit of a
8
business trust on which STT is paid under section 112A
a LTCG u/s 112A (column 14 of Schedule 115AD(1)(iii)) 8a 0
b Deduction under section 54F (Specify details in item D below) 8b 0
c Long-term Capital Gains on sale of capital assets at B7 above (7a - 7b) B8c 0
9 From sale of foreign exchange asset by NON-RESIDENT INDIAN (If opted under chapter XII-A)
a LTCG on sale of specified asset (computed without indexation) 9a 0
b Less deduction under section 115F (Specify details in item D below) 9b 0
c Balance LTCG on sale of specified asset (8a - 8b) B9c 0
d LTCG on sale of asset, other than specified asset (computed without indexation) 9d 0
e Less deduction under section 115F (Specify details in item D below) 9e 0
f Balance LTCG on sale of asset, other than specified asset (8d- 8e) B9f 0
10 From sale of assets where B1 to B8 above are not applicable
In case securities sold include shares of a company other than quoted shares, enter the
A i
following details
a Full value of consideration received/receivable in respect of unquoted shares ia 0
b Fair market value of unquoted shares determined in the prescribed manner ib 0
Full value of consideration in respect of unquoted shares adopted as per
c ic 0
section 50CA for the purpose of Capital Gains (higher of a or b)
ii Full value of consideration in respect of securities other than unquoted shares aii 0
i Cost of acquisition with indexation bi 0
ii Cost of improvement with indexation bii 0
iv Total (bi + bii +biii) biv 0
d Deduction under sections 54F (Specify details in item D below) 9d 0
E Long-term Capital Gains on assets at B9 above ( (9c - 9d) 0
11 Amount deemed to be long-term capital gains
Whether any amount of unutilized capital gain on asset transferred during the previous year shown below
a was deposited in the Capital Gains Accounts Scheme within due date for that year?
Yes No Not applicable. If yes, then provide the details below
Sl. Previous year Section under which Whether new New asset acquired/constructed Amount not used for new asset or
No. in which asset deduction claimed asset acquired remained unutilized in Capital
Year in which Amount utilised
transferred in that year (Yes/no) gains account (X)
asset acquired out of Capital
/constructed Gains account
b Amount deemed to be short term capital gains, other than at 'a' 0
Total amount deemed to be long-term capital gains (aXi + aXii + b) 0
Pass Through Income/ Loss in the nature of Long Term Capital Gain,(Fill up schedule PTI)
12 B11 0
(B11a1+ B11a2 + B11b)
Pass Through Income/ Loss in the nature of Long Term Capital Gain, chargeable @
a1 B11a1 0
10% u/s 112A
a2 B11a2 0
10% under sections other than u/s 112A
b B11b 0
20%
Amount of LTCG included in B1 - B11 but not chargeable to tax or chargeable at special rates in India as
13
per DTAA
Sl. Amount Item No. B1 to B11 Country Article Rate as per Whether Section Rate as Applicable rate
No. of above in which name of Treaty TRC of I.T. per I.T. [lower of (6) or
income included Code DTAA (enter NIL, if obtained Act Act (9)]
not (Y/N)
chargeable)
(1) (2) (3) (4) (5) (6) (7) (8) (9) (10)
a Total amount of LTCG not chargeable to tax as per DTAA B12a 0

b Total amount of LTCG chargeable to tax at special rates as per DTAA B12b 0
Total long term capital gain chargeable under I.T. Act
14 B13 0
(B1e+B2e+B3e+B4c+B5c+B6e+B7c+B8c+B8f+B9e+B10 + B11 - B12a)
C Income chargeable under the head "CAPITAL GAINS" (A9 + B13) (take B13 as nil, if loss) C 0
D Information about deduction claimed against Capital Gains
1 In case of deduction u/s 54/54B/54EC/54F/54GB/115F give following details
a Deduction claimed u/s 54
Amount deposited
Date of
in
Date of purchase/ Amount of
Cost of new Capital Gains
Transfer of construction of deduction
asset Accounts
Original Asset new claimed
Scheme before due
asset
date
b Deduction claimed u/s 54B
Amount deposited Amount
Date of purchase
Date of Transfer Cost of new in Capital Gains of
of new agricultural
of Original Asset agricultural land Accounts Scheme deduction
land
before due date claimed
c Deduction claimed u/s 54D
Cost of purchase/
construction of Amount deposited Amount
Date of purchase
Date of acquisition new land or in Capital Gains of
of new land or
of original asset building for Accounts Scheme deduction
building
industrial before due date claimed
undertaking
d Deduction claimed u/s 54EC
Amount invested in
Date of Transfer of specified/notified bonds Date of investment Amount of deduction
Original Asset (not exceeding fifty lakh claimed
rupees)
e Deduction claimed u/s 54F
Date of
Amount deposited in Amount
Transfer Date of purchase
Cost of new residential Capital Gains of
of /construction of new
house Accounts Scheme deduction
Original residential house
Asset
f Deduction claimed u/s 54G
Date of purchase Cost and expenses
Date of transfer of /construction of incurred for
in Capital Gains of
original asset new asset in an purchase or
Accounts Scheme deduction
from urban area area other than construction of
urban area new asset
g Deduction claimed u/s 54GA
Cost and expenses
Date of transfer of Date of purchase incurred for
in Capital Gains of
original asset /construction of purchase or
Accounts Scheme deduction
from urban area new asset in SEZ construction of
new asset
h Deduction claimed u/s 115F (for Non-Resident Indians)
Amount invested in
Date of Transfer of
new specified asset Amount of deduction
foreign exchange Date of investment
or savings claimed
asset
certificate
i Total deduction claimed (1a + 1b + 1c + 1d + 1e + 1f + 1g + 1h) 0
Set-off of current year capital losses with current year capital gains (excluding amounts included in A8a B12a which is not chargeable
E
under DTAA)
Sl. Type of Capital Gain Capital Gain Short term capital loss Long term capital loss Current
No of year's
15% 30% Applicable Rate DTAA rates 10% 20% DTAA rates
current year capital gains
(2) (3) (4) (5) (6) (7) (8)
(Fill this remaining
column after set off
only if (9=1-2-3-4-6-
computed 7-8)
figure is
positive)
(1)
i Capital Loss to be set 0 0 0 0 0 0 0

off
(Fill this row only if
computed
figure is negative)
ii Short 15% 0 0 0 0 0
Term
iii Capital 30% 0 0 0 0 0
Gain
iv Applicable 0 0 0 0 0
Rate
v DTAA 0 0 0 0 0
rates
vi Long 10% 0 0 0 0 0 0 0 0
Term
vii Capital 20% 0 0 0 0 0 0 0 0
Gain
viii DTAA 0 0 0 0 0 0 0 0
rates
ix Total loss set off 0 0 0 0 0 0 0
(ii + iii + iv + v + vi+vii+viii)
x Loss remaining after set off 0 0 0 0 0 0 0

(i-ix)
The figures of STCG in this table (A1e* etc.) are the amounts of STCG computed in respective column (A1-A6) as reduced by theamount of STCG not chargeable to tax or chargeable at special rates as
per DTAA, which is included therein, if any.
The figures of LTCG in this table (B1e* etc.) are the amounts of LTCG computed in respective column (B1-B10) as reduced by theamount of LTCG not chargeable to tax or chargeable at special rates as
per DTAA, which is included therein, if any.
F Information about accrual/receipt of capital gain
Type of Capital gain / Date Upto 15/6 16/6 to 15/9 16/9 to 15/12 16/12 to 15/3 16/3 to 31/3
(i) (ii) (iii) (iv) (v)
1 Short-term capital gains taxable at the 0 0 0 0 0

rate of 15%
Enter value from item 3iii of schedule
BFLA, if any.
2 Short-term capital gains taxable at the 0 0 0 0 0

rate of 30%
Enter value from item 3iv of schedule
BFLA, if any
3 Short-term capital gains taxable at 0 0 0 0 0

applicable rates
Enter value from item 3v of schedule
BFLA, if any.
4 Short-term capital gains taxable at 0 0 0 0 0

