Acknowledgement Number : 271331900210623 Date of Filing : 21-Jun-2023*

INDIAN INCOME TAX RETURN

FORM [For Individuals, HUFs and Firms (other than LLP) being a resident having total income upto Rs.50 lakh and
Assessment
having income from business and profession which is computed under sections 44AD, 44ADA or 44AE] [Not
ITR4 Year
for an individual who is either Director in a company or has invested in unlisted equity shares or if income-
SUGAM 2023-24
tax is deferred on ESOP or has agricultural income more than Rs.5000] (Please refer instructions for
eligibility)

PART A GENERAL INFORMATION

(A1) First Name (A3) Last Name (A4) Permanent Account Number
(A2) Middle Name
AATIF KHAN HUWPK6418R
(A5) Date of Birth/Formation (DD/MM/YYYY) (A6) Flat/Door/Block No.
27/10/1998 House No 466
(A7) Name of Premises/Building/Village (A8) Road/Street/Post Office (A9) Area/Locality
MIG 1 HUDCO Bhilai West S.O Bhilai-West
(A10) Town/City/District (A11) State (A12) Country/Region (A13) PIN Code/ZIP Code
DURG 33-Chhattisgarh 91- INDIA 490009
(A14) Aadhaar Number(12 digits)/Aadhaar Enrolment Id(28 digits) (if eligible for Aadhaar No.) (A15) Status
4xxx xxxx 2334 Individual
(A16) Residential/Office Phone Number with STD Code /Mobile No.1 (A17) Mobile No.2
/ 91 9644945226 91 9303044828
(A18) Email Address-1(Self)
Email Address-2 (A19) Nature of employment Others
[email protected]
(A20)(a) Filed u/s (Tick)[Please see instruction] (b) Or Filed in response to
139(1)-On or before due date
notice u/s"
(A21) If revised/defective then enter Receipt No. and Date of filing of
original return (DD/MM/YYYY)
(A22) If filed in response to notice u/s 139(9)/142(1)/148/153C or order u/s
119(2)(b)- enter Unique Number/ Document Identification Number (DIN) &
Date of such Notice or Order
(A23) (a) Have you ever opted for new tax regime u/s 115BAC in earlier years ?
Yes No
If Yes is Selected, please furnish the AY in which said option
is excercised along with the date of filing and
acknowledgement number of Form 10IE
(A23) (b) Have you ever opted out of section 115BAC in earlier years ?
Yes No
If Yes is Selected, please furnish the AY in which said option
is opted out along with the date of filing and
acknowledgement number of Form 10IE
(A23) (c) Option for current assessment year (Select Opting in now only if you are opting
Not opting
for first time)
For 'Opting in now' or 'Opt out', please furnish the date of filing and acknowledgement
number of Form 10IE
(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 or more current account
during the previous year? 0
Yes No

(ii) Have you incurred expenditure of an amount or aggregate of amount exceeding Rs. 2 lakhs for travel to a
foreign country for yourself or for any other person? 0
Yes No
(iii) Have you incurred expenditure of an amount or aggregate of amount exceeding Rs. 1 lakh on consumption
of electricity during the previous year? 0
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
(A25) Whether this return is being filed by a representative assessee?
Yes No
If yes, please furnish following information -

*If the return is verified after 30 days of transmission of return data electronically, then date of verification will be considered as date of filing the
return (Notification No.05 of 2022 dated 29-07-2022 issued by the DGIT (Systems), CBDT).”
Acknowledgement Number : 271331900210623 Date of Filing : 21-Jun-2023*

(1) Name of the representative

(2) Capacity of the representative

(3) Address of the representative

Permanent Account Number (PAN)/ Aadhaar

(4)
No. of the representative

PART B GROSS TOTAL INCOME

B1 Income from Business & Profession B1 4,50,000

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

Income from retirement benefit account maintained in a notified country u/s

d id 0
89A

Income from retirement benefit account maintained in a country other than

e ie 0
notified country u/s 89A
Less allowances to the extent exempt u/s 10 [Ensure that it is included in salary income u/s
ii ii 0
17(1)/17(2)/17(3)]
Sl
Nature of Exempt Allowance Description ( If Any Other selected) Amount
No.

