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= = ‘Lisared dive doughs ada, eis f hello MICYCL We ainaannt TNS Fiemme Msc cunant mon Received with thanks from (a Finst name ia UAST WANE foe ers A (xe sex {86 DATE OF BIRTH oe fae remae 1 6 10 1484 (A FLaTooR/sUILOING No- 6-47 @ aStHie, STeeeT 1h MRNo.> (SAHA) 2 9 > ASSUMES 6 for assessment yoar2012-13, having the following patcuars RQ miDoLe NAME ~~ o PERMANENT ACCOUNT NUMBER | Aczraeci2P (AD INCOME TAX WARD/CIRCLE ag noan/sTREET KobAmM 20 Len MW AY 20 a return of ineame in (AiO AREALOCALTY b.n- pPuour (At) TownycrrymisTRicT ei MOAT ORE | (M2 STATE (RF ony ane ee » — Belrcue at-101) > Ar ue de-199 Gross Total Income Deductions under Chapter VI-A Total income Current Loss if any Net Tax Payable Interest Payable Total Tax and Interest Payable Total Advance Tax Paid ‘Total Selt Assessment Tax Paid TyUl Total TDS Deducted 13) Total TCS Deducted £3) Total Prepaid Taxes (B8+B9+B10+B11) ye) Tax Payable ( B7-B12, It B7 > B12) (i) Refund ( B12-B7, I B12 > B7 ) FOR OFFIOIAL > | L. Ake: ors2asrsoraer Puen: aasanaaaie iM: -ROZPGOOI2P mR INORKALAN AS pmicoDe fram enanu & FeisedRetun-1945)0R_inrespouse to ncce + 142() » 18» 1SIWSC CO ees eT eT Sa 1ow4 -B1() > B2 8 (), > BB > Bo > BIO > BIT B12 > B13 -RRRIBM: Wo62:500206 Noaeiea fo: TO warons, intwarone PNK AG Jit i) 1a 19)6 2 pe 22505 ribo vo cit, mic Funan a I = © ceived with thanks ren 8 reumotiggomenn ita 2 SIA» ‘wife tbmerpetone © sprasr name Bz MOLE wane . «lo | : f osrae Te PERANERT RCGOUNT MBER = leon am z AczPhcolarn ‘HOAGSEX (AG DATE OF SIRTH AT INCOME TAX WARD CIRCLE = I cttie fm ThE 9 1 189 . 2 BP FLAT/OOORBULDING ‘Ag ROAD/STREET i alot lacy Sastue) SreeeT fy aiEATOCALTY ‘Ais TOWAUGITY DISTICT wheetohan Cotonsy, “ samp ea gS fave STATE Fea suanapy 2 tf EEil} Gross Total income *B1{ i's i Ae 7904 1 [FF] Deductions under Chapter VIA “aa Lt emote = Ee] Total income “31: (tee g tae ees EY Current Loss it any * Ba) pee G5) Net Tax Payable BS jie 1 sag # 21d interest Payable : {27 | Total Tax and Interest Payable " F5| Total Advance Tax Paid 1 FA rota ett Assessment Tax Pid eit) Total TDS Deducted [5 Totel TCS Deducted EFUP) Total Prepaid Taxes (B9+89+810+811) 4 Tox Payable ( 87-612, f 87 > B12) uF Refuna (812-87, 1 812 > B7) row orcas use cry Received wth thanks from__—__ TRNo.» S1(GAHAI > O2 » OG mC AS{SUGAM)r GA > OS »O 6 for assessmen 4 retum af income in ea 2011-12, having te following parcuirs. a ‘FIRST NAME ‘(RQ MIDDLE NAME z sal eee 1 Lis 1 \ vile (AD LAST WANE (Ad PERMANENT ACCOUNT NUMBER i. = Bpusrehwiy tier iii ity | (AleEIER ele Tee] = AS SEX (R® bate OF BIRTH ‘(KD cor WARD/CIRCLE . : ee “ ~ . witae © samale [TTR ] eo Fone [Ta velenT RB] To ai 1 48 FLAt/oooRULOINE “aS onsTAEET = + bimi wins SX Sy HRI Cr Ppey Ge eet wwi | 6opomys ft . IRI) AREARLOCALITY ‘AIDTOWNCTTYaIsTRICT 5 By vn Py pie, haBiarioieA) {1 | teiti|e 'a19 PINCODE . repo litisiitiy Ele cee 1 PE le and» dec dite 88) » Aa un 1394) » Reed Re 295) 08 reps oie »O 4) » © ud Ossie Nee asa Ee? Y fsooang lees marcheregton og bac Gross Total Income > BIT) pas Deductions under Chapter VI-A > B2 l L . Total Income - 69 ( (ITT TITERGEEE « Current Loss if any : > ea (TT i Net Tax Payable > BS Interest Payable > BG ‘Total Tax and Interest Payable > B7 Total Advance Tax Paid > BB Total Self Assessment Tax Paid > Bo > BIO > BIT >BI2 > BIS »Bid cane four HENATURE OF _ ALAN "ae ence Te se WARDS) FRIGIAL TAMPR (0. HERE _ —" mi =

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