Form PDF 317367410280623

Acknowledgement Number : 317367410280623 Date of Filing : 28-Jun-2023*
INDIAN INCOME TAX RETURN

FORM [For Individuals and HUFs not having income from profits and gains of business or profession] Assessment Year
ITR2 (Please see Rule 12 of the Income-tax Rules, 1962) 2023-24
(Please refer instructions for eligibility)
PART A-GENRAL
PERSONAL INFORMATION
(A1) First Name (A3) Last Name (A4) PAN
(A2) Middle Name
SURENDRANATHA SUJEENDRANATH ASEPS7739L
(A5) Status (A6) Flat/Door/Block No. (A7) Name of Premises/Building/Village
Individual Flat no 605 Andulus Plaza 2 Behind Burjuman Mall
(A8) Road/Street/Post Office (A9) Area/locality (A10) Town/City/District
Bur Dubai Dubai United Arab Emirates
(A11) State (A12) Country/Region (A13) Pin code/Zip code
99-Foreign 971-UNITED ARAB EMIRATES 30504
(A16) Residential/Office Phone Number with Mobile No. 1
(A17) Mobile No. 2
STD/ISD code 971 501401378
(A18) Email Address-1 (self)
(A19) Email Address-2
sujeendra.nath@gmail.com
(A14) Date of Birth/Formation (DD/MM/YYYY)
(A15) Aadhaar Number(12 digits)/Aadhaar Enrolment Id(28 digits) (if eligible for Aadhaar No.)
21/04/1978
139(1)-On or before due
(A20) (a1i) Filed u/s (Tick)[Please see instruction ] (a1ii) Or Filed in response to notice u/s
date
(a2) Are you opting for new tax regime u/s 115BAC ? Yes No
Are you filing return of income under Seventh proviso to section 139(1) but otherwise not required to furnish
(b) Yes No
return of income?
Have you deposited amount or aggregate of amounts exceeding Rs. 1 Crore in one or
(bi) Yes No 0
more current account during the previous year? (Yes/No)
Have you incurred expenditure of an amount or aggregate of amount exceeding Rs. 2
(bii) Yes No 0
lakhs for travel to a foreign country for yourself or for any other person? (Yes/No)
Have you incurred expenditure of amount or aggregate of amount exceeding Rs. 1
(biii) Yes No 0
lakh on consumption of electricity during the previous year? (Yes/No)
Are you required to file a return as per other conditions prescribed under clause (iv) of seventh proviso to
(biv) Yes No
section 139(1) (If yes, please select the relevant condition from the drop down menu)
If revised/defective/Modified, please enter Date of filling of original return (DD/MM/YYYY) and Receipt
(c)
No. -
Date of filling of original return (DD/MM/YYYY)
Receipt No.
If filed, in response to a notice u/s 139(9)/142(1)/148/153C or order u/s 119(2)(b) enter unique
(d) number/ Document Identification Number (DIN) and date of such notice/order, or if filed u/s 92CD,
enter date of advance pricing agreement-
Unique Number/ Document Identification Number (DIN)
Date of such Notice or Order or if filed u/s 92CD enter date of advance pricing agreement
You were a non-resident

(e) Residential Status in India (for individuals) Non Resident
during the previous year
(I) PLEASE SPECIFY THE JURISDICTION(S) OF RESIDENCE DURING THE PREVIOUS YEAR -
Sl.
Jurisdiction(s) of Residence Taxpayer Identification Number(s)
No.
1 2 3
1 971-UNITED ARAB EMIRATES NA
*If the return is verified after 30 days of transmission of return data electronically, then date of verification will be considered as date of filing the
return (Notification No.05 of 2022 dated 29-07-2022 issued by the DGIT (Systems), CBDT).”
(ii) In case you are a Citizen of India or a Person of Indian Origin (POI), please specify -
Total period of stay in India during the previous year (in days) 0
Total period of stay in India during the 4 preceding years (in days) 0
(f) Do you want to claim the benefit under section 115H? (applicable in case of resident)
(g) Are you governed by Portuguese Civil Code as per section 5A?(If "YES" please fill Schedule 5A) No
(h) Whether this return is being filed by a Representative Assesse? No
(1) Name of the representative
(2) Capacity of the Representative
(3) Address of the representative
(4) Permanent Account Number (PAN) of the Representative
(5) Aadhaar No. of the Representative
(i) Whether you are an FII/FPI? Yes No
If yes, provide SEBI Registration Number
(j) Whether you were Director in a company at any time during the previous year? Yes No
Sl. Whether its shares are Director Identification

Name Of Company Type of Company PAN
No. listed or unlisted Number (DIN)
1 2 3 4 5 6
(k) Whether you have held unlisted equity shares at any time during the previous year? Yes No
Shares acquired during the year

Shares
Opening balance Purchas transferred Closing Balance
e price during the year
Name Issue
Type of PAN of per
Sl. Of Price
Compan Compan Date of Face share(in
No. Compan per
y y No. of subscrip Value case of
y share(in
Cost of Shares tion/pur per purchas Sale Cost of
No. of case of No. of No. of
acquisiti chase share e from Conside Shares acquisit
Shares fresh
on existing Shares ration ion
issue)
share
holder)
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
SCHEDULE SALARY - DETAILS OF INCOME FROM SALARY
2 Total Gross Salary (from all employers) 2 0
3 Less : allowances to the extent exempt u/s 10 3 0
Sl. Nature of Exempt

Description Amount
No. Allowance
1 2 3 4
3a Less : Income claimed for relief from taxation u/s 89A 3a 0
4 Net Salary (2 - 3 - 3a) 4 0
5 Deduction u/s 16 (5a + 5b + 5c) 5 0
A Standard deduction u/s 16(ia) 5a 0
B Entertainment allowance u/s 16(ii) 5b 0
C Professional tax u/s 16(iii) 5c 0
6 Income chargeable under the Head 'Salaries' (4 - 5) 6 0
SCHEDULE HP - DETAILS OF INCOME FROM HOUSE PROPERTY
2 Pass through income/loss if any * 2 0
Income under the head “Income from house property” (1k) + 2 (if negative take the
3 3 0
figure to 2i of schedule CYLA)
SCHEDULE CG CAPITAL GAINS
A Short-term Capital Gains (STCG) (Sub-items 3 and 4 are not applicable for residents)
From sale of land or building or both (fill up details separately for each
1
property)
Note 1 : Furnishing of PAN is mandatory, if the tax is deduced under section 194-IA.
Note 2 : In case of more than one buyer, please indicate the respective percentage share and amount.
From sale of equity share or unit of equity oriented Mutual Fund (MF) or unit of a business trust on
2
which STT is paid under section 111A or 115AD(1) (ii) proviso (for FII)
For NON-RESIDENT, not being an FII- from sale of shares or debentures of an Indian company
3
(to be computed with foreign exchange adjustment under first proviso to section 48)
STCG on transactions on which securities transaction
a A3a 0
tax (STT) is paid
STCG on transactions on which securities transaction
b A3b 0
tax (STT) is not paid
For NON-RESIDENT- from sale of securities (other than those at A3) by an FII as per section
4
115AD
In case securities sold include shares of a company
a i
other than quoted shares, enter the following details
Full value of consideration received/receivable in
a ia 0
respect of unquoted shares
Fair market value of unquoted shares determined in
b ib 0
the prescribed manner
Full value of consideration in respect of unquoted

c shares adopted as per section 50CA for the purpose of ic 0
Capital Gains (higher of a or b)
ii Full value of consideration in respect of securities other than unquoted shares aii 0
iii Total(ic+ii) aiii 0
b Deductions under section 48
i Cost of acquisition without indexation bi 0
ii Cost of improvement without indexation bii 0
Expenditure wholly and exclusively in connection with

iii biii 0
transfer
iv Total (bi + bii + biii) biv 0
c Balance (aiii – biv) c 0
Loss to be disallowed u/s 94(7) or 94(8)- for example if security bought/acquired within 3
d months prior to record date and dividend/income/bonus units are received, then loss arising d 0
out of sale of such security to be ignored (Enter positive value only)
e Short-term capital gain on sale of securities by an FII (other than those at A2) (c +d) e 0
5 From sale of assets other than at A1 or A2 or A3 or A4 above
In case of asset sold include shares of a company other

a i
than quoted shares enter the following details
Full value of consideration received/receivable in
a ia 0
respect of unquoted shares
Fair market value of unquoted shares determined in
b ib 0
the prescribed manner
Full value of consideration in respect of unquoted
c shares adopted as per section 50CA for the purpose of ic 0
Capital Gains (higher of a or b)
ii Full value of consideration in respect of assets other than unquoted shares aii 0
iii Total(ic+ii) aiii 0

iii biii 0
transfer
c Balance (aiii – biv) 5c 0
In case of asset (security/unit) loss to be disallowed u/s 94(7) or 94(8)- for example if asset
d bought /acquired within 3 months prior to record date and dividend/income/bonus units are 5d 0
received, then loss arising out of sale of such asset to be ignored (Enter positive value only)
e STCG on assets other than at A1 or A2 or A3 or A4 above (5c + 5d) 5e 0
6 Amount deemed to be short term capital gains
Whether any amount of unutilized capital gain on asset transferred during the previous
a years shown below was deposited in the Capital Gains Accounts Scheme within due date for
that year?
Amount not used for

Section under which New Asset acquired/constructed new asset or
Sl. Previous year in which
deduction claimed in remained unutilized in
No. asset transferred Year in which asset Amount utilised out of Capital gains account
that year
acquired/constructed Capital Gains account (X)
1 2 3 4 5 6
b Amount deemed to be short term capital gains, other than at 'a' 0
Total amount deemed to be short term capital gains (axi + axii + b) A6 0
Pass Through Income/ Loss in the nature of Short Term Capital Gain, (Fill up schedule PTI)
7 A7 0
(A7a + A7b + A7c)
Pass Through Income/ Loss in the nature of Short Term
a A7a 0
Capital Gain, chargeable @ 15%
Pass Through Income/ Loss in the nature of Short Term
b A7b 0
Pass Through Income / Loss in the nature of Short Term
c A7c 0
Capital Gain, chargeable at applicable rates
Amount of STCG included in A1 – A7 but not chargeable to tax or chargeable at special rates
8 A8
in India as per DTAA
Rate as
Item No. per Applicabl
Whether
A1 to A7 Country Treaty Section Rate as e rate
Sl. Amount Article of TRC
above in Code & (enter of I. T. per I. T. [lower of
No. of income DTAA obtained
which Name NIL, if not Act Act (6) or
(Y/N)
included chargeabl (9)]
e)
1 2 3 4 5 6 7 8 9 10
a Total amount of STCG not chargeable to tax in India as per DTAA A8a 0
Total amount of STCG chargeable to tax at special rates in India

