Acknowledgement Number : 647121660130618 Assessment Year : 2018-19

ITR-2
[For Individuals and HUFs not having income from profits and gains of business or profession]

(Please see rule 12 of the Income-tax Rules,1962)

Part A General

Personal Information

First Name NARASIMHACHARY Middle Name

Last Name SRIVATS PAN ABHPS3891D

Date of Birth / Formation (DD/MM/ 07-Sep-1949 Status Individual

YYYY)

ADDRESS

Flat / Door / Block No NO.5A/2, VIGNESH FLATS, Town / City / District CHENNAI

Name of Premises / Building / Village DEVARAJ NAGAR Road / Street / Post Office ANANDARAMKRISHNA STREET

Area / Locality SALIGRAMAM State TAMIL NADU

Country INDIA Pin code 600093

Employer Category(if in employment) Not Applicable Residential/Office Phone Number

with STD code

Income Tax Ward / Circle Mobile no.1 91 9884219976

Mobile no.2 Email Address - 1(Self) [email protected]

Email Address - 2

FILING STATUS

Return filed under Section [Please see instruction number-9(i)] Voluntarily on or before the due date under section 139(1)

Whether original or revised return? Original

Notice number (Where the original return filed was Defective and a notice

was issued to the assessee to file a fresh return Sec139(9))

If revised / defective / Modified, then enter Receipt No

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

If filed, in response to a notice u/s 139(9)/142(1)/148/153A/153C enter date

of such notice, or u/s 92CD enter date of advance pricing agreement

Residential Status Resident

Do you want to claim the benefit u/s 115H (Applicable to Resident)? No

Whether any transaction has been made with a person located in a No

jurisdiction notified u/s 94A of the Act?

Are you governed by Portuguese Civil Code as per section 5A? (If “YES” No

please fill Schedule 5A)

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Acknowledgement Number : 647121660130618 Assessment Year : 2018-19

OTHER DETAILS

Whether this return is being filed by a representative assessee No

(a) Name of the representative

(b) Address of the representative

(c) Permanent Account Number (PAN) of the representative

PART B - TI (Computation of total income)

1 Salaries (6 of Schedule S) 1 0

2 Income from house property (3b of Schedule-HP) (Enter nil if loss) 2 0

3 Capital Gains

a Short-term

i Short term chargeable @15% (7ii of item E of Sch CG) ai 0

ii Short term chargeable @30% (7iii of item E of Sch CG) aii 0

iii Short term chargeable at applicable rate (7iv of item E of Sch CG) aiii 0

iv STCG chargeable at special rates in India as per DTAA aiv 0

v Total Short term (ai+aii+aiii+aiv) 3av 0

b Long term

i Long-term chargeable @ 10% (7v of item E of schedule CG) bi 0

ii Long-term chargeable @ 20% (7vi of item E of schedule CG) bii 0

iii LTCG chargeable at special rates as per DTAA biii 0

iv Total Long-term (bi + bii+biii) (enter nil if loss) 3biv 0

c Total Capital gains (3av + 3biv) (enter nil if loss) 3c 0

4 Income from other sources

a from sources other than from owning race horses and income chargeable to tax at special rate 4a 146834

etc. (1k of Schedule OS) (enter nil if loss)

b Income chargeable to tax at special rate (1fviii of Schedule OS) 4b 0

c from the activity of owning and maintaining race horses (3e of Schedule OS)(enter nil if loss) 4c 0

d Total (4a + 4b + 4c) (enter nil if loss) 4d 146834

5 Total (1+2+3c+4d) 5 146834

6 Losses of current year set off against 5(total of (2xi and 3xi) of Schedule CYLA) 6 0

7 Balance after set off current year losses(5-6) (total of column 4 of Schedule CYLA+4b) 7 146834

8 Brought forward losses set off against 7(2x of Schedule BFLA) 8 0

9 Gross Total income (7-8) (3xi of Schedule BFLA + 4b) 9 146834

10 Income chargeable to tax at special rate under section 111A, 112 etc. included in 9 10 0

11 Deductions under Chapter VI-A [t of Schedule VIA and limited to(9-10)] 11 0

12 Total income (9-11) 12 146830

13 Income which is included in 12 and chargeable to tax at special rates (total of (i) of schedule SI) 13 0

14 Net agricultural income/ any other income for rate purpose (4 of Schedule EI) 14 0
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Acknowledgement Number : 647121660130618 Assessment Year : 2018-19

15 Aggregate income (12-13+14) [applicable if (12-13) exceeds maximum amount not chargeable to 15 0

tax]

16 Losses of current year to be carried forward (total of row xi of Schedule CFL) 16 0

PART B - TTI Computation of tax liability on total income

1 Tax payable on total income

a Tax at normal rates on 15 of Part B-TI 1a 0

b Tax at special rates (total of col.(ii) of Schedule SI) 1b 0

c Rebate on agricultural income [applicable if (12-13) of Part B-TI exceeds maximum amount not 1c 0

chargeable to tax]

