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Government of the People's Republic of Bangladesh National Board of Revenue Taxes Department Particulars of the Assessee: a) Name b) Father's Name/Husband’s Name c) Mother's Name d) Present Address e) Permanent Address f) Status ) Taxpayer's Identification Number (e-TIN): h) Business Identification Number (BIN) MD. HAFIZUR RAHMAN~ Fazlur Rahman Hajera Khatun Ghagra Dokkhin Para, Ghaghra Loskor, Jhenaigati, Sherpur, PO : 2100 Ghagra Dokkhin Para, Ghaghra Loskor, Jhenaigati, Sherpur, PO : 2100 Individual 529582930776/Circle-11 (Nalitabari) N/A This is to certify that Md. Hafizur Rahman is an assessee of the Circle- 11 (Nalitabari), Taxes Zone- Mymensingh. Assessment of the assessee has been completed for the assessment year 2022-2023 under Universal Self Assessment (Section B2BB of Income Tax Ordinance, 1984) and tax paid in full. LEAD (K.H, M. ASHRAFUL HAQUE) Assistant Commissioner of Taxes Circle-11 (Nalitabari), Taxes Zone-Mymensingh Phone- 0931 61784 FORM OF RETURN OF INCOME UNDER THE INCOME. FE THM BR IT-IGA ‘ORDINANCE, 1984 (XXXVI OF 1984) Be a Respectable Taxpayer Satie i ‘Submit return in due time > Photograph of the " wt an ‘Avoid penalty. @y) * Assessee " Gr : Ei (0 be attested Put the tick (¥) mark wherever applicable ‘onthe photograph) Sar Xx] [Cabversatsar_[ 7 Normal_[_X 1, Name of the Assessee: @ MD. HAFIZUR RAHMAN * 2. National ID No. (Ifany) :-g-89137178811402- 3.UTINGfany): (Old TIN) TN: em J2[? >> 1*1*1?71> 13117171 5.(@) Cit taxes Circle O11 (Nalitabary (©) Taxes Zone: faxes Zone-Mymensingi 6. Assessment Year: g022-2023F 7. Residential Status: Resident ¥ !'Non-residnet |X 8,Staus: Individual [VY] Fim [7X ] Association of Persons [X_] Hindu Undivided Family [x] 9, Name of the employer / business (where applicable) 10, Wife/Husband's Name with TIN: 1, Father's Name: Fazlur Rahman 2 12, Mother’s Name: doar Sehr ‘Seal (for other than individual) ‘water ssattentt)| Page 28 a creer mE SCHEDULES SHOWING DETAILS OF INCOME, Name of the Assessee: MD. HAFIZUR RAHMAN m:[s]2]9]s[s8[2]9]3 SR Ta a aT AT Schedule-t (Sal “Amount of Pay & Allowance etn ‘ccuapieal Net Toe Income (Tk) [Basic Pay / Pension Amount 5 Special Pay [Dearess allowance E [Conveyance Allowance 7 5 TTouse rent allowance 5 Medical allowance : Servant allowance/Mobile Allowance = Leave allowance Honorariun/Reward/Fee Overtime allowance Bonus Ex-erata’ Festival Bonus Other allowance /Rest nd Reoreaton allowance Employer's contribution to Recognized Provident Fund nferest accrued on RPF [Deemed income for transpor facility Deemed income for Fee accommodation |Others, if any (give detail) / Gratuity [Net axable income from Salary "i > > ‘Schedule-2 (House Property income) Location ad descrpion ces Th Tk of property 1, Annual rental income _ (170,000 X 12) 22,040,000 F— 2. Calimed Expenses SEPARATE SHEET Repair, Colleton es esa ATTACH Municipal or local ax Tand Revenue - Tnverest on loan/Morigage/Capital charge 2 Insurance Premium : Vacancy allowance : Other, ifany : Total =[ 286,789 Net income (minus 2) pom Page: 378 sf A A aT EAL Schedule-3 (Investment tax eredit) (Section 44(2)(b) read with part'B' of Sixth Schedule) |. Life insurance premium Contribution to deferred annuity . Contribution to Provident Fund to which Provi ‘Self contribution & employer's contribution to Recognized Provident Fund nt Fund Act, 1925 applies 1 2. s. a, 5. Contribution to approved Superannuation Fund [6. Investment