b A8b 0
as per DTAA
9 Total Short-term Capital Gain (A1e+ A2e+ A3a+ A3b+ A4e+ A5e+A6 + A7 - A8a) A9 0
B Long-term capital gain (LTCG) (Sub-items 5, 6, 7 & 8 are not applicable for residents)
From sale of land or building or both (fill up details separately for each
1
property)(in case of co-ownership, enter your share of Capital Gain)
Note 1 : Furnishing of PAN is mandatory, if the tax is deduced under section 194-IA.
Note 2 : In case of more than one buyer, please indicate the respective percentage share and amount.
2 From sale of bonds or debenture (other than capital indexed bonds issued by Government)
a Full value of consideration a 0
iii Expenditure wholly and exclusively in connection with transfer biii 0
c Balance (a – biv) c 0
d Deduction under section 54F (Specify details in item D below) d 0
e LTCG on bonds or debenture (2c – 2d) B2e 0
From sale of, (i) listed securities (other than a unit) or zero coupon bonds where proviso under section
3
112(1) is applicable
From sale of equity share in a company or unit of equity oriented fund or unit of a business
4
trust on which STT is paid under section 112A
a LTCG u/s 112A (column 14 of Schedule 112A) 4a 0
Deduction under section 54F (Specify details in item D

b 4b 0
below)
Long-term Capital Gains on sale of capital assets at B4
c 4c 0
above (4a – 4b)
For NON-RESIDENTS- from sale of shares or debenture of Indian company (to be computed
5
with foreign exchange adjustment under first proviso to section 48)
a LTCG computed without indexation benefit 5a 0
Deduction under sections 54F (Specify details in item D

b 5b 0
below)
c LTCG on share or debenture (5a-5b) B5c 0
For NON-RESIDENTS- from sale of, (i) unlisted securities as per sec. 112(1)(c), (ii) bonds or
6 GDR as referred in sec. 115AC, (iii) securities by FII as referred to in sec. 115AD (other than
securities referred to in section 112A for which column B7 is to be filled up)
For NON-RESIDENTS - From sale of equity share in a company or unit of equity oriented fund
7
or unit of a business trust on which STT is paid under section 112A
LTCG u/s 112A (column 14 of Schedule 115AD(1)(b)
a 7a 0
(iii))
Deduction under section 54F (Specify details in item D
b 7b 0
below)
Long-term Capital Gains on sale of capital assets at B7
c 7c 0
above (7a – 7b)
8 From sale of foreign exchange asset by NON-RESIDENT INDIAN (If opted under chapter XII-A)
LTCG on sale of specified asset (computed without

a 8a 0
indexation)
Less deduction under section 115F (Specify details in
b 8b 0
item D below)
c Balance LTCG on sale of specified asset (8a – 8b) B8c 0
LTCG on sale of asset, other than specified asset

d 8d 0
(computed without indexation)
Less deduction under section 115F (Specify details in
e 8e 0
item D below)
Balance LTCG on sale of asset, other than specified
f 8f 0
asset (8d- 8e)
9 From sale of assets where B1 to B8 above are not applicable
In case assets sold include share of a

a i company other than quoted shares, enter the 0
following details
Full value of consideration
a received/receivable in respect of unquoted ia 0
shares
Fair market value of unquoted shares
b ib 0
determined in the prescribed manner
Full value of consideration in respect of
unquoted shares adopted as per section 50CA
c ic 0
for the purpose of Capital Gains (higher of a
or b)
Full value of consideration in respect of assets
ii aii 0
other than unquoted shares
iii Total (ic + ii) aiii 0
i Cost of acquisition with indexation bi 0
ii Cost of improvement with indexation bii 0

iii biii 0
transfer
c Balance (aiii – biv) 9c 0
d Deduction under sections 54F (Specify details in item D below) 9d 0
e Long-term Capital Gains on assets at B9 above ( (9c – 9d) 9e 0
10 Amount deemed to be long-term capital gains
Whether any amount of unutilized capital gain on asset transferred during the previous year
a shown below was deposited in the Capital Gains Accounts Scheme within due date for that
year?
Amount not used for
Section under which New Asset acquired/constructed new asset or
Sl. Previous year in which
deduction claimed in remained unutilized in
No. asset transferred Year in which asset Amount utilised out of Capital gains account
that year
acquired/constructed Capital Gains account (X)
1 2 3 4 5 6
b Amount deemed to be long-term capital gains, other than at 'a' 0
Total amount deemed to be long-term capital gains(aXi + aXii+aXiii + b ) B10 0
Pass Through Income/ Loss in the nature of Long Term Capital Gain,(Fill up schedule PTI)
11 B11 0
(B11a1+ B11a2 + B11b)
Pass Through Income/ Loss in the nature of Long Term
a1 B11a1 0
Capital Gain, chargeable @ 10% u/s 112A
a2 Capital Gain, chargeable @ 10% under sections other B11a2 0
than u/s 112A
a3 B11a3 0
Amount of LTCG included in B1 - B11 but not chargeable to tax or chargeable at special rates
12
Whether
Item No. B1 Rate as per
Tax Applicable
to B11 Country Treaty
Sl. Amount of Article of Residency Section of Rate as per rate [lower
above in Code & (enter NIL,
No. income DTAA Certificate I.T. Act I.T. Act of (6) or
which Name if not
obtained (9)]
included chargeable)
(Y/N)
1 2 3 4 5 6 7 8 9 10
a Total amount of LTCG not chargeable to tax as per DTAA B12a 0
b Total amount of LTCG chargeable to tax at special rates as per DTAA B12b 0
Total long term capital gain chargeable under I.T. Act

13 B13 0
(B1e+B2e+B3e+B4c+B5c+B6e+B7c+B8c+B8f+B9e+B10 + B11 - B12a)
C1 Sum of Capital Gain Incomes (9ii + 9iii + 9iv + 9v + 9vi + 9vii + 9viii of table E below) C1 0
C2 Income from transfer of Virtual Digital Assets (Col. 7 of Schedule VDA) C2 0
C3 Income chargeable under the head "CAPITAL GAINS"(C1 + C2) C3 0
D Information about deduction claimed against Capital Gains
1 In case of deduction u/s 54 / 54B / 54EC / 54F / 54GB / 115F give following details
a Deduction claimed u/s 54
Amount deposited in
Date of purchase/
Sl. Date of Transfer of Cost of new Capital Gains Amount of deduction
construction of new
No. Original Asset residential house Accounts Scheme claimed
residential house
before due date
1 2 3 4 5 6
b Deduction claimed u/s 54B
Amount deposited in
Sl. Date of Transfer of Cost of new Date of purchase of Capital Gains Amount of deduction
No. Original Asset agricultural land new agricultural land Accounts Scheme claimed
before due date
1 2 3 4 5 6
c Deduction claimed u/s 54EC
Amount invested in
Sl. Date of Transfer of Original specified/notified bonds Amount of deduction
Date of investment
No. Asset (not exceeding fifty lakh claimed
rupees)
1 2 3 4 5
d Deduction claimed u/s 54F
Date of Amount deposited in

Sl. Date of Transfer of purchase/construction Cost of new Capital Gains Amount of deduction
No. Original Asset of new residential residential house Accounts Scheme claimed
house before due date
1 2 3 4 5 6
e Deduction claimed u/s 54GB
Amount Amount
Cost of new
Date of utilised for deposited in
plant and Date of
transfer of PAN of the subscription Date of Capital Gains Amount of
Sl. machinery purchase of
original eligible of equity subscription Accounts deduction
No. purchased by plant and
residential company shares of of shares Scheme claimed
the eligible machinery
property eligible before due
company
company date
1 2 3 4 5 6 7 8 9
f Deduction claimed u/s 115F (for Non-Resident Indians)
Amount invested in new

Sl. Date of Transfer of original Amount of deduction
specified asset or savings Date of investment
No. foreign exchange asset claimed
certificate
1 2 3 4 5
g Total deduction claimed (1a + 1b + 1c + 1d + 1e + 1f) 1g 0
Set-off of current year capital losses with current year capital gains (excluding amounts included in
E
A8a & B12a which is not chargeable under DTAA)
Capital
Current
Gain of
year's
current
capital
year (Fill Short- Short- Long-
gains
Sl. this Short- Short- Term Term Long- Long- Term
Type of Capital gain remaining
No. column Term15% Term 30% Applicable Covered Term 10% Term 20% Covered
after set
only if Rate By DTAA By DTAA
off
computed
(9=1-2-3-
figure is
4-5-6-7-8)
positive)
(1) (2) (3) (4) (5) (6) (7) (8) (9)
Capital Loss to be set off (Fill this

i row only if computed figure is 0 0 0 0 0 0 0
negative)
ii Short Term Capital Gain 15% 0 0 0 0 0
iii Short Term Capital Gain 30% 0 0 0 0 0
Short Term Capital Gain Applicable

iv 0 0 0 0 0
Rate
Short Term Capital Gain Covered
v 0 0 0 0 0
By DTAA
vi Long Term Capital Gain 10% 0 0 0 0 0 0 0 0
vii Long Term Capital Gain 20% 0 0 0 0 0 0 0 0
Long Term Capital Gain Covered By

viii 0 0 0 0 0 0 0 0
DTAA
Total loss set off (ii + iii + iv + v +
ix 0 0 0 0 0 0 0
vi+vii+viii)
x Loss remaining after set off (i-ix) 0 0 0 0 0 0 0
F Information about accrual/receipt of capital gain
Sl. Type of Capital gain/

Upto 15/6 16/6 to 15/9 16/9 to 15/12 16/12 to 15/3 16/3 to 31/3
No. Date
(i) (ii) (iii) (iv) (v)
Short-term capital
gains taxable at the
1 rate of 15% Enter value 0 0 0 0 0
from item 3iii of
schedule BFLA, if any.
Short-term capital
from item 3iv of
schedule BFLA, if any
Short-term capital
gains taxable at
3 applicable rates Enter 0 0 0 0 0
value from item 3v of
Short-term capital
gains taxable at DTAA
4 rates Enter value from 0 0 0 0 0
item 3vi of schedule
BFLA, if any.
Long- term capital
from item 3vi of
Long- term capital
from item 3vii of
Long- term capital

7 rate DTAA rates Enter 0 0 0 0 0
value from item 3ix of
Capital gains on
transfer of Virtual
Digital Asset taxable at
8 0 0 0 0 0
the rate of 30% Enter
value from item 16 of
schedule SI, if any
SCHEDULE VDA - INCOME FROM TRANSFER OF VIRTUAL DIGITAL ASSETS