d Tax Payable on Total Income (1a + 1b - 1c) 1d 0

2 Rebate under section 87A 2 0

3 Tax payable after rebate (1d - 2) 3 0

4 Surcharge

(i) 25% of 12(ii) of Schedule SI 4i 0

(ii) On [(3) – (12(ii) of Schedule SI)] 4ii 0

(iii) Total i + ii 4iii 0

5 Education cess, including secondary and higher education cess on (3 + 4iii ) 5 0

6 Gross tax liability (3 + 4iii + 5) 6 0

7 Tax relief

a Section 89 7a 0

b Section 90/90A (2 of Schedule TR) 7b 0

c Section 91 (3 of Schedule TR) 7c 0

d Total (7a + 7b + 7c) 7d 0

8 Net tax liability (6 – 7d) (enter zero if negative) 8 0

9 Interest and fee payable

a Interest for default in furnishing the return (section 234A) 9a 0

b Interest for default in payment of advance tax (section 234B) 9b 0

c Interest for deferment of advance tax (section 234C) 9c 0

d Fee for default in furnishing return of income (section 234F) 9d 0

e Total Interest and Fee Payable (9a+9b+9c+9d) 9e 0

10 Aggregate liability (8 + 9e) 10 0

11 Taxes Paid

a Advance Tax (from column 5 of 19A) 0

b TDS (total of column 5 of 19B and column 9 of 19C) 151

c TCS (total of column 5 of 19D) 0

d Self-Assessment Tax(from column 5 of 19A) 0

e Total Taxes Paid (11a+11b+11c+11d) 151

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Acknowledgement Number : 647121660130618 Assessment Year : 2018-19

12 Amount payable (Enter if 10 is greater than 11e, else enter 0) 0

13 Refund (If 11e is greater than 10) (Refund, if any, will be directly 150

credited into the bank account) .

Bank Account Details

14 Do you have a bank account in India (Non-residents claiming refund with no bank account in India may select NO)? Yes

a) Bank Account in which refund, if any, shall be credited

Sl No. IFS Code of the Bank Name of the Bank Account Number

1 SBIN0006850 State Bank of India 32412762748

b) Other Bank Account details

Sl No. IFS Code of the Bank Name of the Bank Account Number

c) Non-residents, who are claiming income-tax refund and not having bank account in India may, at their option, furnish the details of one

foreign bank account

Sl No. SWIFT Code Name of the Bank IBAN Country of Location

15 Do you at any time during the previous year :- No

(i) hold, as beneficial owner, beneficiary or otherwise, any asset (including financial interest in any entity) located outside

India or

(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 ]

xyz
xyz
VERIFICATION
xyz
I, N SRIVATS , son/ daughter of NARASIMHACHARY , solemnly declare that to the best of my knowledge and belief,
the information given in the return and 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 return in my capacity as SELF and I am also competent to make this return and verify
it. I am holding permanent account number ABHPS3891D
xyz
Place CHENNAI Date 13-Jun-2018
xyz
16 If the return has been prepared by a Tax Return Preparer (TRP) give further details as below:
TRP

Identification No. of TRP Name of TRP

17 If TRP is entitled for any reimbursement from the Government, amount thereof

IT : Details of payments of Advance Tax and Self-Assessment Tax

Sl.No. BSR Code Date of Deposit(DD/MM/YYYY) Serial number of challan Amount(Rs)

TOTAL

NOTE Enter the totals of Advance tax and Self-Assessment tax in Sl No. 11a & 11d of Part B-TTI

19B-TDS1 : Details of Tax Deducted at Source (TDS) from Salary [As per FORM 16 issued by Employer(s)]

Sl.No. Tax Deduction Account Number Name of the Employer Income chargeable under Total Tax Deducted

(TAN) of the Employer Salaries

TOTAL

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Acknowledgement Number : 647121660130618 Assessment Year : 2018-19

NOTE Please enter total of column 5 in 11b of Part B-TTI

19C(1)- TDS2:Details of Tax Deducted at Source on Income [As per FORM 16A issued by Deductor(s)]

Sl.No. Tax Dedu Name Unique Unclaimed TDS of the current fin. Year* TDS credit out of (6) or (7) or (8) TDS

ction Account of the TDS TDS brought being claimed this Year (only if credit out

Number (TAN)of Deduc Certif forward (b/f) corresponding income is being of (6),

the Emplo yer tor icate offered for tax this year) (7) or (8)

(1) (2) No. Fin. AmountDeducted Deducted in the hands of claimed Claimed in the hands of being

(3) Year b/f in own spouse as per section 5A or in own spouse as per section 5A carried

in hands* any other person as per rule hands or any other person as per forward*

which 37BA(2) (if applicable) rule 37BA(2)

deduct Income TDS PAN of Income TDS PAN of

ed spouse / spouse /

other other

person person

1 CHEP00190B PUN 0 0 0 0

JAB

NATI

ONA

L BA

NK C

IRCL

E OF

FICE

2 MUMS86170A STA 0 151 151 0

TE B

ANK

OF I

NDIA

3 CHEC02364F CAN 0 0 0 0

ARA

BAN

K SA

LIGR

AMA

TOTAL 151

Note: Please enter total column 9 of above in 11b of Part B-TTI

TDS3 : Details of Tax Deducted at Source (TDS) on Income [As per Form 26QB/26QC furnished issued by Deductor(s)]
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Acknowledgement Number : 647121660130618 Assessment Year : 2018-19

Sl.No. PAN of the Name Unique Unclaimed TDS TDS of the current fin. Year* TDS credit out of (6) or (7) or (8) TDS

buyer/Tenant of TDS brought forward being claimed this Year (only if credit

Buyer/ Certificate(b/f) corresponding income is being out of

Tenant Number offered for tax this year) (6), (7)

