Form PDF 871788320190722

Acknowledgement Number:871788320190722 Date of filing:19-07-2022
INDIAN INCOME TAX RETURN

[For Individuals and HUFs not having income from profits and gains of business or Assessment
ITR2 profession] Year
(Please see Rule 12 of the Income-tax Rules, 1962) 2022 - 23
(Please refer instructions)
Part A-GEN GENERAL

(A1) First Name (A3) Last Name (A4) PAN
(A2) Middle Name
GULAB CALLA ABEPC3779R
(A6) Flat/Door/Block No. (A5) Status (Tick)

(A7) Name of Premises/Building/Village ✔ Individual
4/118 HUF
(A8) Road/Street/Post Office (A14) Date of Birth/ Formation (DD/MMM/YYYY) 07-Jul-1948

(A15) Aadhaar Number (12 digit) / Aadhaar Enrolment Id (28 digit) (if eligible for
(A9) Area/locality
Aadhaar)
Jawahar Nagar 7xxx xxxx 7789
(A11) State
(A10) Town/City/District 27-Rajasthan (A13) Pin code/Zip code
Jaipur,Jaipur (A12) Country 302004
91-India
(A16) Residential/Office Phone Number with STD Mobile No. 1
(A17) Mobile No. 2
/ISD code 919214494849
(A18) Email Address-1 (self)
(A19) Email Address-2
[email protected]
✔ 139(1)-On or before due date, 139(4)-After due date, 139(5)-Revised
(a1i) Filed u/s (Tick)[Please see instruction ]
(A20) Return, 92CD-Modified return, 119(2)(b)-after condonation of delay.
(a1ii) Or Filed in response to notice u/s 139(9), 142(1), 148
Are you opting for new tax regime u/s 115BAC ? Yes ✔ No
Are you filing return of income under Seventh proviso to section 139(1) but otherwise not required to furnish return of income? –
(Tick) Yes ✔ No
(b) If yes, please furnish following information
[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 more
(bi) current account during the previous year? (Yes/No) 0
Yes No
Have you incurred expenditure of an amount or aggregate of amount exceeding Rs. 2 lakhs for
(bii) travel to a foreign country for yourself or for any other person? (Yes/No) 0
Yes No
Have you incurred expenditure of amount or aggregate of amount exceeding Rs. 1 lakh on
(biii) consumption of electricity during the previous year? (Yes/No) 0
Yes No
Are you required to file a return as per other conditions prescribed under clause (iv) of seventh proviso to section 139(1) (If yes,
(biv)
please select the relevant condition from the drop down menu) Yes No
If revised/defective/modified, then enter Receipt No.

(c)
and Date of filing original return (DD/MMM/YYYY)
If filed, in response to a notice u/s 139(9)/142(1)/148 or order u/s 119(2)(b) enter unique number/ Document
(Unique
(d) Identification Number (DIN) and date of such notice/order, or if filed u/s 92CD, enter date of advance pricing
Number)
agreement
✔ You were in India for 182 days or more during the previous year
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[section 6(1)(a)]
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 are a citizen of India, who left India, for the purpose of employment,
as a member of the crew of an Indian ship and were in India for 182 days
A. Resident or more during the previous year and 365 days or more within the
preceding 4 years [Explanation 1(a) of section (6)(1)(c)]
You are a citizen of India or a person of Indian origin and have come on
a visit to India during the previous year and were in India for 182 days or
more during the previous year and 365 days or more within the preceding
4 years; or 120 days or more during the previous year and 365 days or
more within the preceding 4 years if the total income, other than income
from foreign sources, exceeds Rs. 15 lakh. [Explanation 1(b) of section (6)
(1)(c)]
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
Residential Status in
years [section 6(6)(a)]
India (for individuals)
(Tick applicable option) You are a citizen of India or person of Indian origin, who comes on a
(e) B. Resident but not visit to India, having total income, other than the income from foreign
Ordinarily Resident sources, exceeding Rs. 15 lakh and have been in India for 120 days or
more but less than 182 days during the previous year [section 6(6)(c)]
You are a citizen of India 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) rws 6
(1A)]
You were a non-resident during the previous year.

Whether you were a resident of any jurisdiction (Yes/No)
If yes,
(i)Please specify the jurisdiction(s) of residence during the previous year -
S. Jurisdiction(s) of Taxpayer Identification Number

C. Non-resident No residence (s)
(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 Total period of stay in India during
the previous year (in days) the 4 preceding years (in days)
Residential Status in
India (for HUF) (Tick D. Resident Resident but not Ordinarily Resident Non-resident
applicable option)
(f) Do you want to claim the benefit under section 115H? (applicable in case of resident) Yes ✔ No
(g) Are you governed by Portuguese Civil Code as per section 5A? Tick) Yes ✔ No (If "YES" please fill Schedule 5A)
Whether this return is being filed by a Representative Assesse? Yes ✔ No

If yes, please furnish following information -
(1) Name of the representative

(h)
(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 -
Sl. Name of Type of PAN Whether its shares are listed or Director Identification Number
No. Company company unlisted (DIN)
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Whether you have held unlisted equity shares at any time during the previous year? Yes ✔ No
(j)
If yes, please furnish following information in respect of equity shares
Sl. No. Name of Type of PAN Opening balance Shares acquired during the year Shares transferred during the Closing balance
Company company year
No. of Cost of No. of Date of Face value Issue price per Purchase price per share No. of Sale No. of Cost of
shares acquisition shares subscription / per share share (in case (in case of purchase shares consideration shares acquisition
purchase of fresh issue) from existing
shareholder)
1a 1b 2 3 4 5 6 7 8 9 10 11 12 13
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SCHEDULES TO THE RETURN FORM (FILL AS APPLICABLE)
Schedule Salary Details of Income from Salary

TAN of Employer (mandatory if tax is
Name of Employer Nature of employer (Tick)
deducted)
All India Radio Pensioners - State Government
DELP09293E
Pin code/ Zip
Address of employer Town/City State
code
M.I. Road,Jaipur jaipur 27-Rajasthan
302001
1 Gross Salary (1a + 1b + 1c + 1d + 1e) 1 1,13,481
Salary as per section 17(1) (drop down to be
a 1a 1,13,481
provided)
Sl. Nature of Salary Amount
No.
I Basic salary 1,13,481

Value of perquisites as per section 17(2) (drop
b 1b 0
down to be provided)
Sl. Nature of Perquisites Amount
No.
I Contribution by 0
employer to fund and
scheme taxable under
section 17(2)(vii)
Profit in lieu of salary as per section 17(3) (drop
c 1c 0
down to be provided)
Sl. Nature of Profit in lieu of Amount
No. salary
Income from retirement benefit account maintained

d 1d 0
in a notified country u/s 89A
Sl. No. Country Amount
Income from retirement benefit account maintained

e 1e 0
in a country "other than notified country u/s 89A"
2 Total Gross Salary (from all employers) 2 1,13,481
Less allowances to the extent exempt u/s 10 (drop down to be provided in
3 e-filing utility) (please refer instructions) 3 0
(Note: Ensure that it is included in Total Gross salary in (2) above )
Sl.No. Nature of Exempt Allowance Amount
3a Less : Income claimed for relief from taxation u/s 89A 3a 0