Cost of Acquisition
(In case of gift; a. Income from
Head under which Enter the amount on transfer of Virtual
Sl. Consideration
Date of Acquisition Date of Transfer income to be taxed which tax is paid u/s Digital Assets (enter
No. Received
(Capital Gain) 56(2)(x) if any b. In nil in case of loss)
any other case cost (Col. 6 – Col. 5)
to previous owner)
1 2 3 4 5 6 7
Total (Sum of all Positive Incomes of Capital Gain in Col. 7) 0
TotIncCapGain
0
SCHEDULE 112A FROM SALE OF EQUITY SHARE IN A COMPANY OR UNIT OF EQUITY ORIENTED FUND OR UNIT OF A BUSINESS TRUST
ON WHICH STT IS PAID UNDER SECTION 112A
Full
Value of
Conside
ration If
shares/u
nits are
acquired
on or
before
If the
31st
long Total
January,
Cost of term Fair Fair Expendi
2018 Balance
acquisiti capital Market Market ture
(Total (6- 13)
Sale- on asset Value Value of wholly
Name of Sale Total Item 4
Share/U No. of price without Cost of was per capital and
Sl. ISIN the Value) deducti (a) of
nit Shares per indexati acquisiti acquire share/u asset as exclusiv
No. Code Share (4*5) or ons LTCG
acquired /Units Share on on d before nit as per ely in
/Unit If (7+12) Schedul
/Unit (higher 01.02.2 on 31st section connecti
shares/u e of
of 8 or 018, - January, 55 (2) on with
nits are ITR2
9) Lower 2018 (ac)- transfer
acquired
of 6 or (4*10)
after
11
31st
January,
2018 -
Please
enter
Full
Value of
Conside
ration
1 1a 2 3 4 5 6 7 8 9 10 11 12 13 14
Total 0 0 0 0 0 0 0 0
SCHEDULE 115 AD(1)(B)(III) PROVISO : FOR NON-RESIDENTS - FROM SALE OF EQUITY SHARE IN A COMPANY OR UNIT OF EQUITY
ORIENTED FUND OR UNIT OF A BUSINESS TRUST ON WHICH STT IS PAID UNDER SECTION 112A
Full
Value of
Conside
ration If
shares/u
nits are
acquired
on or
before
If the
31st
long Total
January,
Cost of term Fair Fair Expendi
2018 Balance
acquisiti capital Market Market ture
(Total (6-13)
Sale on asset Value Value of wholly
Name of Sale Total Item 7
Share/U No. of price without Cost of was per capital and
Sl. ISIN the Value) deducti (a) of
nit Shares per indexati acquisiti acquire share asset as exclusiv
No. Code Share (4*5) or ons LTCG
acquired /Units Share/U on on d before /unit as per ely in
/Unit If (7+12) Schedul
nit (higher 01.02.2 on 31st section connecti
shares/u e of
of 8 or 018, January, 55(2) on with
nits are ITR2
9) Lower 2018 (ac)- transfer
acquired
of 6 or (4*10)
after
11
31st
January,
2018 -
(Please
enter
Full
Value of
Conside
ration)
1 1a 2 3 4 5 6 7 8 9 10 11 12 13 14
Total 0 0 0 0 0 0 0 0
SCHEDULE OS INCOME FROM OTHER SOURCES
1 Gross income chargeable to tax at normal applicable rates (1a+ 1b+ 1c+ 1d + 1e) 1 2,41,983
A Dividends, Gross (ai +aii) 1a 1,62,549
ai Dividend income [other than (ii)] 1ai 1,62,549
aii Dividend income u/s 2(22)(e) 1aii 0
B Interest, Gross (bi + bii + biii + biv + bv + bvi + bvii + bviii + bix) 1b 25,194
bi From Savings Bank bi 0
From Deposits (Bank/ Post Office/ Co-operative

bii bii 0
Society)
biii From Income-tax Refund biii 0
biv In the nature of Pass through income/ loss biv 0
Interest accrued on contributions to provident

bv fund to the extent taxable as per first proviso to bv 0
section 10(11)
bvi fund to the extent taxable as per second bvi 0
proviso to section 10(11)
bvii fund to the extent taxable as per first proviso to bvii 0
section 10(12)
bviii fund to the extent taxable as per second bviii 0
proviso to section 10(12)
bix Others ix 25,194
c Rental income from machinery, plants, buildings, etc., Gross 1c 0
Income of the nature referred to in section 56(2)(x) which is chargeable to

d 1d 0
tax (di + dii + diii + div + dv)
Aggregate value of sum of money received
i i 0
without consideration
In case immovable property is received without
ii ii 0
consideration, stamp duty value of property
In case immovable property is received for
inadequate consideration stamp duty value of
iii iii 0
property in excess of such consideration as
adjusted as per section 56(2)(x)
In case any other property is received without
iv iv 0
consideration, fair market value of property
In case any other property is received for
v inadequate consideration, fair market value of v 0
property in excess of such consideration
e Any other income (please specify nature) e 54,240
Sl.
Country/Region Amount
No.
1 2 3
1 OTHERS 54240
2 Income chargeable at special rates (2a+ 2b+ 2c+ 2d + 2e +2f elements related to Sl. No.1) 2 3,564
a Winnings from lotteries, crossword puzzles etc. chargeable u/s 115BB 2a 0
b Income chargeable u/s 115BBE (bi + bii + biii + biv+ bv + bvi) 2b 0
i Cash credits u/s 68 bi 0
ii Unexplained investments u/s 69 bii 0
iii Unexplained money etc. u/s 69A biii 0
iv Undisclosed investments etc. u/s 69B biv 0
v Unexplained expenditure etc. u/s 69C bv 0
vi Amount borrowed or repaid on hundi u/s 69D bvi 0
Accumulated balance of recognised provident fund taxable u/s

c 2c
111
Sl.
Assessment Year Income benefit Tax benefit
No.
1 2 3 4
Total 0 0
d Any other income chargeable at special rate (total of di to dxx) 2d 3,564
Sl.
Nature Amount
No.
1 2 3
115AD(1)(i) -Income (other than Dividend)

1 received by an FII in respect of securities (other 3564
than units as per Sec 115AB)
Pass through income in the nature of income from other sources chargeable
e 2e 0
at special rates (drop down to be provided)
Sl.
Nature Amount
No.
1 2 3
Amount included in 1 and 2 above, which is chargeable at special rates in

f 2f 0
India as per DTAA (total of column (2) of table below)
Rate as
Item per Applicabl
Country Whether
No.1ai, Treaty Rate as e rate
Sl. Amount /Region Article of TRC Section
1b to 2 in (enter per I.T. [lower of
No. of income Code and DTAA obtained of I.T. Act
which NIL, if not Act (6) or
Name (Y/N)
included chargeabl (8)]
e)
1 2 3 4 5 6 7 8 9 10
Deductions under section 57 (other than those relating to income chargeable at special rates under
3 3
2a, 2b & 2d)
Expenses / Deductions other than "aii" (in case other than family
ai 3ai 0
pension)
Interest expenditure u/s 57(i) on dividend (available only if
aii income offered in 1a) - entered amount Interest expenditure 3aii 0
claimed
Interest expenditure claimed
Eligible amount of interest expenditure u/s 57(i) – Computed

a(iia) 3a(iia) 0
Amount
aiii Deduction u/s. 57(iia) (in case of family pension only) 3aiii 0
b Depreciation 3b 0
c Total 3c 0
4 Amounts not deductible u/s 58 4 0
5 Profits chargeable to tax u/s 59 5 0
5a Income claimed for relief from taxation u/s 89A 5a 0
INCOME FROM RETIREMENT BENEFIT ACCOUNT MAINTAINED IN A NOTIFIED COUNTRY U/S 89A
Sl.
Country/Region Amount
No.
1 2 3
Total 0
Income taxable during the previous year on which relief u/s 89A was claimed in any earlier
2 2 0
previous year
Net Income from other sources chargeable at normal applicable rates(1 ( after reducing income
6 6 2,41,983
related to DTAA portion) - 3 + 4 + 5 - 5a ) (if negative take the figure to 3i of Schedule CYLA)
7 Income from other sources (other than from owning race horses) (2 + 6) (enter 6 as nil, if negative) 7 2,45,547
8 Income from the activity of owning and maintaining race horses 8
a Receipts 8a 0
b Deductions under section 57 in relation to receipts at 8a only 8b 0
c Amounts not deductible u/s 58 8c 0
d Profits chargeable to tax u/s 59 8d 0
e Balance (8a - 8b + 8c + 8d) (if negative take the figure to 6xii of Schedule CFL) 8e 0
9 Income under the head "Income from other sources" (7 + 8e) (take 8e as nil if negative) 9 2,45,547
10 Information about accrual/receipt of income from Other Sources 10
Sl.
Other Source Income Upto 15/6 From 16/6 to 15/9 From 16/9 to 15/12 From 16/12 to 15/3 From 16/3 to 31/3
No.
(i) (ii) (iii) (iv) (v)
Income by way of
winnings from lotteries,
crossword puzzles,
1 races, games, 0 0 0 0 0
gambling, betting etc.
referred to in section
2(24)(ix)
Dividend Income
2 0 0 0 0 1,62,549
referred in Sl.no.1a(i)
Dividend Income u/s
3 115A(1)(a)(i) @ 20% 0 0 0 0 0
(Including PTI Income)
Dividend Income u/s
4 0 0 0 0 0
115AC @ 10%
Dividend Income u/s
5 115ACA (1)(a) @ 10% 0 0 0 0 0
Dividend Income (other
than units referred to
6 in section 115AB) u/s 0 0 0 0 0
115AD(1) (i) @ 20%
Dividend income
7 0 0 0 0 0
taxable at DTAA rates
Income from
retirement benefit
account maintained in
8 a notified country u /s 0 0 0 0 0
89A (Taxable portion
after reducing relief u/s
89A)
SCHEDULE CYLA DETAILS OF INCOME AFTER SET OFF OF CURRENT YEAR LOSSES
Net loss from Other
Income of current year sources chargeable at
Sl. Head / Source of (Fill this column only if House property loss of normal applicable rates Current year’s income
No. Income income is zero or the current year set off (other than loss from remaining after set off
positive) race horses) of the
current year set off
1 2 3 4
Loss to be set off (Fill

this row only if
i 0 0
computed figure is
negative)
ii Salaries 0 0 0 0
iii House property 0 0 0
Short-term capital gain

iv 0 0 0 0
taxable @ 15%
v 0 0 0 0
taxable @ 30%
vi taxable at applicable 0 0 0 0
rates
vii taxable at special rates 0 0 0 0
Long term capital gain
viii 0 0 0 0
taxable @ 10%
Long term capital gain
ix 0 0 0 0
taxable @ 20%
Long term capital gains

taxable at special rates
x 0 0 0 0
Net income from other

xi sources chargeable at 2,41,983 0 2,41,983
normal applicable rates
Profit from the activity
of owning and
xii 0 0 0 0
maintaining race
horses
Total loss set off (ii + iii
xiii + iv + v + vi + vii + viii 0 0
+ ix + x + xi + xii)
Loss remaining after
xiv 0 0
set-off (i – xiii)
SCHEDULE BFLA DETAILS OF INCOME AFTER SET OFF OF BROUGHT FORWARD LOSSES OF EARLIER YEARS
Income after set off, if any, of
Sl. Current year’s income
Head/Source of income current year’s losses as per 5 Brought forward loss set off
No. remaining after set off
of Schedule CYLA)
1 2 3
1 Salaries 0 0
2 House property 0 0 0
Short-term capital gain taxable @

3 0 0 0
15%
Short-term capital gain taxable @
4 0 0 0
30%
Short-term capital gain taxable at
5 0 0 0
applicable rates
Short-term capital gain taxable at
6 0 0 0
special rates in India as per DTAA
Long term capital gain taxable @
7 0 0 0
10%
Long term capital gain taxable @
8 0 0 0
20%
Long term capital gains taxable at
9 0 0 0
special rates in India as per DTAA
Net income from other sources
10 chargeable at normal applicable 2,41,983 2,41,983
rates
Profit from owning and maintaining
11 0 0 0
race horses
Total of brought forward loss set off (2ii + 2iii + 2iv + 2v+ 2vi + 2vii
12 0
+2viii+ 2ix + 2xi)
Current year's income remaining after set off Total of (3i + 3ii + 3iii + 3iv + 3v+ 3vi + 3vii + 3viii+ 3ix +
13 2,41,983
3x + 3xi)
SCHEDULE CFL DETAILS OF LOSSES TO BE CARRIED FORWARD TO FUTURE YEARS

