Form PDF 172586610110424
Form PDF 172586610110424
Form PDF 172586610110424
(A15)(a) Filed u/s (Tick)[Please see instruction] 139(1)-On or before due date
*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 : 172586610110424 Date of Filing : 11-Apr-2024*
Sl.
Nature of Exempt Allowances Description ( If Any Other selected) Total Amount
No.
iia Less : Income claimed for relief from taxation u/s 89A iia 0
i Gross rent received/ receivable/ lettable value during the year i 70,000
Income chargeable under the head 'House Property' (iii - iv - v) + vi (If loss, put the figure in
vii B2 49,000
negative)
Sl.
Nature of Income Description ( If Any Other selected) Total Amount
No.
Quarterly breakup of Dividend Income Quarterly breakup of Income from retirement benefit
account maintained in a notified country u/s 89A
(taxable portion)
Gross Total Income (B1+B2+B3) (If loss, put the figure in negative) Note: To avail the benefit
B4 B4 4,40,000
of carry forward and set off of loss, please use ITR-2
*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 : 172586610110424 Date of Filing : 11-Apr-2024*
C2 0 0
80CCC - Payment in respect Pension Fund
0
C4 80CCD(1B) -Contribution to pension scheme of Central Government 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 : 172586610110424 Date of Filing : 11-Apr-2024*
*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 : 172586610110424 Date of Filing : 11-Apr-2024*
Total 0
D6 Relief u/s 89 (Please ensure to submit Form 10E to claim this relief) D6 0
D11 Total Tax, Fee and Interest (D5 + D7 + D8 + D9 + D10 - D6) D11 0
PART E - OTHER INFORMATION DETAILS OF ALL BANK ACCOUNTS HELD IN INDIA AT ANY TIME DURING THE PREVIOUS YEAR
(EXCLUDING DORMANT ACCOUNTS)
Sl.
IFS Code of the Bank Name of the Bank Account Number Type of account
No.
SCHEDULE 80D
1 Whether you or any of your family member (excluding parents) is a senior citizen? 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 : 172586610110424 Date of Filing : 11-Apr-2024*
(a) Parents 0
Sl. Date of filing of Form Ack. No. of Form 10IA UDID Number (If
Nature of Disability Amount of Deduction
No. 10IA filed available)
1 0
Details of deduction in respect of maintenance including medical treatment of a dependent who is a person with
Schedule 80DD
disability.
Sl. Nature of Amount of Type of PAN of the Aadhaar of the Date of filing of Ack. No. of Form UDID Number (If
No. Disability Deduction dependent dependent dependent Form 10IA 10IA filed available)
1 0
SCHEDULE 80G DETAILS OF DONATIONS ENTITLED FOR DEDUCTION UNDER SECTION 80G
A. DONATIONS ENTITLED FOR 100% DEDUCTION WITHOUT QUALIFYING LIMIT, (WHERE ANY ROW IS FILLED BY THE USER, ALL THE
FIELDS IN THAT ROW SHOULD BECOME MANDATORY)
(1) (2) (3) (4) (5) (6) (7) (9) (10) (11) (12)
Total A 0 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 : 172586610110424 Date of Filing : 11-Apr-2024*
B. DONATIONS ENTITLED FOR 50% DEDUCTION WITHOUT QUALIFYING LIMIT (WHERE ANY ROW IS FILLED BY THE USER, ALL THE
FIELDS IN THAT ROW SHOULD BECOME MANDATORY)
(1) (2) (3) (4) (5) (6) (7) (9) (10) (11) (12)
Total B 0 0 0 0
C. DONATIONS ENTITLED FOR 100% DEDUCTION SUBJECT TO QUALIFYING LIMIT (WHERE ANY ROW IS FILLED BY THE USER, ALL THE
FIELDS IN THAT ROW SHOULD BECOME MANDATORY)
(1) (2) (3) (4) (5) (6) (7) (9) (10) (11) (12)
Total C 0 0 0 0
D. DONATIONS ENTITLED FOR 50% DEDUCTION SUBJECT TO QUALIFYING LIMIT (WHERE ANY ROW IS FILLED BY THE USER, ALL THE
FIELDS IN THAT ROW SHOULD BECOME MANDATORY)
(1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12)
Total D 0 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 : 172586610110424 Date of Filing : 11-Apr-2024*
(1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12)
Total 0 0 0 0
Total 0 0 0 0
TAX PAYMENTS
Sl.
BSR Code Date of Deposit (DD/MM/YYYY) Serial Number of Challan Tax paid
No.
Total 0
SCHEDULE TDS1 - DETAILS OF TAX DEDUCTED AT SOURCE FROM SALARY [AS PER FORM 16 ISSUED BY EMPLOYER(S)]
Sl. Income chargeable under
TAN of the Deductor Name of the Deductor Total Tax Deducted
No. salaries
Total 0
SCHEDULE TDS2 - DETAILS OF TAX DEDUCTED AT SOURCE FROM INCOME OTHER THAN SALARY [AS PER FORM 16A ISSUED BY
DEDUCTOR(S)]
Gross receipt which
Sl. Name of the Year of tax TDS Credit out of
TAN of the Deductor is subject to tax Tax Deducted
No. Deductor deduction (5)claimed this year
deduction
Total 0
SCHEDULE TDS3 DETAILS OF TAX DEDUCTED AT SOURCE (AS PER FORM 16C FURNISHED BY THE PAYER(S))
Gross receipt TDS Credit out
Sl. PAN of the Aadhaar Number Name of the Year of tax
which is subject Tax Deducted of (6) claimed
No. Tenant of the Tenant Tenant deduction
to tax deduction this year
Total 0
SCHEDULE TCS
Tax Collection Gross payment TCS Credit out of (5)
Sl. Name of the Year of tax
Account Number of which is subject to Tax Collected claimed this year
No. Collector collection
the Collector tax collection
*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 : 172586610110424 Date of Filing : 11-Apr-2024*
Total 0
VERIFICATION
I, RAMESH son/ daughter of HARIPRASAD solemnly declare that to the best of my knowledge and belief, the information given in the return is
correct and complete and is in accordance with the provisions of the Income-tax Act, 1961. I further declare that I am making this return in my
capacity as Self and I am also competent to make this return and verify it. I am holding permanent account number EQXPR6382B
Place: 49.43.5.79
Date: 11-Apr-2024
If the return has been prepared by a Tax Return Preparer (TRP) give further details below:
If TRP is entitled for any reimbursement from the Government, amount thereof 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).”