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4 Net Salary (2 - 3 - 3a) 4 1,13,481

5 Deduction u/s 16 (5a + 5b + 5c) 5 50,000
A Standard deduction u/s 16(ia) 5a 50,000
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 63,481
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Schedule HP Details Of Income From House Property (Please Refer Instructions)

Address of property 1 Town/ City State PIN Code/ Zip Code Owner of Property
1
A-38,Bajaj Nagar Jaipur 27-Rajasthan 302017 Self
Is the property co-owned? Yes ✔ No (if “YES” please enter following details)
Your percentage of share in the property (%) 100
Sl. Name of other Co-owner(s) PAN/Aadhaar of other Co-owner(s) Percentage share of other co-owner(s) in
No. property (%)
[Tick the
applicable
option] Sl. Name(s) of Tenant (if PAN/ Aadhaar No. of Tenant(s) PAN/TAN of Tenant(s) (if TDS credit
✔ Let out No. let out) (Please see note) is claimed)
Self-
occupied 1 State Bank of India
Deemed let
out
a Gross rent received or receivable or letable value 1a 1,81,000
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
e Annual value ( 1 a – 1 d) (nil, if self -occupied etc. as per section 23(2)of the Act) 1e 1,81,000
f Annual value of the property owned (own percentage share x 1 e) 1f 1,81,000
g 30% of 1 f 1g 54,300
h Interest payable on borrowed capital 1h 0
i Total ( 1 g + 1 h) 1i 54,300
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 1,26,700
Address of property 2 Town/ City State PIN Code/ Zip Code Owner of Property
2
4/118,Jawahar Nagar Jaipur 27-Rajasthan 302004 Self
Is the property co-owned? Yes ✔ No (if “YES” please enter following details)
Your percentage of share in the property (%) 100
Sl. Name of other Co-owner(s) PAN/Aadhaar of other Co-owner(s) Percentage share of other co-owner(s) in
No. property (%)
[Tick the
applicable
option]
Let out
Sl. Name(s) of Tenant (if PAN/ Aadhaar No. of Tenant(s) PAN/TAN of Tenant(s) (if TDS credit
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✔ Self- No. let out) (Please see note) is claimed)
occupied
Deemed let
out
a Gross rent received or receivable or letable value 2a 0
b The amount of rent which cannot be realized 2b 0
c Tax paid to local authorities 2c 0
d Total ( 2 b + 2 c) 2d 0
e Annual value ( 2 a – 2 d) (nil, if self -occupied etc. as per section 23(2)of the Act) 2e 0
f Annual value of the property owned (own percentage share x 2 e) 2f 0
g 30% of 2 f 2g 0
h Interest payable on borrowed capital 2h 0
i Total ( 2 g + 2 h) 2i 0
j Arrears/Unrealised rent received during the year less 30% 2j 0
k Income from house property 2 ( 2 f – 2 i + 2 j) 2k 0
3 Pass through income/loss if any * 3 0
Income under the head “Income from house property” (1k + 2k + 3)
4 4 1,26,700
(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.
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Schedule CG Capital Gains

A Short-term Capital Gains (STCG) (Sub-items 3 and 4 are not applicable for residents)
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 section 111A or
2
115AD(1)(ii) proviso (for FII)
a Full value of consideration 2a 0
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 (i + ii + iii) biv 0
c Balance (2a – biv) 2c 0
Loss to be disallowed u/s 94(7) or 94(8)- for example if asset bought/acquired within 3
d months prior to record date and dividend/income/bonus units are received, then loss arising 2d 0
out of sale of such asset to be ignored (Enter positive value only)
e Short-term capital gain on equity share or equity oriented MF (STT paid) (2c +2d) A2e 0
For NON-RESIDENT, not being an FII- from sale of shares or debentures of an Indian company (to be computed with foreign exchange
3
adjustment under first proviso to section 48)
a STCG on transactions on which securities transaction tax (STT) is paid A3a 0
b STCG on transactions on which securities transaction tax (STT) is not paid A3b 0
4 For NON-RESIDENT- from sale of securities (other than those at A2) by an FII as per section 115AD
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
iii Total (ic + ii) aiii 0
ii Cost of improvement without indexation bii 0
iv Total (i + ii + iii) biv 0
c Balance (4aiii – biv) 4c 0
Loss to be disallowed u/s 94(7) or 94(8)- for example if security bought/acquired within 3
d months prior to record date and dividend/income/bonus units are received, then loss arising 4d 0
out of sale of such security to be ignored (Enter positive value only)
e Short-term capital gain on sale of securities by an FII (other than those at A2) (4c +4d) A4e 0
5 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, enter the following
a i
details

c ic 0
ii Full value of consideration in respect of securities other than unquoted shares aii 1,07,726
iii Total (ic + ii) aiii 1,07,726
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i Cost of acquisition without indexation bi 84,000
iv Total (i + ii + iii) biv 84,000
c Balance (5aiii – biv) 5c 23,726
In case of asset (security/unit) loss to be disallowed u/s 94(7) or 94(8)- for example if asset
d bought/acquired within 3 months prior to record date and dividend/income/bonus units are 5d 0
received, then loss arising out of sale of such asset to be ignored (Enter positive value only)
e STCG on assets other than at A1 or A2 or A3 or A4 above (5c + 5d) A5e 23,726
6 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 deposited in the Capital Gains
Accounts Scheme within due date for that year?
a
yes No Not applicable. If yes, then provide the details below
Sl. Previous year in which Section under which deduction New asset acquired/constructed Amount not used for new asset or remained
No. asset transferred claimed in that year unutilized in Capital gains account (X)
Year in which asset Amount utilised out of
acquired/constructed Capital Gains account
b Amount deemed to be short term capital gains, other than at 'a' 0
Total amount deemed to be short term capital gains (axi + b) A6 0
7 Pass Through Income/ Loss in the nature of Short Term Capital Gain, (Fill up schedule PTI) (A7a + A7b + A7c) A7 0
a Pass Through Income/ Loss in the nature of Short Term Capital Gain, chargeable @ 15% A7a 0
b Pass Through Income/ Loss in the nature of Short Term Capital Gain, chargeable @ 30% A7b 0
Pass Through Income/ Loss in the nature of Short Term Capital Gain, chargeable at
c A7c 0
applicable rates
8 Amount of STCG included in A1 – A7 but not chargeable to tax in India as per DTAA
Sl. Amount of Item No. A1 to A7 above in Country name Article of Rate as per Treaty Whether TRC Section of I. Rate as per I. Applicable rate [lower
No. income which included & Code DTAA (enter NIL, if not obtained T. Act T. Act of (6) or (9)]
chargeable (Y/N)
(1) (2) (3) (4) (5) (6) (7) (8) (9) (10)
a Total amount of STCG not chargeable to tax in India as per DTAA A8a 0
b Total amount of STCG chargeable to tax at special rates in India as per DTAA A8b 0
9 Total Short-term Capital Gain (A1e+ A2e+ A3a+ A3b+ A4e+ A5e+A6 + A7 - A8a) A9 23,726
B Long-term capital gain (LTCG) (Sub-items, 5 , 6, 7 & 8 are not applicable for residents)
2 From sale of bonds or debenture (other than capital indexed bonds issued by Government)
a Full value of consideration 2a 0
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
3
112(1) is applicable (ii) GDR of an Indian company referred in sec. 115ACA
a Full value of consideration 3a 2,74,814
Cost of
acquisition
i bi 1,62,701
without
indexation
Cost of
Improvement
ii bii 0
without
indexation
Expenditure
wholly and
exclusively
iii biii 0
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in
connection
with transfer
Total (bi + bii