Loss from owning
Sl. Short-term capital Long-term Capital
AssesmentYear Date of filling House property loss and maintaining
No. loss loss
race horses
1 2 3 4 5 6
i 2015-16 0 0 0
ii 2016-17 0 0 0
iii 2017-18 0 0 0
iv 2018-19 0 0 0
v 2019-20 0 0 0 0
vi 2020-21 0 0 0 0
vii 2021-22 0 0 0 0
viii 2022-23 0 0 0 0
Total of earlier year

ix 0 0 0 0
losses
Adjustment of above
x losses in Schedule 0 0 0 0
BFLA
2023-24(Current year
xi 0 0 0 0
losses)
Total loss carried
xii 0 0 0 0
forward to future years
SCHEDULE VI-A DEDUCTIONS UNDER CHAPTER VI-A
Amounts System Calculated
1 Part B - Deduction in respect of certain payments
80C - Life insurance premium, deferred annuity, contributions to provident 0

a 0
fund, subscription to certain equity shares or debentures, etc.
b 80CCC - Payment in respect Pension Fund 0 0
c 80CCD(1) - Contribution to pension scheme of Central Government 0 0
80CCD(1B)- Contribution to pension scheme of Central Government by the 0

d 0
Employee
80CCD(2) - Contribution to pension scheme of Central Government by the 0

e 0
Employer
f 80D-Deduction in respect of Health Insurance premia 0 0
80DD - Maintenance including

g medical treatment of a dependent 0 0
who is a person with disability
80DDB - Medical treatment of

h 0 0
specified disease
i 80E - Interest on loan taken for higher education 0 0
j 80EE - Interest on loan taken for residential house property 0 0
80EEA - Deduction in respect of interest on loan taken for certain house 0

k 0
property
l 80EEB - Deduction in respect of purchase of electric vehicle 0 0
80G - Donations to certain funds, charitable institutions, etc. (Please fill

m 0 0
80G Schedule. This field is auto-populated from schedule.)
n 80GG - Rent paid 0 0
80GGA - Certain donations for scientific research or rural development

o 0 0
(Please fill 80GGA Schedule. This field is auto-populated from schedule.)
p 80GGC - Donation to Political party 0 0
2 Part C, CA and D- Deduction in respect of certain incomes/other deduction
q 80QQB - Royalty income of authors of certain books. 0 0
r 80RRB - Royalty on patents 0 0
s 80TTA - Interest on saving bank Accounts 0 0
t 80TTB - Interest on deposits in case of senior citizens 0 0
80U - In case of a person with

u 0 0
disability.
ua Any other deduction - 80CCH 0 0
v Deduction (Total a to ua) 0 0
SCHEDULE 80G DETAILS OF DONATIONS ENTITLED FOR DEDUCTION UNDER SECTION 80G
A Donations entitled for 100% deduction without qualifying limit
City or Amount of donation Eligible

Sl. Name of State code PAN of the
Address Town or Pin code Amount of
No. the Donee & Name Donee Donation in Donation in Total
District Donation
cash other mode donation
1 2 3 4 5 6 7 8 9 10 11
Total 0 0 0 0
B Donations entitled for 50% deduction without qualifying limit

District Donation
1 2 3 4 5 6 7 8 9 10 11
Total 0 0 0 0
C Donations entitled for 100% deduction subject to qualifying limit

District Donation
1 2 3 4 5 6 7 8 9 10 11
Total 0 0 0 0
D Donations entitled for 50% deduction subject to qualifying limit
ARN Amount of donation

City or Eligible
Sl. Name of State code PAN of the (Donation
Address Town or Pin code Donation Amount of
No. the Donee & Name Donee Reference Donation Total
District in other Donation
Number) in cash donation
mode
1 2 3 4 5 6 7 8 9 10 11 12
Total 0 0 0 0
E Total Amount of Donations (Aix + Bix + Cix + Dix) 0 0 0 0
SCHEDULE 80GGA DETAILS OF DONATIONS FOR SCIENTIFIC RESEARCH OR RURAL DEVELOPMENT

Relevant
clause Amount of Donation
City Or Eligible
Sl. under Name of State Code PAN of
Address Town Or Pincode Donation Amount of
No. which Donee & Name Donee Donation Total
District in other donation
deduction in cash Donation
is claimed mode
1 2 3 4 5 6 7 8 9 10 11 12
Total Donations 0 0 0 0
SCHEDULE AMT - COMPUTATION OF ALTERNATE MINIMUM TAX PAYABLE UNDER SECTION 115JC
1 Total Income as per item 12 of PART-B-TI 1 2,45,547
2 Adjustment as per section 115JC(2)
Deduction claimed under any section included in Chapter VI-A under the
a 2a 0
heading "C.— Deductions in respect of certain incomes"
3 Adjusted Total Income under section 115JC(1) (1+2a) 3 2,45,547
4 Tax payable under section 115JC [18.5% of (3)] (if 3 is greater than Rs. 20 lakhs) 4 0
SCHEDULE AMTC - COMPUTATION OF TAX CREDIT UNDER SECTION 115JD
1 Tax under section 115JC in assessment year 2023-24 (1d of Part-B-TTI) 0
2 Tax under other provisions of the Act in assessment year 2023-24 (7 of Part-B-TTI) 742
Amount of tax against which credit is available [enter (2 – 1) if 2 is greater than 1,

3 742
otherwise enter 0]
Utilisation of AMT credit Available (Sum of AMT credit utilized during the current year is subject to maximum of amount mentioned
4
in 3 above and cannot exceed the sum of AMT Credit Brought Forward)
AMT Credit
AMT Credit
Balance AMT
Sl. Balance brought Utilised during the
Assessment Year Credit Carried
No. Set-off in earlier forward to the Current
Gross Forward
assessment years current Assessment Year
assessment year
(A) (B1) (B2) (B3) = (B1) – (B2) (C) (D)= (B3) - (C)
Current AY (enter 1 -
11 0 0
2, if 1>2 else enter 0
Total 0 0 0 0 0
Amount of tax credit under section 115JD utilised during the year [total of item No. 4
5 0
(C)]
Amount of AMT liability available for credit in subsequent assessment years [total of 4
6 0
(D)]
SCHEDULE SPI - INCOME OF SPECIFIED PERSONS (SPOUSE, MINOR CHILD ETC.) INCLUDABLE IN INCOME OF THE ASSESSEE AS PER
SECTION 64
Sl. PAN of person Aadhaar of person Head of Income in
Name of person Relationship Amount (Rs)
No. (optional) (optional) which included
1 2 3 4 5 6
SCHEDULE SI - INCOME CHARGEABLE TO TAX AT SPECIAL RATES (PLEASE SEE INSTRUCTIONS NO. 9 FOR RATE OF TAX) INCOME
CHARGEABLE TO TAX AT SPECIAL RATES
Sl.
Section/Description Special rate (%) Income (i) Tax thereon (ii)
No.
1 2 3 4 5
111 - Tax on accumulated balance

1 1.0 0 0
of recognised PF
111A STCG on shares units on
2 15.0 0 0
which STT paid
3 112 LTCG on Others 20.0 0 0
112 proviso - Long term capital

4 10.0 0 0
gains (without indexing)
112A-LTCG on equity shares/units
5 of equity oriented fund/units of 10.0 0 0
business trust on which STT is paid
112(1)(c)(iii)(Long term capital
gains on transfer of unlisted
6 10.0 0 0
securities in the case of non-
residents)
115BB (Winnings from lotteries,
crosswords puzzles, races
including horse races, card games
7 30.0 0 0
and other games of any sort or
gambling or betting of any form or
nature whatsoever)
115AD(1)(ii) -STCG (other than on
equity share or equity oriented
8 30.0 0 0
mutual fund referred to in section
111A) by an FII
115AD(1)(b)(ii) Proviso- Short term
9 capital gains referred to in section 15.0 0 0
111A
115A(1)(a)(i)- Dividends interest
10 and income from units purchase in 20.0 0 0
foreign currency
115A(1)(a)(ii)- Interest received
11 from govt/Indian Concerns recived 20.0 0 0
in Foreign Currency
115A(1) (a)(iia) -Interest from

12 5.0 0 0
Infrastructure Debt Fund
115A(1) (a)(iiaa) -Interest as per
13 5.0 0 0
Sec. 194LC(1)
115A(1) (a)(iiaa) -Interest as
14 referred in proviso to section 4.0 0 0
194LC(1)
115A(1) (a)(iiab) -Interest as per
15 5.0 0 0
Sec. 194LD
115A(1)(a)(iiac) -Interest as per
16 5.0 0 0
Sec. 194LBA
115A(1) (a)(iii) - Income received
17 in respect of units of UTI 20.0 0 0
purchased in Foreign Currency
115A(1)(b)(A) & 115A(1)(b)(B)-
18 Income from royalty & technical 10.0 0 0
services
115AC(1)(a) - Income by way of
19 interest on bonds purchased in 10.0 0 0
foreign currency - non-resident
115AC(1)(b) - Income by way of
20 Dividend on GDRs purchased in 10.0 0 0
115AC(1)(c) -LTCG arising from the
transfer of bonds or GDR
21 10.0 0 0
purchased in foreign currency -
non-resident
115ACA(1)(a) - Income from GDR
22 purchased in foreign currency - 10.0 0 0
resident
115ACA(1)(b) - LTCG arising from
23 the transfer of GDR purchased in 10.0 0 0
foreign currency -resident
115AD(1)(i) -Income (other than
Dividend) received by an FII in
24 20.0 3,564 713
respect of securities (other than
units as per Sec 115AB)
115AD(1)(i) Proviso -Income
received by an FII in respect of
25 5.0 0 0
bonds or government securities as
per Sec 194LD
115AD(1)(iii)-Long term capital
26 10.0 0 0
gains by an FII
27 Proviso to 115AD(iii) 10.0 0 0
115BBA - Tax on non-residents

28 20.0 0 0
sportsmen or sports associations
29 115BBC - Anonymous donations 30.0 0 0
115BBE - Tax on income referred

30 to in sections 68 or 69 or 69A or 60.0 0 0
69B or 69C or 69D
115BBF -Tax on income from
31 10.0 0 0
patent
115BBG -Tax on income from
32 10.0 0 0
transfer of carbon credits
33 115E(a) Investment income 20.0 0 0
115E(a)-LTCG on any asset other