DTAA rates
Enter value from item 3vi of schedule
BFLA, if any.
5 Long- term capital gains taxable at the 0 0 0 0 0

rate of 10%
Enter value from item 3vi of schedule
BFLA, if any.

rate of 20%
Enter value from item 3vii of schedule
BFLA, if any.

rate DTAA rates
Enter value from item 3ix of schedule
BFLA, if any.
Note: Please include the income of the specified persons (spouse, minor child etc.) referred to in Schedule SPI while computing the income under this head
Schedule From sale of equity share in a company or unit of equity oriented fund or unit of a business trust on which
112A STT is paid under section 112A
Sl. Share ISIN Name No. of Sale- Full Value of Cost of acquisition Cost of If the long term capital asset Fair Market Value per Total Fair Market Value of Expenditure wholly and Total Balance (6-13)
No. /Unit Code of the Shares price Consideration without indexation acquisition was acquired before share/unit as on 31st capital asset as per section exclusively in deductions Item 4 (a) of
Acquired Share /Units per (Total Sale Value) Higher of 8 & 9 01.02.2018, -Lower of 6 & 11 January,2018 55(2)(ac)- (4*10) connection with transfer (7+12) LTCG Schedule
/Unit Share (4*5) of ITR3
/Unit
(Col (Col 1a) (Col (Col 3) (Col (Col 5) (Col 6) (Col 7) (Col 8) (Col 9) (Col 10) (Col 11) (Col 12) (Col 13) (Col 14)
1) 2) 4)
Total 0 0 0 0 0 0 0 0
Schedule 115AD(1) For NON-RESIDENTS - From sale of equity share in a company or unit of equity oriented fund or
(b)(iii) proviso unit of a business trust on which STT is paid under section 112A
Sl. Share ISIN Name No. of Sale- Full Value of Cost of acquisition Cost of If the long term capital asset Fair Market Value per Total Fair Market Value of Expenditure wholly and Total Balance (6-13)
No. /Unit Code of the Shares price Consideration without indexation acquisition was acquired before share/unit as on 31st capital asset as per section exclusively in deductions Item 7 (a) of
Acquired Share /Units per (Total Sale Value) Higher of 8 & 9 01.02.2018, -Lower of 6 & 11 January,2018 55(2)(ac)- (4*10) connection with transfer (7+12) LTCG Schedule
/Unit Share (4*5) of ITR3
/Unit
(Col (Col 1a) (Col (Col 3) (Col (Col 5) (Col 6) (Col 7) (Col 8) (Col 9) (Col 10) (Col 11) (Col 12) (Col 13) (Col 14)
1) 2) 4)
Total 0 0 0 0 0 0 0 0
Schedule OS Income from other sources

1 Gross income chargeable to tax at normal applicable rates (1a+ 1b+ 1c+ 1d + 1e) 1 461
a Dividends, Gross (not exempt u/s. 10(34) and u/s. 10(35)) 1a 0
ai Dividend income [other than (ii)] ai 0
aii Dividend income u/s 2(22)(e) aii 0
b Interest, Gross (bi + bii + biii + biv+ bv) 1b 461
i From Savings Bank bi 461
From Deposits (Bank/ Post Office/ Co-

ii bii 0
operative) Society/)
iii From Income-tax Refund biii 0
iv In the nature of Pass through income/ loss biv 0
v Others bv 0
c Rental income from machinery, plants, buildings, etc., Gross 1c 0
Income of the nature referred to in section 56(2)(x) which is chargeable to tax (di
d 1d 0
+ dii + diii + div + dv)
Aggregate value of sum of money received

i di 0
without consideration
In case immovable property is received

ii without consideration, stamp duty value of dii 0
property
In case immovable property is received for

iii inadequate consideration, stamp duty value diii 0
of property in excess of such consideration
In case any other property is received

iv without consideration, fair market value of div 0
property
In case any other property is received for

v inadequate consideration, fair market value dv 0
of property in excess of such consideration
e Any other income (please specify nature) 1e 0
Sl. No. Nature Amount
1 Family Pension 0
Income chargeable at special rates (2a+ 2b+ 2c+ 2d + 2e +2f elements related to Sl. No.
2 2 0
1)
a Winnings from lotteries, crossword puzzles etc. chargeable u/s 115BB 2a 0
b Income chargeable u/s 115BBE (bi + bii + biii + biv+ bv + bvi) 2b 0
i Cash credits u/s 68 bi 0
ii Unexplained investments u/s 69 bii 0
iii Unexplained money etc. u/s 69A biii 0
iv Undisclosed investments etc. u/s 69B biv 0

v Unexplained expenditure etc. u/s 69C bv 0
Amount borrowed or repaid on hundi u/s

vi bvi 0
69D
c Accumulated balance of recognised provident fund taxable u/s 111 2c 0
S.No. Assessment Year Income benefit Tax benefit
(i) (ii) (iii) (iv)
d Any other income chargeable at special rate (total of di to dxx) 2d 0
Pass through income in the nature of income from other sources chargeable at special
e 2e 0
rates (drop down to be provided)
Amount included in 1 and 2 above, which is chargeable at special rates in India as per
2f 0
DTAA (total of column (2) of table below)
Sl. Amount Item No. Country Article Rate as per Whether Section Rate Applicable
No. of 1 & 2 in name & of Treaty TRC of I.T. as rate [lower
f income which Code DTAA (enter NIL, obtained Act per I. of (6) or
included if not (Y/N) T. (10)]
chargeable) Act Applicable
rate
(1) (2) (3) (4) (5) (6) (7) (8) (9) (10)
Deductions under section 57 (other than those relating to income chargeable at special rates under 2a, 2b, 2d, 2e and
3
2f)
Expenses / Deductions (in case of other than

a(i) 3a(i) 0
family pension)
Deduction u/s. 57(iia) (in case of family pension

a(ii) 3a(ii) 0
only)
Depreciation (available only if income offered in 1.c

b 3b 0
of "schedule OS")
c Interest expenditure u/s 57(1) 3c
Interest expenditure claimed 0
Interest expenditure claimed 0
d Total 3d 0
4 Amounts not deductible u/s 58 4 0
5 Profits chargeable to tax u/s 59 5 0
Net Income from other sources chargeable at normal applicable rates (1(after reducing income related to
6 6 461
DTAA portion) - 3 + 4 + 5) (If negative take the figure to 4i of schedule CYLA )
7 Income from other sources (other than from owning race horses) (2 + 6) (enter 6 as nil, if negative) 7 461
8 Income from the activity of owning and maintaining race horses
a Receipts 8a 0
Deductions under section 57 in relation to

b 8b 0
receipts at 8a only
c Amounts not deductible u/s 58 8c 0
d Profits chargeable to tax u/s 59 8d 0

e Balance (8a - 8b + 8c + 8d) (if negative take the figure to 10xiii of Schedule CFL) 8e 0
9 Income under the head "Income from other sources" (7 + 8e) (take 8e as nil if negative) 9 461
10 Information about accrual/receipt of income from Other Sources
S. Other Source Income Upto From From 16 From 16 From

No. 15/6 16/6 to /9 to 15 /12 to 16/3 to
15/9 /12 15/3 31/3
(i) (ii) (iii) (iv) (v)
1 Dividend Income 0 0 0 0 0
2 Income by way of winnings from lotteries, crossword puzzles, 0 0 0 0 0

races, games, gambling, betting etc. referred to in section 2(24)
(ix)
3 Dividend Income chargeable under DTAA rates 0 0 0 0 0
Note: Please include the income of the specified persons (spouse, minor child etc.) referred to in Schedule SPI while computing the income
under this head.
INDIAN INCOME TAX RETURN
(For individuals and HUFs having income from profits and gains of business or Assessment
ITR-3 profession) Year
(Please see rule 12 of the Income-tax Rules,1962) 2021- 22
Schedule CYLA Details of Income after set-off of current years losses