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

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

c Professional tax u/s 16(iii) ivc 0

v Income chargeable under the head 'Salaries' (iii - iv) B2 0

B3 Type Of House Property B3

i Gross rent received/ receivable/ lettable value during the year i 0

ii Tax paid to local authorities ii 0

iii Annual Value (i - ii) iii 0

iv 30% of Annual Value iv 0

v Interest payable on borrowed capital v 0

vi Arrears/Unrealized Rent received during the year Less 30% vi 0

Income chargeable under the head 'House Property' (iii - iv - v) + vi (If loss, put the figure in
negative) Note:- Maximum loss from house property that can be set-off in computing income
vii B3 0
of this year is INR 2, 00,000. To avail the benefit of carry forward and set of loss, please use
ITR -3/5.

*If the return is verified after 30 days of transmission of return data electronically, then date of verification will be considered as date of filing the
return (Notification No.05 of 2022 dated 29-07-2022 issued by the DGIT (Systems), CBDT).”
Acknowledgement Number : 271331900210623 Date of Filing : 21-Jun-2023*

B4 Income from Other Sources B4 0

Sl
Nature of Income Description ( If Any Other selected) Total Amount
No.

Quarterly breakup of Dividend Income Quarterly breakup of Income from retirement benefit
account maintained in a notified country u/s 89A
(taxable portion)

(i) Up to 15-Jun-2022 0 (i) Up to 15-Jun-2022 0

From 16-Jun-2022 to From 16-Jun-2022 to 15-

(ii) 0 (ii) 0
15-Sep-2022 Sep-2022
From 16-Sep-2022 to From 16-Sep-2022 to
(iii) 0 (iii) 0
15-Dec-2022 15-Dec-2022
From 16-Dec-2022 to From 16-Dec-2022 to
(iv) 0 (iv) 0
15-Mar-2023 15-Mar-2023
From 16-Mar-2023 to From 16-Mar-2023 to
(v) 0 (v) 0
31-Mar-2023 31-Mar-2023

Less: Deduction u/s 57(iia) (in case of family pension only) 0

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

Gross Total Income (B1+B2+B3+B4) To avail the benefit of carry forward and set off of loss,
B5 B5 4,50,000
please use ITR-3/5.

*If the return is verified after 30 days of transmission of return data electronically, then date of verification will be considered as date of filing the
return (Notification No.05 of 2022 dated 29-07-2022 issued by the DGIT (Systems), CBDT).”
Acknowledgement Number : 271331900210623 Date of Filing : 21-Jun-2023*

PART C - DEDUCTIONS AND TAXABLE TOTAL INCOME

Sl.No. Section Amount System Calculated

C1 80C - Life insurance premium, deferred annuity, contributions to 0 0

provident fund, subscription to certain equity shares or debentures, etc.

C2 80CCC - Payment in respect Pension Fund 0 0

C3 80CCD(1) - Contribution to pension scheme of Central Government 0 0

C4 80CCD(1B) -Contribution to pension scheme of Central Government 0 0

C5 80CCD(2) - Contribution to pension scheme of Central Government by 0 0

employer

C6 80D - Deduction in respect of health insurance premia 0 0

C7 80DD - Maintenance including 0 0

medical treatment of a dependent
who is a person with disability

C8 80DDB - Medical treatment of 0 0

specified disease

C9 80E - Interest on loan taken for higher education 0 0

C10 80EE - Interest on loan taken for residential house property 0 0

C11 80EEA - Deduction in respect of interest on loan taken for certain house 0 0
property

C12 80EEB - Deduction in respect of purchase of electric vehicle 0 0

C13 80G - Donations to certain funds, charitable institutions 0 0

C14 80GG - Rent paid 0 0

C15 80GGC - Donation to Political party 0 0

C16 80TTA - Interest on deposits in saving bank Accounts 0 0

C17 80TTB- Interest on deposits in case of senior citizens. 0 0

*If the return is verified after 30 days of transmission of return data electronically, then date of verification will be considered as date of filing the
return (Notification No.05 of 2022 dated 29-07-2022 issued by the DGIT (Systems), CBDT).”
Acknowledgement Number : 271331900210623 Date of Filing : 21-Jun-2023*