34 than a specified asset-non resident 20.0 0 0
Indian
115E(b) - Income by way of long
35 10.0 0 0
term capital gains
STCGDTAARate - STCG Chargeable
36 at special rates in India as per 1.0 0 0
DTAA
LTCGDTAARate - LTCG Chargeable
37 at special rates in India as per 1.0 0 0
DTAA
OSDTAARate - Other source
38 income chargeable under DTAA 1.0 0 0
rates
Pass Through Income in the nature

of Short Term Capital Gain
39 15.0 0 0
chargeable @ 15% Under Section
111A
40 of Short Term Capital Gain 30.0 0 0
chargeable @ 30%
41 of Long Term Capital Gain 10.0 0 0
chargeable @ 10%
chargeable @ 10% u/s 112A
chargeable @ 20%
PTI-115A(1)(a)(i)- Dividends
44 interest and income from units 20.0 0 0
purchase in foreign currency
PTI-115A(1)(a)(ii)- Interest
received from govt/Indian
45 20.0 0 0
Concerns received in Foreign
Currency
PTI-115A(1) (a)(iia) -Interest from
46 5.0 0 0
Infrastructure Debt Fund
PTI-115A(1) (a)(iiaa) -Interest as
47 5.0 0 0
per Sec. 194LC(1)
PTI-115A(1)(a)(iiaa) -Income
received by non-resident as
48 4.0 0 0
referred in proviso to section
194LC(1)
PTI-115A(1) (a)(iiab) -Interest as
49 5.0 0 0
per Sec. 194LD
PTI-115A(1) (a)(iiac) -Interest as
50 5.0 0 0
per Sec. 194LBA
PTI-115A(1) (a)(iii) -Income
51 received in respect of units of UTI 20.0 0 0
purchased in foreign currency
PTI-115A(1)(b)(A) & PTI-115A(1)(b)
52 (B)- Income from royalty & 10.0 0 0
technical services
PTI-115AC(1)(a) - Income by way
53 of interest on bonds purchased in 10.0 0 0
PTI-115AC(1)(b) - Income by way
54 of Dividend on GDRs purchased in 10.0 0 0
PTI-115ACA(1)(a) - Income from
55 GDR purchased in foreign currency 10.0 0 0
- resident
PTI-115AD(1)(i) - Income (being
dividend) received by an FII in
56 20.0 0 0
units referred to in section 115AB)
115AD(1)(i) - Income (being
dividend) received by an FII in
57 20.0 0 0
units referred to in section 115AB)
PTI-115AD(1)(i) -Income(other than
Dividend) received by an FII in
58 20.0 0 0
units as per Sec 115AB)
PTI-115AD(1)(i) -Income received
by an FII in respect of bonds or
59 5.0 0 0
government securities as per Sec
194LD
PTI-115BBA - Tax on non-residents
60 20.0 0 0
sportsmen or sports associations
PTI-115BBF - Tax on income from
61 10.0 0 0
patent
PTI-115BBG - Tax on income from
62 10.0 0 0
transfer of carbon credits
63 PTI-115E(a) - Investment income 20.0 0 0
64 115BBH - VDA 30.0 0 0
Total 3,564 713
TotSplRateInc
3,564
TotSplRateIncTax
713
SCHEDULE EI - DETAILS OF EXEMPT INCOME (INCOME NOT TO BE INCLUDED IN TOTAL INCOME OR NOT CHARGEABLE TO TAX)
1 Interest Income 1 0
Gross Agricultural receipts (other than income to be excluded

2 i i 0
under rule 7A, 7B or 8 of I.T. Rules)
ii Expenditure incurred on agriculture ii 0
iii Unabsorbed agricultural loss of previous eight assessment years iii 0
iv Net Agricultural income for the year (i – ii – iii) (enter nil if loss) 2 0
In case the net agricultural income for the year exceeds Rs.5 lakh, please furnish the
v
following details (Fill up details separately for each agricultural land)
Wherther the
Measurement of Wherther the
Sl. agricultural land is
Name of District Pin code agricultural land in agricultural land is
No. owned or held on
Acre irrigated or rain fed
lease
1 2 3 4 5 6
3 Other exempt income (including exempt income of minor child) 3 0
Sl.
Nature Of Income Description Amount
No.
1 2 3 4
4 Income not chargeable to tax as per DTAA
Sl. Country code & Whether TRC

Amount Of Income Nature Of Income Article of DTAA Head of Income
No. Name obtained (Y/N)
1 2 3 4 5 6 7
Total Income from DTAA not chargeable to tax 4 0
5 Pass through income not chargeable to tax (Schedule PTI) 5 0
6 Total (1+2+3+4+5) 6 0
SCHEDULE PTI - PASS THROUGH INCOME DETAILS FROM BUSINESS TRUST OR INVENTMENT FUND AS PER SECTION 115UA, 115UB
Share the
Investment Name of current year
PAN of the
entity business loss Net TDS on such
Sl. business Sl. Current Year
covered by trust/ Head of Income distributed income/Loss( amount, If
No. trust/investm No. income
section investment by 7-8) any
ent fund
115UA/115UB fund investment
fund
(1) (2) (3) (4) (5) (6) (7) (8) (9) (10)
SCHEDULE FSI - DETAILS OF INCOME FROM OUTSIDE INDIA AND TAX RELIEF (AVAILABLE IN CASE OF RESIDENT)
Tax payable Tax relief
Relevant
Income from on such available in
Taxpayer article of
Sl. Sl. Head of outside Tax paid income under India(e) = ( c )
Country Code Identification DTAA if relief
No. No. Income India(included outside india normal or (d)
Number claimed u/s 90
in Part B-Ti) provision in whichever is
or 90A
India lower
(a) (b) (c) (d) (e) (f)
SCHEDULE TR - SUMMARY OF TAX RELIEF CLAIMED FOR TAXES PAID OUTSIDE INDIA (AVAILABLE ONLY IN CASE OF RESIDENT)
1 Summary of Tax relief claimed
Total taxes paid outside Total tax relief available

Tax Relief Claimed
Sl. Taxpayer Identification India (total of (c) of (total of (e) of Schedule
Country Code under section (specify
No. Number Schedule FSI in respect FSI in respect of each
90, 90A or 91)
of each country) country)
1 2 3 4 5 6
Total 0 0
Total Tax relief available in respect of country where DTAA is applicable (section
2 2 0
90/90A) (Part of total of 1(d))
Total Tax relief available in respect of country where DTAA is not applicable (section
3 3 0
91) (Part of total of 1(d))
Whether any tax paid outside India, on which tax relief was allowed in India, has been
4 refunded/credited by the foreign tax authority during the year? If yes, provide the 4
details below
a Amount of tax refunded 0
b Assessment year in which tax relief allowed in India
SCHEDULE FA - DETAILS OF FOREIGN ASSETS AND INCOME FROM ANY SOURCE OUTSIDE INDIA
Details of Foreign Depository Accounts held (including any beneficial interest) at any time during the calendar year ending as on 31st
A1
December, 2022
Gross
interest
Peak
Country Name of Address of Account paid/credite
Sl. Account balance Closing
Name and financial financial Zip Code Status opening d to the
No. number during the balance
Code institution institution date account
period
during the
period
1 2 3 4 5 6 7 8 9 10 11
Details of Foreign Custodial Accounts held (including any beneficial interest) at any time during the calendar year ending as on 31st
A2
December, 2022
Gross
interest
paid/credit
ed to the
account
during the
period
(drop
down to
be
provided
Peak specifying
Country Name of Address of Account
Sl. Nature of Account balance Closing nature of
Name and financial financial ZIP code Status opening
No. Amount number during the balance amount
Code institution institution date
period viz.
interest/di
vidend
/proceeds
from sale
or
redemptio
n of
financial
assets/
other
income)
1 2 3 4 5 6 7 8 9 10 11 12
Details of Foreign Equity and Debt Interest held (including any beneficial interest) in any entity at any time during the calendar year ending as
A3
on 31st December, 2022
Total Total
gross gross
amount proceeds
Initial Peak value
Date of paid/credit from sale
Country value of of
Sl. Name of Address of Nature of acquiring Closing ed with or
Name and Zip code the investmen
No. entity entity entity the balance respect to redemptio
Code investmen t during
interest the n of
t the period
holding investmen
during the t during
period the period
1 2 3 4 5 6 7 8 9 10 11 12
Details of Foreign Cash Value Insurance Contract or Annuity Contract held (including any beneficial interest) at any time during the calendar
A4
year ending as on 31st December, 2022
Total gross
amount
Name of financial
Address of The cash value or paid/credited
Sl. Country Name institution in
financial Zip code Date of contract surrender value with respect to
No. and Code which insurance
institution of the contract the contract
contract held
during the
period
1 2 3 4 5 6 7 8
Details of Financial Interest in any Entity held (including any beneficial interest) at any time during the calendar year ending as on 31st
B
December, 2022
Nature
Income taxable and offered
of
Total Income in this return
Country Interest-
Name of Address Date Investme accrued Nature
Sl. Name Nature Direct
Zip code the of the since nt (at from of Item
No. and of entity /Benefici Schedule
Entity Entity held cost) (in such Income number
Code alowner Amount where
rupees) Interest of
/Benefici offered
schedule
ary
1 2 3 4 5 6 7 8 9 10 11 12 13 14
C Details of Immovable Property held (including any beneficial interest) at any time during the calendar year ending as on 31st December, 2022
Ownership Income taxable and offered in

-Direct/ Total Income this return
Country Address of
Sl. Beneficial Date of Investmen derived Nature of
Name and Zip code the Schedule Item
No. owner/ acquisition t (at cost) from the Income
Code Property Amount where number of
Beneficiar (in rupees) property
y offered schedule
1 2 3 4 5 6 7 8 9 10 11 12
Details of any other Capital Asset held (including any beneficial interest) at any time during the calendar year ending as on 31st December,
D
2022
Ownership Income taxable and offered in
-Direct/ Total Income this return
Country
Sl. Nature of Beneficial Date of Investmen derived Nature of
Name and Zip code Schedule Item
No. Asset owner/ acquisition t (at cost) from the Income
Code Amount where number of
Beneficiar (in rupees) asset
y offered schedule
1 2 3 4 5 6 7 8 9 10 11 12
Details of account(s) in which you have signing authority held (including any beneficial interest) at any time during the calendar year ending
E
as on 31st December, 2022 and which has not been included in A to D above.
Name of Peak If (7) is yes, Income offered in
Whether If (7) is
the Balance/ this return
Address Name of income yes,
Institutio Country Investme
Sl. of the the Account accrued Income Item
n in Name Zip code nt during Schedule
No. Institutio account Number is taxable accrued number
which the and Code the year Amount where
n holder in your in the of
account (in offered
hands? account schedule
is held rupees)
1 2 3 4 5 6 7 8 9 10 11 12 13
F Details of trusts, created under the laws of a country outside India, in which you are a trustee, beneficiary or settlor
Wheth
If (8) is yes, Income
er If (8) is
offered in this return
Countr income yes,
Addres Name Addres Name Addres Date
y Name Name Addres derive Income Schedu Item
Sl. Zip s of of s of of s of since
Name of the of s of d is derive le numbe
No. code the trustee trustee Benefic Benefic positio
and trust Settlor Settlor taxabl d from Amoun where r of
trust s s iaries iaries n held
Code e in the t
offere schedu
your trust d le
hands?
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17
Details of any other income derived from any source outside India which is not included in,- (i) items A to F above and, (ii) income under the
G
head business or profession
If (6) is yes, Income offered in this
Name of Address of Whether return
Country
Sl. the person the person Income Nature of taxable in
Name and Zip code Schedule Item
No. from whom from whom derived income your
Code Amount where number of
derived derived hands?
offered schedule
1 2 3 4 5 6 7 8 9 10 11
SCHEDULE 5A - INFORMATION REGARDING APPORTIONMENT OF INCOME BETWEEN SPOUSES GOVERNED BY PORTUGUESE CIVIL CODE
Name of the spouse
PAN / Aadhaar of the spouse
Sl. Receipts received under Amount apportioned in Amount of TDS deducted TDS apportioned in the
No. Heads of Income the head the hands of the spouse on income at (ii) hands of spouse
(i) (ii) (iii) (iv) (v)
1 House Property 0 0 0 0
2 Capital gains 0 0 0 0
3 Other sources 0 0 0 0
4 Total 0 0 0 0
SCHEDULE AL ASSETS AND LIABILITIES AT THE END OF THE YEAR (APPLICABLE IN A CASE WHERE TOTAL INCOME EXCEEDS RS.50
LAKH)
A Details of immovable assets
AddressAL
Amount
Sl. Descriptio Name of
Road/ Town/ (cost) in
No. n Flat/ Door/ Premises / Area/
Street/Pos City/ State Country Pin Code Zip Code Rs.
Block No Building / Locality
t Office District
Village
1 2 3 4 5 6 7 8 9 10 11 12
B Details of Movable Asset
SI Description Amount
i Jewellery, bullion etc. 0
ii Archaeological collections, drawings, painting, sculpture or any work of art 0
iii Vehicles, yachts, boats and aircrafts 0
(iv) Financial assets Amount(cost) in Rs.
(a) Bank (including all deposits) 0
(b) Shares and securities 0
(c) Insurance policies 0
(d) Loans and advances given 0
(e) Cash in hand 0
C Liability in relation to Assets at (A+B) 0
INFORMATION RELATED TO TAX DEFERRED - RELATABLE TO INCOME ON PERQUISITES REFERRED IN SECTION

