Name & Address of the Employee Bishnu Chottopadhyay

P A N No. AAPB 5566C

D a t a

I n p u tS h e e t

Arrears Relief U/s 89(1) for only West Bengal Govt employee After Arrears Pay of ROPA -09

Prepared by Pranab Banerjee, Kalisthanpara, Jiaganj, Murshidabad, West Bengal. Email:- pranab.banerjee83@gmail.
Cell No. 9474316768, 8906279547
Taxable Income for the Financial Year 2008-2009

Rs. 115,000

Taxable Income for the Year(2011-2012)..

Rs. 230,000

Arrears Received in the Year 2009-2010(1st Instlment)..

Rs. 15,703

Arrears Received in the financil year 2010-2011( 2nd Installment)

Rs. 15,703

Arrears Received in the Financial Year 2011-2012 ( 3rd Installments)

Rs. 15,703

Total Taxable Income after getting the one,two & three Instalment as
ROPA-09 of financial year 2008-2009 is Rs.

Rs. 146,406

if you have not availed

the Arrears Relief in the THIS
Year, then Put this Cell "0"
if you have not availed
the Arrears Relief in the this
Year, then Put this Cell "0"

Put Male or
Female

Male

availed
in the THIS
Cell "0"

FORM NO.10 E
[See rule 21AA]

Form for furnishing particulars of income under section 192(2A) for the year ending 31 st March, 2011 for
claiming relief under section 89(1) by a Government servant or an employee in a 2[company,co-operative
society,local authority ,university, instituty
1

Name and address of the employee

Bishnu Chottopadhyay

Permanent account number

Residential status

AAPB 5566C
PERMANENT RESIDENT

Particulars of income referred to in rule 21A of the Income-tax Rules, 1962,during the previous year relevant to
assessment year 2012-13
1 (a)

Salary received in arrears or in advance in accordance with the provisions of

sub-rule (2) of rule 21A.

Rs. 15,703

(b)
Payment in the nature of gratuity in respect of past services, extending over a
period of not less than 5 years in accordance with the provisions of sub-rule (3) of
rule 21A.

Not Applicable

Payment in the nature of compensation from the employer or former employer at

or in connection with termination of employment after continuous service of not
less than 3 years or where the unexpired portion of term of employment is also
not less than 3 ye

Not Applicable

Payment in commutation of pension in accordance with the provisions of subrule (5) of rule 21A

Not Applicable

(c)

(d)

2
Detailed particulars of payments referred to above may be given in Annexure
I,II,IIA,III, or IV as the case may be.

ANNEX-I

..
Signature of the employee
Verification
stated above

I,
is true to the best of my knowledge and belief.
Verified today, the

Day of

Place: .
Date:

Signature of the employee

Pranab Banerjee,Jiaganj, Murshisabad, West Bengal.

ANNEXURE-I
[See item 2 of Form No.10E]

Arrears or advance salary

Sl No.

Particulars

Amount (Rs.)

Total income (excluding salary received in arrears or advance)

Rs. 214,297

Salary received in arrears or advance

Rs. 15,703

Total income (as increased by salary received in arrears or advance)

[Add item 1 and item 2]

Rs. 230,000

Tax on total income [as per item 3]

Rs. 5,150

Tax on total income [as per item 1]

Rs. 3,533

Tax on salary received in arrears or advance

[Difference of item 4 and item 5]

Rs. 1,617

Tax computed in accordance with Table "A"

[Brought from column 7 of Table A]

Rs. 1,247

Relief under Section 89(1) [Indicate difference between the amounts mentioned
against item 6 and item 7]

Rs. 370

TABLE "A"
[See item 7 of Annexure 1]
Total income of
the relevent
previous year
(Rs.)

Salary
received in
arrears or
advance
relating to the
relevent
previous year
as mentioned
in column (1)
(Rs.)

(2)

(3)

(4)

(5)

(6)

(7)

Rs. 146,406

Rs. 15,703

Rs. 162,109

Rs. 0

Rs. 1,247

Rs. 1,247

Previous
year

(1)

2008-09

Place:
Date:

Total income (as Tax on total

increased by income [as per
salary received
column (2)in arrears or
After Rebate
advance) of the and including
relevent
Edn Cess and
previous year
Surcharge]
mentioned in
(Rs.)
column (1) [add
colmn 2 & 3]
(Rs.)

Signature:
Name:
Designation:
Dept:

Tax on total
Difference in tax
income[as per
[Amount under
column (4)
column (6) minus
After Rebate amount under column
and including
(5)]
(Rs.)
Edn Cess and
Surcharge]
(Rs.)

Pranab Banerjee, Jiaganj, Murshidabad,West Bengal

pranab.banerjee83@gmail.com