Form PDF 484105870150723
Form PDF 484105870150723
Form PDF 484105870150723
(A1) PAN (A2) First Name (A2a) Middle Name (A3) Last Name
ATZPG8914F NAVEEN KUMAR GALI
(A5) Aadhaar Number(12 digits)/Aadhaar Enrolment Id(28 digits) (if
(A4) Date of Birth (A6) Mobile No
eligible for Aadhaar No.)
20/06/1986 +91 9949743920
2xxx xxxx 8513
(A9) Name of (A10) Road/Street/Post Office,
(A7) Email Address (A8) Flat/Door/Block No. Premises/Building/Village Area/Locality
[email protected] Q NO T 2-222 KRISHNA NAGAR 5INCLINE ROAD Godavarikhani S.O
NEAR STADIUM Godavarikhani
(A11) Town/City/District (A12) State (A13) Country/Region (A14) PIN Code/ZIP Code
KARIM NAGAR 36-Telangana 91-INDIA 505209
(A15)(a) Filed u/s (Tick)[Please see instruction] 139(1)-On or before due date
*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 : 484105870150723 Date of Filing : 15-Jul-2023*
Sl.
Nature of Exempt Allowances Description ( If Any Other selected) Total Amount
No.
iia Less : Income claimed for relief from taxation u/s 89A iia 0
Income chargeable under the head 'House Property' (iii - iv - v) + vi (If loss, put the figure in
vii B2 0
negative)
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)
*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 : 484105870150723 Date of Filing : 15-Jul-2023*
Gross Total Income (B1+B2+B3) (If loss, put the figure in negative) Note: To avail the benefit
B4 B4 6,57,786
of carry forward and set off of loss, please use ITR-2
C11 80EEA - Deduction in respect of interest on loan taken for certain house 0
0
property
C14 80GG - Rent paid (Please submit form 10BA to claim deduction) 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 : 484105870150723 Date of Filing : 15-Jul-2023*
*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 : 484105870150723 Date of Filing : 15-Jul-2023*
Total 0
D6 Relief u/s 89 (Please ensure to submit Form 10E to claim this relief) D6 0
D11 Total Tax, Fee and Interest (D5 + D7 + D8 + D9 + D10 - D6) D11 16,442
D14 Refund (D12 - D11) (if D12 > D11) D14 6,210
PART E - OTHER INFORMATION DETAILS OF ALL BANK ACCOUNTS HELD IN INDIA AT ANY TIME DURING THE PREVIOUS YEAR
(EXCLUDING DORMANT ACCOUNTS)
Sl. Select Account for Refund
IFS Code of the Bank Name of the Bank Account Number
No. Credit
SCHEDULE 80D
1 Whether you or any of your family member (excluding parents) is a senior citizen? No
*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 : 484105870150723 Date of Filing : 15-Jul-2023*
(a) Parents 0
SCHEDULE 80G DETAILS OF DONATIONS ENTITLED FOR DEDUCTION UNDER SECTION 80G
A. DONATIONS ENTITLED FOR 100% DEDUCTION WITHOUT QUALIFYING LIMIT, (WHERE ANY ROW IS FILLED BY THE USER, ALL THE
FIELDS IN THAT ROW SHOULD BECOME MANDATORY)
(1) (2) (3) (4) (5) (6) (7) (9) (10) (11) (12)
Total A 0 0 0 0
B. DONATIONS ENTITLED FOR 50% DEDUCTION WITHOUT QUALIFYING LIMIT (WHERE ANY ROW IS FILLED BY THE USER, ALL THE
FIELDS IN THAT ROW SHOULD BECOME MANDATORY)
Amount of donation
City or Eligible
Sl. Name of PAN of the
Address Town or State code Pin code Amount of
No. the Donee Donee Donation in Donation in Total
District Donation
cash other mode donation
(1) (2) (3) (4) (5) (6) (7) (9) (10) (11) (12)
Total B 0 0 0 0
C. DONATIONS ENTITLED FOR 100% DEDUCTION SUBJECT TO QUALIFYING LIMIT (WHERE ANY ROW IS FILLED BY THE USER, ALL THE
FIELDS IN THAT ROW SHOULD BECOME MANDATORY)
(1) (2) (3) (4) (5) (6) (7) (9) (10) (11) (12)
*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 : 484105870150723 Date of Filing : 15-Jul-2023*
Total C 0 0 0 0
D. DONATIONS ENTITLED FOR 50% DEDUCTION SUBJECT TO QUALIFYING LIMIT (WHERE ANY ROW IS FILLED BY THE USER, ALL THE
FIELDS IN THAT ROW SHOULD BECOME MANDATORY)
(1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12)
Total D 0 0 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 : 484105870150723 Date of Filing : 15-Jul-2023*
(1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12)
Total 0 0 0 0
TAX PAYMENTS
Sl.
BSR Code Date of Deposit (DD/MM/YYYY) Serial Number of Challan Tax paid
No.
Total 0
SCHEDULE TDS1 - DETAILS OF TAX DEDUCTED AT SOURCE FROM SALARY [AS PER FORM 16 ISSUED BY EMPLOYER(S)]
Sl. Income chargeable under
TAN of the Deductor Name of the Deductor Total Tax Deducted
No. salaries
Total 22,648
SCHEDULE TDS2 - DETAILS OF TAX DEDUCTED AT SOURCE FROM INCOME OTHER THAN SALARY [AS PER FORM 16A ISSUED BY
DEDUCTOR(S)]
Gross receipt which
Sl. Name of the Year of tax TDS Credit out of
TAN of the Deductor is subject to tax Tax Deducted
No. Deductor deduction (5)claimed this year
deduction
(1) (2) (3) (4) (5) (6) (7)
Total 0
SCHEDULE TDS3 DETAILS OF TAX DEDUCTED AT SOURCE (AS PER FORM 16C FURNISHED BY THE PAYER(S))
Gross receipt TDS Credit out
Sl. PAN of the Aadhaar Number Name of the Year of tax
which is subject Tax Deducted of (6) claimed
No. Tenant of the Tenant Tenant deduction
to tax deduction this year
Total 0
SCHEDULE TCS
Total 0
VERIFICATION
*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 : 484105870150723 Date of Filing : 15-Jul-2023*
I, NAVEEN KUMAR GALI son/ daughter of RAJAIAH GALI 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 ATZPG8914F
Place: 152.58.235.228
Date: 15-Jul-2023
If the return has been prepared by a Tax Return Preparer (TRP) give further details below:
If TRP is entitled for any reimbursement from the Government, amount thereof 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).”