SCHEDULE ESOP
17(2) (VI) RECEIVED FROM EMPLOYER, BEING AN ELIGIBLE START - UP REFERRED TO IN SECTION 80-IAC
Has any of the following events occurred during the previous year
relevant to current assessment year
Forty-eight
Such specified security or months have
sweat equity shares were expired from
Ceased to be the employee the end of Balance
sold
of the employer who the relevant amount of tax
Amount of allotted or transferred assessment Amount of deferred to
Tax deferred such specified security or year in which tax payable be carried
Assesement
Sl.No. brought sweat equity share? specified in the current forward to
Year
forward from security or Assessment the next
earlier AY (ii) Total Year Assessment
sweat equity
Amount of years Col (3-
shares
(i) Option Tax 9)
referred to
Selected Attributed
in the said
out of the
(i) Option (ii) Date of *clause were
sale
Selected Ceasing allotted. If
yes, specify
date
(1) (2) (3) (4) (5) (6) (7) (8) (9) (10)
1. 2021-22 0 0 0 0
2. 2022-23 0 0 0 0
3. 2023-24 0
4 Total Amount of Tax Attributed 0
PART B – TI COMPUTATION OF TOTAL INCOME
1 Salaries (6 of Schedule S) 1 0
2 Income from house property (4of Schedule-HP) (Enter nil if loss) 2 0
3 Capital Gains 3
a ShortTerm
i Short term chargeable @15% (9ii of item E of Sch CG) ai 0
ii Short term chargeable @30% (9iii of item E of Sch CG) aii 0
iii Short term chargeable at applicable rate (9iv of item E of Sch CG) aiii 0
Short-term chargeable at special rates in India as per DTAA (9v of item E

iv aiv 0
of Schedule CG)
v Total Short term (ai+aii+aiii+aiv) (enter nil if loss) av 0
b LongTerm
i Long term chargeable @10% (9vi of item E of Sch CG) bi 0
ii Long term chargeable @20% (9vii of item E of Sch CG bii 0
Long-term chargeable at special rates in India as per DTAA (9viii of item E

iii biii 0
of schedule CG)
iv Total Long-term (bi + bii + biii) (enter nil if loss) biv 0
c Sum of Short-term / Long-term Capital Gains (3av + 3biv) (enter nil if loss) 3c 0
d Capital gains chargeable @ 30 % u/s 115BBH (C2 of Schedule CG) 3d 0
e Total Capital Gains (3c+3d) 3e 0
4 Income from other sources 4
Net Income from Other sources chargeable to tax at Normal Applicable rates (6 of
a 4a 2,41,983
Schedule OS) (enter nil if loss)
b Income chargeable to tax at special rates(2 of Schedule OS) 4b 3,564
Income from the activity of owning & maintaining race horses (8e of Schedule OS)
c 4c 0
(enter nil if loss)
d Total (4a + 4b + 4c)(enter nil if loss) 4d 2,45,547
5 Total of head wise income (1 + 2 + 3e + 4d) 5 2,45,547
6 Losses of current year set off against 5 6 0
7 Balance after set off current year losses (5-6) 7 2,45,547
8 Brought forward losses set off against 7 8 0
9 Gross Total income (7-8) 9 2,45,547
Income chargeable to tax at special rate under section 111A, 112,, 112A etc. included
10 10 3,564
in 9
11 Deductions under Chapter VI-A 11 0
12 Total income (9 - 11) 12 2,45,547
Income which is included in 12 and chargeable to tax at special rates (total of (i) of
13 13 3,564
schedule SI)
14 Net agricultural income/ any other income for rate purpose (2 of Schedule EI) 14 0
Aggregate income (12-13+14) [applicable if (12-13) exceeds maximum amount not

15 15 2,41,983
chargeable to tax]
16 Losses of current year to be carried forward (total of row xi of Schedule CFL) 16 0
17 Deemed income under section 115JC (3 of schedule AMT) 17 2,45,547
PARTB-TTI - COMPUTATION OF TAX LIABILITY ON TOTAL INCOME
Tax payable on deemed total income under section 115JC (4 of

1 a 1a 0
Schedule AMT)
b Surcharge on (a) (if applicable) 1b 0
c Health and Education Cess @ 4% on (1a+1b) above 1c 0
d Total Tax Payable on deemed total income (1a+1b+1c) 1d 0
2 Tax payable on total income
a Tax at normal rates on 15 of Part B-TI 2a 0
b Tax at special rates (total of (ii) of Schedule-SI) 2b 713
Rebate on agricultural income [applicable if (12-13) of Part B-TI

c 2c 0
exceeds maximum amount not chargeable to tax]
d Tax Payable on Total Income (2a + 2b -2c) 2d 713
3 Rebate under section 87A 2d 0
4 Tax Payable after rebate (2d-3) 3 713
5 Surcharge
Surcharge Computed before marginal relief
i (25% of 27(iv)) of Schedule SI 5ii 0
10% or 15% as applicable / On [(4) – ( 15(ii) of schedule SI- tax

ii 5ii 0
on income referred to in 5(ii) above)]
Surcharge after marginal relief
ia (25% of 27(iv)) of Schedule SI 5ia 0
iia 10% or 15% as applicable 5iia 0
iii Total (ia + iia) 5iii 0
6 Health and Education cess @ 4% on (4 + 5iv ) 6 29
7 Gross tax liability (4 + 5iv + 6) 7 742
8 Gross tax payable (higher of 1d and 7)(8a + 8b) 8 742
Tax on income without including income on perquisites referred

a in section 17(2)(vi) received from employer, being an eligible 8a 742
start-up referred to in section 80-IAC ( Schedule Salary)
Tax deferred - relatable to income on perquisites referred in
b section 17(2)(vi) received from employer, being an eligible start- 8b 0
up referred to in section 80-IAC
Tax deferred from earlier years but payable during current AY (
c 8c 0
total of col 7 of schedule Tax deferred on ESOP
Credit under Section 115JD of tax paid in earlier years (applicable if 7 is more than 1d)(5 of Schedule
9 9 0
AMTC)
10 Tax payable after credit under section 115JD (8a+8c-9) 10 742
11 TaxRelief
Section 89 (Please ensure to submit Form 10E to claim this

a 11a 0
relief)
b Section 90/90A (2 of Schedule TR) 11b 0
c Section 91 (3 of Schedule TR) 11c 0
d Total (11a + 11b+ 11c) 11d 0
12 Net tax liability (10-11de) (enter zero if negative) 12 742
13 Interest and fee payable 13
a Interest for default in furnishing the return (section 234A) 13a 0
b Interest for default in payment of advance tax (section 234B) 13b 0
c Interest for deferment of advance tax (section 234C) 13c 0
d Fee for default in furnishing return of income (section 234F) 13d 0
e Total Interest and Fee Payable (13a+13b+13c+13d) 13e 0
14 Aggregate liability (12+13e) 14 742
15 TaxPaid
a Advance Tax (from column 5 of 20A) 15a 0
b TDS (total of column 5 of 20B and column 9 of 20C) 15b 51,107
c TCS (total of column 7(i) of 20D) 15cc 0
d Self Assessment Tax (from column 5 of 20A) 15d 0
e Total Taxes Paid (15a+15b+15c+15d) 15e 51,107
16 Amount payable (Enter if 14 is greater than 15e, else enter 0) 16 0
17 Refund (If 15e is greater than 14) (Refund, if any, will be directly credited into the bank account) 17 50,370
Do you have a bank account in India (Non-residents claiming refund with no bank account in India
18 Y
may select NO)
a Details of all bank accounts held in india at any time during the previous year(excluding dormant accounts)
IFSC Code of the bank in Indicate the account in

Sl.
case bank account held in Name of the Bank Account Number which you prefer to get
No.
India your refund credited
1 2 3 4 5
1 KKBK0000424 KOTAK MAHINDRA BANK 1411231410
2 KKBK0000424 KOTAK MAHINDRA BANK 1411231427
Note:
1. Minimum one account should be selected for refund credit.
2. In case of Refund, multiple acccounts are selected for refund credit, then refund will be credited to
one of the account decided by CPC after processing the return.
Rows can be added as required
b) Non- residents, who are claiming income-tax refund and not having bank account in India may, at their option, furnish the
ii
details of one foreign bank account:
Sl.
SWIFT Code Name of the Bank Country / Region of Location IBAN
No.
1 2 3 4 5
Do you at any time during the previous year,-