iv biv 1,62,701
+biii)
c Balance (3a – biv) 3c 1,12,113
Deduction under sections 54F (Specify

d 3d 0
details in item D below)
e Long-term Capital Gains on assets at B3 above (3c – 3d) B3e 1,12,113
From sale of equity share in a company or unit of equity oriented fund or unit of a business trust on
4
which STT is paid under section 112A
LTCG u/s 112A (column 14 of Schedule

a 4a 0
112A)

b 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
5
foreign exchange adjustment under first proviso to section 48)
LTCG computed without indexation

a 5a 0
benefit

b 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 in sec. 115AC, (iii) securities by
6
FII as referred to in sec. 115AD (other than securities referred to in section 112A for which column B7 is to be filled up)
a i
following details

c ic 0
ii Full value of consideration in respect of securities other than unquoted shares aii 0
iii Total (ic + ii) aiii 0
iv Total (bi + bii +biii) biv 0
c Balance (6aiii – biv) 6c 0
d Deduction under sections /54F (Specify details in item D below) 6d 0
e Long-term Capital Gains on assets at 6 above in case of NON-REESIDENT (6c - 6d) B6e 0
For NON-RESIDENTS - From sale of equity share in a company or unit of equity oriented fund or unit of a business trust on which STT is paid
7
under section 112A
a LTCG u/s 112A (column 14 of Schedule 115AD(1)(iii)) 7a 0
b Deduction under section 54F (Specify details in item D below) 7b 0
c Long-term Capital Gains on sale of capital assets at B7 above (7a – 7b) B7c 0
8 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) 8a 0
b Less deduction under section 115F (Specify details in item D below) 8b 0
c Balance LTCG on sale of specified asset (8a – 8b) B8c 0
d LTCG on sale of asset, other than specified asset (computed without indexation) 8d 0
e Less deduction under section 115F (Specify details in item D below) 8e 0
f Balance LTCG on sale of asset, other than specified asset (8d- 8e) B8f 0
9 From sale of assets where B1 to B8 above are not applicable
A i
following details
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c ic 0
ii Full value of consideration in respect of securities other than unquoted shares aii 3,65,472
iii Total (ic + ii) aiii 3,65,472
i Cost of acquisition with indexation bi 2,81,306
ii Cost of improvement with indexation bii 0
iv Total (bi + bii +biii) biv 2,81,306
c Balance (9aiii – biv) 9c 84,166
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) 84,166
10 Amount deemed to be long-term capital gains
Whether any amount of unutilized capital gain on asset transferred during the previous year shown below was deposited in the Capital Gains
a Accounts Scheme within due date for that year?
Yes No Not applicable. If yes, then provide the details below
Sl. Previous year in which Section under which deduction New asset acquired/constructed Amount not used for new asset or remained
No. asset transferred claimed in that year unutilized in Capital gains account (X)
Year in which asset Amount utilised out of
acquired/constructed Capital Gains account
b Amount deemed to be short term capital gains, other than at 'a'
Total amount deemed to be long-term capital gains (axi + axii + b) B10 0
11 Pass Through Income/ Loss in the nature of Long Term Capital Gain,(Fill up schedule PTI) (B11a1+ B11a2 + B11b) B11 0
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%
12 Amount of LTCG included in B1 - B11 but not chargeable to tax or chargeable at special rates in India as per DTAA
Sl. Amount of Item No. B1 to B11 above in which Country name & Article of Rate as per Treaty Whether TRC Section of I.T. Rate as per I.T. Applicable rate [lower of (6) or
No. income included Code DTAA (enter NIL, if not obtained Act Act (9)]
chargeable) (Y/N)
(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
13 Total long term capital gain chargeable under I.T. Act (B1e+B2e+B3e+B4c+B5c+B6e+B7c+B8c+B8f+B9e+B10 + B11 - B12a) B13 1,96,279
C Income chargeable under the head "CAPITAL GAINS" (A9 + B13) (take B13 as nil, if loss) C 2,20,005
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
Date of Transfer of Date of purchase/ Cost of new asset Amount deposited in Amount of deduction
Original Asset construction of new Capital Gains Accounts claimed
asset Scheme before due date
b Deduction claimed u/s 54B
Date of Transfer of Original Date of purchase of new agricultural Cost of new agricultural Amount deposited in Capital Gains Accounts Scheme before Amount of
Asset land land due date deduction
claimed
c Deduction claimed u/s 54EC
Date of Transfer of Amount invested in specified/notified bonds (not exceeding fifty lakh rupees) Date of investment Amount of deduction claimed
Original Asset
d Deduction claimed u/s 54F
Date of Transfer Date of purchase/construction of new residential Cost of new residential Amount of Amount deposited in Capital Gains Accounts Scheme before
of house house deduction due date
Original Asset claimed
e Deduction claimed u/s 54GB
Date of transfer of PAN of the Amount utilised for Date of Cost of new plant and Date of Amount deposited in Capital Amount of
original residential eligible subscription of equity shares subscription machinery purchased by the purchase of Gains Accounts Scheme deduction
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property company of eligible company of shares eligible company plant and before due date claimed
machinery
f Deduction claimed u/s 115F (for Non-Resident Indians)
Date of Transfer of Amount invested in new specified asset or savings certificate Date of investment Amount of deduction claimed
foreign exchange asset
g Total deduction claimed (1a + 1b + 1c + 1d + 1e + 1f) 1g 0
E Set-off of current year capital losses with current year capital gains (excluding amounts included in A8a & B12a which is not chargeable under DTAA)
Sl.No Type of Capital Gain Capital Gain of Short term capital loss Long term capital loss Current year’s capital gains
current year (Fill this column remaining after set off

15% 30% Applicable Rate Covered By DTAA 10% 20% Covered By DTAA
only if computed figure is positive) (9=1-2-3-4-6-7-8)
(2) (3) (4) (5) (6) (7) (8)
(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 30% 0 0 0 0 0
Capital
Gain
iv Applicable 23,726 0 0 0 23,726
Rate
v Covered 0 0 0 0 0
By DTAA
vi Long 10% 1,12,113 0 0 0 0 0 0 1,12,113
Term
vii 20% 84,166 0 0 0 0 0 0 84,166
Capital
Gain
viii Covered 0 0 0 0 0 0 0 0
By DTAA
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 rate of 15% 0 0 0 0 0
Enter value from item 3iii of schedule BFLA, if any.
2 Short-term capital gains taxable at the rate of 30% 0 0 0 0 0