in approved debenture stock, stock or shares 7. Contribution to deposit pension scheme 8. Contribution to Benevolent Fund and Group Insurance Premium lo. Contribution to Zakat Fund 10. Others, ifany (give details) Total Axx ee Rae *Please attach the certificate of investment 2 Rank Statement _3 finer ocean % 0 e&-Gratin ortax te — FEaeaNa n. rR, s B. “Incomplete return will not be acceptable. ‘Statement of assets and liabilities as on 30 June 2022 Name of the Assessee: MD. HAFIZUR RAHMAN SARA AH AA NElrr 108 m:[s[z2[s[Ts—Ts[z]o°]3[e|[7]7 1. (@) Business Capital (Closing balance) (b) Directors Shareholding in Limited Companies (at cost) Name of Companies umber of Shares 2. Non-Agricultural Property Land/House property (Description and location) (As Before) 3. Agricultural Property (cost including legal charges) Land property (Total land and location of land) 4. Investments: (@) Shares/Debentures (b) Saving Centficate/Sanchaypatra (©) FDR (@) Loans given (©) Other Investment RAx aa nx F8.875,0004Nil) | (ni) Th B22 167 5. Motor Vehicles {purchase price) 6. Jewellary (As Before) 7. Furniture Inheritance (As Before) 8. Electronic Equipment Inheritance (As Before) 9. Cash asset Outside Business: (@) Cash in hand (b) Cash at bank (©) Other deposits Page: 58 —4700,0007 absITSHe— Toral= Tk 23277874 Page Total (Carried Over)= Tk 247,779,831 | cri) (Walue Unknown) 7K| £386,450 Jail) (Walue Unknown) | 236,504 Nil) (Value Unknown) en He A Page Total ( Brought Over) = 10, Any other assets TK | LATTE (nity (Give details) Total assets= Tk 247,779,838 1, Less Liabilities: (a) Mortgage secured on property or land Tk «ni (b) Unsecured loans Tk (ni) (©) Bank loan Tk (ni) (a) Others Tk -_ (Nil) Total Hiabilities= —Tk| z 12, Net Wealth as on last date ofthis income year Tr 47,779,838 (Difference between total assets and total liabilities) 13, Net Wealth as on last date of previous income year 1 246,527 5364 14, Accretion of Wealth (Difference between | 24,252,301 15, (a) Family expenditure (Total expenditure as per I TK 2,106,302} (b) Number of dependant children of the family ‘Adult Chile 16, Total accretion of Wealth (Total of serial 14 and 15) | 2 358,608 > 17, Sources of Fund: Shown Return Income Tk 22,358,604 2 (i) Tax exempted / Tax free Income Tk : (Gil) Other Receipts Capital Gain Tk 18, Difference (Between serial 16 and 17) | solemnly declare that to the best of my knowledge and belief the information given in the IT-10B is correct and complete. MD. HAFIZUR RAHMAN Name & signature of the Assessee Date 29-Aug-2022 * Assets and liabilities of self, spouse (if she/he is not an assesssee), minor children and dependant(s) to be shwon in the above statements. * If needed, please use separate sheet. ett SEPT ome an LB Statement under section 75(2)(@ 1984 (XXXVI of 1984) regarding particulars of life style af aT OT Ta and section 80 of the Income Tax Ordinance, Name ofthe Assessee: MD. HAFIZUR RAHMAN slz]°1s1#[|2]9|3|]°]7]7] 6 Serial No, Particulars of Expenditure “Amount of Tk ‘Comments 1 [Personal and fooding expenses 480,000 2 [Tax paid including TDS of the last FY p03 3___ [Accommodation expenses | ___ Own House [Transport expenses / Conveyance e500 3 __[Blecrie Bill for residence eno 6 [Wasa Bill for residence 212,000 7___ [Gas Bill for residence ei,700 %___ [Telephone Bil for residence “14,000 97 [education expenses for children 10 __ [Personal expenses for Foreign travel 1 [Festival and ater special expenses, any ean 50 