Form PDF 828997910301122 PDF
Form PDF 828997910301122 PDF
Form PDF 828997910301122 PDF
(A23) Have you opted for new tax regime u/s 115BAC and filed Form 10IE in AY 2021-22 ? Yes ✔ No
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Acknowledgement Number:828997910301122 Date of filing : 30-Nov-2022
(A24) Are you filing return of income under Seventh proviso to section 139(1) but otherwise not required to furnish
return of income? (Not applicable in case of firm) - (Tick) Yes ✔ No
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)]
(i) Have you deposited amount or aggregate of amounts exceeding Rs. 1 Crore in one 0
or more current account during the previous year? Yes ✔ No
(ii) Have you incurred expenditure of an amount or aggregate of amount exceeding 0
Rs. 2 lakhs for travel to a foreign country for yourself or for any other person?
Yes ✔ No
(iii) Have you incurred expenditure of amount or aggregate of amount exceeding Rs. 0
1 lakh on consumption of electricity during the previous year? Yes ✔ No
(iv) Are you required to file a return as per other conditions prescribed under clause (iv) of seventh proviso to
section 139(1) (If yes, please select the relevant condition from the drop down menu) Yes ✔ No
S.No Amount
(A25) Whether this return is being filed by a representative assessee? (Tick) Yes ✔ No
If yes, please furnish following information -
(1) Name of the representative
(2) Capacity of the representative
(3) Address of the representative
(4) Permanent Account Number (PAN)/ Aadhaar No. of the representative
PART B GROSS TOTAL INCOME Whole - Rupee only
B1 Income from Business & Profession (NOTE-Enter value from E8 of Schedule BP) B1 6,28,539
B2 i Gross Salary (ia + ib + ic + id + ie) i 0
a Salary as per section 17(1) ia 0
b Value of perquisites as per section 17(2) ib 0
c Profit in lieu of salary as per section 17(3) ic 0
d Income from retirement benefit account id 0
maintained in a notified country u/s 89A
iia Less : Income claimed for relief from taxation u/s iia 0
89A
iii Net Salary (i - ii - iia) iii 0
iv Deductions u/s 16 (iva + ivb + ivc) iv 0
a Standard deduction u/s 16(ia) iva 0
b Entertainment allowance u/s 16(ii) ivb 0
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Acknowledgement Number:828997910301122 Date of filing : 30-Nov-2022
i Up to 15-Jun-2021 0 i Up to 15-Jun-2021 0
ii From 16-Jun-2021 to 0 ii From 16-Jun-2021 to 0
15-Sep-2021 15-Sep-2021
iii From 16-Sep-2021 to 0 iii From 16-Sep-2021 to 0
15-Dec-2021 15-Dec-2021
iv From 16-Dec-2021 to 0 iv From 16-Dec-2021 to 0
15-Mar-2022 15-Mar-2022
v From 16-Mar-2022 to 0 v From 16-Mar-2022 to 0
31-Mar-2022 31-Mar-2022
Less: Deduction u/s 57(iia) (in case of family pension only) 0
Less: Income claimed for relief from taxation u/s 89A 0
B5 Gross Total Income (B1+B2+B3+B4) B5 6,31,572
To avail the benefit of carry forward and set off of loss, please use ITR-3/5.
Part C - Deductions and Taxable Total Income
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Acknowledgement Number:828997910301122 Date of filing : 30-Nov-2022
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Acknowledgement Number:828997910301122 Date of filing : 30-Nov-2022
Total 0
D21 Details of all Bank Accounts held in India at any time during the
previous year (excluding dormant accounts)
Sl. IFS Code of the Bank Name Account Number Select Account for Refund Credit
of the
Bank
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Acknowledgement Number:828997910301122 Date of filing : 30-Nov-2022
BAN
K
OF
INDIA
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
SCHEDULE BP - DETAILS OF INCOME FROM BUSINESS OR PROFESSION
COMPUTATION OF PRESUMPTIVE BUSINESS INCOME UNDER SECTION 44AD
S. Name of Business Business code Description
No.
E3 Gross Receipts E3 0
E4 Presumptive Income under section 44ADA (50% of E3) or the E4 0
amount claimed to have been earned, whichever is higher
NOTE- If Income is less than 50% of Gross Receipts, it is
mandatory to have a tax audit under 44AB & other ITR as applicable
has to be filed
Sl. Registration No. of Whether owned/ Tonnage capacity of Number of months Presumptive income u
No goods carriage leased/hired goods carriage(in for which goods /s 44AE for the goods
MT) carriage was owned carriage (Computed
/leased/hired by @ Rs.1000 per ton
assessee per month in case
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Acknowledgement Number:828997910301122 Date of filing : 30-Nov-2022
tonnage exceeds
12MT, or else @ Rs.