Enter value from item 3iv of schedule BFLA, if any
3 Short-term capital gains taxable at applicable rates 23,726 0 0 0 0

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

Enter value from item 3vi of schedule BFLA, if any.
5 Long- term capital gains taxable at the rate of 10% 1,12,113 0 0 0 0

Enter value from item 3vi of schedule BFLA, if any.
6 Long- term capital gains taxable at the rate of 20% 84,166 0 0 0 0

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

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
12 of 44

From sale of equity share in a company or unit of equity oriented fund or unit of a business
Schedule 112A
trust on which STT is paid under section 112A
Sl. No. Share/Unit acquired ISIN Code Name of No. of Sale-price Full Value of Cost of Cost of If the long Fair Total Fair Expenditure Total Balance (6-
the Share Shares per Share Consideration acquisition acquisition term Market Market wholly and deductions 13) Item 4
/Unit /Units /Unit (Total Sale without capital Value per Value of exclusively (7+12) (a) of
Value) (4*5) indexation asset was share/unit capital in LTCG
(higher of acquired as on 31st asset as connection Schedule
8 or 9) before January, per with of ITR2
01.02.2018, 2018 section 55 transfer
-Lower of (2)(ac)-
6 & 11 (4*10)
(Col 1) (col 1a) (Col 2) (Col 3) (Col 4) (Col 5) (Col 6) (Col 7) (Col 8) (Col 9) (Col 10) (Col 11) (Col 12) (Col 13) (Col 14)
Total 0 0 0 0 0 0 0 0
13 of 44

115AD(1)(b)(iii) For NON-RESIDENTS - From sale of equity share in a company or unit of equity oriented
proviso fund or 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 Total Fair Market Value of Expenditure wholly Total Balance (6-13)
No. /Unit Code of the Shares price Consideration without indexation acquisition was acquired before per share/unit as on capital asset as per and exclusively in deductions Item 7 (a) of
acquired Share /Units per (Total Sale Value) (higher of 8 or 9) 01.02.2018, -Lower of 6 & 11 31st January,2018 section 55(2)(ac)- (4*10) connection with (7+12) LTCG
/Unit Share (4*5) transfer Schedule of
/Unit ITR2
(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
14 of 44

Schedule OS Income from Other Sources

Gross income chargeable to tax at normal applicable rates (1a+ 1b+
1 1 0
1c+ 1d + 1e)
a Dividends Gross (ai +aii) 1a 0
ai Dividend income [other than (ii)] 1ai 0
aii Dividend income u/s 2(22)(e) 1aii 0
b Interest, Gross (bi + bii + biii + biv + bv + bvi + bvii + bviii + bix) 1b 0
i From Savings Bank bi 0
From Deposits (Bank/ Post
ii bii 0
Office/ Co-operative)
iii From Income-tax Refund biii 0
In the nature of Pass through
iv biv 0
income/ loss
Interest accrued on contributions
to provident fund to the extent
v bv 0
taxable as per first proviso to
section 10(11)
vi bvi 0
taxable as per second proviso to
section 10(11)
vii bvii 0
taxable as per first proviso to
section 10(12)
viii bviii 0
taxable as per second proviso to
section 10(12)
ix Others bix 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
d 1d 0
chargeable to tax (di + dii + diii + div + dv)
Aggregate value of sum of money
i di 0
received without consideration
In case immovable property is
ii received without consideration, dii 0
stamp duty value of property
In case immovable property is
15 of 44
received for inadequate
iii consideration stamp duty value of diii 0
property in excess of such
consideration as adjusted as per
section 56(2)(x)
In case any other property is
iv received without consideration, div 0
fair market value of property
In case any other property is
received for inadequate
v consideration, fair market value dv 0
of property in excess of such
consideration
e Any other income (please specify nature) 1e 0
Sl. Nature Amount
No.
1 Family Pension 0
2 Income from retirement benefit account maintained in a notified country u/s 0
89A
Country Amount
3 Income from retirement benefit account maintained in a country "other than 0

notified country u/s 89A"
Income chargeable at special rates (2a+ 2b+ 2c+ 2d + 2e +2f
2 2 0
elements related to Sl. No.1)
Winnings from lotteries, crossword puzzles etc. chargeable u/s
a 2a 0
115BB
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
Undisclosed investments etc. u/s
iv biv 0
69B
Unexplained expenditure etc. u/s
v bv 0
69C
Amount borrowed or repaid on
vi bvi 0
hundi u/s 69D
Accumulated balance of recognised provident fund taxable u/s
c 2c 0
111
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

Sl. No. Nature Amount
Pass through income in the nature of income from other sources chargeable at special
e 2e 0
rates (drop down to be provided)
Sl. No. Nature Amount
16 of 44
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.1ai, 1b to Country Article Rate as per Treaty Whether Section Rate as Applicable rate
f No. of 2 in which name & of (enter NIL, if not TRC of I.T. per I.T. [lower of (6) or
income included Code DTAA chargeable) obtained (Y Act Act (10)]
/N)
(1) (2) (3) (4) (5) (6) (7) (8) (9) (10)
Deductions under section 57 (other than those relating to income chargeable at special rates
3
under 2a, 2b & 2d)
Expenses / Deductions other than "aii"
ai 3ai 0
(in case other than family pension)
Interest expenditure u/s 57(i) (available
aii only if income offered in 1a) - entered 3aii
amount
Interest expenditure claimed 0
a Eligible amount of interest expenditure u 3a
0
(iia) /s 57(i) – Computed Amount (iia)
Deduction u/s. 57(iia) (in case of family
aiii 3aiii 0
pension only)
b Depreciation 3b 0
c Total 3c 0
4 Amounts not deductible u/s 58 4 0
5 Profits chargeable to tax u/s 59 5 0
5a Income claimed for relief from taxation u/s 89A 5a 0
Net Income from other sources chargeable at normal applicable rates (1(after
6 reducing income related to DTAA portion) – 3 + 4 + 5 - 5a) (If negative take the 6 0
figure to 3i of schedule CYLA )
Income from other sources (other than from owning race horses) (2 + 6) (enter 6 as
7 7 0
nil, if negative)
8 Income from the activity of owning and maintaining race horses
a Receipts 8a 0
Deductions under section 57 in
b 8b 0
relation to receipts at 8a only
c Amounts not deductible u/s 58 8c 0
d Profits chargeable to tax u/s 59 8d 0
Balance (8a - 8b + 8c + 8d) (if negative take the figure to 6xi of Schedule
e 8e 0
CFL)
Income under the head"Income from other sources" (7 + 8e) (take 8e as nil if
9 9 0
negative)
10 Information about accrual/receipt of income from Other Sources
S.No. Other Source Income Upto 15/6 From 16/6 to 15/9 From 16/9 to 15/12 From 16/12 to 15/3 From 16/3 to 31/3
(i) (ii) (iii) (iv) (v)
1 Income by way of winnings 0 0 0 0 0
from lotteries, crossword
puzzles, races, games,
17 of 44
gambling, betting etc.
referred to in section 2(24)
(ix)
2 Dividend Income referred 0 0 0 0 0
in Sl.no.1a(i)
3 Dividend Income u/s 115A 0 0 0 0 0
(1)(a)(i) @ 20% (Including
PTI Income)
4 Dividend Income u/s 0 0 0 0 0
115AC @ 10%
5 Dividend Income u/s 0 0 0 0 0
115ACA (1)(a) @ 10%
(Including PTI Income)
6 Dividend Income (other 0 0 0 0 0
than units referred to in
section 115AB) u/s 115AD
(1)(i) @ 20% (Including PTI
Income)
7 Dividend income taxable at 0 0 0 0 0
DTAA rates
8 Income from retirement 0 0 0 0 0
benefit account maintained
in a notified country u/s
89A (Taxable portion after
reducing relief u/s 89A)
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.
18 of 44

