Professional Documents
Culture Documents
xyz
INDIAN INCOME TAX RETURN
[For Individuals, HUFs and Firms (other than LLP) being
a resident having total income upto Rs.50 Lakh and Assessment
FORM
12-Jun-1971 building
(A7) Name of Premises/ Building/ Village (A8) Road/Street/Post Office (A9) Area/Locality
(A10) Town/City/District (A11) State (A12) Country/Region (A13) PIN Code/ZIP Code
KENDUJHAR 24 - Odisha 91 - India 758002
(A14) Aadhaar Number (12 digits)/ Aadhaar Enrolment Id (28 digits) (if eligible for (A15) Status
Aadhaar No.)
Individual
6xxx xxxx 0628
HUF
Firm (other than LLP)
(A16) Residential/Office Phone Number with STD code/ (A17) Mobile No.2 (A18) Email Address-1 (Self)
Mobile No.1 manoranjanmoharana8
91 9938986212
91 88953970 / 91 8895397077 3@gmail.com
Email Address-2
mmoharana71@gmail.c
om
(A19) Nature of Employment - Central Govt. State Govt. Public Sector Undertaking CG - Pensioners SG -
Pensioners PSU - Pensioners Other Pensioners Others Not Applicable (e.g. Family Pension etc.)
(A20) (a) Filed u/s [Please 139(1)-On or before due date 139(4)-After due date 142(1) 148 139(5)-
see instruction]-
Revised Return 139(9) 119(2)(b)- After Condonation of delay 139(8A)
(A23) Have you opted for new tax regime u/s 115BAC and filed Form 10IE in AY 2021-22? Yes No
Option for current assessment year
1 of 9
Acknowledgement Number : 295945460300722 Date of filing : 30-Jul-2022
(A25) Whether this return is being filed by a representative assessee? (Tick) Yes No
If yes, please furnish following information -
(1) Name of the representative
(2) Capacity of the representative
(3) Address of the representative
(4) Permanent Account Number (PAN)/ Aadhaar No. of the representative
PART B GROSS TOTAL INCOME Whole- Rupee ( ) only
B1 Income from Business & Profession (Note- Enter value from E8 of Sch BP) B1 4,05,467
Other selected)
iia Less: Income claimed for relief from taxation u/s 89A iia 0
v Income chargeable under the head ‘Salaries’ (iii – iv) ( NOTE- Ensure to B2 0
Quarterly breakup of Dividend Income Quarterly breakup of Income from retirement benefit
account maintained in a notified country u/s 89A (taxable
portion)
i Up to 15-Jun-2021 0 i Up to 15-Jun-2021 0
debentures, etc.
3 of 9
Acknowledgement Number : 295945460300722 Date of filing : 30-Jul-2022
Government
Government
Government by employer
schedule.)
D6 Relief u/s 89(Please ensure to submit Form 10E to claim this relief) D6 0
4 of 9
Acknowledgement Number : 295945460300722 Date of filing : 30-Jul-2022
D12 Total Tax, Fee and Interest (D7 + D8 + D9 + D10 + D11) D12 0
D15 Total TDS Claimed (total of column 4 of Schedule-TDS1 and column 6 of D15 0
Schedule-TDS2)
D20 Exempt income only for reporting purposes (If agricultural income is more than Rs.5,000/-, use ITR 3/5)
Sl. No. Nature of Income Description (If 'Any Other' is selected) Amount
Total 0
D21 Details of all Bank Accounts held in India at any time during the previous
year (excluding dormant accounts)
SL.No. IFS Code of the bank Name of the Bank Account Number Select Account
for Refund Credit
a Through a/c payee cheque or a/c payee bank draft or bank E1a 14,93,163
electronic clearing system or prescribed electronic modes
5 of 9
Acknowledgement Number : 295945460300722 Date of filing : 30-Jul-2022
E3 Gross Receipts E3 0
Sl no Registration No. Whether owned/leased/hired Tonnage Capacity Number of Presumptive income u/s
of goods carriage of goods months for which 44AE for the goods carriage
carriage(in MT) goods carriage (Computed @ Rs.1000 per ton
was owned/ per month in case tonnage
leased / hired exceeds 12MT, or else @ Rs.7500
by assessee per month) or the amount
claimed to have been actually
earned, whichever is higher
(i) (1) (2) (3) (4) (5)
Add row options as necessary (At any time during the year the number of vehicles should not exceed 10 vehicles)
E10 Total of value of outward supplies as per the GST returns filed 0
FINANCIAL PARTICULARS OF THE BUSINESS
Note : For E11 to E25 furnish the information as on 31st day of March,2022