Total Expenditure 21106 309 I solemnly declare that to the best of my know IT-1OBB js correct and complete. I nceded, please use separate sheet ation given inthis MD. HAFIZUR RAHMAN Name & signature of the Assessee Date 29-Aug-2022 Acknowledge Receipt of Income Tax Return Name of the Assessee: [MD. HAFIZUR RAHMAN Assessment Year: 72022-2023 UTIN / TIN: s[z2[o~Ts[s/7z]°;3;e|7[716 Circle: ‘Taxes Circle-011 (Nalitabari) ‘Taxes Zone: ‘Taxes Zone-Mymensingh Page: 778 ‘feo Aart OAK Sat RT Inst th Instructions: (1) This return of income shall be signed and verified by the individual assessee of person as prescribed wis 75 of the Income Tax Ordinance, 1984. (2) Enclose where applicable: (a) Salar statement for salary; Bank statement for interest; Certificate for interest on savings, instruments; Rent agreement, receipts of municipal & land revenue, statement of house property Joan interest, insurance premium for house property income; Statement of Professional ineome as per IT Rule-8; Copy of assessment’ income statement & balance sheet for partnersh income; Documents of eapital gain; Dividend warrant for dividend income; Document support of investments in savings certificates, LIP, DPS, Zakat, stock/share etc. (b) Statement of ineoem and expenditure; Manufacturing A/C, Trading & Profit & Loss A/C ‘and Balance sheet; (©) Depreciation chart claiming depreciation as per THIRD SCHEDULE of the Income Tax Ordinance, 1984. (@ Computation of income according to Income tax Law; (3) Enclose separate statement for: (@) any income ofthe spouse of the assesse (if she/he isnot anassesse), mi gpendant; (6) tax exempted income (4) Fulfilment ofthe conditions laid down in nule-38 is mandatory for submission off under "Self Assessment”. 5) Documents furnished to support the declaration should be signed by the assessed authorised representative. |(6) The assessee shall submit hisher photograph with return after every five year. |(7) Fumish the following information: (a) Name, address & TIN ofthe partners ifthe assessee is a firm; (b) Name of firm, address & TIN if the assessee is a partner; (©) Name of the company, address & TIN if the assessec isa director. |(8) Assets and liabilitis of self, spouse (if she/he is not an assessee), minor children and 15. Tax payable (difference between serial 13 and = 520,732 16. Tax Payments: (@) Tax deducted / Collected at source (Please submit supporting documents! statement) (b) Advance tax wis 64/68 (Please attach challan) (©) Tax paid on the basis ofthis return (ws 74) (Please attach challan/pay order/bank draf/cheque) Tk (@) Adjustment of Tax Refund (if any) T%| ‘Total of (@) (6) (€) and (@) = 20,732 17. Difference between serial 15 and 16 (ifany) Tk 0 18. Tax exempted & Tax free income Tk 19. Income tax paid in the last assessment year. Poe “If needed, please use separate sheet. 1_MD. HAFIZUR RAHMAN Father/Husband Fazlur Rahman m[Es]2]o[s]* 7 7 2 9 o 6 solemnly declare that tothe best ‘of my knowledge and belief the information given inthis return and statements and documents annexed herewith is correct and complete. Place: Mymensingh Date: 30-Nov-2021 Signature MD. HAFIZUR RAHMAN (Name in block letters) Designation and ‘Seal (for other than individual) ‘SCHEDULES SHOWING DETAILS OF INCOME AOA FAH TAT RA Nei wi MD. HAFIZUR RAHMAN m([s]2]9]1*1l8l2?]