Business Loss
Other sources
Income of (other than
loss (other
current year House speculation Current year?
than loss from
Sl. Head/ Source of (Fill this property loss loss or s Income
owning race
No Income column only if of the current specified remaining
horses) of the
income is zero year set off business loss) after set off
current year
or positive) of the current
set off
year set off
1 2 3 4 5=1-2-3-4
i Loss to be set off 0 0 0
ii Salaries 0 0 0 0
iii House property 0 0 0 0 0
Income from
Business (excluding
speculation profit and
iv 8,88,169 0 0 8,88,169
income from
specified business)
or profession
v Speculative Income 0 0 0 0
Specified Business
vi 0 0 0 0
Income
Short-term capital
vii 0 0 0 0 0
gain taxable @ 15%
Short-term capital
viii 0 0 0 0 0
gain taxable @ 30%
Short-term capital
ix gain taxable at 0 0 0 0 0
applicable rates
Short-term capital
gain taxable at
x 0 0 0 0 0
special rates in India
as per DTAA
Long term capital
xi 0 0 0 0 0
gain taxable @ 10%
Long term capital
xii 0 0 0 0 0
gain taxable @ 20%
Long term capital
gains taxable
xiii 0 0 0 0 0
atspecial rates in
India as per DTAA
Net income from
xiv other sources 461 0 0 461
chargeable at normal
applicable rates
Profit from the
activity of owning
xv 0 0 0 0 0
and maintaining race
horses
Income from other
sources taxable at
xvi 0 0 0 0 0
special rates in India
as per DTAA
xvii Total loss set off 0 0 0
xviii Loss remaining after set-off (i ? xvii) 0 0 0
(For Individuals and HUFs having income from profits and gains of business or Assessment
(Please see Rule 12 of the Income-tax Rules, 1962) 2021 - 22
Schedule BFLA Details of Income after Set off of Brought Forward Losses of earlier years
Sl. Head/ Income after set off, Brought forward Brought forward Brought forward Current year?s
No. Source of if any, of current loss set off depreciation set off allowance under income remaining
Income year?s losses as section 35(4) set off after set off
per 5 of Schedule
CYLA)
1 2 3 4 5
i Salaries 0 0
ii House 0 0 0 0 0
property
iii Business 8,88,169 0 0 0 8,88,169
(excluding
speculation
income and
income
from
specified
business)
iv Speculation 0 0 0 0 0
Income
v Specified 0 0 0 0 0
Business
Income
vi Short-term 0 0 0 0 0
capital gain
taxable @
15%
vii Short-term 0 0 0 0 0
capital gain
taxable @
30%
viii Short-term 0 0 0 0 0
capital gain
taxable at
applicable
rates
ix Short-term 0 0 0 0 0
capital gain
taxable at
special
rates in
India as
per DTAA
x Long term 0 0 0 0 0
capital gain
taxable @
10%
xi Long term 0 0 0 0 0
capital gain
taxable @
20%
xii Long term 0 0 0 0 0
capital
gains
taxable at
special
rates in
India as
per DTAA
xiii Net income 461 0 0 0 461
from other
sources
chargeable
at normal
applicable
rates
xiv Profit from 0 0 0 0 0
owning and
maintaining
race
horses
xv Income 0 0 0 0 0
from other
sources
income
taxable at
special
rates in
India as
per DTAA
xvi Total of brought forward loss 0 0 0
set off (2ii + 2iii + 2iv + 2v +
2vi + 2vii +2viii + 2ix + 2x + 2xi
+ 2xii + 2xiv)
xvii Current year's income remaining after set off Total of (5i + 5ii + 5iii + 5iv + 5v+ 5vi + 5vii + 8,88,630
5viii+ 5ix + 5x + 5xi + 5xii + 5xiii + 5xiv + 5xv)
Details of Losses to be carried forward to future years
Sl. Assessment Date Total Loss from business other than Loss from Loss Total Total Loss from
No. Year of House loss from speculative business speculative from Short- Long- owning and
(1) (2) Filing Property and specified business business specified term term maintaining
(3) Loss (6) business Capital Capital race horses
(4) Brought Amount Brought (7) Loss Loss (10)
forward as forward (8) (9)
Business adjusted Business
Loss on Loss
(5a) account available
of for set
opting off
for during
taxation the year
u/s (5c=5a-
115BAC 5b)
(5b)
i 2010-11 0
ii 2011-12 0
iii 2012-13 0
iv 2013-14 0 0 0 0 0 0 0
v 2014-15 0 0 0 0 0 0 0
vi 2015-16 0 0 0 0 0 0 0
vii 2016-17 0 0 0 0 0 0 0
viii 2017-18 0 0 0 0 0 0 0 0 0
ix 2018-19 0 0 0 0 0 0 0 0 0
x 2019-20 0 0 0 0 0 0 0 0 0
xi 2020-21 0 0 0 0 0 0 0 0 0
xii Total of earlier 0 0 0 0 0 0 0 0 0

year losses b/f
xiii Adjustment of 0 0 0 0 0 0 0 0 0
above
losses in
schedule BFLA
xiv 2021-22 0 0 0 0 0 0 0 0 0
(Current Year
Losses to be
carry
forwarded)
xv Total loss 0 0 0 0 0 0 0 0 0
carried forward
to future years
Schedule UD Unabsorbed depreciation and allowance under section 35(4)

Sl Assessment Depreciation Allowance under section 35(4)
No Year
Amount of Amount of Balance carried Amount of Amount of Balance Carried
brought depreciation forward to the brought allowance set- forward to the
forward set-off against next year forward off against the next year
unabsorbed the current year unabsorbed current year
depreciation income allowance income
(1) (2) (3) (4) (5) (6) (7) (8)
1 2021-22 0 0
Total 0 0 0 0 0 0
(Please see rule 12 of the Income-tax Rules,1962) 2021 - 22
Schedule ICDS Effect of Income Computation Disclosure Standards on profit

Sl. ICDS Amount (+) or (-)
No.
(i) (ii) (iii)
I Accounting Policies 0
II Valuation of Inventories (other than the effect of change in method of valuation u/s 145A, 0
ifthe same is separately reported at col. 4d or 4e of Part A-OI)
III Construction Contracts 0
IV Revenue Recognition 0
V Tangible Fixed Assets 0
VI Changes in Foreign Exchange Rates 0
VII Government Grants 0
VIII Securities (other than the effect of change in method of valuation u/s 145A, if the same 0
isseparately reported at col. 4d or 4e of Part A-OI)
IX Borrowing Costs 0
X Provisions, Contingent Liabilities and Contingent Assets 0
11a. Total effect of ICDS adjustments on profit (I+II+III+IV+V+VI+VII+VIII+IX+X) (if positive) 0
11b. Total effect of ICDS adjustments on profit (I+II+III+IV+V+VI+VII+VIII+IX+X) (if negative) 0

(Please see rule 12 of the Income-tax Rules,1962) 2021- 22
Schedule 10AA Deduction under section 10AA

Deductions in respect of units located in Special Economic Zone
Sl Undertaking Assessment year in which unit begins to Sl Amount of deduction
manufacture/produce/provide services
Total deduction under section 10AA (a + b) 0

(For Individuals and HUFs not having income from profits and gains of business or
ITR3 profession)
(Please see Rule 12 of the Income-tax Rules, 1962) 2 0 2 1 - 2 2
Schedule 80D
1 Whether you or any of your family member (excluding parents) is a senior citizen?
(a) Self & Family 0
(i) Health Insurance 0
(ii) Preventive Health Checkup 0
(b) Self & Family (Senior Citizen) 0
(iii) Medical Expenditure (This deduction to be claimed on which health insurance is not claimed) 0
2 Whether any one of your parents is a senior citizen
(a) Parents 0
(b) Parents (Senior Citizen) 0
(iii) Medical Expenditure 0
3 Eligible Amount of Deduction 0
(For Individuals and HUFs not having income from profits and gains of business or
ITR3 profession)
(Please see Rule 12 of the Income-tax Rules, 1962) 2 0 2 1 - 2 2
Schedule 80G Details of donations entitled for deduction under section 80G
Donations entitled for 100% deduction without
A
qualifying limit
Eligible
Name and address of PAN of
Amount of donation Amount of
Donee Donee
donation
Donation in Donation in
Total Donation
cash other mode
Total 0 0 0 0
Donations entitled for 50% deduction without
B
qualifying limit
Eligible
Donee Donee
donation
Total Donation
cash other mode
Total 0 0 0 0
Donations entitled for 100% deduction subject
C
to qualifying limit
Eligible
Donee Donee
donation
Total Donation
cash other mode
Total 0 0 0 0
Donations entitled for 50% deduction subject to
D
qualifying limit
Eligible
Donee Donee
donation
Total Donation
cash other mode
Total 0 0 0 0
TOTAL ELIGIBLE
AMOUNT OF
E 0
DONATIONS (A + B +
C + D)
Details of donations to research associations etc. [deduction under sections 35(1)(ii) or 35(1)(iia) or 35(1)
Schedule RA
(iii) or 35(2AA)]
Name and address of donee PAN of Amount of donation Eligible Amount of
Donee donation
Donation in cash Donation in other Total Donation

