Acknowledgement Number : 283308570210923 Date of Filing : 21-Sep-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 (A2) Middle Name (A3) Last Name (A4) PAN
AKHIL P ANTONY BRVPA3519H
(A5) Status (A6) Flat/Door/Block No. (A7) Name of Premises/Building/Village
Individual BETHEL 68/1
(A8) Road/Street/Post Office
(A9) Area/locality (A10) Town/City/District
Kazhakuttam S.O, Kazhakkoottam-Menamkulam
THIRUVANANTHAPURAM, 695582, Kerala, INDIA Thiruvananthapuram
(Part)
(A11) State (A12) Country/Region (A13) Pin code/Zip code
16-Kerala 91-India 695582
(A16) Residential/Office Phone Number with Mobile No. 1
(A17) Mobile No. 2
STD/ISD code 91 6261935509
(A18) Email Address-1 (self)
(A19) Email Address-2
[email protected]
(A14) Date of Birth/Formation (DD/MM/YYYY) (A15) Aadhaar Number(12 digits)/Aadhaar Enrolment Id(28 digits) (if eligible for Aadhaar No.)
18/03/1994 4xxx xxxx 5265

(A20) (a1i) Filed u/s (Tick)[Please see instruction ] (a1ii) Or Filed in response to notice u/s 139(4)-After due 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 in India for

182 days or more
(e) Residential Status in India (for individuals) Resident
during the previous year
[section 6(1)(a)]

(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

(ii) In case you are a Citizen of India or a Person of Indian Origin (POI), please specify -

*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).”
Acknowledgement Number : 283308570210923 Date of Filing : 21-Sep-2023*

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) No

(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

*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).”
Acknowledgement Number : 283308570210923 Date of Filing : 21-Sep-2023*

SCHEDULE SALARY - DETAILS OF INCOME FROM SALARY

Name of Employer Nature of Employer TAN of Employer (mandatory if tax is deducted)

VIKRAM SARABAHI SPACE CENTRE Central Government TVDV01047E
Address of employer Town/City State Pin code/ Zip code
TRIVANDRUM- 695022 TRIVANDRUM 16-Kerala 695022

1 Gross Salary (1a + 1b + 1c + 1d + 1e + 1f) 1 9,86,580

Salary as per section 17(1) (drop down to be

a 1a 9,86,580
provided)

Sl
Nature of Salary Description Amount
No.

1 2 3 4

1 Basic Salary 9,86,580

Value of perquisites as per section 17(2) (drop

b 1b 0
down to be provided)

Sl
Nature of Perquisites Description Amount
No.

1 2 3 4

Profit in lieu of salary as per section 17(3) (drop

c 1c 0
down to be provided)

Sl Nature of Profit in lieu

Description Amount
No. of salary

1 2 3 4

Income from retirement benefit account

d 1d 0
maintained in a notified country u/s 89A

Sl
Country/Region Amount
No.

1 2 3

Income from retirement benefit account

e maintained in a country "other than notified 1e 0
country u/s 89A"
Income taxable during the previous year on which
f relief u/s 89A was claimed in any earlier previous 1f 0
year

2 Total Gross Salary (from all employers) 2 9,86,580

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 9,86,580

5 Deduction u/s 16 (5a + 5b + 5c) 5 52,500

*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).”
Acknowledgement Number : 283308570210923 Date of Filing : 21-Sep-2023*

A Standard deduction u/s 16(ia) 5a 50,000

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

C Professional tax u/s 16(iii) 5c 2,500

6 Income chargeable under the Head 'Salaries' (4 - 5) 6 9,34,080

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

*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).”
Acknowledgement Number : 283308570210923 Date of Filing : 21-Sep-2023*

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

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) 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
Capital Gain, chargeable @ 30%
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

*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).”
Acknowledgement Number : 283308570210923 Date of Filing : 21-Sep-2023*

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

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 (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)

*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).”
Acknowledgement Number : 283308570210923 Date of Filing : 21-Sep-2023*

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

b Deductions under section 48

i Cost of acquisition with indexation bi 0

ii Cost of improvement with 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) 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?

*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).”
Acknowledgement Number : 283308570210923 Date of Filing : 21-Sep-2023*

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
Pass Through Income/ Loss in the nature of Long Term
a2 Capital Gain, chargeable @ 10% under sections other B11a2 0
than u/s 112A
Pass Through Income/ Loss in the nature of Long Term
a3 B11a3 0
Capital Gain, chargeable @ 20%
Amount of LTCG included in B1 - B11 but not chargeable to tax or chargeable at special rates
12
in India as per DTAA
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

*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).”
Acknowledgement Number : 283308570210923 Date of Filing : 21-Sep-2023*

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)

*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).”
Acknowledgement Number : 283308570210923 Date of Filing : 21-Sep-2023*

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
gains taxable at the
2 rate of 30% Enter value 0 0 0 0 0
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
schedule BFLA, if any.
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
gains taxable at the
5 rate of 10% Enter value 0 0 0 0 0
from item 3vi of
schedule BFLA, if any.
Long- term capital
gains taxable at the
6 rate of 20% Enter value 0 0 0 0 0
from item 3vii of
schedule BFLA, if any.