Financial Amount DeductedDeducted in the hands of claimed Claimed in the hands of or (8)

year in b/f in own spouse as per section 5A in own spouse as per section 5A or being

which hands or any other person as hands any other person as per rule carried

TDS is per rule 37BA(2) 37BA(2) forward

deducted Income TDS PAN of Income TDS PAN of

spouse / spouse /

other other

person person

TOTAL

Note: Please enter total column 9 of above in 11b of Part B-TTI

TCS : Details of Tax Collected at Source (TCS) [As per Form 27D issued by Collector(s)]

Sl.No. Tax Deduction and Name of the Tax Collected Amount out of (4) Amount out of (4) being claimed in the hands

Collection Account Collector being claimed of spouse, if section 5A is applicable

Number of the

Collector

TOTAL

NOTE Please enter total of column (5) of Schedule-TCS in 11c

Schedule S:Details of Income from Salary

2 Total Income chargeable

Schedule HP:Details of Income from House Property

1 Income under the head "Income from house property"

(a) Unrealized rent and Arrears of rent received during the year under section 25A 1a

after deducting 30%

(b) Total (1j + 2j +3a) (if negative take the figure to 2i of schedule CYLA) 1b

NOTE Please include the income of the specified persons referred to in Schedule SPI while computing the income under this head.

Schedule CG:Capital Gains

A Short-term capital gain (STCG) (Sub-items 3 & 4 are not applicable for residents)

1 From sale of land or building or both

a i Full value of consideration received/receivable ai 0

ii Value of property as per stamp valuation authority aii 0

iii Full value of consideration adopted as per section 50C for the purpose of Capital Gains (ai or aii) aiii 0

b Deductions under section 48

i Cost of acquisition without indexation bi 0

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Acknowledgement Number : 647121660130618 Assessment Year : 2018-19

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

c Balance (aiii – biv) 1c 0

d Deduction under section 54B (Specify details in item D below) 1d 0

e Short-term Capital Gains on Immovable property (1c - 1d) A1e 0

3 For NON-RESIDENT, not being an FII- from sale of shares or debentures of an Indian company (to be computed with foreign exchange

adjustment under first proviso to section 48)

a STCG on transactions on which securities transaction tax (STT) is paid A3a 0

b STCG on transactions on which securities transaction tax (STT) is not paid A3b 0

4 For NON-RESIDENT- from sale of securities (other than those at A2) by an FII as per section 115AD

a(i) In case securities sold include shares of a company other than quoted shares, enter the following details

a) Full value of consideration received/receivable in respect of unquoted shares ia 0

b) Fair market value of unquoted shares determined in the prescribed manner ib 0

c) Full value of consideration in respect of unquoted shares adopted as per section 50CA for the purpose ic 0

of Capital Gains (higher of a or b)

ii Full value of consideration in respect of securities other than unquoted shares ii 0

iii Total (ic + ii) iii 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 (i + ii + iii) biv 0

c Balance (4aiii – biv) 4c 0

d Loss to be disallowed u/s 94(7) or 94(8)- for example if security bought/acquired within 3 months prior to 4d 0

record date and dividend/income/bonus units are received, then loss arising 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) (4c +4d) A4e 0

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

a (i) In case assets sold include shares of a company other than quoted shares, enter the following details

a) Full value of consideration received/receivable in respect of unquoted shares ia 0

b) Fair market value of unquoted shares determined in the prescribed manner ib 0

c) Full value of consideration in respect of unquoted shares adopted as per section 50CA for the purpose ic 0

of Capital Gains (higher of a or b)

(ii) Full value of consideration in respect of assets other than unquoted shares ii 0

(iii) Total (ic + ii) iii 0

b Deductions under section 48

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Acknowledgement Number : 647121660130618 Assessment Year : 2018-19

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 (i + ii + iii) biv 0

c Balance (5aiii - 5biv) 5c 0

d In case of asset (security/unit) loss to be disallowed u/s 94(7) or 94(8)- for example if asset bought/ 5d 0

acquired within 3 months prior to record date and dividend/income/bonus units are 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) A5e 0

6 Amount Deemed to be short-term capital gains

a Whether any amount of unutilized capital gain on asset transferred during the previous years shown below was

deposited in the Capital Gains Accounts Scheme within due date for that year? If yes, then provide the details below

Sl.No. Previous year Section under which New asset acquired/constructed Amount not used for new asset or

in which asset deduction claimed in Year in which asset Amount utilised out remained unutilized in Capital gains

transferred that year acquired/constructed of Capital Gains account (X)

account

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

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

7 Amount of STCG included in A1-A6 but not chargeable to tax or chargeable at special rates in India as per DTAA

Sl.No. Amount of Item no. A1 to Country Article of Rate as per Whether Tax Section of Rate as per Applicable

income A6 above in Name,Code DTAA Treaty(enter Residency I.T. Act I.T. Act rate [lower of

which included NIL, if not Certificate (6) or (9)]

chargeable) obtained?