Schedule CYLA Details of Income after Set off of Current Year Losses
Sl. Head/ Source of Income Income of current year (Fill House property Net loss from Other sources chargeable at normal Current year’s
No. this column only if income loss of the applicable rates (other than loss from race Income
is zero or positive) current year set horses) of the current year set off remaining after
off set off
1 2 3 4=1-2-3
i Loss to be set off (Fill this 0 0

row only if computed
figure is negative)
ii Salaries 63,481 0 0 63,481
iii House property 1,26,700 0 1,26,700
iv Short-term capital gain 0 0 0 0

taxable @ 15%
v Short-term capital gain 0 0 0 0

taxable @ 30%
vi Short-term capital gain 23,726 0 0 23,726

taxable at applicable rates
vii Short-term capital gain 0 0 0 0

taxable at special rates in
India as per DTAA
viii Long term capital gain 1,12,113 0 0 1,12,113

taxable @ 10%
ix Long term capital gain 84,166 0 0 84,166

taxable @ 20%
x Long term capital gains 0 0 0 0

taxable at special rates in
India as per DTAA
xi Net income from other 0 0 0

sources chargeable at
normal applicable rates
xii Profit from the activity of 0 0 0 0

owning and maintaining
race horses
xiii Total loss set off (ii + iii + iv + v + vi + vii + viii + ix + x + xi + 0 0

xii)
xiv Loss remaining after set-off (i – xiii) 0 0
19 of 44

Schedule BFLA Details of Income after Set off of Brought Forward Losses of earlier years
Sl. Head/ Source of Income Income after set off, if any, of current year’s losses Brought forward Current year’s income
No. as per 4 of Schedule CYLA) loss set off remaining after set off
1 2 3
i Salaries 63,481 63,481
ii House property 1,26,700 0 1,26,700
iii Short-term capital gain taxable @ 15% 0 0 0
iv Short-term capital gain taxable @ 30% 0 0 0
v Short-term capital gain taxable at applicable 23,726 0 23,726

rates
vi Short-term capital gain taxable at special 0 0 0

rates in India as per DTAA
vii Long term capital gain taxable @ 10% 1,12,113 0 1,12,113
viii Long term capital gain taxable @ 20% 84,166 0 84,166
ix Long term capital gains taxable at special 0 0 0

rates in India as per DTAA
x Net income from other sources chargeable 0 0 0

at normal applicable rates
xi Profit from owning and maintaining race 0 0 0

horses
xii Total of brought forward loss set off (2ii + 2iii + 2iv + 2v+ 2vi + 2vii +2viii+ 2ix + 2xi) 0
xiii Current year's income remaining after set off Total of (3i + 3ii + 3iii + 3iv + 3v+ 3vi + 3vii + 3viii+ 3ix + 3x + 3xi) 4,10,186
20 of 44

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

Assessment Date of House property loss Short-term capital loss Long-term Capital loss Loss from owning and
Year Filing (DD maintaining race horses
/MMM
/YYYY)
1 2 3 4 5 6
i 2014-15 0 0 0
ii 2015-16 0 0 0
iii 2016-17 0 0 0
iv 2017-18 0 0 0
v 2018-19 0 0 0 0
vi 2019-20 0 0 0 0
vii 2020-21 0 0 0 0
viii 2021-22 0 0 0 0
ix Total of 0 0 0 0
earlier year
losses
x Adjustment 0 0 0 0
of above
losses in
Schedule
BFLA
xi 2022-23 0 0 0 0
(Current year
losses)
xii Total loss 0 0 0 0

carried
forward to
future years
21 of 44

Schedule VI-A Deductions under Chapter VI-A

1 Part B- Deduction in respect of certain payments
a 80C 0 b 80CCC 0
c 80CCD(1) 0 d 80CCD(1B) 0
e 80CCD(2) 0 f 80D 0
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 80GGA 0 p 80GGC 0
2 Part C, CA and D- Deduction in respect of certain incomes/other deduction
q 80QQB 0 r 80RRB 0
s 80TTA 0 t 80TTB 0
u 80U 0
v Total deductions under Chapter VI-A (Total of a to u) v 0
22 of 44

Schedule 80G Details of donations entitled for deduction under section 80G
Donations entitled for 100% deduction without
A
qualifying limit
Eligible
PAN of Amount
Name and address of Donee Amount of donation
Donee of
donation
Donation in Donation in Total
cash other mode Donation
Total 0 0 0 0
Donations entitled for 50% deduction without
B
qualifying limit
Eligible
Name and address of PAN of
Amount of donation Amount of
Donee Donee
donation
Total 0 0 0 0
Donations entitled for 100% deduction subject to
C
qualifying limit
Eligible
Donee Donee
donation
Total 0 0 0 0
Donations entitled for 50% deduction subject to
D
qualifying limit
Eligible
Donee Donee
donation
Total 0 0 0 0
E Total donations (A + B + C + D) 0
23 of 44

Schedule
Details of donations for scientific research or rural development
80GGA
Sl. Relevant clause under which deduction is Name and PAN Amount of donation Eligible
No. claimed (drop down to be provided) address of of Amount of
Donee Donee donation
Donation Donation in Total

in cash other mode Donation
Total donation 0 0 0 0
24 of 44

[For Individuals and HUFs not having income from profits and gains of business Assessment
ITR2 or profession] Year
Schedule AMT Computation of Alternate Minimum Tax payable under section 115JC
1 Total Income as per item 12 of PART-B-TI 1 4,10,190
2 Adjustment as per section 115JC(2)
Deduction claimed under any section included in Chapter VI-A
a under the heading "C.—Deductions in respect of certain 2a 0
incomes"
3 Adjusted Total Income under section 115JC(1) (1+2a) 3 4,10,190
4 Tax payable under section 115JC [18.5% of (3)] (if 3 is greater than Rs. 20 lakhs) 4 0
25 of 44

Schedule AMTC Computation of tax credit under section 115JD

1 Tax under section 115JC in assessment year 2022-23 (1d of Part-B-TTI) 1 0
2 Tax under other provisions of the Act in assessment year 2022-23 (7 of Part-B-TTI) 2 0
Amount of tax against which credit is available [enter (2 – 1) if 2 is greater than 1,
3 3 0
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)
i 2013-14 0 0 0 0 0
ii 2014-15 0 0 0 0 0
iii 2015-16 0 0 0 0 0
iv 2016-17 0 0 0 0 0
v 2017-18 0 0 0 0 0
vi 2018-19 0 0 0 0 0
vii 2019-20 0 0 0 0 0
viii 2020-21 0 0 0 0 0
ix 2021-22 0 0 0 0 0
x Current AY (enter 0 0
1-2, if 1>2 else
enter 0)
xi Total 0 0 0 0 0
Amount of tax credit under section 115JD utilised during the year [total of item No. 4
5 5 0
(C)]
Amount of AMT liability available for credit in subsequent assessment years [total of 4
6 6 0
(D)]
26 of 44