*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).”
Acknowledgement Number : 283308570210923 Date of Filing : 21-Sep-2023*

Long- term capital

gains taxable at the
7 rate DTAA rates Enter 0 0 0 0 0
value from item 3ix of
schedule BFLA, if any.
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

1 31/07/2022 17/01/2023 Capital Gain 50,000 36,757 0

Total (Sum of all Positive Incomes of Capital Gain in Col. 7) 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

*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).”
Acknowledgement Number : 283308570210923 Date of Filing : 21-Sep-2023*

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 2,529

A Dividends, Gross (ai +aii) 1a 0

ai Dividend income [other than (ii)] 1ai 0

aii Dividend income u/s 2(22)(e) 1aii 0

B Interest, Gross (bi + bii + biii + biv + bv + bvi + bvii + bviii + bix) 1b 2,529

bi From Savings Bank bi 897

From Deposits (Bank/ Post Office/ Co-operative

bii bii 1,632
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)
Interest accrued on contributions to provident
bvi fund to the extent taxable as per second bvi 0
proviso to section 10(11)
Interest accrued on contributions to provident
bvii fund to the extent taxable as per first proviso to bvii 0
section 10(12)
Interest accrued on contributions to provident
bviii fund to the extent taxable as per second bviii 0
proviso to section 10(12)

bix Others ix 0

*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).”
Acknowledgement Number : 283308570210923 Date of Filing : 21-Sep-2023*

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 0

Sl.
Country/Region Amount
No.

1 2 3

2 Income chargeable at special rates (2a+ 2b+ 2c+ 2d + 2e +2f elements related to Sl. No.1) 2 0

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 0

Sl.
Nature Amount
No.

1 2 3

*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).”
Acknowledgement Number : 283308570210923 Date of Filing : 21-Sep-2023*

Pass through income in the nature of income from other sources chargeable
e at special rates (drop down to be provided) 2e 0

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 2,529
related to DTAA portion) - 3 + 4 + 5 - 5a ) (if negative take the figure to 3i of Schedule CYLA)

*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).”
Acknowledgement Number : 283308570210923 Date of Filing : 21-Sep-2023*

7 Income from other sources (other than from owning race horses) (2 + 6) (enter 6 as nil, if negative) 7 2,529

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 2,529

*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).”
Acknowledgement Number : 283308570210923 Date of Filing : 21-Sep-2023*

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 0
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
(Including PTI Income)
Dividend Income (other
than units referred to
6 in section 115AB) u/s 0 0 0 0 0
115AD(1) (i) @ 20%
(Including PTI Income)
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 9,34,080 0 0 9,34,080

iii House property 0 0 0

Short-term capital gain

iv 0 0 0 0
taxable @ 15%
Short-term capital gain
v 0 0 0 0
taxable @ 30%
Short-term capital gain
vi taxable at applicable 0 0 0 0
rates
Short-term capital gain
vii taxable at special rates 0 0 0 0
in India as per DTAA
Long term capital gain
viii 0 0 0 0
taxable @ 10%
Long term capital gain
ix 0 0 0 0
taxable @ 20%

*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).”
Acknowledgement Number : 283308570210923 Date of Filing : 21-Sep-2023*

Long term capital gains

taxable at special rates
x 0 0 0 0
in India as per DTAA

Net income from other

xi sources chargeable at 2,529 0 2,529
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 9,34,080 9,34,080

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 2,529 2,529
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 9,36,609
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

*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).”
Acknowledgement Number : 283308570210923 Date of Filing : 21-Sep-2023*

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 1,19,668

a 1,19,668
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 55,946 27,973

80CCD(1B)- Contribution to pension scheme of Central Government by the 50,000

d 50,000
Employee

80CCD(2) - Contribution to pension scheme of Central Government by the 1,09,164

e 1,09,164
Employer

f 80D-Deduction in respect of Health Insurance premia 5,600 5,600

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

*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).”
Acknowledgement Number : 283308570210923 Date of Filing : 21-Sep-2023*

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 897 897

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) 3,41,275 3,13,302

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

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

*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).”
Acknowledgement Number : 283308570210923 Date of Filing : 21-Sep-2023*

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

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

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 6,23,310

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 6,23,310

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) 38,648

Amount of tax against which credit is available [enter (2 – 1) if 2 is greater than 1,

3 38,648
otherwise enter 0]

*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).”
Acknowledgement Number : 283308570210923 Date of Filing : 21-Sep-2023*

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)

1 2013-14 0 0 0 0 0

2 2014-15 0 0 0 0 0

3 2015-16 0 0 0 0 0

4 2016-17 0 0 0 0 0

5 2017-18 0 0 0 0 0

6 2018-19 0 0 0 0 0

7 2019-20 0 0 0 0 0

8 2020-21 0 0 0 0 0

9 2021-22 0 0 0 0 0

10 2022-23 0 0 0 0 0

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

Total 0 0

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)