(1) (2) (3) (4) (5) (6) (7) (8) (9) (10)

a Total amount of STCG not chargeable to tax in India as per DTAA A7a 0

b Total amount of STCG chargeable at special rates in India as per DTAA A7b 0

8 Total Short-term Capital Gain (A1e+ A2e+ A3a+ A3b+ A4e+ A5e+A6 - A7a) A8 0

B Long-term capital gain (LTCG) (Sub-items 4, 5 & 6 are not applicable for residents)

1 From sale of land or building or both

a i Full value of consideration received/receivable ai 0

ii Value of property as per stamp valuation authority aii 0

iii Full value of consideration adopted as per section 50C for the purpose of Capital Gains (ai or aii) aiii 0

b Deductions under section 48

i Cost of acquisition with indexation bi 0

ii Cost of Improvement with indexation bii 0

iii Expenditure wholly and exclusively in connection with transfer biii 0

iv Total (bi + bii + biii) biv 0

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Acknowledgement Number : 647121660130618 Assessment Year : 2018-19

c Balance (aiii – biv) 1c 0

d Deduction under section 54/54B/54EC/54EE/54F/54GB (Specify details in item D below)

S. No. Section Amount

Total 1d 0

e Long-term Capital Gains on Immovable property (1c - 1d) B1e 0

2 From sale of bonds or debenture (other than capital indexed bonds issued by Government)

a Full value of consideration 2a 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

c Balance (2a - biv) 2c 0

d Deduction under sections 54EC/54EE/54F (Specify details in item D below)

S. No. Section Amount

Total 2d 0

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

4 For NON-RESIDENTS- from sale of shares or debenture of Indian company (to be computed with foreign exchange adjustment under first

proviso to section 48)

a LTCG computed without indexation benefit 4a 0

b Deduction under sections 54EC/54EE/54F (Specify details in item D below) 4b

S. No. Section Amount

Total 4b 0

c LTCG on share or debenture (4a – 4b) B4c 0

6 From sale of foreign exchange asset by NON-RESIDENT INDIAN (If opted under chapter XII-A)

a LTCG on sale of specified asset (computed without indexation) 6a 0

b Less deduction under section 115F (Specify details in item D below) 6b 0

c Balance LTCG on sale of specified asset (6a – 6b) B6c 0

d LTCG on sale of asset, other than specified asset (computed without indexation) 6d 0

e Less deduction under section 115F (Specify details in item D below) 6e 0

f Balance LTCG on sale of asset, other than specified asset (6d – 6e) B6f 0

7 From sale of assets where B1 to B6 above are not applicable

a (i) In case assets sold include shares of a company other than quoted shares, enter the following details

a) Full value of consideration received/receivable in respect of unquoted shares ia 0

b) Fair market value of unquoted shares determined in the prescribed manner ib 0

c) Full value of consideration in respect of unquoted shares adopted as per section 50CA for the purpose of ic 0

Capital Gains (higher of a or b)

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Acknowledgement Number : 647121660130618 Assessment Year : 2018-19

(ii) Full value of consideration in respect of assets other than unquoted shares ii 0

(iii) Total (ic + ii) iii 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

c Balance (7aiii – biv) 7c 0

d Deduction under sections 54EC/54EE/54F (Specify details in item D below)

S. No. Section Amount

Total 7d 0

e Long-term Capital Gains on assets at B7 above (7c-7d) B7e 0

8 Amount deemed to be long-term capital gains

a Whether any amount of unutilized capital gain on asset transferred during the previous years shown below was

deposited in the Capital Gains Accounts Scheme within due date for that year? If yes, then provide the details below

Sl.No. Previous year Section under which New asset acquired/constructed Amount not used for new asset or

in which asset deduction claimed in Year in which asset Amount utilised out remained unutilized in Capital gains

transferred that year acquired/constructed of Capital Gains account (X)

account

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

Total amount deemed to be short term capital gains (aXi + aXii + b) B8 0

9 Amount of LTCG included in B1- B8 but not chargeable to tax or chargeable at special rates in India as per DTAA

Sl.No (1) Amount of Item No. B1 Country Article of Rate as per Whether Tax Section Rate as per Applicable rate

income (2) to B8 above Name,Code DTAA (5) Treaty (enter Residency of I.T. I.T. Act (9) [lower of (6) or (9)]

in which (4) NIL, if not Certificate Act (8) (10)

included (3) chargeable) obtained? (7)

(6)

a Total amount of LTCG not chargeable to tax under DTAA B9a 0

b Total amount of LTCG chargeable at special rates as per DTAA B9b 0

10 Total long term capital gain chargeable under I.T. Act [B1e +B2e +B3e + B4c + B5e +B6c B10 0

+ B6f+ B7e+ B8 - B9a] (In case of loss take the figure to 5xi of schedule CFL)

C Income chargeable under the head “CAPITAL GAINS” (A8 + B10) (take B10 as nil, if C 0

loss) (If C is negative, take the figure to 4xi of schedule CFL and if it is positive, take the

figure to respective row in item E)

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

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Acknowledgement Number : 647121660130618 Assessment Year : 2018-19