(i) hold, as beneficial owner, beneficiary or otherwise, any asset (including financial interest in any
entity) located outside India; or
19 NO
(ii) have signing authority in any account located outside India; or
(iii) have income from any source outside India?
[applicable only in case of a resident] [Ensure Schedule FA is filled up if the answer is Yes ]
TAX PAYMENTS
A DETAILS OF PAYMENTS OF ADVANCE TAX AND SELF ASSESSMENT TAX
Sl.
BSR Code Date of Deposit (DD/MM/YYYY) Serial Number of Challan Amount (RS)
No.
1 2 3 4 5
Total 0
SCHEDULE TDS1 - DETAILS OF TAX DEDUCTED AT SOURCE FROM SALARY AS PER FORM 16 ISSUED BY EMPLOYER(S)]
Sl. Tax Deduction Account Income chargeable under
Name of the Employer Total tax deducted
No. Number (TAN) of the Employer Salary
1 2 3 4 5
Total 0
DETAILS OF TAX DEDUCTED AT SOURCE (TDS) ON INCOME [AS PER FORM 16A ISSUED OR FORM 16B/ 16C/16E FURNISHED BY
DEDUCTOR(S)]
TDS
TDS of the current
credit TDS credit being claimed this Year
Unclaimed Financial Year (TDS
relatin (only if corresponding income is
TDS brought deducted during FY Correspondin
g to being offered for tax this year. Not
Aadha forward (b/f) 2022-23) g Receipt
self PAN of TAN of applicable if TDS is deducted u/s
ar of /withdrawals
/other Other the 194N)
Other Deducted in offered TDS
person Person Deduc
Person credit
[spous (if TDS tor/PA the hands of
(if TDS spouse as per being
Sl. e as credit N/Aad
credit section 5A or Claimed in the hands of carrie
No. per relate haar Fin. Deduc
relate any other spouse as per section 5A or d
sectio d to of Year ted in
d to person as per Claime any other person as per rule forwar
n 5A other Tenan in TDS own
other rule 37BA(2) d in 37BA(2) (if applicable) Head d
/other person t/Buye which b/f hands Gross
person (if applicable) own Of
person ) r deduct Amou
) hands Incom
as per ed nt
Incom Aadha e
rule Incom TDS PAN
37BA( TDS e ar
e
2)]
(10) (10)
(1) (2) (3)(a) (3)(b) (4) (5) (6) (7) (8)(a) (8)(b) (9) (10)(a) (10)(c) (11) (12) (13)
(b) (d)
Income
from
MUMG0
1 Self 0 18 0 0 18 0 0 85 Other 0
0234D
Source
s
Income
from
DELP37
2 Self 0 100 0 0 100 0 0 480 Other 0
047D
Source
s
Income
from
MUMG0
3 Self 0 298 0 0 298 0 0 1,429 Other 0
9195E
Source
s
Income
from
BLRC19
4 Self 0 176 0 0 176 0 0 845 Other 0
652D
Source
s
Income
from
MUMK1
5 Self 0 104 0 0 104 0 0 500 Other 0
1971B
Source
s
Income
from
MUMH2
6 Self 0 425 0 0 425 0 0 2,040 Other 0
0429D
Source
s
Income
from
MUMT0
7 Self 0 25 0 0 25 0 0 120 Other 0
0188G
Source
s
Income
from
MUMH0
8 Self 0 193 0 0 193 0 0 924 Other 0
4900A
Source
s
Income
from
MUMS9
9 Self 0 901 0 0 901 0 0 4,331 Other 0
9307F
Source
s
Income
from
MUMT0
10 Self 0 425 0 0 425 0 0 2,040 Other 0
0249E
Source
s
Income
from
MUMB2
11 Self 0 822 0 0 822 0 0 3,947 Other 0
2923F
Source
s
Income
from
MUMK3
12 Self 0 8 0 0 8 0 0 37 Other 0
2143G
Source
s
Income
from
MUMM
13 Self 0 596 0 0 596 0 0 2,864 Other 0
18898F
Source
s
Income
from
MUMT2
14 Self 0 302 0 0 302 0 0 1,449 Other 0
4689A
Source
s
Income
from
BLRA30
15 Self 0 15 0 0 15 0 0 69 Other 0
632A
Source
s
Income
from
PNEB1
16 Self 0 113 0 0 113 0 0 540 Other 0
5964E
Source
s
Income
from
PNED0
17 Self 0 655 0 0 655 0 0 3,150 Other 0
0993G
Source
s
Income
from
AHMA2
18 Self 0 3 0 0 3 0 0 12 Other 0
5338F
Source
s
Income
from
MUMH0
19 Self 0 18 0 0 18 0 0 85 Other 0
5080F
Source
s
Income
from
PNEB0
20 Self 0 2 0 0 2 0 0 8 Other 0
5806D
Source
s
Income
from
MUMI1
21 Self 0 240 0 0 240 0 0 1,150 Other 0
6212A
Source
s
Income
from
DELI03
22 Self 0 18 0 0 18 0 0 84 Other 0
105E Source
s
Income
from
AHMA2
23 Self 0 8 0 0 8 0 0 38 Other 0
5485F
Source
s
Income
from
PNER3
24 Self 0 75 0 0 75 0 0 360 Other 0
0150B
Source
s
Income
from
MUMD1
25 Self 0 26 0 0 26 0 0 125 Other 0
0213A
Source
s
Income
from
CHET0
26 Self 0 119 0 0 119 0 0 570 Other 0
8980G
Source
s
Income
from
AHMA2
27 Self 0 84 0 0 84 0 0 400 Other 0
5598G
Source
s
Income
from
AHMG0
28 Self 0 21 0 0 21 0 0 100 Other 0
5349B
Source
s
Income
from
MUMU0
29 Self 0 143 0 0 143 0 0 684 Other 0
3782C
Source
s
Income
from
JPRL01
30 Self 0 8 0 0 8 0 0 39 Other 0
384F
Source
s
Income
from
MUMA6
31 Self 0 44 0 0 44 0 0 210 Other 0
7455D
Source
s
Income
from
MUML1
32 Self 0 36 0 0 36 0 0 173 Other 0
3465E
Source
s
Income
from
DELE00
33 Self 0 15 0 0 15 0 0 70 Other 0
063A
Source
s
Income
from
MUMI0
34 Self 0 243 0 0 243 0 0 1,165 Other 0
6277F
Source
s
Income
from
MUMR0
35 Self 0 200 0 0 200 0 0 960 Other 0
0462A
Source
s
Income
from
BLRS02
36 Self 0 13 0 0 13 0 0 60 Other 0
580E
Source
s
Income
from
MUMI0
37 Self 0 17 0 0 17 0 0 77 Other 0
3877G Source
s
Income
from
MUMG0
38 Self 0 325 0 0 325 0 0 1,563 Other 0
0425F
Source
s
Income
from
MUMC2
39 Self 0 26 0 0 26 0 0 125 Other 0
7531A
Source
s
Income
from
MUML0
40 Self 0 46 0 0 46 0 0 220 Other 0
4496C
Source
s
Income
from
RTKT03
41 Self 0 71 0 0 71 0 0 340 Other 0
153D
Source
s
Income
from
MRTT0
42 Self 0 52 0 0 52 0 0 250 Other 0
1175G
Source
s
Income
from
RTKB03
43 Self 0 44 0 0 44 0 0 210 Other 0
826E
Source
s
Income
from
CALJ02
44 Self 0 182 0 0 182 0 0 875 Other 0
250D
Source
s
Income
from
CHET0
45 Self 0 10 0 0 10 0 0 47 Other 0
0142C
Source
s
Income
from
MRTJ00
46 Self 0 52 0 0 52 0 0 250 Other 0
275C
Source
s
Income
from
PNET00
47 Self 0 19 0 0 19 0 0 90 Other 0
043B
Source
s
Income
from
MUMG0
48 Self 0 88 0 0 88 0 0 420 Other 0
5740A
Source
s
Income
from
BPLR03
49 Self 0 174 0 0 174 0 0 835 Other 0
207B
Source
s
Income
from
HYDD0
50 Self 0 94 0 0 94 0 0 450 Other 0
0080D
Source
s
Income
from
CHNT0
51 Self 0 457 0 0 457 0 0 2,196 Other 0
0969D
Source
s
Income
from
MUMZ0
52 Self 0 234 0 0 234 0 0 1,125 Other 0
0074E Source
s
Income
from
HYDK0
53 Self 0 8 0 0 8 0 0 36 Other 0
0762G
Source
s
Income
from
MUMC0
54 Self 0 42 0 0 42 0 0 200 Other 0
0352C
Source
s
Income
from
CALT02
55 Self 0 150 0 0 150 0 0 720 Other 0
810D
Source
s
Income
from
MUMM
56 Self 0 611 0 0 611 0 0 2,934 Other 0
20584E
Source
s
Income
from
MUMC0
57 Self 0 700 0 0 700 0 0 3,360 Other 0
3626A
Source
s
Income
from
PNEB1
58 Self 0 373 0 0 373 0 0 1,560 Other 0
6470G
Source
s
Income
from
PNEP31
59 Self 0 43 0 0 43 0 0 206 Other 0
189E
Source
s
Income
from
MUMJ0
60 Self 0 379 0 0 379 0 0 1,822 Other 0
5285A
Source
s
Income
from
DELM0
61 Self 0 312 0 0 312 0 0 1,500 Other 0
0046E
Source
s
Income
from
MUMI0
62 Self 0 337 0 0 337 0 0 1,620 Other 0
5060G
Source
s
Income
from
PNEA0
63 Self 0 31 0 0 31 0 0 145 Other 0
5159A
Source
s
Income
from
MUMN0
64 Self 0 83 0 0 83 0 0 400 Other 0
0837E
Source
s
Income
from
CMBL0
65 Self 0 100 0 0 100 0 0 480 Other 0
3078F
Source
s
Income
from
MUMT0
66 Self 0 27 0 0 27 0 0 129 Other 0
9972E
Source
s
Income
from
JDHH00
67 Self 0 10 0 0 10 0 0 45 Other 0
659B Source
s
Income
from
MUML0
68 Self 0 742 0 0 742 0 0 3,564 Other 0
0051C
Source
s
Income
from
BPLD02
69 Self 0 4 0 0 4 0 0 19 Other 0
761D
Source
s
Income
from
DELN0
70 Self 0 140 0 0 140 0 0 675 Other 0
2125E
Source
s
Income
from
MUMF0
71 Self 0 325 0 0 325 0 0 1,560 Other 0
1185C
Source
s
Income
from
BLRY00
72 Self 0 7 0 0 7 0 0 34 Other 0
006G
Source
s
Income
from
HYDN0
73 Self 0 146 0 0 146 0 0 700 Other 0
0212C
Source
s
Income
from
CALL00
74 Self 0 172 0 0 172 0 0 826 Other 0
050B
Source
s
Income
from
BRDG0
75 Self 0 402 0 0 402 0 0 1,930 Other 0
0596B
Source
s
Income
from
PNEK01
76 Self 0 99 0 0 99 0 0 473 Other 0
954B
Source
s
Income
from
DELD0
77 Self 0 150 0 0 150 0 0 718 Other 0
1285E
Source
s
Income
from
MUMH0
78 Self 0 151 0 0 151 0 0 720 Other 0
7226C
Source
s
Income
from
MUMA0
79 Self 0 78 0 0 78 0 0 374 Other 0
0665A
Source
s
Income
from
CHES0
80 Self 0 99 0 0 99 0 0 473 Other 0
0555C
Source
s
Income
from
DELI04
81 Self 0 1,362 0 0 1,362 0 0 6,542 Other 0
124B
Source
s
Income
from
DELI04
82 Self 0 103 0 0 103 0 0 495 Other 0
379E Source
s
Income
from
MUMC0
83 Self 0 339 0 0 339 0 0 1,415 Other 0
4370C
Source
s
Income
from
AHMG0
84 Self 0 30 0 0 30 0 0 138 Other 0
1348E
Source
s
Income
from
MUMI0
85 Self 0 110 0 0 110 0 0 523 Other 0
3974F
Source
s
Income
from
AGRP1
86 Self 0 17 0 0 17 0 0 78 Other 0
0035E
Source
s
Income
from
MUML0
87 Self 0 312 0 0 312 0 0 1,500 Other 0
8914D
Source
s
Income
from
BLRI01
88 Self 0 981 0 0 981 0 0 4,713 Other 0
423C
Source
s
Income
from
CHEE0
89 Self 0 35 0 0 35 0 0 165 Other 0
3392E
Source
s
Income
from
DELJ03
90 Self 0 48 0 0 48 0 0 230 Other 0
437A
Source
s
Income
from
MUMM
91 Self 0 200 0 0 200 0 0 960 Other 0
15369E
Source
s
Income
from
DELO0
92 Self 0 1,210 0 0 1,210 0 0 5,810 Other 0
7879E
Source
s
Income
from
MUMV1
93 Self 0 191 0 0 191 0 0 914 Other 0
0117C
Source
s
Income
from
PNEK21
94 Self 0 500 0 0 500 0 0 2,400 Other 0
069G
Source
s
Income
from
RTKM0
95 Self 0 108 0 0 108 0 0 519 Other 0
2382C
Source
s
Income
from
MUMH0
96 Self 0 794 0 0 794 0 0 3,420 Other 0
3189E
Source
s
Income
from
MUMG1
97 Self 0 148 0 0 148 0 0 710 Other 0
2311F
Source
s
Income
from
DELO0
98 Self 0 184 0 0 184 0 0 882 Other 0
4946E
Source
s
Income
from
CALI01
99 Self 0 510 0 0 510 0 0 2,450 Other 0
639B
Source
s
Income
from
RTKE03
100 Self 0 125 0 0 125 0 0 600 Other 0
121G
Source
s
Income
from
KLPT01
101 Self 0 7,230 0 0 7,230 0 0 23,170 Other 0
797F
Source
s
Income
from
PNEG2
102 Self 0 1,089 0 0 1,089 0 0 5,229 Other 0
2843C
Source
s
Income
from
DELR38
103 Self 0 1,068 0 0 1,068 0 0 5,132 Other 0
715F
Source
s
Income
from
CALE01
104 Self 0 216 0 0 216 0 0 1,040 Other 0
693G
Source
s
Income
from
MUMT1
105 Self 0 1,791 0 0 1,791 0 0 5,739 Other 0
8975F
Source
s
Income
from
MUMS2
106 Self 0 24 0 0 24 0 0 113 Other 0
7599F
Source
s
Income
from
BLRW0
107 Self 0 295 0 0 295 0 0 1,415 Other 0
0126A
Source
s
Income
from
DELU0
108 Self 0 471 0 0 471 0 0 2,265 Other 0
5703F
Source
s
Income
from
BLRG0
109 Self 0 487 0 0 487 0 0 2,340 Other 0
0784A
Source
s
Income
from
MUMC0
110 Self 0 916 0 0 916 0 0 4,400 Other 0
4736E
Source
s
Income
from
JDHH00
111 Self 0 2,009 0 0 2,009 0 0 9,653 Other 0
716C
Source
s
Income
from
DELH0
112 Self 0 1,208 0 0 1,208 0 0 5,800 Other 0
0028A Source
s
Income
from
PNEC0
113 Self 0 305 0 0 305 0 0 1,463 Other 0
0013G
Source
s
Income
from
CALB05
114 Self 0 44 0 0 44 0 0 213 Other 0
144G
Source
s
Income
from
DELH0
115 Self 0 485 0 0 485 0 0 2,330 Other 0
1586E
Source
s
Income
from
DELS13
116 Self 0 37 0 0 37 0 0 175 Other 0
196B
Source
s
Income
from
MUMI0
117 Self 0 302 0 0 302 0 0 1,450 Other 0
5171F
Source
s
Income
from
MUMS3
118 Self 0 382 0 0 382 0 0 1,830 Other 0
6859E
Source
s
Income
from
DELR09
119 Self 0 181 0 0 181 0 0 870 Other 0
664E
Source
s
Income
from
MUMT0
120 Self 0 825 0 0 825 0 0 3,969 Other 0
9401A
Source
s
Income
from
BRDS0
121 Self 0 110 0 0 110 0 0 525 Other 0
2426E
Source
s
Income
from
MUMT2
122 Self 0 1,108 0 0 1,108 0 0 5,311 Other 0
4925F
Source
s
Income
from
DELV18
123 Self 0 3,121 0 0 3,121 0 0 15,008 Other 0
086F
Source
s
Income
from
MUMK0
124 Self 0 5,380 0 0 5,380 0 0 17,243 Other 0
1323A
Source
s
Income
from
MUMS0
125 Self 0 52 0 0 52 0 0 250 Other 0
0310C
Source
s
Income
from
MUMJ0
126 Self 0 163 0 0 163 0 0 776 Other 0
0918B
Source
s
Income
from
CHEC0
127 Self 0 195 0 0 195 0 0 935 Other 0
0173F Source
s
Income
from
DELS21
128 Self 0 202 0 0 202 0 0 975 Other 0
126A
Source
s
Total 51,107
DETAILS OF TAX DEDUCTED AT SOURCE (TDS) ON INCOME [AS PER FORM 16B/16C FURNISHED BY DEDUCTOR(S)]
TDS
credit TDS of the current
relatin Unclaimed Financial Year (TDS TDS credit being claimed this
g to TDS brought deducted during FY Year (only if corresponding Correspondin
forward (b/f) 2022-23) income is being offered for tax g Receipt
self PAN Aadha
/other of ar of this year) offered
perso Other Other Deducted in
Aadha TDS
n Perso Perso TAN the hands of
ar No. credit
[spou n (if n (if of the spouse as
of the being
Sl. se as TDS TDS Buyer per section Claimed in the hands of
Buyer carrie
No. per credit credit /Tena
/Tena Fin. Deduc 5A or any spouse as per section 5A d
sectio relate relate nt/De
nt/De Year ted in other person Claim or any other person as per forwa
n 5A d to d to ductor in TDS Head
/other other other
ductor own as per rule ed in rule 37BA(2) (if applicable) Gross rd
which b/f hands 37BA(2) (if Of
perso perso perso own Amou
deduc applicable) hands Incom
n as n) n) nt
ted e
per
Incom Aadha
rule Incom TDS PAN
TDS e ar
37BA( e
2)]
(10) (10) (10) (10)
(1) (2) (3)(a) (3)(b) (4)(a) (4)(b) (5) (6) (7) (8)(a) (8)(b) (9) (11) (12) (13)
(a) (b) (c) (d)
Total 0
SCHEDULE TCS - DETAILS OF TAX COLLECTED AT SOURCE [AS PER FORM 27D ISSUED BY THE COLLECTOR(S)]
TCS of the current
financial Year (TCS TCS credit being claimed this
collected during the year
TCS credit Unclaimed TCS FY 2022-23)
relating to brought forward (b/f) Collected
Tax
Self/Other PAN Of in the Claimed in the hand
Deduction
Person Other hands of of spouse as per
and Tax TDS credit
[Spouse as Person (If the section 5A or any
Sl. Collection being
per TCS Credit spouse as other person as per
No. Account carried
section related to Collected per Claimed in rule 37-I(1)(if
Number of forward
5A/Other other in own section 5A own hands applicable)
the Fin. Year
person as person) Amount hands or any
Collector in which
per Rule b/f other
37-I(1) deducte person as
per rule
TCS PAN
37-I(1)) (if
applicable)
1 (2)(i) (2)(ii) (3) (4) (5) (6)(i) (6)(ii) (7)(i) (7)(i)(a) (7)(i)(b) (8)
Total 0
SCHEDULE 80D
If you are individual, whether you or any of your family member(excluding parents) is a senior
1
citizen?If you are HUF, whether any member of HUF is a senior citizen?
(a) Self & Family 0
(i) Health Insurance 0
(ii) Preventive Health Checkup 0
(b) Self & Family including Senior Citizen 0
Medical Expenditure (This deduction to be claimed on which health insurance is

