INDIAN INCOME TAX RETURN [For individuals being a resident (other than not ordinarily resident) having total income upto Rs.50 lakh, having Income from Salaries, one house property, other sources (Interest etc.), | Assessment SARA and agricultural income upto Rs. thousand] Year [Not for an individual who is either Director ina company orhas 2021 - 22 invested in unlisted equity shares or in cases where TDS has been deducted u/s 194N or if income-tax is deferred on ESOP] (Refer instructions for eligibility) PART A GENERAL INFORMATION PAN Name Date of Birth ‘Aachear Number (12 digts/Aadhaar Enrolment Id (28 digits) DNSPS7858N ANWAR HUSSAIN SHAIK 30-Nov-1970 (i eligible for Aadhaar No.) ‘xxx x09 2000 Mobile No. Email Address Address, +91 9059998024 anwar40884@gmail.com 3-247/a/1, MADEENA NAGAR, Kodad, NALGONDA, Kodad .0, 508206 Filed uls (Tick) £1 139(1}-On or before due date, Nature of employment Please see 1) 139(4)-Botated, C1 139(5)-Revised, Ci Central Govt. State Govt. instruction] 1 119(2)(0)- After Condonation of delay Public Sector Undertaking Ci Pensioners 11 Others (Or Filed in 1 139(9), 014211), 8 148, 011530, LINot Applicable (e.9. Family Pension etc.) response tonotice 11153C us Ifrevisedidefective, then enter Receipt No. and Date of filing orginal return (ODIMMYYYY) If fied in response to notice uls 139(9)/142(1)/148/153A/153C or order uls 119 (2\b)- enter Unique Number/Document Identification Number (DIN) & Date of such Notice or Order ‘Are you opting for new tax regime uls 115BAC 71 Yes FINo, ‘Are you fling return of income under Seventh proviso to section 139(1) but otherwise not required to furish return of income? - (Tick) Yes BNo Ifyes, please furnish folowing information [Note: To be filed only if@ person is not required to furnish a return of income under section 139(1) but fling return of income due to futfiling ‘one or more conditions mentioned in the seventh proviso to section 139(1)] Have you deposited amount or aggregate of amounts exceeding Rs. 1 Crore in one or more current <0 ‘account during the previous year? Yes #1 No Have you incurred expenditure of an amount or aggregate of amount exceeding Rs. 2 lakhs for <0 travel o a foreign country for yoursetf or for any other person? Des HNo Have you incurred expenditure of amount or aggregate of amount exceeding Rs. 1 lakh on <0 consumption of electricity during the previous year? Cl Yes No PART B GROSS TOTAL INCOME Whole- Rupee (< ) only B1 i Gross Salary (iatibtic) i <7,69,453, @ Salary aspersection 17(1) ia €7,69,453 b Value of perquisites as per ib <0 section 17(2) © Profitiniieu of salary as per ic <0 section 17(3) ji Less allowances to the extent exempt uls 10 ii £71,340 (Ensure that itis included in salary income u's 17(1)/17(2V17(3) )z @ See 10(13A)Allowance to meet «71,340 S expenditure incurred on house 3 rent 2 a & iiNet Salary (i) ii £698,113 SM Deductions us 16 va + wbsive iv £52,400 3 @ Standard deduction w's 16(a) va 50,000 & > Enteranment allowance us 16. vo 10 @ € —Professionaltaxuls 16) ve «2,400 ¥ Income chargeable under the head ‘Salaries (i -iv) Bt £645,713 82 Tick applicable option TiSett Occupied Let Out LI Deemed Let Out 1 | Gross rent received! receivable! lettable value during the year i 70 ii Tax pid to local authorities i <0 ii Annual Value (=i) ii 0 30% of Annual Vale wv 20 By nterest payable on borrowed capital v 20 § 2 vi Arearsmeatsed rent received =v <0 during the year less 30% B wi Income chargeable under the head House Property (ii-iv-v)+ vi (floss, put B2 0 3 the figure in negative) Note. - Maximum loss from House Property that