Sl.No Date of transfer Cost of new Date of purchase/construction of Amount deposited in Amount of deduction claimed

of original asset residential house new residential house Capital Gains Accounts

Scheme before due date

(b) Deduction claimed u/s 54B

Sl.No Date of transfer Cost of new Date of purchase of new Amount deposited in Amount of deduction claimed

of original asset agricultural land agricultural land Capital Gains Accounts

Scheme before due date

(c) Deduction claimed u/s 54EC

Sl.No Date of transfer of original asset Amount invested in specified/ Date of investment Amount of deduction claimed

notified bonds

(d) Deduction claimed u/s 54EE

Sl.No Date of transfer of original asset Amount invested in specified Date of investment Amount of deduction claimed

asset

(e) Deduction claimed u/s 54F

Sl.No Date of transfer Cost of new Date of purchase/construction of Amount deposited in Amount of deduction claimed

of original asset residential house new residential house Capital Gains Accounts

Scheme before due date

(f) Deduction claimed u/s 54GB

Sl.No Date of transfer PAN of the Amount utilised Date of Cost of new Date of Amount Amount of

of original eligible company for subscription of subscription plant and purchase deposited in deduction

residential equity shares of of shares machinery of plant and Capital Gains claimed

property eligible company purchased machinery Accounts

by the Scheme

eligible before due

company date

(g) Deduction claimed u/s 115F (for Non-Resident Indians)

Sl.No Date of transfer of original foreign Amount invested in new Date of investment Amount of deduction claimed

exchange asset specified asset or savings

certificate

(h) Total deduction claimed (1a + 1b + 1c + 1d + 1e + 1f + 1g) 1h

E Set-off of current year capital losses with current year capital gains (excluding amounts included in A7 and B9 which is chargeable under

DTAA)

Sl.No Type of Capital Gain of current Short term capital loss set off Long term capital loss set off Current year’s

Gain year (Fill this 15% 30% applicable rate 10% 20% capital gains

column only if remaining after

computed figure set off (7=

is positive) 1-2-3-4-5-6)

1 2 3 4 5 6 7
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Acknowledgement Number : 647121660130618 Assessment Year : 2018-19

i Loss to be 0 0 0 0 0

set off (Fill

this row if

computed figure

is negative)

ii Short 15% 0 0 0 0

iii term 30% 0 0 0 0

iv capital applica 0 0 0 0

gain ble rate

v Long 10% 0 0 0 0 0 0

vi term 20% 0 0 0 0 0 0

capital

gain

vii Total loss set off (ii + iii + iv + v + 0 0 0 0 0

vi)

viii Loss remaining after set off (i – vii) 0 0 0 0 0

F Information about accrual/receipt of capital gain

Type of Capital gain / Date Upto 15/6 (i) 16/6 to 15/9 (ii) 16/9 to 15/12 16/12 to 15/3 16/3 to 31/3

(iii) (iv) (v)

1 Short-term capital gains taxable at the rate of 15% 0 0 0 0 0

Enter value from item 3iii of schedule BFLA, if any.

2 Short-term capital gains taxable at the rate of 30% 0 0 0 0 0

Enter value from item 3iv of schedule BFLA, if any.

3 Short-term capital gains taxable at applicable rates 0 0 0 0 0

Enter value from item 3v of schedule BFLA, if any..

4 Long- term capital gains taxable at the rate of 10% 0 0 0 0 0

Enter value from item 3vi of schedule BFLA, if any.

5 Long- term capital gains taxable at the rate of 20% 0 0 0 0 0

Enter value from item 3vii of schedule BFLA, if any.

Note:Please include the income of the specified persons referred to in Schedule SPI while computing the income under this head

Schedule OS: Income from other sources

1 Income

a Dividend (Excluding taxable at special Rates) Gross 1a 0

b Interest, (Excluding taxable at special Rates) Gross 1b 146834

c Rental income from machinery, plants, buildings, etc., 1c 0

Gross

d Others, Gross (excluding income from owning race horses)Mention the nature

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Acknowledgement Number : 647121660130618 Assessment Year : 2018-19

SL Nature Income

No

1 Winnings from lotteries, crossword puzzles etc. 0

2 (a) Cash credits u/s 68 0

3 (b) Unexplained investments u/s 69 0

4 (c) Unexplained money etc. u/s 69A 0

5 (d) Undisclosed investments etc. u/s 69B 0

6 (e) Unexplained expenditurte etc. u/s 69C 0

7 (f) Amount borrowed or repaid on hundi u/s 69D 0

8 Total ( a + b + c + d + e + f) 0

9 Aggregate value of sum of money received without consideration 0

10 In case immovable property is received without consideration, stamp 0

duty value of property

11 In case immovable property is received without consideration, stamp 0

duty value of property in excess of such consideration

12 In case immovable property is received without consideration, fair 0

market value of property

13 In case immovable property is received without consideration, fair 0

market value of property in excess of such consideration

14 Total (a+ b + c +d + e) 0

Total (1di + 1dii+ 1diii + 1div) 0

e Total (1a + 1b + 1c + 1dv) 1e 146834

f Income included in '1e' chargeable to tax at special rate (to be taken to schedule SI)

i Income by way of winnings from lotteries, crossword puzzles, races, games, gambling, 1fi 0

betting etc (u/s 115BB)

ii Dividend Income from domestic company that exceeds Rs.10 Lakh (u/s 115BBDA) 1fii 0

iii Deemed Income chargeable to tax u/s 115BBE 1fiii 0

iv Income from patent chargeable u/s 115BBF 1fiv 0

v Tax on income from transfer of carbon credits 115BBG 1fv 0

vi Any other income chargeable to tax at the rate specified under chapter XII/XII-A 1fvi 0

vii Income chargeable at special rates under DTAA

Sl. No. Amount of Nature of Country Article of Rate as per Whether TRC Section of I.T. Rate as per Applicable

income income name and DTAA Treaty obtained Act I.T. Act Rate [lower of

Code (6) or (9)]