mode
Total 0 0
Schedule 80-IA
Deduction in respect of profits of an undertaking

a referred to in section 80-IA(4)(ii) [Telecommunication
services]

b referred to in section 80-IA(4)(iii) [Industrial park and
SEZs]

c
referred to in section 80-IA(4)(iv) [Power]

referred to in section 80-IA(4)(v) [Revival of power
d generating plant] and deduction in respect of profits of
an undertaking referred to in section 80-IA(4)(vi) [Cross-
country natural gas distribution network]
e Total deductions under section 80-IA (a + b + c + d) 0

Schedule 80-IB Deductions under section 80-IB
Deduction in respect of industrial undertaking located in Jammu &

a
Kashmir or Ladakh [Section 80-IB(4)]
b Deduction in the case of multiplex theatre [Section 80-IB(7A)]
c Deduction in the case of convention centre [Section 80-IB(7B)]
Deduction in the case of undertaking which begins commercial

d
production or refining of mineral oil [Section 80-IB(9)]
Deduction in the case of an undertaking developing and building

e
housing projects [Section 80-IB(10)]
Deduction in the case of an undertaking engaged in processing,

f preservation and packaging of fruits, vegetables, meat, meat
products, poultry, marine or dairy products
Deduction in the case of an undertaking engaged in integrated

g business of handling, storage and transportation of food grains
[Section 80-IB(11A)]
Deduction in the case of an undertaking engaged in operating

h
and maintaining a rural hospital [Section 80-IB(11B)]
Deduction in the case of an undertaking engaged in operating

i and maintaining a hospital in any area, other than excluded area
[Section 80-IB(11C)
j Total deduction under section 80-IB (Total of a to i) 0

Schedule 80-IC or 80-

Deductions under section 80-IC or 80-IE
IE
DEDUCTION a Deduction in respect of undertaking located in Sikkim
U/S 80-IC or
80-IE b Deduction in respect of undertaking located in Himachal Pradesh
c Deduction in respect of undertaking located in Uttaranchal
dh Total deduction for undertakings located in North-east (total of da to dg) 0
e Total deduction under section 80-IC or 80-IE (a + d + c + dh) 0
Deductions under Chapter VI-A
Part B- Deduction in respect of certain payments

a 80C 97,847 b 80CCC 0
80CCD
c 80CCD(1) 0 d 0
(1B)
e 80CCD(2) 0 f 80D 0
1 g 80DD 0 h 80DDB 0
i 80E 0 j 80EE 0
k 80EEA 0 l 80EEB 0
m 80G 0 n 80GG 0
o 80GGC 0
Total Deduction under Part B (total of a to o) 1 97,847
2 Part C- Deduction in respect of certain incomes
p 80-IA 0 q 80-IAB 0
r 80-IB 0 s 80-IBA 0
80-IC/ 80-
t 0 u 80JJA 0
IE
v 80JJAA 0 w 80QQB 0
x 80RRB 0
Total Deduction under Part C (total of p to x ) 2 0
3 Part CA and D- Deduction in respect of other incomes/other deduction
i 80TTA 461 ii 80TTB 0
iii 80U 0
Total Deduction under Part CA and D (total of i, ii and iii) 3 461
4 Total deductions under Chapter VI-A (1 + 2 + 3) 4 98,308
Schedule AMT Computation of Alternate Minimum Tax payable under section 115JC
1 Total Income as per item 14 of PART-B-TI 1 7,90,320
2 Adjustment as per section 115JC(2)
Deduction claimed under any section included in
a Chapter VI-A under the heading "C.?Deductions 2a 0
in respect of certain incomes"
b Deduction claimed u/s 10AA 2b 0
Deduction claimed u/s 35AD as reduced by the
c amount of depreciation on assets on which such 2c 0
deduction is claimed
d Total Adjustment (2a+ 2b+ 2c) 2d 0
3 Adjusted Total Income under section 115JC(1) (1+2d) 3 7,90,320
4 Tax payable under section 115JC [18.5% of (3)] (if 3 is greater than Rs. 20 lakhs) 4 0
Schedule AMTC Computation of tax credit under section 115JD