°l31°l7 1716 ‘Schedule-1 (Salar “Amount of Pay & Allowance camountot | Srempe | Net Tatable Income (Tk) Base Pay Pension Amount : Special Pay nee lie [Conreyeae Allowance : House rent allowance : [Medial allowance Servant allowance/Mable Allowance = Leave allowance ecorrin/RewardFee Oven allowance ants gna Petal a Othe allowance / Rest and Recreation allowance aapioyers conmntion to Rocopalzed Providon Fund Interest accrued on RPF ecmed income for tans fey T Deemed icone for es accommodation Others, if any (give deta) Gray Net tnable income fom Salary 5 = ; ous P Tocston a deseripcion 7 nh hn of property 1, Annual rental income _ (157,500 X 12) #-1,890,0007- Lb: Calimed Expenses ISEPARATE SHEET Repair, Collection, es pao rtacu Mantepal or toeal tax Tand Revenue Trees on oun Mortgag/Capial hare 5 —— : Vovaney allowance : Othe ifany = Total=| 254,369 J Net income (1 minus 2) asst Page: 378 SR AOA OHM FA BEA Schedule-3 (Investment tax eredit) (Section 44(2)(b) read with part’B' of Sixth Schedule) 1 Life insurance premium Tk }2. Contribution to deferred annuity Tk - |3. Contribution to Provident Fund to which Provident Fund Act, 1925 applies Tk - |4. Self contribution & employer's contribution to Recognized Provident Fund Tk : 5. Contribution to approved Superannuation Fund Tk : [6. Investment in approved debenture stock, stock or shares Tk 1. Contribution to deposit pension scheme Tk 8. Contribution to Benevolent Fund and Group Insurance Premium Tk - lo. Tk 10. Others, ifany (give details) Tk : Total Tk *Please attach the certificate of investment. List of documents furnished | 2-Bank statement _3.Fiouse Rent Income Statement 0. © Challan for Tax Tk 16,993 fF uw. 12. 13. “Incomplete return will not be acceptable. Page: 48 WE HOT IATA HT Statement of assets and liabilities as on 30 June 2021 Name of the Assessee: MD. HAFIZUR RAHMAN m(fsl2]97s] 8 z[°T3;e[7[7]« Form No. IT-10B 28,875, 000FNil) Co) 1. @) Business Capital (Closing balance) TK| (b) Directors Shareholding in Limited Companies (at cost) 1K ‘Name of Companies ‘Number of Shares 2. Non-Agricultural Property: Land/House property (Description and location) (As Before) 1K 3. Agricultural Propet (ost including legal charges) Land property (Total land and location of land) (As Before) Tr ETE 712,857,600 4. Investments: (@) Shares/Debentures Tk (b) Saving Certificate/Sanchaypatra Tk (FDR ‘Tk (@) Loans given Tk (©) Other Investment 1k ‘5. Motor Vehicles (purchase price) 6. Jewellary TK nit (As Before) (Value Unknown) 17. Furniture Inheritance Tk 334500 NI) (As Before) (Value Unknown) 8, Electronic Equipment Inheritance TK 199,860 Nil) (As Before) (Value Unknown) 9. Cash asset Outside Business; (@) Cash in hand ‘Tk Ee 1436,769 (b) Cash at bank Tk 21,279,807 (©) Other deposits Total= Tk 2716576 ge Total (Carried Over) = Tk| 246,527. wt iter men oan wat ae Page Total ( Brought Over) = Tk| 246527 536 10, Any other assets 1K a) (Give details) Total assets= TH 246527536 f— 1, Less Liabilities: (@) Mortgage secured on property or land Tk ni) (b) Unsecured loans Tk (nil) (©) Bank loan 1 wi) (@ Others 1k = Nil) Total liabilities= TK - 12, Net Wealth as on last date of this income year TH 246,827,536 (Difference between total assets and total liabilities) 13, Net Wealth as on last date of previous income year K 45302,901 14, Accretion of Wealth (Difference between serial 12 and 13) mK EGS mK 21,021,139 15, (a) Family expenditure (Total expenditure as per IT 10 BB) (b) Number of dependant children of the family: ‘Adult child 16, Total accretion of Wealth (Total of serial 14 and 15) 1K Za 17. Sources of Fund: (@ Shown Return