Total amount of income chargeable to tax under DTAA 1fvi 0

viii Income included in ‘1e’ chargeable to tax at special rate (1fi +1fii + 1fiii+1fiv+1fv+1fvi +1fvii ) 1fvii 0

g Gross amount chargeable to tax at normal applicable rates (1e-1fviii) 1g 146834

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h Deductions under section 57 (other than those relating to income under 1fi, 1fii, 1fiii, 1fiv, 1fv, 1fvi and 1fvii for non-residents)

i Expenses / Deductions hi 0

ii Depreciation hii 0

iii Total hiii 0

i Amounts not deductible u/s 58 1i 0

j Profits chargeable to tax u/s 59 1j 0

k Income from other sources (other than from owning race horses and amount chargeable to tax at 1k 146834

special rate) (1g – hiii + 1i + 1j) (If negative take the figure to 3ix of schedule CYLA)

2 Income from other sources (other than from owning race horses) (1fviii + 1k) (enter 1k as nil, if negative) 2 146834

3 Income from the activity of owning and maintaining race horses

a Receipts 3a 0

b Deductions under section 57 in relation to (4) 3b 0

c Amounts not deductible u/s 58 3c 0

d Profits chargeable to tax u/s 59 3d 0

e Balance (3a – 3b + 3c + 3d) (if negative take the figure to 6xi of Schedule CFL) 3e 0

4 Income under the head “Income from other sources” (2 + 3e) (take 3e as nil if negative) 4 146834

NOTE Please include the income of the specified persons referred to in Schedule SPI while computing the income under this head.

Schedule CYLA:Details of Income after set-off of current years losses

Sl.No. Head/ Source of Income of current year House property loss of the current year set off Other sources loss Current year's

Income (Fill this column only (other than loss from Income remaining

if income is zero or race horses) of the after set off

positive) current year set off

1 2 3 5=1-2-3-4

i Loss to be set off 0 0

ii Salaries 0 0 0 0

iii House property 0 0 0

iv Short-term capital gain 0 0 0 0

taxable @ 15%

v Short-term capital gain 0 0 0 0

taxable @ 30%

vi Short-term capital gain 0 0 0 0

taxable at applicable

rates

vii Long term capital gain 0 0 0 0

taxable @ 10%

viii Long term capital gain 0 0 0 0

taxable @ 20%

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Acknowledgement Number : 647121660130618 Assessment Year : 2018-19

ix Other sources 146834 0 146834

(excluding profit

from owning race

horses and amount

chargeable to special

rate of tax)

x Profit from owning 0 0 0 0

and maintaining race

horses

xi Total loss set off (ii + iii + iv + v + vi + vii + viii + 0 0

ix + x )

xii Loss remaining after set-off (i - xi) 0 0

Schedule BFLA:Details of Income after Set off of Brought Forward Losses of earlier years

Sl.No Head/ Source of Income Income after set off, if Brought forward Current year's income

any, of current year’s loss set off remaining after set off

losses as per col. 4

of Schedule CYLA

1 2 3

i Salaries 0 0

ii House property 0 0 0

iii Short-term capital gain taxable @ 15% 0 0 0

iv Short-term capital gain taxable @ 30% 0 0 0

v Short-term capital gain taxable at applicable rates 0 0 0

vi Long-term capital gain taxable @ 10% 0 0 0

vii Long term capital gain taxable @ 20% 0 0 0

Viii Other sources (excluding profit from owning race horses and winnings 146834 146834

from lottery, game etc.)

ix Profit from owning and maintaining race horses 0 0 0

x Total of brought forward loss set off (ii2 + iii2 + iv2 + v2 + vi2 + vii2 + ix2) 0

xi Current year’s income remaining after set off Total (i3 + ii3 + iii3 + iv3 + v3+ vi3+ vii3 + viii3+ ix3) 146834

Schedule CFL:Details of Losses to be carried forward to future years

Sl.No. Assessment Year Date of Filing House property loss Short-term capital Long-term Capital Loss from owning

(DD/MM/YYYY) loss loss and maintaining

race horses

1 2 3 4 5 6

i 2010-11

ii 2011-12

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Acknowledgement Number : 647121660130618 Assessment Year : 2018-19

iii 2012-13

iv 2013-14

v 2014-15

vi 2015-16

vii 2016-17

viii 2017-18

ix Total of earlier year

losses

x Adjustment of above

losses in Schedule

BFLA

xi 2018-19 (Current

year losses)

xii Total loss Carried

Forward to future

years

Schedule VI-A:Deductions under Chapter VI-A

1.Part B- Deduction in respect of certain payments

a 80C - Life insurance premia, deferred annuity, contributions to provident fund,

subscription to certain equity shares or debentures, etc.

b 80CCC - Payment in respect Pension Fund

c 80CCD(1) - Contribution to pension scheme of Central Government

d 80CCD(1B)- Contribution to pension scheme of Central Government

e 80CCD(2) - Contribution to pension scheme of Central Government by the

Employer

f 80CCG - Investment made under an equity savings scheme

g 80D -

(A) Health Insurance Premium

(B) Medical expenditure

(C) Preventive health check-up

h 80DD - Maintenance including medical treatment of

a dependent who is a person with disability

i 80DDB - Medical treatment of specified disease

j 80E - Interest on loan taken for higher education

k 80EE - Interest on loan taken for residential house property

l 80 G - Donations to certain funds, charitable institutions, etc

m 80GG - Rent paid

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Acknowledgement Number : 647121660130618 Assessment Year : 2018-19

n 80GGA - Certain donations for scientific research or rural development

o 80GGC - Donation to Political party

2.Part C, CA and D- Deduction in respect of certain incomes/other deduction

p 80QQB - Royalty income of authors of certain books.

