INDIAN INCOME TAX RETURN VERIFICATION FORM Assessment Year

~
cz::
o ITR-V [Where the data of the Return of Income ill Form ITR-l (SAHAJ), ITR-2, ITR-3,
2018-19
~ ITR-4(SUGAI\1), ITR-S, ITR-7 transmitted electronically without digital signature] •

Name Of PremiseslBuildinglViIlagc
IITR-4

Designation of AO (Ward I Circle)

1377576120191118

I, ,MADHUSUDHAN BHAGIRATH son/ BUH1'B1403N

solemnly declare to the best of my knowledge'and the IIIlUIIIl~llUIl
electronically by me vide acknowledgement n~nib~r;,ine'ntioned above is correct and COmple! hat the amount of total income and other particulars
shown therein are truly stated and are in accordance with the provisions of the Income-tax Act, 1961, in respect of inc orne chargeable to income-tax for
the previous year relevant to the assessment year 2018-19, I further declare that Iam making this return in my capacity as
Self and 1 am also competent to make this return and verify it.

Sign here Date 19-11-2018 Place HYDERABAD

If the return has been prepared by a Tax Return Preparer (TRP) give further details as below:

Identification No, ofTRP NameofTRP Counter Signatul'l' ofTRP

fil~I~11111
For Office Use Only
Receipt No Filed from IP address 1103,248,211. 130

1111
Date

Seal and signature of BUHPB1403N04377576120191118670C9116EA55CCE63F=71\620275E07 A5821 EBE233

receiving official

Please send the duly signed Form ITR-V to "Centralized Processing Centre, Income Tax Department, Bcngaluru 560500", hy ORDI"ARY
OST OR SPEED POST O~L Y, within 120 days from date of transmitting the data electronically, Form ITR- V shall not he received ill any other
ffice of the Income-tax Department or in any other manner. The confirmation of receipt of this Form ITR- Vat ITD-CPC will be sent to [he e-mail
ddrcss rr36037@gl11ui1.col11
 Tax Payer Counterfoil Payment Status: I Success

PAN t BUHPBI403i'; I SBI Ref NO'. : IKOOVBSqXR

Recei,,~d from : MAl)XXXXl)HA~

RHAGIRATII Tender Challan
BSR Code
date 1\0
Rs: LI_5S_0/_- ~ CIN nOl4431 191118 01512

Date of
(in words) : Five Hundred And "'lfty Rupees Only 19-11-2018
challan :

Drawn On : Iiniernet Banking through SBII State Bank of India

Gandhinagar
PAN ON ACCOUNT 0), L.~COM.E TAX
Bangalore
O~: i\,fajor Head :OTHER THAN
(Internet Collection Center)
CO~PA:'IoIIES TAXI0021l
Minor Head: SEI,F ASSESS"fENT TAX
13001

for the assessment 2018-l9

year:
 Tax Payer Counterfoil Payment Status: 1 Success

PA~ I Rl'HP81403N I SBI Ref No. : IKOOVIlTIA5

Received from: MAOXXXXOITAl\I
RHAGJRATH Tender Challan
BSR Code
date :\0
Rs: 1380/-
L- ~
CIN 0011352 191118 01559

(in words) : Three Hundred And Eighty Rupees Date of

19-11-2018
Only challan:
",
Drawn On : Iinternct Banking through SBII
State Bank ofTndia
Gandhinagar
PAN ON ACCOUNT OF INCOME TAX
Bangalore
O~: Major Head :OTHER THAN
(Jnternet Collection Center)
COMPANIES TAX[()021)
Minor Head: SELF ASSESSMENT TAX
[3001

For the assessment 2018-19

year:
NAME OF THE ASSESSEE B MADHUSUDHAN
S/o B ANAND
HNO-3-43 BONTHAPALLY
MEDAK -502313

STATUS INDIVIDUAL

PAN NO BUHPB1403N

FINANCIAL YEAR 2017-2018

ASSESSMENTYEAR 2018-2019

D.O.B 19-12-1989

COMPUTATION OF INCOME STATEMENT

INCOME FROM BUSINESS: 403605
(Enclosed P& L Account)
Gross total income 403605
Less: Deduction U/S VI-A 119200
Net taxble income 284405

Tax there on 1721

Less: Rebate U/S 87-A 1721
Taxpayable NIL
Late Fee Payable 1000
Total tax and Late Fee 1000
Less: TDS Paid 73
Tax payable 927
Less:Late Fee paid 930
Tax due NIL
 B MADHUSUDHAN
HNO-3-43 BONTHAPALL Y
MEDAK-502313
Trading &Profit Loss Account for the year ended 31-03-2018
Particulars Amount Rs. Particulars Amount Rs.
TO.Opening stock 62547 By.Sales 1824566
TO.Purchases 1115133 By.Closing stock 85631
TO.Salaries & wages 210544
TO. Power & fuel exp 18544
TO. Staff -Welfare 8214
TO. Telephone charges 5417
TO.Printing & stationery 4877
TO.Rent 54000
TO.Travelling exp 3021
TO.Pooja & Festival exp 7568
TO. Depreciation 7545
TO. Convyance 5325
TO.Office Expences 3857
TO.Net pofit 403605
1910197 1910197
 B MADHUSUDHAN
HNO-3-43 BONRHAPALLY
MEDAK -502313
Balance sheet for the year ended 31-03-2018
Amount Amount
Liabilities Rs. Assets Rs.
Capital 302544 Furniture 11700
Add :Profit 403605 Less:Dep 1170 10530
706149
Less: Drawings 210322 495827 Vehicle 42500
Less:Dep 6375 36125
Advances & Deposits 50000
Sundry Debtors 304318
cash & Bank balance 21544
Out standing Liabilities 12321 Closing stock 85631

508148 508148