Income of specified persons (spouse, minor child etc.) includable in income of the assessee
Schedule SPI
as per section 64
Sl Name of person PAN/ Aadhaar of person Relationship Amount Head of Income in which
No (optional) (Rs) included
27 of 44

Income chargeable to tax at special rates (please see instructions No. 9 for rate of tax)
Schedule SI
Income chargeable to tax at special rates
Sl. No. Section Special rate Income Taxable Tax thereon
Income
after
adjusting
for min
chargeable
to tax
1 111 - Tax on accumulated 1% 0 0

balance of recognised provident
fund
2 111A or section 115AD(1)(ii)- 15 % 0 0
Proviso (STCG on shares units on
which STT paid)
3 115AD(1)(ii) -STCG (other than 30 % 0 0
on equity share or equity oriented
mutual fund referred to in section
111A) by an FII
4 112 proviso (LTCG on listed 10 % 1,12,113 11,020
securities/ units without indexation)
5 112(1)(c)(iii)(LTCG on unlisted 10 % 0 0
securities in case of non-residents)
6 115ACA(1)(b) - LTCG arising from 10 % 0 0
the transfer of GDR purchased in
foreign currency -resident
7 115ACA(1)(a) - Income from GDR 10 % 0 0
purchased in foreign currency -
resident
8 115ACA(1)(b) - LTCG arising from 10 % 0 0
the transfer of GDR purchased in
foreign currency -resident
9 115AD(1)(iii)-Long term capital 10 % 0 0
gains by an FII
10 115E(b) - Income by way of long 10 % 0 0
term capital gains
11 112 Long term capital gains (with 20 % 84,166 0
indexing)
12 115BB (Winnings from lotteries, 30 % 0 0
puzzles, races, games etc.)
13 115BBE - Tax on income referred 60 % 0 0
to in sections 68 or 69 or 69A or
69B or 69C or 69D
28 of 44
14 115BBF - Income under head 10 % 0 0
other sources
15 115BBF - Income under head 10 % 0 0
other sources
16 115BBG - Income under head 10 % 0 0
other sources
17 Other source income chargeable 1% 0 0
under DTAA rates
Total 1,96,279 11,020
29 of 44

Details of Exempt Income (Income not to be included in Total Income or not chargeable to
Schedule EI
tax)
1 Interest income 1 0
Gross Agricultural receipts (other than income to be excluded
i i 0
under rule 7A, 7B or 8 of I.T. Rules)
ii Expenditure incurred on agriculture ii 0
Unabsorbed agricultural loss of previous eight assessment
2 iii iii 0
years
iv 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 the
v
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 Nature of Country name Article of Head of Whether TRC
No. income income & Code DTAA Income obtained (Y/N)
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
30 of 44

Pass Through Income details from business trust or investment fund as per section 115UA,
Schedule PTI
115UB
Note: Please refer to the instructions for filling out this schedule.
31 of 44

Schedule FSI Details of Income from outside India and tax relief (Available in case of resident)
32 of 44

Details Summary of tax relief claimed for taxes paid outside India (available only in case of
Schedule TR
resident)
1 Summary of Tax relief claimed
Country Taxpayer Total proportionate taxes paid outside Total tax relief available (total Tax Relief Claimed
Code Identification India (total of (c) of Schedule FSI in of (f) of Schedule FSI in under section
Number respect of each country) respect of each country) (specify 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
2 2 0
90/90A) (Part of total of 1(d))
Total Tax relief available in respect of country where DTAA is not applicable
3 3 0
(section 91) (Part of total of 1(d))
Whether any tax paid outside India, on which tax relief was allowed in India, has
4 been refunded/credited by the foreign tax authority during the year? If yes, 4 NO
provide the details below
Amount of tax Assessment year in which tax
a 0 b
refunded relief allowed in India
33 of 44

Schedule FA 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 calendar year ending as on 31st December, 2021
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 calendar year ending as on 31st December, 2021
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) (12)
A3 Details of Foreign Equity and Debt Interest held (including any beneficial interest) in any entity at any time during the calendar year ending as on 31st December, 2021
Sl Country Country Name Address ZIP Nature Date of Initial value 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 of the investment during balance respect to the holding during the redemption of investment during the
entity entity interest investment the period 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 calendar year ending as on 31st December, 2021
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 calendar year ending as on 31st December, 2021
Sl Country Name ZIP Nature of Name and Address Nature of Date Total Investment (at Income accrued from Nature of Income taxable and offered in this return
No and code Code entity of the Entity Interest-Direct since cost) (in rupees) such Interest Income
Amount Schedule Item number
/Beneficialowner held
where offered of schedule
/Beneficiary
(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 calendar year ending as on 31st December, 2021
Sl Country Name ZIP Address of the Ownership-Direct/ Beneficial Date of Total Investment (at Income derived from Nature of Income taxable and offered in this return
No and code Code Property owner/ Beneficiary acquisition cost) (in rupees) the property Income
Amount Schedule Item number
where offered of 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 calendar year ending as on 31st December, 2021
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 calendar year ending as on 31st December, 2021 and which has not been included in A to D above.
34 of 44
Sl Name of the Address Country Zip Name of Account Peak Balance/ Investment during the Whether income If (7) is yes, If (7) is yes, Income offered in
No Institution in which of the Name Code the Number year (in rupees) Peak Balance/ accrued is taxable in Income accrued this return
the account is held Institution and Code account Investment during the year your hands? in the account
Amount Schedule Item
holder
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 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 address of position taxable in your hands? derived from the trust return
code trust trustees Settlor Beneficiaries held

Amount Schedule Item
where number
offered of
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 Income Nature of Whether taxable in your If (6) is yes, Income offered in this return
No code CODE whom 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.
35 of 44

Information regarding apportionment of income between spouses governed by Portuguese Civil

Schedule 5A
Code
Name of the
spouse
PAN/ Aadhaar
of the spouse
Receipts Amount of TDS
Heads of Amount apportioned in TDS apportioned in
received under deducted on income
Income the hands of the spouse the hands of spouse
the head at (ii)
(i) (ii) (iii) (iv) (v)
House
1 0 0 0 0
Property
Capital
2 0 0 0 0
gains
Other
3 0 0 0 0
sources
4 Total 0 0 0 0
36 of 44

Assets and Liabilities at the end of the year (applicable in a case where total income exceeds Rs.50
Schedule AL
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. Amount (cost) in
Description
No. Rs.
(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
Amount (cost) in
(iv) Financial assets
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 Liabilities in relation to Assets at (A + B) 0
Note: Please refer to instructions for filling out this schedule.
37 of 44