*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).”
Acknowledgement Number : 283308570210923 Date of Filing : 21-Sep-2023*

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

*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).”
Acknowledgement Number : 283308570210923 Date of Filing : 21-Sep-2023*

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

*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).”
Acknowledgement Number : 283308570210923 Date of Filing : 21-Sep-2023*

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

*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).”
Acknowledgement Number : 283308570210923 Date of Filing : 21-Sep-2023*

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

*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).”
Acknowledgement Number : 283308570210923 Date of Filing : 21-Sep-2023*

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

*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).”
Acknowledgement Number : 283308570210923 Date of Filing : 21-Sep-2023*

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 9,34,080

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

*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).”
Acknowledgement Number : 283308570210923 Date of Filing : 21-Sep-2023*

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 2,529
Schedule OS) (enter nil if loss)

b Income chargeable to tax at special rates(2 of Schedule OS) 4b 0

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 2,529

5 Total of head wise income (1 + 2 + 3e + 4d) 5 9,36,609

6 Losses of current year set off against 5 6 0

7 Balance after set off current year losses (5-6) 7 9,36,609

8 Brought forward losses set off against 7 8 0

9 Gross Total income (7-8) 9 9,36,609

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

11 Deductions under Chapter VI-A 11 3,13,302

12 Total income (9 - 11) 12 6,23,310

Income which is included in 12 and chargeable to tax at special rates (total of (i) of
13 13 0
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 6,23,310
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 6,23,310

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 37,162

b Tax at special rates (total of (ii) of Schedule-SI) 2b 0

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 37,162

3 Rebate under section 87A 2d 0

*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).”
Acknowledgement Number : 283308570210923 Date of Filing : 21-Sep-2023*

4 Tax Payable after rebate (2d-3) 3 37,162

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 1,486

7 Gross tax liability (4 + 5iv + 6) 7 38,648

8 Gross tax payable (higher of 1d and 7)(8a + 8b) 8 38,648

Tax on income without including income on perquisites referred

a in section 17(2)(vi) received from employer, being an eligible 8a 38,648
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 38,648

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 38,648

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 5,000

e Total Interest and Fee Payable (13a+13b+13c+13d) 13e 5,000

*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).”
Acknowledgement Number : 283308570210923 Date of Filing : 21-Sep-2023*

14 Aggregate liability (12+13e) 14 43,648

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 38,677

c TCS (total of column 7(i) of 20D) 15cc 0

d Self Assessment Tax (from column 5 of 20A) 15d 4,970

e Total Taxes Paid (15a+15b+15c+15d) 15e 43,647

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 0

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 SBIN0002279 SBI 20238470716

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 ]

*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).”
Acknowledgement Number : 283308570210923 Date of Filing : 21-Sep-2023*

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

1 6360014 21/09/2023 5229 4,970

Total 4,970

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

1 TVDV01047E VIKRAM SARABHAI SPACE CENTRE 9,86,580 38,309

Total 38,309

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 Unclaimed TDS credit being claimed this Year
Financial Year (TDS
relatin TDS brought (only if corresponding income is
deducted during FY Correspondin
g to forward (b/f) being offered for tax this year. Not
Aadha 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 the hands of credit
[spous (if TDS tor/PA
(if TDS spouse as per being
Sl. e as credit N/Aad
credit Fin. section 5A or Claimed in the hands of carrie
No. per relate haar Deduc
relate Year any other spouse as per section 5A or d
sectio d to of ted in
d to in TDS person as per Claime any other person as per rule forwar
n 5A other Tenan
other which b/f own d in Head d
/other person t/Buye rule 37BA(2) 37BA(2) (if applicable) Gross
person deduct hands Of
person ) r (if applicable) own Amou
) ed hands Incom
as per nt
e
rule Incom Incom Aadha
TDS TDS PAN
37BA( e e ar
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
AHMA1
1 Self 0 368 0 0 368 0 0 36,757 Other 0
8899G
Source
s

Total 368

*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).”
Acknowledgement Number : 283308570210923 Date of Filing : 21-Sep-2023*

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
self PAN Aadha forward (b/f) 2022-23) income is being offered for tax g Receipt
/other of ar of this year) offered
perso Other Other
Aadha Deducted in 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 N
citizen?If you are HUF, whether any member of HUF is a senior citizen?

(a) Self & Family 5,600

(i) Health Insurance 5,600

(ii) Preventive Health Checkup 0

(b) Self & Family including Senior Citizen 0

(i) Health Insurance 0

(ii) Preventive Health Checkup 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 P

*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).”
Acknowledgement Number : 283308570210923 Date of Filing : 21-Sep-2023*

(a) Parents 0

(i) Health Insurance 0

(ii) Preventive Health Checkup 0

(b) Parents including Senior Citizen 0

(i) Health Insurance 0

(ii) Preventive Health Checkup 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 5,600

VERIFICATION

I, AKHIL P ANTONY son/ daughter of ANTONY POULOSE 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 BRVPA3519H. 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: 21-Sep-2023 Place: THIRUVANANTHAPURAM 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”.

*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).”