(iii) 0
not claimed at (i) above)
2 Whether any one of your parents is a senior citizen
(a) Parents 0
(b) Parents including Senior Citizen 0
Medical Expenditure (This deduction can be claimed on which health insurance is

(iii) 0
not claimed at (i) above)
3 Eligible Amount of Deduction 0
VERIFICATION
I, SURENDRANATHA SUJEENDRANATH son/ daughter of SURENDRANATHA PILLAI GOPALA solemnly declare that to the best of my knowledge
and belief, the information given in the return and the schedules thereto 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 ASEPS7739L. I further declare that the critical assumptions specified in the agreement have been satisfied and all the
terms and conditions of the agreement have been complied with. (Applicable in a case where return is furnished under section 92CD)
Date: 28-Jun-2023 Place: 49.37.179.1 Sign Here:
If the return has been prepared by a Tax Return Preparer (TRP) give further details below:
TRP PIN (10 digit) Name of TRP Counter Signature of TRP
If TRP is entitled for any reimbursement from the Government, amount thereof 0
Note:
1. Submission date is the system date of e-Filing portal of Income Tax Department. The same is available in the Acknowledgement/ITR-V generated
after submission of return.
2. Verification Date is the date of e-Verification at e-Filing portal of Income Tax Department or the date of receipt of ITR-V at CPC, Bengaluru. The
same will be available in View Returns/Forms option of e-Filing portal. In case of e-Verification, it is available in Acknowledgement”.

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Acknowledgement Number : 317367410280623 Date of Filing : 28-Jun-2023*

INDIAN INCOME TAX RETURN

Date of filling of original return (DD/MM/YYYY)

Unique Number/ Document Identification Number (DIN)

You were a non-resident

1 971-UNITED ARAB EMIRATES NA

(h) Whether this return is being filed by a Representative Assesse? No

(1) Name of the representative

(2) Capacity of the Representative

(3) Address of the representative

(4) Permanent Account Number (PAN) of the Representative

(5) Aadhaar No. of the Representative

(i) Whether you are an FII/FPI? Yes No

If yes, provide SEBI Registration Number

Sl. Whether its shares are Director Identification

Shares acquired during the year

SCHEDULE SALARY - DETAILS OF INCOME FROM SALARY

2 Total Gross Salary (from all employers) 2 0

3 Less : allowances to the extent exempt u/s 10 3 0

Sl. Nature of Exempt

3a Less : Income claimed for relief from taxation u/s 89A 3a 0

4 Net Salary (2 - 3 - 3a) 4 0

5 Deduction u/s 16 (5a + 5b + 5c) 5 0

A Standard deduction u/s 16(ia) 5a 0

B Entertainment allowance u/s 16(ii) 5b 0

C Professional tax u/s 16(iii) 5c 0

6 Income chargeable under the Head 'Salaries' (4 - 5) 6 0

SCHEDULE HP - DETAILS OF INCOME FROM HOUSE PROPERTY

2 Pass through income/loss if any * 2 0

SCHEDULE CG CAPITAL GAINS

Full value of consideration in respect of unquoted

iii Total(ic+ii) aiii 0

b Deductions under section 48

i Cost of acquisition without indexation bi 0

ii Cost of improvement without indexation bii 0

Expenditure wholly and exclusively in connection with

iv Total (bi + bii + biii) biv 0

c Balance (aiii – biv) c 0

5 From sale of assets other than at A1 or A2 or A3 or A4 above

In case of asset sold include shares of a company other

iii Total(ic+ii) aiii 0

b Deductions under section 48

i Cost of acquisition without indexation bi 0

ii Cost of improvement without indexation bii 0

Expenditure wholly and exclusively in connection with

iv Total (bi + bii + biii) biv 0

c Balance (aiii – biv) 5c 0

e STCG on assets other than at A1 or A2 or A3 or A4 above (5c + 5d) 5e 0

6 Amount deemed to be short term capital gains

Amount not used for

b Amount deemed to be short term capital gains, other than at 'a' 0

Total amount deemed to be short term capital gains (axi + axii + b) A6 0

Total amount of STCG chargeable to tax at special rates in India

a Full value of consideration a 0

b Deductions under section 48

i Cost of acquisition without indexation bi 0

ii Cost of improvement without indexation bii 0

iii Expenditure wholly and exclusively in connection with transfer biii 0

iv Total (bi + bii + biii) biv 0

d Deduction under section 54F (Specify details in item D below) d 0

e LTCG on bonds or debenture (2c – 2d) B2e 0

a LTCG u/s 112A (column 14 of Schedule 112A) 4a 0