Income Te 2285774 (Gi) Tax exempted / Tax free Income Tk 2 (ii) Other Receipts Capital Gain Tk Tx B25, 774 18, Difference (Between serial 16 and 17) Tk 0) T solemnly declare that to the best of my knowledge and belief the information given in the IT-10B is correct and complete. MD. HAFIZUR RAHMAN [Name & signature of the Assessee Date 30-Nov-2021 + sets and abies of elf spouse sherbet mot am sssse), minor children and dependents tobe shnon I the above salemens + fneded please use separate she. 025 Page: 678 Sot ep sir: Form No. IT-10BB ‘Statement under section 75(2(d){i) and section 80 of the Income Tax Ordinance, 1984 (XXXVI of 1984) regarding particulars of lifestyle Name ofthe Assess MD. HAFIZUR RAHMAN m[Es[2[o]s]s]2]°]s]e|[7[71 6 Serial No. Particulars of Expenditure ‘Amount of Th. ‘Comments 1 [Personal and fooding expenses 283,500 2 [Tax pad including TDS of the ast FY saat 3 [Accommodation expenses E ‘Own Howe “4 [Transport experecs / Cuveyeace -e_80,360- 3S__[Blectric Bill for residence ZA BOF 6 __|Wasa Bill for residence <11,320F 7___ |Gas Bill for residence zz %___ [Telephone Bill for residence 22,860) 9 [Education expenses for children 10 [Personal expenses for Foreign travel Ti [Festival and other special expenses, Wany eS 750/> “Total Expenditure Aro 39 Uf needed, please use separate sheet. MD. HAFIZUR RAHMAN Name & signature of the Assessee Date 30-Nov-2021 Acknow! fJucome Ty Name of the Assesse: [iD. HAFIZUR RAHMAN Assessment Year 2021-2022 UTIN/ TIN: s]?7]°1s1*17]9/s]*°|71716 Circe Taxes Circle O11 (Nalitabar) 7] Taxes Zone: Taxes Zone-Mymensingh Page: 718 eee TH RHEE instructions to fill up the Return Form structions: |(1) This return of income shall be signed and verified by the individual assessee of person as prescribed u/s 75 of the Income Tax Ordinance, 1984, |c2) Enclose where applicable:- (8) Salar statement for salary; Bank statement for interest; Certificate for interest on savings instruments; Rent agreement, receipts of municipal & land revenue, statement of house property loan interest, insurance premium for house property income; Statement of Professional income 1s per IT Rule-8; Copy of assessment/ income statement & balance sheet for partnership income; Documents of capital gain; Dividend warrant for dividend income; Documents in support of investments in savings certificates, LIP, DPS, Zakat, tockishare etc. (b) Statement of incoem and expenditure; Manufacturing A/C, Trading & Profit & Loss A/C and Balance sheet; (© Depreciation chart claiming depreciation as per THIRD SCHEDULE of the Income Tax Ordinance, 1984. (@) Computation of income according to Income tax Laws |3) Enclose separate statement for: (a) any income of the spouse of the assessee (if she/he is not an assessee), minor chil () tax exempted income (4) Fulfilment of the conditions lid down in rule-38 is mandatory for submission of |) Documents furnished to support the declaration should be signed by the assessee under "Self Assessment” authorised representative. (6) The assessee shall submit his/her photograph with return after every five year. (7) Fumish the following information: (@ Name, address & TIN of the partners ifthe assessee isa firm; (b) Name of firm, address & TIN if the assessee is a partner; (©) Name of the company, address & TIN if the assessee isa director. (8) Assets and liabilitis of self, spouse (if she/he is mot an assessee), minor chiren and

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