C18 80U - In case of a person with disability 0 0

C19 Total deductions (Add items C1 to C18) 0 0

C20 Taxable Total Income (B5 - C19) 4,50,000

PART D - TAX COMPUTATIONS AND TAX STATUS

D1 Tax payable on total income D1 10,000

D2 Rebate on 87A D2 10,000

D3 Tax payable after Rebate (D1-D2) D3 0

D4 Health and Education Cess @ 4% on (D3) D4 0

D5 Total Tax, and Cess (D3 + D4) D5 0

D6 Relief u/s 89 (Please ensure to submit Form 10E to claim this relief) D6 0

D7 Balance Tax after Relief (D5 – D6) D7 0

D8 Total Interest u/s 234A D8 0

D9 Total Interest u/s 234B D9 0

D10 Total Interest u/s 234C D10 0

D11 Fee u/s 234F D11 0

D12 Total Tax, Fee and Interest (D7 + D8 + D9 + D10 + D11) D12 0

D13 Total Advance Tax Paid D13 0

D14 Total Self-Assessment Tax Paid D14 0

D15 Total TDS Claimed ( total of column 4 of Schedule-TDS1 and column 6 of Schedule- D15 0
TDS2 )
D16 Total TCS Collected ( total of column (5) of Schedule-TCS ) D16 0

D17 Total Taxes Paid (D13 + D14 + D15 +D16) D17 0

D18 Amount payable (D12 - D17, If D12 > D17) D18 0

D19 Refund (D17 - D12, If D17 > D12) D19 0

PART E - OTHER INFORMATION DETAILS OF ALL BANK ACCOUNTS HELD IN INDIA AT ANY TIME DURING THE PREVIOUS YEAR
(EXCLUDING DORMANT ACCOUNTS)
Select Account for Refund
Sl No. IFS Code of the Bank Name of the Bank Account Number
Credit

1 BARB0DBDURG BANK OF BARODA 7320100020154

2 FDRL0005555 FEDERAL BANK 55550125487387

3 BARB0DURGXX BANK OF BARODA 07320100020154

EXEMPT INCOME ONLY FOR REPORTING PURPOSES (IF AGRICULTURAL INCOME IS MORE THAN RS.5,000/-, USE ITR 3/5)

Sl No. Nature of Income Description (If 'Any Other' is selected) Amount

*If the return is verified after 30 days of transmission of return data electronically, then date of verification will be considered as date of filing the
return (Notification No.05 of 2022 dated 29-07-2022 issued by the DGIT (Systems), CBDT).”
Acknowledgement Number : 271331900210623 Date of Filing : 21-Jun-2023*

Total 0

SCHEDULE BP - DETAILS OF INCOME FROM BUSINESS OR PROFESSION

COMPUTATION OF PRESUMPTIVE BUSINESS INCOME UNDER SECTION 44AD

Sl
Name of Business Business code Description
No.
Retail sale of textiles, apparel, footwear,
1 REATIL OF TEXTILE REATIL OF TEXTILE
leather goods

E1 Gross Turnover or Gross Receipts i

Through a/c payee cheque or a/c payee bank draft or bank electronic clearing
a E1a 3,50,000
system received or prescribed electronic modes received before specified date

b Any other mode E2b 28,50,000

E2 Presumptive Income under section 44AD ii

a 6% of E1a or the amount claimed to have been earned, whichever is higher E2a 1,50,000

b 8% of E1b or the amount claimed to have been earned, whichever is higher E2b 3,00,000

c Total (a + b) E2c 4,50,000

COMPUTATION OF PRESUMPTIVE INCOME FROM PROFESSIONS UNDER SECTION 44ADA

Sl
Name of Business Business code Description
No.