1 Tax under section 115JC in assessment year 2021-22 (1d of Part-B-TTI) 1 0
2 Tax under other provisions of the Act in assessment year 2021-22 (2i of Part-B-TTI) 2 73,387
Amount of tax against which credit is available [enter (2 ? 1) if 2 is greater than 1,
3 3 73,387
otherwise enter 0]
Utilisation of AMT credit Available (Sum of AMT credit utilized during the current year is subject to maximum of
4
amount mentioned in 3 above and cannot exceed the sum of AMT Credit Brought Forward)
S. Assessment Year AMT Credit AMT Credit Utilised Balance AMT
No. (A) during the Current Credit Carried
Gross Set-off in Balance brought Assessment Year Forward
(B1) earlier forward to the current (C) (D)= (B3) ?(C)
assessment assessment year
years (B3) = (B1) ? (B2)
(B2)
viii Current AY 0 0
(enter 1-2, if 1>2
else enter 0)
ix Total 0 0 0 0 0
5 Amount of tax credit under section 115JD utilised during the year [total of item No. 4 (C)] 5 0
Amount of AMT liability available for credit in subsequent assessment years [total of 4
6 6 0
(D)]
Schedule Income of specified persons (spouse, minor child etc.) includable in income of the assessee as per
SPI section 64
Sl Name of person PAN/ Aadhaar of person Relationship Amount (Rs) Head of Income in
No (optional) which included
Schedule SI Income chargeable to tax at special rates (please see instructions No. 9 for rate of tax)
Sl. Section Special Income Taxable Income Tax thereon
No. rate after
adjusting for min
chargeable to tax
1 111 - Tax on accumulated balance of 1% 0 0 0
recognised PF
2 111A or section 115AD(1)(ii)- Proviso 15 % 0 0 0
(STCG on shares units on which STT
paid)
3 115AD(1)(b)(ii)- Short term capital gains 15 % 0 0 0
referred to in section 111A
4 112 (LTCG on others) 20 % 0 0 0
5 112 proviso (LTCG on listed securities/ 10 % 0 0 0
units without indexation)
6 112(1)(c)(iii)(LTCG on unlisted securities 10 % 0 0 0
in case of non-residents)
7 112A (LTCG on sale of shares or units 10 % 0 0 0
on which STT is paid)
8 115A(1)(a)(i)- Dividends interest and 20 % 0 0 0
income from units purchase in foreign
currency
9 115A(1)(a)(ii)- Interest received from 20 % 0 0 0
Govt/Indian Concerns received in
Foreign Currency
10 1115A(1) (a)(iia) -Interest from 5% 0 0 0
Infrastructure Debt Fund
11 115A(1) (a)(iiaa) -Interest as per Sec. 5% 0 0 0
194LC(1)
12 115A(1) (a)(iiaa) -Interest received by 4% 0 0 0
non-resident as referred in proviso to
section 194LC(1)
13 115A(1) (a)(iiab) -Interest as per Sec. 5% 0 0 0
194LD
14 115A(1) (a)(iiac) -Interest as per Sec. 5% 0 0 0
194LBA
15 115A(1) (a)(iiac) -Distributed income 10 % 0 0 0
being Dividend referred to in section
194LBA
16 115A(1) (a)(iii) - Income received in 20 % 0 0 0
respect of units of UTI purchased in
Foreign Currency
17
115A(1)(b)- Income from royalty or fees
115A(1)(b)- Income from royalty or fees 10 % 0 0 0
for technical services received from
Government or Indian concern -
chargeable u/s 115A(1)(b)
18 115AC(1)(a) - Income by way of interest 10 % 0 0 0
on bonds purchased in foreign currency
19 115AC(1)(c) -LTCG arising from the 10 % 0 0 0
transfer of bonds or GDR purchased in
foreign currency - non-resident
20 115ACA(1)(a) - Income from GDR 10 % 0 0 0
purchased in foreign currency -resident
21 115ACA(1)(b) - LTCG arising from the 10 % 0 0 0
transfer of GDR purchased in foreign
currency -resident
22 115AD(1)(i) -Income (other than 20 % 0 0 0
dividend) received by an FII in respect of
securities(other than units as per Sec
115AB)
23 115AD(1)(i) - Income being dividend 20 % 0 0 0
received by an FII in respect of
securities (other than units referred to in
section115AB)
24 115AD(1)(i) -Income received by an FII 5% 0 0 0
in respect of bonds or government
securities as per Sec 194LD
25 115AD(1)(ii) -STCG (other than on 30 % 0 0 0
equity share or equity oriented mutual
fund referred to in section 111A) by an
FII
26 115AD(1)(iii)-Long term capital gains by 10 % 0 0 0
an FII
27 Securities referred in section 112A read 10 % 0 0 0
with section 115AD
28 115BB (Winnings from lotteries, puzzles, 30 % 0 0 0
races, games etc.)
29 115BBA - Income received by non- 20 % 0 0 0
resident sportsmen or sports
associations or entertainer
30 115BBC - Anonymous donations 30 % 0 0 0
31 115BBE - Tax on income referred to in 60 % 0 0 0
sections 68 or 69 or 69A or 69B or 69C
or 69D
32 115BBF -Tax on income from patent 10 % 0 0 0
(Income from BP)
33 115BBF -Tax on income from patent 10 % 0 0 0
34 115BBG -Tax on income from transfer 10 % 0 0 0
of carbon credits(Income from BP)
35 115BBG-Tax on income from transfer of 10 % 0 0 0
carbon credits
36 115E(a)-Investment income 20 % 0 0 0
37 115E(a)-LTCG on any asset other than 20 % 0 0 0
a specified asset-non resident Indian
a specified asset-non resident Indian
38 115E(b) - Income by way of long term 10 % 0 0 0
capital gains
39 STCGDTAARate - STCG Chargeable at 1% 0 0 0
special rates in India as per DTAA
40 LTCGDTAARate - LTCG Chargeable at 1% 0 0 0
special rates in India as per DTAA
41 Other source income chargeable under 1% 0 0 0
DTAA rates
42 Pass Through Income in the nature of 15 % 0 0 0
Short Term Capital Gain chargeable @
15% u/s 111A
Short Term Capital Gain chargeable @
30%
Long Term Capital Gain chargeable @
10% u/s 112A
10% u/s other than u/s 112A
20%
47 PTI_115A(1)(a)(i)- Dividends in the case 20 % 0 0 0
of non-residents
48 PTI_115A(1)(a)(ii)- Interest received in 20 % 0 0 0
the case of non-residents
49 PTI_115A(1)(a)(iia)- Interest received by 5% 0 0 0
non-resident from infrastructure debt
fund
50 PTI_115A(1)(a)(iiaa)- Income received 5% 0 0 0
by non-resident as referred in section
194LC(1)
51 PTI_115A(1) (a)(iiaa) -Interest received 4% 0 0 0
by non-resident as referred in proviso to
section 194LC(1)
52 PTI_115A(1)(a)(iiab)- Income received 5% 0 0 0
194LD
53 PTI_115A(1)(a)(iiac)- Income received 5% 0 0 0
194LBA
54 PTI_115A(1) (a)(iiac) -Distributed 10 % 0 0 0
income being Dividend referred to in
section 194LBA
55 PTI_115A(1)(a)(iii)- Income from units 20 % 0 0 0
purchased in foreign currency in the
case of non-residents
56 PTI_115A(1)(b)-Income from royalty or 10 % 0 0 0
fees for technical services received from
Government or Indian concern

Government or Indian concern
57 PTI_115AC(1)(a)- Income by way of 10 % 0 0 0
interest on bonds purchased in foreign
currency
58 PTI_115ACA(1)(a )- Income from GDR 10 % 0 0 0
purchased in foreign currency or long
term capital gains arising from their
transfer in case of a resident employee
of an Indian company, engaged in
knowledge based industry or service
59 PTI_115AD(1)(i)-PTI - Income (being 20 % 0 0 0
Dividend) received by an FII in respect
of securities(other than units referred to
in section115AB)
60 PTI_115AD(1)(i)- PTI - Income (other 20 % 0 0 0
than dividend) received by an FII in
respect of securities (other than units
referred to in section115AB)
61 PTI_115AD(1)(i)- Income received by an 5% 0 0 0
FII in respect of bonds or government
securities referred to in section 194LD
62 PTI_115BBA- Income received by non- 20 % 0 0 0
resident sportsmen or sports
associations or entertainer
63 PTI_115BBC- Anonymous donations 30 % 0 0 0
64 PTI_115BBF- Tax on income from patent 10 % 0 0 0
65 PTI_115BBG- Tax on income from 10 % 0 0 0
transfer of carbon credits
66 PTI_115E(a)- Investment income of a 20 % 0 0 0
non-resident Indian
Total 0 0 0
Information regarding partnership firms in which you are partner anytime during the previous year
Number of firms in which you are partner
Sl Name of PAN of Firm Whether the Whether section Percentage Amount of share Capital balance on
No Firm firm is liable 92E is applicable Share in the in the profit 31st March in the
for audit? (Yes to firm? (Yes/ No) profit of the firm
/No) firm
i ii
Total 0 0
Schedule EI Details of Exempt Income (Income not to be included in Total Income or not chargeable to tax)
1 Interest income 1 0
Gross Agricultural receipts (other than income to be
i i 0
excluded under rule 7A, 7B or 8 of I.T. Rules)
ii Expenditure incurred on agriculture ii 0
Unabsorbed agricultural loss of previous eight
iii iii 0
assessment years
2
Agricultural income portion relating to Rule 7, 7A, 7B
iv iv 0
(1), 7B(1A) and 8(from Sl. No. 39 of Sch. BP)
v Net Agricultural income for the year (i ? ii ? iii) (enter nil if loss) 2 0
In case the net agricultural income for the year exceeds Rs.5 lakh, please furnish
vi
the following details (Fill up details separately for each agricultural land)
3 Other exempt income (including exempt income of minor child) 3 0
SL.No Other exempt income Amount
4 Income not chargeable to tax as per DTAA

Sl. Amount of income Nature of Country Article Head of Whether TRC
No. income name & of DTAA Income obtained (Y/N)
Code
III Total Income from DTAA not chargeable to tax 4 0

5 Pass through income not chargeable to tax (Schedule PTI) 5 0
6 Total (1+2+3+4+5) 6 0
Schedule PTI Pass Through Income details from business trust or investment fund as per section 115UA, 115UB
Note: Please refer to the instructions for filling out this schedule.
Schedule- Details of Tax on secondary adjustments as per section 92CE(2A) as per the schedule provided in e-
TPSA filing utility
Amount of primary adjustment on which option u/s 92CE(2A) is exercised & such excess
1 0
money has notbeen repatriated within the prescribed time
Sl.No Financial Year Amount
a Additional Income tax payable @ 18% on above 0

