First Name Middle Name Last Name PAN

ASHIM KUMAR PRAMANICK AGIPP3702G

Flat / Door / Building Status
0 I
INFORMATION

Road/Street/Post Office Area/Locality DOB (YYYY/MM/DD)

PERSONAL

78, MOTILAL COLONY 0 1968-11-22

Town/City/District State Pin code Sex
KOLKATA WEST BENGAL 700081 M
Country
91- INDIA Employer Category
Email id (STDcode)-Ph No Mobile No.
mukhopadhyay3102@gmail.com ( )- 9830357496 PSU
,
Income Tax Ward/Circle Return filed under Section- 12
[Please see instruction number-9(ii)]
Whether Original or Revised return? O
FILING STATUS

If revised, enter Original Ack no / Date

Date
If u/s 139(9)-defective return , enter
Original Ack No
If u/s 139(9)-defective return , enter If u/s 139(9)-defective return , enter
Notice No Notice Date
Residential Status RES Tax Status NT
Whether Person governed by N
Portuguese Civil Code under Sec 5A ?
1 Income from Salary / Pension (Ensure to fill Sch TDS1) 1 643618
Type of House Property Self Occupied
2 Income from one House Property -23827
3 Income from Other Sources (Ensure to fill Sch TDS2) 1016
4 Gross Total Income (1+2+3) 4 620807
5 Deductions under chapter VI A (Section)
a 80C 100000 100000 h 80G 0 0
b 80CCC 0 0i 80GG 0 0
c 80 CCD 0 0 j 80GGA 0 0
INCOME & DEDUCTIONS

(i) (Employers
Contribution)
c 80 CCD 0 0 k 80GGC 0 0
(ii) (Employees /
Self Employed
Contribution)
d 80D 0 0l 80U 0 0
e 80DD 0 0 m 80CCG 0 0
f 80DDB 0 0 n 80RRB 0 0
g 80E 0 0 o 80QQB 0 0
p 80TTA 1016 1016
6 Deductions (Total of 5a to 5p) 6 101016
7 Total Income (4-6) 7 519790
8 Tax Payable on Total Income 8 33958
9 Education Cess, including secondary and higher secondary cess on 8 9 1019
COMPUTATION

10 Total Tax and Education Cess (Payable)(8+9) 10 34977

11 Relief under Section 89 11 0
12 Balance Tax Payable (10-11) 12 34977
TAX

13(i) Interest u/s 234A 0

13(ii) Interest u/s 234B 0
13(iii) Interest u/s 234C 0
14 Total Interest u/s 234A 234B 234C 14 0
15 Total Tax and Interest Payable (12+14) 15 34980
 16 Taxes Paid
TAXES PAID a Advance Tax (from item 25) 16a 0
b TDS (Total from item 23 + item 24) 16b 34976
c Self Assessment Tax (item 25) 16c 0
Total Taxes Paid(16a + 16b + 16c) 17 34976
17
18 Tax Payable (15-17) (if 15 is greater than 17) 18 0
19 Refund (17-15) if 17 is greater than 15 19 0
20 Enter your Bank Account Number 10150663799
REFUND

21 Select Yes if you want your refund by direct deposit into bank account, select No if you want refund by cheque
Y
22 In case of direct deposit to your bank account give additional details
IFSC Code Type of Account SAV
SBIN0002054
23 Details of Tax Deducted at Source from Salary [As per Form 16 issued by Employer(s)]
SI.NO Tax Deduction Name of the Employer Income chargeable Total Tax Deducted
Account Number under the
(TAN) of the head Salaries
Employer
1 CALI00434A AIR INDIA LTD 643618 34976
26 Exempt income for reporting purposes only 0

VERIFICATION
xyz
I, ASHIM KUMAR PRAMANICK son/daughter of SANTOSH KUMAR PRAMANICK solemnly declare that to the best of my
knowledge and belief, the information given in the return thereto is correct and complete and that 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 income
chargeable to Income-tax for the previous year relevant to the Assessment Year 2013-14.

Place KOLKATA Date 2013-08-18 PAN AGIPP3702G

27 If the return has been prepared by a Tax Return Preparer (TRP) give further details as below:
Identification No. of TRP Name of TRP Counter Signature of TRP
28 If TRP is entitled for any reimbursement from the Government, amount thereof