q 80RRB - Royalty on patents

r 80TTA - Interest on saving bank Accounts

s 80U - In case of a person with disability.

t Total deductions under Chapter VI-A (Total of a to s)

Schedule 80G:Details of donation entitled for deduction under Section 80G

A. Donations entitled for 100% deduction without qualifying limit

Sl.No. Name of donee Address Detail City or Town State Code PinCode PAN of Donee Amount of Eligible

or District donation Amount of

Donation

Total A

B.Donations entitled for 50% deduction without qualifying limit

Sl.No. Name of donee Address Detail City or Town State Code PinCode PAN of Donee Amount of Eligible

or District donation Amount of

Donation

Total B

C. Donations entitled for 100% deduction subject to qualifying limit

Sl.No. Name of donee Address Detail City or Town State Code PinCode PAN of Donee Amount of Eligible

or District donation Amount of

Donation

Total C

D. Donations entitled for 50% deduction subject to qualifying limit

Sl.No. Name of donee Address Detail City or Town State Code PinCode PAN of Donee Amount of Eligible

or District donation Amount of

Donation

Total D

E.Total Amount of Donations (A + B + C + D)

F.Total Eligible amount of Donations (A + B + C + D)

Schedule SPI

Income of specified persons (spouse, minor child etc) includable in income of the assessee (income of the

minor child, in excess of Rs. 1,500 per child, to be included)

Sl.No. Name of person PAN of person (optional) Relationship Nature of Income Amount (Rs)

Schedule SI:Income chargeable to tax at special rates (please see instructions No. 9 for rate of tax)

Sl.No Section/Description Special rate (%) Income (i) Tax thereon (ii)

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1 111 - Tax on accumulated balance of recognised PF 1 0 0

2 Chargeable at DTAA Rate 1 0 0

3 111A (STCG on shares where STT paid) 15 0 0

4 112 (LTCG on others) 20 0 0

5 112 proviso (LTCG on listed securities/ units without 10 0 0

indexation)

6 112(1)(c)(iii)(LTCG on unlisted securities in case of non- 10 0 0

residents)

7 115BB (Winnings from lotteries, puzzles, races, games 30 0 0

etc.)

8 115AD(1)(ii) -STCG (other than on equity share or equity 30 0 0

oriented mutual fund referred to in section 111A) by an FII

Total 0 0

Schedule EI:Details of Exempt Income (Income not to be included in Total Income)

1 Interest income 1

2 Dividend income from domestic company (amount not exceeding Rs. 10 lakh) 2

3 Long-term capital gains from transactions on which Securities Transaction Tax is paid 3

4 i Gross Agricultural receipts (other than income to be excluded under rule 7A, 7B i

or 8 of I.T. Rules)

ii Expenditure incurred on agriculture ii

iii Unabsorbed agricultural loss of previous eight assessment years iii

Net Agricultural income for the year (i – ii – iii) (enter nil if loss) 4

5 Others, including exempt income of minor child

S.No. Nature of Income Amount

Total 5

6 Total (1 + 2 + 3 + 4 + 5) 6

Schedule PTI:Pass Through Income details from business trust or investment fund as per section 115UA,115UB

Sl Name of business trust/ PAN of the business Sl Head of income Amount of income TDS on such amount,if

investment fund trust/investment fund any

NOTE : Please refer to the instructions for filling out this schedule

Schedule FSI:Details of Income from outside India and tax relief

Sl Country Code Taxpayer Sl.No. Head of Income Tax paid outside Tax payable on Tax relief Relevant

Identification income from outside India such income available in article of

Number India(included under normal India(e)= DTAA if relief

in PART B- provisions in (c) or (d) claimed u/s

TI) India whichever is 90 or 90A

lower

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Acknowledgement Number : 647121660130618 Assessment Year : 2018-19

(a) (b) (c) (d) (e) (f)

Note: Please refer to the instructions for filling out this schedule

Schedule TR:Summary of tax relief claimed for taxes paid outside India

1 Summary of Tax relief claimed

Sl.No Country Code Taxpayer Identification Total taxes paid Total tax relief Tax Relief Claimed

Number outside India (total of available(total of under section (specify

(c) of Schedule FSI (e) of Schedule FSI 90, 90A or 91)

in respect of each in respect of each

country) country

(a) (b) (c) (d) (e)

Total

2 Total Tax relief available in respect of country where DTAA is applicable (section 90/90A) (Part of total of 2

1(d))

3 Total Tax relief available in respect of country where DTAA is not applicable (section 91) (Part of total of 3

1(d))

4 Whether any tax paid outside India, on which tax relief was allowed in India, has been refunded/credited 4

by the foreign tax authority during the year? If yes, provide the details below

4a Amount of tax refunded 4a

4b Assessment year in which tax relief allowed in India 4b

Note:Please refer to the instructions for filling out this schedule.