b Surcharge @ 12% on "a" 0
2
c Health & Education cess on (a+b) 0
d Total Additional tax payable (a+b+c) 0
3 Taxes paid 0
4 Net tax payable (2d-3) 0
Date(s) of deposit of tax on Serial
Name of Bank and BSR
secondary adjustments as per number Amount deposited
Branch Code
section 92CE(2A) of challan
Amount Deposited 0
Schedule FSI Details of Income from outside India and tax relief (Available in case of resident)
(For Individuals and HUFs having income from profits and gains of business or profession) Assessment Year
ITR3
Schedule TR Summary of tax relief claimed for taxes paid outside India (Available in case of resident)
1 Summary of Tax relief claimed
Country Tax Total taxes paid outside India (total Total tax relief available (total of Tax Relief Claimed
Code Identification of (c) of Schedule FSI in respect of (f) of Schedule FSI in respect of under section (specify
Number each country) each country) 90, 90A or 91)
(a) (b) (c) (d) (e)
Total 0 0
Total Tax relief available in respect of country where DTAA is applicable (section 90
2 2 0
/90A) (Part of total of 1(d))
Total Tax relief available in respect of country where DTAA is not applicable (section 91)
3 3 0
(Part of total of 1(d))
Whether any tax paid outside India, on which tax relief was allowed in India, has been
4 refunded/credited by the foreign tax authority during the year? If yes, provide the details 4
below
Amount of tax Assessment year in which tax relief
a 0 b
refunded allowed in India
Details of Foreign Assets and Income from any source outside India
A1 Details of Foreign Depository Accounts held (including any beneficial interest) at any time during the relevant accounting period
Sl Country Country Name of financial Address of financial ZIP Account Status Account Peak balance during Closing Gross interest paid/credited to the account
No name code institution institution code number opening date the period balance during the period
(1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12)
A2 Details of Foreign Custodial Accounts held (including any beneficial interest) at any time during the relevant accounting period
Sl Country Country Name of Address of ZIP Account Status Account Peak balance Closing Gross interest paid/credited to the account during the period
No name code financial financial code number opening during the balance (drop down to be provided specifying nature of amount viz. interest/dividend
institution institution date period /proceeds from sale or redemption of financial assets/ other income)
(1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) Nature of amount Amount
(12a) (12b)
A3 Details of Foreign Equity and Debt Interest held (including any beneficial interest) in any entity at any time during the relevant accounting period
Sl Country Country Name Address ZIP Nature Date of Initial value of Peak value of Closing Total gross amount paid/credited with Total gross proceeds from sale or
No name code of of entity code of acquiring the the investment during balance respect to the holding during the period redemption of investment during the
entity entity interest investment the period period
(1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13)
A4 Details of Foreign Cash Value Insurance Contract or Annuity Contract held (including any beneficial interest) at any time during the relevant accounting period
Sl Country Country Name of financial institution in which Address of financial ZIP Date of The cash value or surrender value Total gross amount paid/credited with respect to the
No name code insurance contract held institution code contract of the contract contract during the period
(1) (2) (3) (4) (5) (6) (7) (8) (9)
B Details of Financial Interest in any Entity held (including any beneficial interest) at any time during the relevant accounting period
Sl Country Name ZIP Nature Name and Address Nature of Interest-Direct Date Total Investment (at Income accrued from Nature of Income taxable and offered in this return
No and code Code of entity of the Entity /Beneficialowner/Beneficiary since cost) (in rupees) such Interest Income
Amount Schedule Item number
held
where of schedule
offered
(1) (2) 2a (3) (4) (5) (6) (7) (8) (9) (10) (11) (12)
C Details of Immovable Property held (including any beneficial interest) at any time during the relevant accounting period
Sl Country Name ZIP Address of the Ownership-Direct/ Beneficial Date of Total Investment (at cost) Income derived from Nature of Income taxable and offered in this return
No and code Code Property owner/ Beneficiary acquisition (in rupees) the property Income
Amount Schedule Item number of
where offered schedule
(1) (2) 2b (3) (4) (5) (6) (7) (8) (9) (10) (11)
D Details of any other Capital Asset held (including any beneficial interest) at any time during the relevant accounting period
Sl Country Name ZIP Nature of Ownership-Direct/ Beneficial Date of Total Investment (at cost) Income derived from Nature of Income taxable and offered in this return
No and code Code Asset owner/ Beneficiary acquisition (in rupees) the asset Income
Amount Schedule Item number of
where offered schedule
(1) (2) 2b (3) (4) (5) (6) (7) (8) (9) (10) (11)
E Details of account(s) in which you have signing authority held (including any beneficial interest) at any time during the relevant accounting period and which has not been included in A to D above.
Sl Name of the Institution Address of Country Zip Name of Account Peak Balance/ Investment during the year Whether income If (7) is yes, If (7) is yes, Income offered in
No in which the account is the Name and Code the account Number (in rupees) Peak Balance/ Investment accrued is taxable in Income accrued in this return
held Institution Code holder during the year your hands? the account
Amount Schedule Item
where number
offered of
schedule
(1) (2) (3) (3a) (3b) (4) (5) (6) (7) (8) (9) (10) (11)
F Details of trusts, created under the laws of a country outside India, in which you are a trustee, beneficiary or settlor
Sl Country ZIP Name and Name and Name and Name and address Date since Whether income derived is If (8) is yes, Income If (8) is yes, Income offered in this
No Name and CODE address of the address of address of of Beneficiaries position taxable in your hands? derived from the trust return
code trust trustees Settlor held

Amount Schedule Item
where number of
offered schedule
(1) (2) (2b) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12)
G Details of any other income derived from any source outside India which is not included in,- (i) items A to F above and, (ii) income under the head business or profession
Sl Country Name and ZIP Name and address of the person from whom Income Nature of Whether taxable in your If (6) is yes, Income offered in this return
No code CODE derived derived income hands?

Amount Schedule where Item number of
offered schedule
(1) (2) (2b) (3) (4) (5) (6) (7) (8) (9)
Note: Please refer to instructions for filling out this schedule. In case of an individual, not being an Indian citizen, who is in India on a business, employment or student visa, an asset acquired during any previous year in which he was non-resident
is not mandatory to be reported in this schedule if no income is derived from that asset during the current previous year.
Schedule 5A Information regarding apportionment of income between spouses governed by Portuguese Civil Code
Name of the
spouse
PAN/ Aadhaar
/
of the spouse
Whether books of accounts of spouse is audited u/s 44AB? or Whether your spouse is a partner
of a firm whose accounts are required to be audited u/s 44AB under this Act?
Whether books of accounts of spouse is audited u/s 92E? or Whether your spouse is a partner of
a firm whose accounts are required to be audited u/s 92E under this Act?
Amount of TDS
Heads of Receipts received Amount apportioned in TDS apportioned in
deducted on income at
Income under the head the hands of the spouse the hands of spouse
(ii)
(i) (ii) (iii) (iv) (v)
House
1 0 0 0 0
Property
Business or
2 0 0 0 0
profession
3 Capital gains 0 0 0 0
Other
4 0 0 0 0
sources
5 Total 0 0 0 0
Assets and Liabilities at the end of the year (applicable in a case where total income exceeds Rs.50 lakh)
A Details of immovable assets

Sl. No. Description Address Pin code Amount (cost) in Rs.
(1) (2) (3) (4) (5)
B Details of movable assets

Sl.
Description Amount (cost) in Rs.
No.
(1) (2) (3)
(i) Jewellery, bullion etc. 0
(ii) Archaeological collections, drawings, painting, sculpture or any work of art 0
(iii) Vehicles, yachts, boats and aircrafts 0
(iv) Financial assets Amount (cost) in Rs.
(a) Bank (including all deposits) 0
(b) Shares and securities 0
(c) Insurance policies 0
(d) Loans and advances given 0
(e) Cash in hand 0
C Interest held in the assets of a firm or association of persons (AOP) as a partner or member thereof
Sl. Name and address of the firm(s)/ PAN of the firm/ Assessee?s investment in the firm/ AOP on cost
No. AOP(s) AOP basis
(1) (2) (3) (4)
D Liabilities in relation to Assets at (A + B + C) 0
Note: Please refer to instructions for filling out this schedule.
(Please see rule 12 of the Income-tax Rules,1962) 2021 - 22
Schedule GST INFORMATION REGARDING TURNOVER/GROSS RECEIPT REPORTED FOR GST

Sl. GSTIN No(s). Annual value of outward supplies as per the GST return(s) filed
No.
(1) (2) (3)
Please furnish the information above for each GSTIN No. separately
Part B ? TI Computation of total income

