INDIAN INCOME TAX RETURN VERIFICATION FORM.
Assessment Year
2 1TR-4, ITR48 (SUGAM),ITRS, ITR6 transmitted electronically without digital signature)
(Please sce Role 12 ofthe Incomes Ral 1862)
SS
Name PAN
BALAKRISHNAN KIZHAKKEVEETTIL
|AESPB7497Q
$2 MatibooriBiock No Name Of Fremises/Bulding/Vilage Form No. whish
zee | 33 SURABHT hhas been ITR-1
e258 electronically
BEE | esnoap CHALA EAST
Zee
32 |Townicigyoieice State Pin Status Individual
2° | kanyur
5 KERALA 7061
2
= Designation of AO (Ward / Circle) [TO WD-3. KANNUR ‘Original or Revised | ORIGINAL
filing Acknowledgement Number [735402360040813 Date(DD MM-AYYY))[_04-08-2013
T [Gross Total Income 7 707820
2 [ Deductions under Chapter VTA 2 101300
[8 [tar tncome 3 06520
3 3 [Current Vear Tse any En 7
8¢ [epnataraaite a SEB
2 © [s | terest Payable 5 0
8 6 | Total Tax and Interest Payable 6 52883
S35 [7 [axes Pata
ge a [Advance Tax 7 3
ge e 7 Sa
5 : 7 0
& @_| Self Assessment Tax 7a 0
[Hota Taxes Paid (at TPT 77—) 7e S28
© [Tax Payable Te) + °
| Refand Ce) >
VERIFICATION
HAKKEVE! son! daughter of KIZHAKKEVEETTIL RAM, holding permanent account number AESPB7497Q
BALAKRISHNAN KI
solemnly declare to the best of my knowledge and belie, the information given in the return and the schedules thereto which have been transmitted
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