6 of 9
Acknowledgement Number : 295945460300722 Date of filing : 30-Jul-2022
TOTAL 0
Note:Enter the totals of Advance tax and Self-Assessment tax in D13 and D14
Schedule-TCS Details of Tax Collected at Source [As per Form 27D issued by the Collector(s)]
SL.No. Tax Collection Account Number of Name of Collector Details of amount paid as Tax Collected Amount out of (4)
the Collector mentioned in Form 26AS being claimed
Col (1) Col (2) Col (3) Col (4) Col (5)
TOTAL 0
TOTAL 0
Note: Enter the total of column 4 of Schedule-TDS1 and column 6 of Schedule-TDS2 in D15
SCHEDULE TDS2 - DETAILS OF TAX DEDUCTED AT SOURCE ON INCOME OTHER THAN SALARY [As per Form
16 A issued or Form 16C or Form 16D furnished by Deductor(s)]
Sl.No. TAN of the Unclaimed TDS TDS of the TDS credit being Corresponding Receipt/ TDS credit
Deductor/ brought forward (b/f) current Fin. Year claimed this withdrawals offered being carried
PAN/Aadhaar Year (only if forward
No.of Tenant corresponding
receipt is being
offered for tax
this year not
applicable if
TDS is deducted
u/s 194N)
Fin. Year in TDS b/f TDS Deducted TDS Claimed Gross Head of
which deducted Amount Income
(1) (2) (3) (4) (5) (6) (7) (8) (9)
Total 0
Note: Enter the total of column 6 of Schedule TDS2 and column 4 of Schedule-TDS1 in D15
7 of 9
Acknowledgement Number : 295945460300722 Date of filing : 30-Jul-2022
Details of Tax Deducted at Source [TDS 2(ii)] [as per form 16C furnished by the payer(s)]
Sl.No. PAN/Aadhaar no. of Tenant Unclaimed TDS TDS of the TDS credit Corresponding TDS credit
brought forward (b/f) current being receipt offered being
Financial Year claimed this carried
Year (only if forward
corresponding
receipt
is being
offered for
tax this year)
Financial Year TDS b/f TDS Deducted TDS Claimed Gross Head of
in which TDS Amount Income
is deducted
1 2 3 4 5 6 7 8 9
Total 0
Note: Enter the total of column 6 of Schedule TDS2 and column 4 of Schedule-TDS1 in D15
Schedule 80D
citizen?
2 Whether any one of your parents is a senior citizen Not claiming for Parents
(a) Parents 0
SCHEDULE 80G - DETAILS OF DONATIONS ENTITLED FOR DEDUCTION UNDER SECTION 80G
A.Donations entitled for 100% deduction without qualifying limit
SL. No. Name of Address City or Town State code Pincode PAN of the Donee Amount of donation Eligible
the Donee or District Donation Donation in Total Amount of
in cash other mode Donation Donation
0 0 0 0
Total A
B. Donations entitled for 50% deduction without qualifying limit
SL. No. Name of Address City or Town State code Pincode PAN of the Donee Amount of donation
the Donee or District
8 of 9
Acknowledgement Number : 295945460300722 Date of filing : 30-Jul-2022
Donation Donation in Total Eligible
in cash other mode Donation Amount of
Donation
0 0 0 0
Total B
C. Donations entitled for 100% deduction subject to qualifying limit
SL. No. Name of Address City or Town State code Pincode PAN of the Donee Amount of donation Eligible
the Donee or District Donation Donation in Total Amount of
in cash other mode Donation Donation
0 0 0 0
Total C
D. Donations entitled for 50% deduction subject to qualifying limit
SL. No. Name of Address City or Town State Pincode PAN of the Donee Amount of donation Eligible
the Donee or District Donation Donation in Total Amount of
in cash other mode Donation Donation
0 0 0 0
Total D
0 0 0 0
E. Total Amount of Donations (A + B + C+ D)
xyz
xyz
xyz
VERIFICATION
I, MANORANJAN MAHARANA son/ daughter of INDRAMANI MAHARANA solemnly declare that to the best of
my knowledge and belief, the information given in the return is correct and complete and is in accordance with the
provisions of the Income-tax Act, 1961. I further declare that I am making this return in my capacity as Self and I am
also competent to make this return and verify it. I am holding permanent account number AQEPM2706M
Place : 49.37.46.219
Date : 30-Jul-2022
If the return has been prepared by a Tax Return Preparer (TRP) give further details as below:
9 of 9