can be set-off INR 2,00,000.To aval the benef of cary forward and set off of loss, please use ITR-2 83 Income from Other Sources 83 0 S.No Nature of Income Description ( f Any Other Total Amount selected) 0 Less. Deduction uls57(ia) (in case of fiy pension only) 0 B4 Gross Total Income (B1+82+B3) (i loss, put the figure in negative) Ba £645,713 Note To aval the benefit of carry forward and set of of loss, please use ITR-2 Part C - Deductions and Taxable Total Income (Refer instructions for Deduction limit as per Income-tax Act. Please note that the deduction in respect of the investment! deposit! payments forthe period 01-04-2020 to 31-07-2020 cannot be claimed again, if already claimed in the AY 2020-21) s. Section ‘Amount ‘system Calculated No. C1. 80C-- Life insurance premia, deferred annuity, contributions to +1,50,000 +=1,50,000 provident fund, subscription to certain equity shares or Gebentures, ete 2, B0CCC - Payment in respect Pension Fund.te <0 0 63, 80CCD(") - Contrbution to pension scheme of Central “0 <0 Government C4, B0CCD(18) - Contbution to pension scheme of Central <0 0 Government 5, 80CCDQ2)- Contribution to pension scheme of Central 70 20 Government by employer C8, 80D Deduction in respect of Health Insurance premia (Please fil <0 <0 800 Schedule. This fed is auto-populated from schedule 80D.) C7. ODD - Maintenance including medical treatment of a dependent “0 0 ‘who is a person with disability C8, 80DDB - Medical treatment of specified disease <0 <0C9, 808 - Interest on loan taken for higher education x0 x0 (C10. | 80EE - Interest on loan taken for residential house property x0 +0 C11. 80EEA - Deduction in respect of interest on loan taken for certain <0 <0 house property C12. 80EEB - Deduction in respect of purchase of electric vehicle 0 0 C13. 80G - Donations to certain funds, charitable insttutions, etc. £1,499 1.499 (Please fll 806 Schedule. This field is auto-populated from schedule) C14, 80GG- Rent paid x0 x0 C15. B0GGA - Certain donations for scientific research or rural <0 0 development (Please fll 88GGA Schedule. This field is auto- Populated from schedule.) C16. 80GGC - Donation to Poltical party <0 <0 C17. SOTTA-_Intereston deposits in savings Accounts 0 0 C18. 8OTTB- Interest on deposits in case of senior eizens 20 20 19. 0U-In case ofa person with disability <0 <0 Total Deductions (Add items C1 to C19) £1,81,490 £1,51,400 Note: Total deductions under chapter VIA cannot exceed GTI Total Income 24,94,210 Exempt income (For reporting Purposes) S.No Nature of Income Description (If Any Other selected) Total Amount Total Amount x0 PART D - COMPUTATION OF TAX PAYABLE DI Tax £12211 D2 Rebate u 12211 D3 Tax 0 payable Is 87, payable on total after income rebate D4 Heath <0 D5 Total Tax x0 D6 Reliefuls x0 and and Cess 89 education (Please Cess censure to @4% on submit D3 Form 10E to-claim this relief) D7 Interest u <0 D8 Interest u <0 D9 Interest w <0 18.2348 Js 2348 Js 2340 DIO Fee wis <0 D1 Total Tax, Fee and interest (D5*D7+D8+D9+D10 - D6) x0 234F D12_ Total 20 D13. Amount 20 D14 Refund 0 Taxes payable (012- Paid on Dit) 12) (it D12>011) DisD12) PART E - OTHER INFORMATION Details of all Bank Accounts held in India at any time during the previous year (excluding dormant accounts) Sl, _ IFS Code of the Bank Name of the Bank ‘Account Number Select Account for Refund Credit1 sBiNooz0181 STATE BANK OF INDIA 52163046363 a 41, Minimum one account should be selected for refund credit. 