Information related to Tax deferred - relatable to income on perquisites referred in section 17

Schedule ESOP
(2)(vi) received from employer, being an eligible start-up referred to insection 80-IAC
Sl. Assessment Amount of Tax deferred Has any of the following events occurred during the previous year relevant to current assessment year Amount of Balance
No. Year brought forward from earlier tax payable amount of

Such specified security or sweat equity shares were sold Ceased to be the employee of the employer who allotted or Forty-eight months have expired
AY in the tax deferred
(Specify the date and amount of tax attributed to such sale out of Col 3) transferred such specified security or sweat equity share? from the end of the relevant
current to be
assessment year in which
Assessment carried
(i) Option selected (ii) Total Amount of Tax (i) Option selected (ii) Date of Ceased to be
specified security or sweat equity
Year forward to
Attributed out of the sale employee
shares referred to in the said
the next
*clause were allotted. If yes,
Assessment
specify date
years Col
(3- 7)
(1) (2) (3) (4) (5) (6) (7) (8)
1 2021-22 0 0 0 0
2 2022-23 0
38 of 44

Part B –
Computation of total income
TI
1 Salaries (6 of Schedule S) 1 63,481
2 Income from house property ( 4 of Schedule HP) (enter nil if loss) 2 1,26,700
3 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

iii aiii 23,726
schedule CG)
Short-term chargeable at special rates in India as per DTAA (9v
iv aiv 0
of item E of Schedule CG)
v Total Short-term (ai + aii + aiii + aiv) (enter nil if loss) 3av 23,726
Long-term
i Long-term chargeable @ 10% (9vi of item E of schedule CG) bi 1,12,113
ii Long-term chargeable @ 20% (9vii of item E of schedule CG) bii 84,166
b
Long-term chargeable at special rates in India as per DTAA
iii biii 0
(9viii of item E of schedule CG)
iv Total Long-term (bi + bii + biii) (enter nil if loss) 3biv 1,96,279
c Total capital gains (3av + 3biv) (enter nil if loss) 3c 2,20,005
4 Income from other sources
Net income from other sources chargeable to tax at normal applicable
a 4a 0
rates (6 of Schedule OS) (enter nil if loss)
b Income chargeable to tax at special rates ( 2 of Schedule OS) 4b 0
Income from the activity of owning and maintaining race horses ( 8e
c 4c 0
of Schedule OS) (enter nil if loss)
d Total (4a + 4b + 4c) (enter nil if loss) 4d 0
5 Total of head wise income (1+2+3c+4d) 5 4,10,186
Losses of current year set off against 5 (total of 2xiii and 3xiii of Schedule
6 6 0
CYLA)
Balance after set off current year losses (5-6) (total of column 4 of
7 7 4,10,186
Schedule CYLA + 2 of Schedule OS)
8 Brought forward losses set off against 7 ( 2xii of Schedule BFLA) 8 0
9 Gross Total income (7-8) (3xiii of Schedule BFLA + 2 of Schedule OS) 9 4,10,186
Income chargeable to tax at special rate under section 111A, 112, 112A etc.
39 of 44
10 included in 9 10 1,96,279
11 Deductions under Chapter VI-A [v of Schedule VIA and limited to (9-10)] 11 0
12 Total income (9 - 11) 12 4,10,190
Income which is included in 12 and chargeable to tax at special rates (total
13 13 1,96,279
of column (i) of schedule SI)
Net agricultural income/ any other income for rate purpose ( 3 of Schedule
14 14 0
EI)
Aggregate income (12-13+14) [applicable if (12-13) exceeds maximum
15 15 0
amount not chargeable to tax]
Losses of current year to be carried forward (total of row xi of Schedule
16 16 0
CFL)
17 Deemed income under section 115JC (3 of Schedule AMT) 17 4,10,190
40 of 44

Part B –TTI Computation of tax liability on total income

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

1
Health and Education Cess @ 4% on (1a + 1b)
c 1c 0
above
d Total tax payable on deemed total income (1a + 1b + 1c) 1d 0
Tax payable on total income 11,020
a Tax at normal rates on 15 of Part B-TI 2a 0
b Tax at special rates (total of col. (ii) of Schedule SI) 2b 11,020

2
Rebate on agricultural income [applicable if (12-13)
c of Part B-TI exceeds maximum amount not 2c 0
chargeable to tax]
d Tax Payable on Total Income (2a + 2b - 2c) 2d 11,020
3 Rebate under section 87A 3 11,020
4 Tax payable after rebate (2d - 3) 4 0
5 Surcharge 0
Surcharge computed before marginal relief
i @ 25% of 15(ii) of Schedule SI 5i 0
10% or 15% as applicable of 2(ii), 3(ii), 8(ii), 11(ii),

21(ii), 23(ii) , Dividend income u/s 115AD(1)(a) of
ii 5ii 0
Schedule SI and Dividend income included in Part
B TI
On [(4) – ( 16(ii), 2(ii), 3(ii), 8(ii), 11(ii), 21(ii), 23(ii)

iii 5iii 0
of Schedule SI)]
Surcharge after marginal relief
ia @ 25% of 15(ii) of Schedule SI 5ia 0
@10% or 15%, as applicable of 2(ii), 3(ii), 8(ii), 11

iia (ii), 21(ii), 23(ii) of Schedule SI On [(4) – ( 16(ii), 2 5iia 0
(ii), 3(ii), 8(ii), 11(ii), 21(ii), 23(ii) of Schedule SI)]
iii Total (ia + iia) 5iii 0
6 Health and Education Cess @ 4% on (4 + 5iv) 6 0
7 Gross tax liability (4 + 5iv + 6) 7 0
8 Gross tax payable (higher of 1d and 7) (8a+8b) 8 0
Tax on income without including income on

perquisites referred in section 17(2)(vi) received
a 8a 0
from employer, being an eligible start-up referred to
in section 80-IAC ( Schedule Salary) (8-8b)
Tax deferred - relatable to income on perquisites

referred in section 17(2)(vi) received from employer,
b being an eligible start-up referred to in section 80- 8b 0
41 of 44
IAC
Tax deferred from earlier years but payable during

c current AY ( total of col 7 of schedule Tax deferred 8c 0
on ESOP
Credit u/s 115JD of tax paid in earlier years (applicable only if 7 is higher than 1d) (row 5 of
9 9 0
Schedule AMTC)
10 Tax payable after credit u/s 115JD (8a + 8c - 9) 10 0
11 Tax relief
a Section 89(Please ensure to submit Form 10E to claim this relief) 11a 0
b Section 90/ 90A (2 of Schedule TR) 11b 0
c Section 91 (3 of Schedule TR) 11c 0
d Total (11a + 11b + 11c) 11d 0
12 Net tax liability (10 - 11d) (enter zero if negative) 12 0
13 Interest and fee payable
Interest for default in furnishing the return (section