E3 Gross Receipts E3 0

Presumptive Income under section 44ADA (50% of E3) or the amount claimed to have
been earned, whichever is higher NOTE- If Income is less than 50% of Gross Receipts,
E4 E4 0
it is mandatory to have a tax audit under 44AB & other ITR as applicable has to be
filed
COMPUTATION OF PRESUMPTIVE INCOME FROM GOODS CARRIAGES UNDER SECTION 44AE
Sl
Name of Business Business code Description
No.
Presumptive income u
/s 44AE for the goods
carriage (Computed @
Rs.1000 per ton per
Number of months for
month in case
which goods carriage
Sl Registration No. of Whether owned/ Tonnage capacity of tonnage exceeds
was owned
No. goods carriage leased/hired goods carriage(in MT) 12MT, or else @ Rs.
/leased/hired by
7500 per month) or
assessee
the amount claimed to
have been actually
earned, whichever is
higher
Presumptive Income from Goods Carriage under section 44AE [total of column (5)]
E5 NOTE- If the profits are lower than prescribed under S.44AE or the number of Vehicles E5 0
owned at any time exceed 10 then other ITR, as applicable, has to be filed

E6 Salary and interest paid to the partners NOTE - This is to be filled up only by firms E6 0

E7 Presumptive Income u/s 44AE (E5-E6) E7 0

E8 Income chargeable under the head 'Business or Profession (E2c+E4+E7) E8 4,50,000

E9 INFORMATION REGARDING TURNOVER/GROSS RECEIPT REPORTED FOR GST

Sl Annual Value of Outward Supplies as per the GST
GSTIN No.(s)
No. Returns Filed

E10 Total of value of Outward Supplies as per the GST returns filed E10 0

FINANCIAL PARTICULARS OF THE BUSINESS NOTE- FOR E11 TO E25 FURNISH THE INFORMATION AS ON 31ST DAY OF MARCH, 2022
E11 Partners/ Members own capital E11 8,00,000

*If the return is verified after 30 days of transmission of return data electronically, then date of verification will be considered as date of filing the
return (Notification No.05 of 2022 dated 29-07-2022 issued by the DGIT (Systems), CBDT).”
Acknowledgement Number : 271331900210623 Date of Filing : 21-Jun-2023*

E12 Secured loans E12 0

E13 Unsecured loans E13 0

E14 Advances E14 0

E15 Sundry creditors E15 2,00,000

E16 Other liabilities E16 0

E17 Total capital and liabilities (E11+E12+E13+E14+E15+E16) E17 10,00,000

E18 Fixed assets E18 0

E19 Inventories E19 15,00,000

E20 Sundry debtors E20 4,50,000

E21 Balance with banks E21 0

E22 Cash-in-hand E22 1,27,896

E23 Loans and advances E23 0

E24 Other assets E24 0

E25 Total assets (E18+E19+E20+E21+E22+E23+E24) E25 20,77,896

SCHEDULE IT - DETAILS OF ADVANCE TAX AND SELF ASSESSMENT TAX PAYMENTS

Sl No. BSR Code Date of Deposit (DD/MM/YYYY) Challan No. Tax paid

Total 0

SCHEDULE TCS - DETAILS OF TAX COLLECTED AT SOURCE [AS PER FORM 27D ISSUED BY THE COLLECTOR(S)]
Details of amount paid
Tax Collection Account Amount out of (4) being
Sl No. Name of the Collector as mentioned in Form Tax Collected
Number of the Collector claimed
26AS

Total 0

SCHEDULE TDS1 - DETAILS OF TAX DEDUCTED AT SOURCE FROM SALARY

[AS PER FORM 16 ISSUED BY EMPLOYER(S)]

Sl No. TAN Name of the Employer Income under Salary Tax deducted

Total 0

SCHEDULE TDS2(I) - DETAILS OF TAX DEDUCTED AT SOURCE ON INCOME OTHER THAN SALARY [AS PER FORM 16 A ISSUED BY
DEDUCTOR(S)]
TDS credit
being claimed
TDS of the this Year (only
Unclaimed TDS brought Corresponding Receipt /
forward (b/f) current Fin. if
corresponding withdrawals offered
Year (TDS
Tax Deduction deducted receipt is
Account during the FY being offered TDS credit
Sl No. Number (TAN) 2022-23) for tax this being carried
of the year not forward
Deductor applicable if
Fin. Year in TDS is
which TDS is TDS b/f deducted u/s Gross Amount Head of
deducted 194N) Income
TDS Deducted
TDS Claimed