1 Salaries (6 of Schedule S) 1 0
2 Income from house property ( 4 of Schedule HP) (enter nil if loss) 2 0
3 Profits and gains from business or profession
Profit and gains from business other than speculative
i business and specified business (A38 of Schedule 3i 8,88,169
BP) (enter nil if loss)
Profit and gains from speculative business (3(ii) of
ii Table E of Schedule BP) (enter nil if loss and take the 3ii 0
figure to schedule CFL)
Profit and gains from specified business ( 3(iii) of
iii Table E of Schedule BP) (enter nil if loss and take the 3iii 0
figure to schedule CFL)
Income chargeable to tax at special rates (3e & 3f of
iv 3iv 0
Schedule BP)
v Total (3i + 3ii + 3iii + 3iv) (enter nil if 3v is a loss) 3v 8,88,169
4 Capital gains
Short term
i Short-term chargeable @ 15% (9ii of item E of schedule CG) ai 0
ii Short-term chargeable @ 30% (9iii of item E of schedule CG) aii 0
a Short-term chargeable at applicable rate (9iv of item E of schedule

iii aiii 0
CG)
Short-term chargeable at special rates in India as per DTAA (9v of
iv aiv 0
item E of Schedule CG)
v Total Short-term (ai + aii + aiii + aiv) (enter nil if loss) 4av 0
Long-term
i Long-term chargeable @ 10% (9vi of item E of schedule CG) bi 0
ii Long-term chargeable @ 20% (9vii of item E of schedule CG) bii 0
b
Long-term chargeable at special rates in India as per DTAA (9viii
iii biii 0
of item E of schedule CG)
iv Total Long-term (bi + bii + biii) (enter nil if loss) 4biv 0
c Total capital gains (4av + 4biv) (enter nil if loss) 4c 0
5 Income from other sources
Net income from other sources chargeable to tax at normal applicable
a 5a 461
rates (6 of Schedule OS) (enter nil if loss)
b Income chargeable to tax at special rates ( 2 of Schedule OS) 5b 0
Income from the activity of owning and maintaining race horses ( 8e of
c Schedule OS) (enter nil if loss) 5c 0
d Total (5a + 5b + 5c) (enter nil if loss) 5d 461
6 Total of head wise income (1+2+3v+4c+5d) 6 8,88,630
Losses of current year to be set off against 6 (total of 2xvii, 3xvii and 4xvii of Schedule
7 7 0
CYLA)
Balance after set off current year losses (6 ? 7) (total of serial number (ii) to (xv) column
8 8 8,88,630
5 of Schedule CYLA+5b+3iv)
Brought forward losses to be set off against 8 (total of 2xvi, 3xvi and 4xvi of Schedule
9 9 0
BFLA)
Gross Total income (8-9) (also total of serial no (i) to (xiv) of column 5 of Schedule
10 9 8,88,630
BFLA+ 5b+ 3iv)
Income chargeable to tax at special rate under section 111A, 112, 112A etc. included in
11 11 0
10
12 Deductions under Chapter VI-A
Part-B, CA and D of Chapter VI-A [(1 + 3) of Schedule VI-A and limited upto (total
a 12a 98,308
of i,ii,iii,iv,v,viii,xiii,xiv) of column 5 of BFLA]
b Part-C of Chapter VI-A [(2 of Schedule VI-A and limited upto iii5 of BFLA] 12b 0
c Total (12a + 12b) [limited upto (10-11)] 12c 98,308
13 Deduction u/s 10AA (c of Sch. 10AA) 13 0
14 Total income (10 - 12c - 13) 14 7,90,320
Income which is included in 14 and chargeable to tax at special rates (total of (i) of
15 15 0
schedule SI)
16 Net agricultural income/ any other income for rate purpose ( 3 of Schedule EI) 16 0
Aggregate income (14-15+16) [applicable if (14-15) exceeds maximum amount not
17 17 7,90,320
chargeable to tax]
18 Losses of current year to be carried forward (total of row xiv of Schedule CFL) 18 0
19 Deemed income under section 115JC (3 of Schedule AMT) 19 7,90,320
Part B ? TTI Computation of tax liability on total income

Tax payable on deemed total income u/s 115JC (4 of Schedule
a 1a 0
AMT)
1 b Surcharge on (a) (if applicable) 1b 0

c Health and Education Cess @ 4% on (1a + 1b) above 1c 0
d Total tax payable on deemed total income (1a + 1b + 1c) 1d 0
2 Tax payable on total income 70,564
A Tax at normal rates on 17 of Part B-TI 2a 70,564
Tax at special rates (total of col. (ii) of
B 2b 0
Schedule-SI)
Rebate on agricultural income
[applicable if (14-15) of Part B-TI
C 2c 0
exceeds maximum amount not
chargeable to tax]
D Tax Payable on Total Income (2a + 2b - 2c) 2d 70,564
E Rebate under section 87A 2e 0
F Tax payable after rebate (2d ? 2e) 2f 70,564
G Surcharge Surcharge computed Surcharge after
before marginal relief marginal relief
i @25% of 17(ii) of 2gi 0 ia 0
Schedule SI
ii @10% or 15%, as 2gii 0 iia 0
applicable of 2(ii),3(ii), 9(ii),
12(ii), 22(ii), 24(ii) of
Schedule SI
iii On [(2f) ? (17(ii),2(ii),3(ii), 9 2giii
(ii), 12(ii), 22(ii), 24(ii) of
Schedule SI)]]
iv Total (ia + iia) 2giv 0
H Health and Education Cess @ 4% on (2f + 2giii) 2h 2,823
I Gross tax liability (2f + 2giv + 2h) 2i 73,387
3 Gross tax payable (higher of 1d and 2i) 3 73,387
Tax on income without including income on perquisites referred in section 17(2)(vi) received from
3a 3a 73,387
employer, being an eligible start-up referred to in section 80-IAC ( Schedule Salary)
Tax deferred - relatable to income on perquisites referred in section 17(2)(vi) received from
3b 3b 0
employer, being an eligible start-up referred to in section 80-IAC
Credit under section 115JD of tax paid in earlier years (applicable if 2i is more than 1d) (5 of
4 4 0
Schedule AMTC)
5 Tax payable after credit under section 115JD (3a - 4) 5 73,387
6 Tax relief
a Section 89 (Please ensure to submit Form 10E to claim this relief) 6a 0
b Section 90/ 90A (2 of Schedule TR) 6b 0
c Section 91 (3 of Schedule TR) 6c 0
d Total (6a + 6b + 6c) 6d 0
7 Net tax liability (5 - 6d) (enter zero if negative) 7 73,387
8 Interest and fee payable
a Interest for default in furnishing the return (section 234A) 8a 0
b Interest for default in payment of advance tax (section 234B) 8b 0
c Interest for deferment of advance tax (section 234C) 8c 0
d Fee for default in furnishing return of income (section 234F) 8d 5,000
e Total Interest and Fee Payable (8a+8b+8c+8d) 8e 5,000
9 Aggregate liability (7 + 8e) 9 78,387
10 Taxes Paid
a Advance Tax (from column 5 of 17A) 10a 0
b TDS (total of column 5 of 18B and column 9 of 17C) 10b 76,561
c TCS (total of column 7 of 17D) 10c 0
d Self-Assessment Tax (from column 5 of 17A) 10d 1,826
e Total Taxes Paid (10a + 10b + 10c + 10d) 10e 78,387
11 Amount payable (Enter if 9 is greater than 10e, else enter 0) 11 0
Refund (If 10e is greater than 9) (Refund, if any, will be directly credited into the bank
12 12 0
account)
Do you have a bank account in India (Non- Residents claiming refund with no bank account in
13 Yes
India may select No)
i. a) Details of all Bank Accounts held in India at any time during the previous year (excluding dormant accounts)
IFS Code of the Bank in Indicate the account in which you

Sl. Account prefer to get your refund credited, if
case of Bank Accounts Name of the Bank
No Number
held in India any (tick accounts
EQUITAS SMALL
1 ESFB0001018 FINANCE BANK 200000540944 ✔
LIMITED
2 IDIB000S037 INDIAN BANK 6570981158 ✔
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
Rows can be added as required
b) Non- residents, who are claiming income-tax refund and not having bank account in India may, at their option,
ii
furnish the details of one foreign bank account:
Sl. No. SWIFT Code Name of the Bank Country of Location IBAN
Do you at any time during the previous year,?