a 13a 0
234A)
Interest for default in payment of advance tax

b 13b 0
(section 234B)
Interest for deferment of advance tax (section

c 13c 0
234C)
Fee for default in furnishing return of income

d 13d 0
(section 234F)
e Total Interest and Fee Payable (13a+13b+13c+13d) 13e 0
14 Aggregate liability (12 + 13e) 14 0
15 Taxes Paid 18,100
a Advance Tax (from column 5 of 20A) 15a 0
b TDS (total of column 5 of 20B and column 9 of 20C) 15b 18,100
c TCS (total of column 5 of 20D) 15c 0
d Self-Assessment Tax (from column 5 of 20A) 15d 0
e Total Taxes Paid (15a + 15b + 15c + 15d) 15e 18,100
16 Amount payable (Enter if 14 is greater than 15e, else enter 0) 16 0
Refund (If 15e is greater than 14) (Refund, if any, will be directly credited into the bank
17 17 18,100
account)
Do you have a bank account in India (Non- Residents claiming refund with no bank account in India
18 Yes
may select No)
Sl. IFS Code of the Bank in case of Name of the Account Indicate the account in which you prefer to get
No Bank Accounts held in India Bank Number your refund credited, if any (tick accounts
STATE
1 SBIN0003227 BANK OF 20402087283
INDIA
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, furnish the details
ii
of one foreign bank account:
42 of 44
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 entity)
located outside India; or Yes
19 ✔
(ii) have signing authority in any account located outside India; or No
(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 ]
20 TAX PAYMENTS
A Details of payments of Advance Tax and Self-Assessment Tax
Sl No BSR Code Date of Deposit (DD/MMM/YYYY) Serial Number of Challan Amount (Rs)
(1) (2) (3) (4) (5)
Advance Tax and Self Assessment Tax (total of column 5) 0
Note: Enter the totals of Advance tax and Self-Assessment tax in Sl No. 15a & 15d of Part B-TTI
B Details of Tax Deducted at Source from Salary [As per Form 16 issued by Employer(s)]
Sl Tax Deduction Account Number (TAN) Name of the Income chargeable under Total tax deducted
No of the Employer Employer Salaries
(1) (2) (3) (4) (5)
I DELP09293E PUNJAB 1,13,481 0

NATIONAL BANK
Note: Please enter total of column 5 in 11b of Part B-TTI
C Details of Tax Deducted at Source (TDS) on Income [As per Form 16 A issued 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) 2021-22) being offered for tax this year,not being
[spouse as per Person (if Aadhaar of applicable if TDS deducted u/s 194N) carried
section 5A TDS credit Tenant/ forward

Fin. Year TDS Deducted Deducted in the Claimed Claimed in the hands of Gross Head
/other person related to Buyer
in which b/f in own hands of spouse in own spouse as per section 5A Amount of
as per rule other
deducted hands as per section 5A hands or any other person as per Income
37BA(2)] person)
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
I Self MUMS86153E 0 3,620 0 0 3,620 0 0 36,200 HP 0
II Self MUMS86153E 0 3,620 0 0 3,620 0 0 36,200 HP 0
III Self MUMS86153E 0 3,620 0 0 3,620 0 0 36,200 HP 0
IV Self MUMS86153E 0 3,620 0 0 3,620 0 0 36,200 HP 0
V Self MUMS86153E 0 3,620 0 0 3,620 0 0 36,200 HP 0
TDS claimed in own hands (total of column 9) 18,100
Note: Please enter total of column 9 in15b of Part B- TTI
D Details of Tax Deducted at Source (TDS) on Income [As per Form 16B/16C furnished by Deductor(s)]
Sl TDS credit PAN/ PAN Unclaimed TDS TDS of the current Financial TDS credit being claimed this Year Corresponding TDS
No relating to self Aadhaar of /Aadhaar brought forward Year (TDS deducted during FY (only if corresponding income is Receipt offered credit
/other person Other No. of (b/f) 2021-22) being offered for tax this year) being
43 of 44
[spouse as per Person (if the carried
Fin. Year TDS Deducted Deducted in the Claimed Claimed in the hands of Gross Head
section 5A/other TDS credit Buyer / forward
in which b/f in own hands of spouse as in own spouse as per section 5A Amount of
person as per related to Tenant
deducted hands per section 5A or hands or any other person as per Income
rule 37BA(2)] other
any other person 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
TDS claimed in own hands (total of column 9) 0
Note: Please enter total of column 9 in15b of Part B- TTI
E Details of Tax Collected at Source (TCS) [As per Form 27D issued by the Collector(s)]
Sl Tax Deduction and Collection Name of Tax Amount out of Amount out of (4) being claimed in the
No Account Number of the the Collected (4) being hands of spouse, if section 5A is
Collector Collector claimed applicable
(1) (2) (3) (4) (5) (6)
TCS being claimed this year (total of column 5) 0
Note: Please enter total of column (5) in 11c of Part B-TTI
VERIFICATION
I, Gulab Calla son/ daughter of Sayam Lal Purohit 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) ABEPC3779R (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: 19-07-2022 Sign Here:
If the return has been prepared by a Tax Return Preparer (TRP) give further details below:
Identification No. of TRP Name of TRP Counter Signature of TRP
If TRP is entitled for any reimbursement from the Government, amount thereof 0
44 of 44

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Acknowledgement Number:871788320190722 Date of filing:19-07-2022

INDIAN INCOME TAX RETURN

Part A-GEN GENERAL

(A6) Flat/Door/Block No. (A5) Status (Tick)

(A8) Road/Street/Post Office (A14) Date of Birth/ Formation (DD/MMM/YYYY) 07-Jul-1948

(a1ii) Or Filed in response to notice u/s 139(9), 142(1), 148

If revised/defective/modified, then enter Receipt No.

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

You were a non-resident during the previous year.

S. Jurisdiction(s) of Taxpayer Identification Number

Whether this return is being filed by a Representative Assesse? Yes ✔ No

(1) Name of the representative

(3) Address of the representative

(4) Permanent Account Number (PAN)/ Aadhaar No. of the Representative

INDIAN INCOME TAX RETURN

SCHEDULES TO THE RETURN FORM (FILL AS APPLICABLE)

Schedule Salary Details of Income from Salary

I Basic salary 1,13,481

Income from retirement benefit account maintained

Sl. No. Country Amount

Income from retirement benefit account maintained

3a Less : Income claimed for relief from taxation u/s 89A 3a 0

4 Net Salary (2 - 3 - 3a) 4 1,13,481

INDIAN INCOME TAX RETURN

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

INDIAN INCOME TAX RETURN

Schedule CG Capital Gains

a Full value of consideration 2a 0

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 (i + ii + iii) biv 0

c Balance (2a – biv) 2c 0

a STCG on transactions on which securities transaction tax (STT) is paid A3a 0

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

iii Total (ic + ii) aiii 0

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 (i + ii + iii) biv 0

c Balance (4aiii – biv) 4c 0

5 From sale of assets other than at A1 or A2 or A3 or A4 above

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

iii Total (ic + ii) aiii 1,07,726

b Deductions under section 48

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 84,000

c Balance (5aiii – biv) 5c 23,726

e STCG on assets other than at A1 or A2 or A3 or A4 above (5c + 5d) A5e 23,726

6 Amount deemed to be short term capital gains

b Amount deemed to be short term capital gains, other than at 'a' 0

Total amount deemed to be short term capital gains (axi + b) A6 0