Schedule FA:Details of Foreign Assets and Income from any source outside India

A Details of Foreign Bank Accounts held (including any beneficial interest) at any time during the previous year

Sl.No. Country Zip Name Address Account Status Account IBAN/ Account Peak Interest Interest taxable and offered in

(1) Code Code(2b) of the of the holder (5) Number SWIFT opening Balance accrued this return

and Bank Bank name (6a) Code date (7) During in the Amount Schedule Item

Name(2a) (3a) (3b) (4) (6b) the Year account (10) (Rs) where number

(8) (Rs) (9) (Rs) offered of

(11) schedule

(12)

B Details of Financial Interest in any Entity held (including any beneficial interest) at any time during the previous year

Sl.No. Country Zip Nature Name Address Nature Date Total Investment Income Nature Income taxable and offered in

(1) Code Code(2b) of of the of the of since (at cost)(7) (Rs) accrued of this return

and entity Entity Entity Interest held from Income Amount Schedule Item

Name(2a) (3) (4a) (4b) (5) (6) such (9) (10) (Rs) where number

Interest(8) offered of

(Rs) (11) schedule

(12)

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Acknowledgement Number : 647121660130618 Assessment Year : 2018-19

C Details of Immovable Property held (including any beneficial interest) at any time during the previous year

Sl.No. Country Zip Address Ownership Date of Total Income Nature of Income taxable and offered in this

(1) Code and Code(2b) of the (4) acquisition Investment derived Income (8) return

Name(2a) Property (3) (5) (at cost) from the Amount (9) Schedule Item

(6) (Rs) property (Rs) where number of

(7) (Rs) offered schedule

(10) (11)

D Details of any other Capital Asset held (including any beneficial interest) at any time during the previous year

Sl.No. Country Zip Code(2b) Nature of Ownership Date of Total Income Nature of Income taxable and offered in this

(1) Code and Asset (3) (4) acquisition Investment derived Income (8) return

Name(2a) (5) (at cost) from the Amount (9) Schedule Item

(6) (Rs) property (Rs) where number of

(7) (Rs) offered schedule

(10) (11)

E Details of account(s) in which you have signing authority held (including any beneficial interest) at any time during the previous year and which

has not been included in A to D above.

Sl.No. Name Address Country Zip Code Name Account Peak Whether If (7) If (7) is yes, Income offered in this

(1) of the of the Code and (3c) of the Number Balance/ income is yes, return

Institution Institution Name account (5) Investment accrued Income Amount Schedule Item

in which (3a) (3b) holder (4) during the is taxable accrued (9) (Rs) where number of

the year (6) in your in the offered schedule

account is (Rs) hands? account (10) (11)

held (2) (7) (8) (Rs)

F Details of trusts, created under the laws of a country outside India, in which you are a trustee, beneficiary or settlor.

Sl.No. Country Zip Name Address Name Address Name Address Name Address Date Whether If (8) If (8) is yes, Income

(1) Code Code of the of the of of of of of of since income is yes, offered in this return

and (2b) trust trust trustees trustees Settlor Settlor Benefic Benefic position derived Income Amount ScheduleItem

Name(2a) (3a) (3b) (4a) (4b) (5a) (5b) iaries iaries held is accrued (9) where number

(6a) (6b) (7) taxable in the (Rs) offered of

in your account (10) schedule

hands? (8) (Rs) (11)

(8)

G 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

head business or profession

Sl.No. Country Zip Name of Address of Income Nature of Whether If (6) is yes, Income offered in this

(1) Code and Code(2b) the person the person derived (4) income (5) taxable in return

Name(2a) from whom from whom your hands?

derived (3a) derived (3b) (6)

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Acknowledgement Number : 647121660130618 Assessment Year : 2018-19

Amount (7) Schedule Item

(Rs) where number of

offered (8) schedule

(9)

Note: Please refer to instructions for filling out this schedule. In case of an individual, not being an Indian citizen, who is in India on a business,

employment or student visa, an asset acquired during any previous year in which he was non-resident is not mandatory to be reported in this

schedule if no income is derived from that asset during the current previous year.

Schedule 5A:Information regarding apportionment of income between spouses governed by Portuguese Civil Code

Name of the spouse

PAN of the spouse

Heads of Income Income received under the Amount apportioned in the Amount of TDS deducted TDS apportioned in the

head hands of the spouse on income at (ii) hands of spouse

(i) (ii) (iii) (iv) (v)

1 House Property

3 Capital gains

4 Other sources

5 Total

Schedule AL:Asset and Liability at the end of the year (applicable in a case where total income exceeds Rs.50 lakh)

A Do you own any immovable asset ?

Details of immovable asset

Sl.No. Description (2) Address (3) Amount (cost) in Rs.

(1) (4)

B Details of movable asset

Sl.no Description (2) Amount (cost) in Rs.

(1) (3)

(i) Jewellery, bullion etc.

(ii) Archaeological collections, drawings, painting, sculpture or any work of art.

(iii) Vehicles, yachts, boats and aircrafts

(iv) Financial asset.

(a) Bank (including all deposits).

(b) Shares and securities.

(c) Insurance policies.

(d) Loans and advances given.

(e) Cash in hand.

C Liability in relation to Assets at (A+B)

This form has been electronically verified by NARASIMHACHARY SRIVATS having PAN ABHPS3891D on 13-Jun-2018 from IP address 171.60.245.8
using Electronic Verification Code QWJ7GZ4GAI generated through Aadhaar OTP mode.

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