2. In case of Refund, multiple accounts are selected for refund credit, then refund wil be crecited to one of the account decided by CPC after processing the return ‘Schedule 80D 1 Whether you or any of your family member (excluding parents) is a senior citzen? Not claiming for SeitFamily (@) Sets Famiy 0 () Heath Insurance 0 (i) Preventive Heath Checkup 0 (0) Self Family (Senior Citizen) 20 (Heat Insurance 20 (i) Preventive Heath Checkup <0 Gi) Medical Expenditure (This deduction tobe claimed on which health insurance isnot 20 claimed) 2 Whether any one of your parents is a senor citizen Not claiming for parents (@) Parents 20 (Heath Insurance <0 (i) Preventive Heath Checkup 70 (©) Parents (Senior Citizen) <0 (Heath Insurance <0 (i) Preventive Health Checkup <0 (ii) Medical Expenditure eo 3. Eligible Amount of Deduction 0 ‘Schedule 80G: Details of donations entitled for deduction under section 806 ‘A Donations entitled for 100% deduction without qualifying limit, (where any row is filed by the user, all the fields in that row should become mandatory) No. Na Cy erTonn Sits cose Pincode PAN fthe mount ontion Egle Amount ot 8 Danan ents 0% aston mt uti mt ere aya Hye tr ae es nao stausbaoe Man) zo zo zo to rao x0 xo to 0 . Donations entitled for 100% deduction subject to qualifying limit (where any row is filed by the user, all the fields in that row should become mandatory) Sho. Name otite Adee cor Ste Pncade ae lpi Amount ot0 setae fo to fo te te fo fe 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) Sho, Name ofits | Adwess lye St Pncode PAN motto onton gle Amount ot to to to to sia to te to fo -oonatens Av 8+ c+0) 0 ea Face ao SNo, falerant Name of Address Gly or State—-Pincode PANO Dateof ‘Amount of donation Eligible eal Town or Code the Donation [Amount of men Donee District Donee incash --—Panation Donation in Telsl Donation een ineash othermode Donation ‘Schedule sT Details of Advance Tax and Self-Assessment Tax payments BSR Code Date of Deposit (ODIMMYYYY) ‘Serial Number of Challan Tox paid col(t) col @) ol(3) cota) Total 0 Details of Tax Deducted at Source (TDS) on Salary Income. SiNo, TAN of the Deductor Name ofthe Deductor Income chargeable under Total Tax Deducted 1 2 a 4 Tota x0 Details of Tax Deducted at Source (TDS) from Income Other than Salary SL TANof Name ofthe Gross receipt which is Year of ‘Tax Deducted TDS Credit out of (5) No, the Deduetor subject to tax deduetion tax claimed this ye Deductor deduction 1 2 34 5 6 Tota 0 Details of Tax Deducted at Source [As per Form 16C furnished by the Payer(s] SL PAN Aadhaar Name ofthe ‘Gross receipt which is Year of No, ofthe Number Tenant subjectto. tax Tenant of tex deduction deduction the Tenant 1 2 3 as Total Details of Tax Collected at Source (TCS) “Tax Deducted TDs creat out of (6) claimed thi yeat 0sh | tax Name ofthe ‘Gross payment which is. | Year of ‘Tax Collected ToS credit out of (5) No, Collection Collector ‘subjectto. tax claimed this ye Account taxcollection collection Number of the Collector 1 2 34 5 ‘ Tota x0 VERIFICATION |, ANWAR HUSSAIN SHAIK son/ daughter of MAQBOOL HUSSAIN SHAIK solemnly declare that to the best of my knowledge and bolief, the information given in the return is correct and complete and is in accordance with the provisions ofthe Income-tax Act, 1961. | further declare that | am making this return in my capacity as. Self and | am also competent to make this return and very it. | am holding permanent account number DNSPS7858N Date: 01-Oct-2021 ‘the return has been prepared by a Tax Return Preparer (TRP) give further details below: ‘dontfeaion Ne, of TRE Name of TRE Counter Signature of TRP \WTRP is ented for any reimbursement from the Government aunt thereof £0