7500 per month) or
the amount claimed
to have been actually
earned, whichever is
higher
Add row options as necessary (At any time during the year the number of vehicles should not exceed 10 vehicles)
E5 Presumptive Income from Goods Carriage under section 44AE [total E5 0
of column (5)]
NOTE- If the profits are lower than prescribed under S.44AE or the
number of Vehicles owned at any time exceed 10 then other ITR, as
applicable, has to be filed
E6 Salary and interest paid to the partners E6 0
NOTE - This is to be filled up only by firms
E7 Presumptive Income u/s 44AE (E5-E6) E7 0
E8 Income chargeable under the head 'Business or Profession' E8 6,28,539
(E2c+E4+E7)
1 20NPZPS8151F1Z4 0
E10 Total of value of Outward Supplies as per the GST returns filed 0
FINANCIAL PARTICULARS OF THE BUSINESS
NOTE- For E11 to E25 furnish the information as on 31st day of March, 2022
Note: Please refer to instructions for filling out this schedule (E15, E19,
E20, E22 are mandatory and others if available)
SCHEDULE IT - DETAILS OF ADVANCE TAX AND SELF ASSESSMENT TAX PAYMENTS
Total 0
Note: Enter the totals of Advance tax and Self-Assessment tax in D13 & D14
Schedule TCS - Details of Tax Collected at Source [As per Form 27D issued by the Collector(s)]
Col (1) Col (2) Col (3) Col (4) Col (5)
Total 0
Note: Please enter total of column (5) of Schedule-TCS in D16
SCHEDULE TDS1 - DETAILS OF TAX DEDUCTED AT SOURCE FROM SALARY
[As per Form 16 issued by Employer(s)]
Total 0
Note: Enter the total of column 4 of Schedule-TDS1 and column 6 of Schedule-TDS2 in D15
SCHEDULE TDS2 - DETAILS OF TAX DEDUCTED AT SOURCE ON INCOME OTHER THAN SALARY
[As per Form 16 A issued or Form 16C or Form 16D furnished by Deductor(s)]
Sl. TAN of Deductor Unclaimed TDS TDS of the TDS credit being Corresponding Receipt / TDS credit
No. / PAN / Aadhaar brought current claimed this Year withdrawals being
No.of Tenant forward (b/f) Fin. Year (only if offered carried
corresponding forward
receipt is being
offered for tax
this year , not
applicable if TDS
is deducted u/s
194N)
1 0 0 0 0 0
Total 0
Note: Enter the total of column 6 of Schedule TDS2 and column 4 of Schedule-TDS1 in D15
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Acknowledgement Number:828997910301122 Date of filing : 30-Nov-2022
Details of Tax Deducted at Source [TDS 2(ii)] [as per form 16C furnished by the payer(s)]
Sl.No PAN/Aadhaar no. Unclaimed TDS TDS of the TDS credit being Corresponding Receipt TDS Credit
of Tenant brought current claimed this offered being
forward (b/f) Financial Year (only if carried
Year corresponding forward
receipt is being
offered for tax
this year)
1 2 3 4 5 6 7 8 9
Total 0
Note: Enter the total of column 6 of Schedule TDS2 and column 4 of Schedule-TDS1 in D15
Schedule 80D
1 Whether you or any of your family member (excluding parents) is a senior Not claiming for Self/Family
citizen?
(a) Self & Family 0
(i) Health Insurance 0
(ii) Preventive Health Checkup 0
(b) Self & Family including Senior Citizen 0
(i) Health Insurance 0
(ii) Preventive Health Checkup 0
(iii) Medical Expenditure (This deduction can be claimed on which health 0
insurance is not claimed at (i) above)
2 Whether any one of your parents is a senior citizen Not claiming for parents
(a) Parents 0
(i) Health Insurance 0
(ii) Preventive Health Checkup 0
(b) Parents including Senior Citizen 0
(i) Health Insurance 0
(ii) Preventive Health Checkup 0
(iii) Medical Expenditure (This deduction can be claimed on which health 0
insurance is not claimed at (i) above)
3 Eligible Amount of Deduction 0
SCHEDULE 80G - DETAILS OF DONATIONS ENTITLED FOR DEDUCTION UNDER SECTION 80G
SL. Name of Address City or State Code Pin code PAN of Amount of donation Eligible Amount
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Acknowledgement Number:828997910301122 Date of filing : 30-Nov-2022
mode
- 0 0 0 0
Total A 0 0 0 0
SL. Name of Address City or State Code Pin code PAN of Amount of donation Eligible Amount
- 0 0 0 0
Total B 0 0 0 0
SL. Name of Address City or State Code Pin code PAN of Amount of donation Eligible Amount
- 0 0 0 0
Total C 0 0 0 0
SL. Name of Address City or State Code Pin code PAN of Amount of donation Eligible Amount
- 0 0 0 0
Total D 0 0 0 0
VERIFICATION
I, NAVEEN SHREEVASTAVA son/ daughter of BISHWANATH PRASAD solemnly declare that to the best of
my knowledge and belief, the information given in the return is correct and complete and is in accordance with the
provisions of the Income-tax Act, 1961. I further declare that I am making this return in my capacity as Self and
I am also competent to make this return and verify it. I am holding permanent account number NPZPS8151F .
Place: 49.37.75.196
Date: 30-Nov-2022
If the return has been prepared by a Tax Return Preparer (TRP) give further details as below:
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