Total 0

SCH TDS 2(II) DETAILS OF TAX DEDUCTED AT SOURCE [AS PER FORM 16C / 16D FURNISHED BY PAYER(S)]
*If the return is verified after 30 days of transmission of return data electronically, then date of verification will be considered as date of filing the
return (Notification No.05 of 2022 dated 29-07-2022 issued by the DGIT (Systems), CBDT).”
Acknowledgement Number : 271331900210623 Date of Filing : 21-Jun-2023*

TDS credit
being
Unclaimed TDS brought TDS of the claimed this Corresponding Receipt
forward (b/f) current Year (only if offered
Financial correspondin TDS Credit
PAN of the Aadhaar No Year g receipt is being
Sl No. Tenant / of the tenant being carried
Deductor / Deductor offered for
Fin. Year in forward
tax this Gross Head of
which TDS b/f
TDS year)
deducted Amount Income
Deducted
TDS Claimed

Total 0

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 including Senior Citizen 0

(i) Health Insurance 0

(ii) Preventive Health Checkup 0

Medical Expenditure (This deduction to be claimed on which health insurance is

(iii) 0
not claimed at (i) above)

2 Whether any one of your parents is a senior citizen

(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 insurance is 0
not claimed at (i) above)

3 Eligible Amount of Deduction 0

SCHEDULE 80G DETAILS OF DONATIONS ENTITLED FOR DEDUCTION UNDER SECTION 80G

A. DONATIONS ENTITLED FOR 100% DEDUCTION WITHOUT QUALIFYING LIMIT

City or Amount of donation Eligible

Name of PAN of
Sl No. Address Town or State code Pin code Amount of
the Donee Donee Donation in Donation in Total
District Donation
cash other mode donation

Total A 0 0 0 0

B. DONATIONS ENTITLED FOR 50% DEDUCTION WITHOUT QUALIFYING LIMIT

Amount of donation
City or PAN of Eligible
Name of
Sl No. Address Town or State code Pin code Donee Amount of
District
the Donee Donation in Donation in Total Donation
cash other mode donation

*If the return is verified after 30 days of transmission of return data electronically, then date of verification will be considered as date of filing the
return (Notification No.05 of 2022 dated 29-07-2022 issued by the DGIT (Systems), CBDT).”
Acknowledgement Number : 271331900210623 Date of Filing : 21-Jun-2023*

Total B 0 0 0 0

C. DONATIONS ENTITLED FOR 100% DEDUCTION SUBJECT TO QUALIFYING LIMIT

City or Amount of donation Eligible

Name of PAN of
Sl No. Address Town or State code Pin code Amount of
the Donee Donee Donation in Donation in Total
District Donation
cash other mode donation

Total C 0 0 0 0

D. DONATIONS ENTITLED FOR 50% DEDUCTION SUBJECT TO QUALIFYING LIMIT

ARN Amount of donation

City or Eligible
Name of PAN of (Donation
Sl No. Address Town or State code Pin code Donation Amount of
the Donee Donee Reference Donation Total
District in other Donation
Number) in cash donation
mode

Total D 0 0 0 0

E. Total Amount of Donations (A + B + C + D) 0 0 0 0

VERIFICATION

I, AATIF KHAN son/ daughter of SHER KHAN 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 HUWPK6418R

Place: 103.68.221.91

Date: 21-Jun-2023

If the return has been prepared by a Tax Return Preparer (TRP) give further details below:

TRP PIN (10 digit) Name of TRP Counter Signature of TRP

Amount to be paid to TRP 0

*If the return is verified after 30 days of transmission of return data electronically, then date of verification will be considered as date of filing the
return (Notification No.05 of 2022 dated 29-07-2022 issued by the DGIT (Systems), CBDT).”