(i) hold, as beneficial owner, beneficiary or otherwise, any asset (including financial interest in any
Yes
14 entity) located outside India; or ✔ No
(ii) have signing authority in any account located outside India; or
(iii) have income from any source outside India?
[applicable only in case of a resident] [Ensure Schedule FA is filled up if the answer is Yes ]
15 TAX PAYMENTS
A Schedule-IT Details of payments of Advance Tax and Self-Assessment Tax
Sl BSR Code Date of Deposit (DD Serial Number Amount
No /MMM/YYYY) of Challan (Rs)
(1) (2) (3) (4) (5)
1 6390340 12773 1,826

Advance Tax and Self Assessment Tax (total of column 5) 1,826
Note: Enter the totals of Advance tax and Self-Assessment tax
in Sl No. 10a & 10d of Part B-TTI
B Schedule TDS1 - Details of Tax Deducted at Source from Salary [As per Form 16 issued by Employer(s)]
Sl Tax Deduction Account Number (TAN) of the Name of the Income chargeable under Total tax
No Employer Employer Salaries deducted
(1) (2) (3) (4) (5)
Total Tax Deducted 0

Schedule TDS2 - Details of Tax Deducted at Source (TDS) on Income [As per Form 16 A issued or Form 16B/16C
C
furnished by Deductor(s)]
Sl TDS credit PAN/ TAN of the Unclaimed TDS TDS of the current Financial TDS credit being claimed this Year Corresponding TDS
No relating to self Aadhaar of Deductor/ brought forward Year (TDS deducted during FY (only if corresponding income is Receipt offered credit
/other person Other PAN/ (b/f) 2020-21) being offered for tax this year, not being
[spouse as per Person (if Aadhaar of applicable if TDS is deducted u/s carried
section 5A/other TDS credit Tenant/ 194N) forward
person as per related to Buyer

Fin. Year TDS Deducted Deducted in the Claimed Claimed in the hands of Gross Head of
rule 37BA(2)] other
in which b/f in own hands of spouse in own spouse as per section 5A Amount Income
person)
deducted hands as per section 5A hands or any other person as per
or any other rule 37BA(2) (if applicable)
person as per rule
37BA(2) (if
applicable)
(1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13)
Income TDS Income TDS PAN/
Aadhaar
1 Self / CHEI10009G 0 76,400 0 0 76,400 0 0 / 38,20,000 Not 0
Applicable
(only in
case TDS
is
deducted
u/s 194N)
2 Self / MRIL00089F 0 161 0 0 161 0 0 / 21,100 Income 0
from
Business
&
Profession
TDS claimed in own hands (total of column 9) 76,561

Note: Please enter total of column 9 in 10b of Part B- TTI
Schedule TDS3 - Details of Tax Deducted at Source (TDS) on Income [As per Form 16A issued or Form 16B/16C
D
/16D furnished by Deductor(s)]
Sl TDS credit relating PAN/ Aadhaar PAN Unclaimed TDS TDS of the current Financial Year TDS credit being claimed this Year Corresponding TDS
No to self /other of Other /Aadhaar brought forward (TDS deducted during FY 2020-21) (only if corresponding income is being Receipt offered credit
person [spouse as Person (if No. of (b/f) offered for tax this year, not applicable being
per section 5A TDS credit the if TDS is deducted u/s 194N) carried
/other person as related to Buyer / forward

Fin. Year TDS Deducted Deducted in the Claimed Claimed in the hands of Gross Head
per rule 37BA(2)] other person) Tenant
in which b/f in own hands of spouse as in own spouse as per section 5A Amount of
deducted hands per section 5A or hands or any other person as per Income
any other person as rule 37BA(2) (if applicable)
per rule 37BA(2) (if
applicable)
(1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13)
Income TDS Income TDS PAN/
Aadhaar
TDS claimed in own hands (total of column 9) 0
Note: Please enter total of column 9 in 10b of Part B- TTI
E Schedule TCS - Details of Tax Collected at Source (TCS) [As per Form 27D issued by the Collector(s)]
Sl Tax Deduction and Tax Name of Unclaimed TCS TCS of Amount out of (5) or (6) being Amount out
No Collection Account the brought forward (b the claimed this Year (only if of (5) or (6)
Number of the Collector /f) current corresponding income is being being carried
Collector fin. offered for tax this year) forward
Fin. Year Amount year
in which b/f
collected
(1) (2) (3) (4) (5) (6) (7) (8)
TCS being claimed this year (total of column 7) 0

Note: Please enter total of column (5) in 11c of Part B-TTI
VERIFICATION
I, SRINIVASAN RAHAVENDHIRAN son/ daughter of SRINIVASAN solemnly declare that to the best of my knowledge and
belief, the information given in the return and schedules thereto is correct and complete and is in accordance with the
provisions of the Income-tax Act, 1961.
I further declare that I am making return in my capacity as Self and I am also competent to make this return and verify it. I am
holding permanent account number (if allotted) AOSPR0329F (Please see instruction) I further declare that the critical
assumptions specified in the agreement have been satisfied and all the terms and conditions of the agreement have been
complied with. (Applicable in a case where return is furnished under section 92CD)
Date: 28-Mar-2022
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INDIAN INCOME TAX RETURN ACKNOWLEDGEMENT

Name SRINIVASAN RAHAVENDHIRAN

Current Year business loss, if any 1 0

Total Income 7,90,320

Book Profit under MAT, where applicable 2 0

Adjusted Total Income under AMT, where applicable 3 7,90,320

Net tax payable 4 73,387

Interest and Fee Payable 5 5,000

Total tax, interest and Fee payable 6 78,387

Taxes Paid 7 78,387

(+)Tax Payable /(-)Refundable (6-7) 8 0

Dividend Tax Payable 9 0

Total Dividend tax and interest payable 11 0

(+)Tax Payable /(-)Refundable (11-12) 13 0

Accreted Income as per section 115TD 14 0

Additional Tax payable u/s 115TD 15 0

Interest payable u/s 115TE 16 0

Additional Tax and interest payable 17 0

Tax and interest paid 18 0

(+)Tax Payable /(-)Refundable (17-18) 19 0

DO NOT SEND THIS ACKNOWLEDGEMENT TO CPC, BENGALURU

Liabilities Amount Assets Amount

For M R N R & Associates

Gross Profit 20,90,828

Net Profit 8,88,630

For M R N R & Associates

Father's Name : SRINIVASAN Previous year 2020-21

Date of birth : 22-Jul-79 PAN AOSPR0329F

Address: : 2/164, South Chitra Street,

Income from Business Sree Laxmee Traders

Income from Salary

Gross total income 8,88,630

Less: Deduction under Chapter VI-A

Taxable income 7,90,322

Total tax payable 78,387

e-Filing Acknowledgement Number / Quarterly Statement Receipt Number Date of e-Filing

Name : SRINIVASAN RAHAVENDHIRAN

Address : OLD NO 236/3NEW NO 86/4, , Srirangam, TIRUCHIRAPPALLI,

Form No. : Form 3CB-3CD

Assessment Year : 2021-22

Filing Type : Original

Capacity : Chartered Accountant

(This is a computer generated Acknowledgement Receipt and needs no signature)

INDIAN INCOME TAX RETURN Assessment Year

Part A-GEN GENERAL

Road/Street/Post Office Date of Birth/ Formation (DD/MMM/YYYY)

Residential/Office Phone Number with STD code/Mobile No. 1

Email Address-1 (self)

139(1)-On or Before due date,

Are you opting for new tax regime u/s 115BAC ?

Date of filing of form 10-IE Acknowledgment Number

Have you incurred expenditure of an amount or aggregate of amount exceeding Rs. 2

If revised/Defective/Modified, then enter Receipt

You have been a non-resident in India in 9 out of 10 preceding years [section

You were a non-resident during the previous year.

S.No Jurisdiction of residence Taxpayer Identification Number

Whether this return is being filed by a representative assessee? (Tick) ✔

(1) Name of the representative

(2) Capacity of the Representative (drop down to be provided)