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1
2 PAN NO.
3 Designation4 Name of the Office
5 Basic Pay as on MAR-13
6
7 AFTER AAS/INCREMENT/STEP-UP
8
910 AI11 PP/FP12 HMA
13
14
15
16
1 ZPPF/GPF/CPS ZPPF
3 GIS 120
4 APGLI 450
5 CSS 0
0
FEB
CA(PH ALLOWANCE)
MONTH OF INCREMENT/AAS/STEP-UP
ZPHS, KARUMANCHI
MONTH OF NEW BASIC AFTER AAS/INCREMENT/STEP-UP
7000
ZPPF ENHANCEMENTMONTH(SELECT'0' IF NOT
ENHANCED)
PAY AFTER INCREMENT/AAS/STEP-UP
Name of the Employee
CCA 0
3000
RENT ACTUALLY PAID PER MONTH
0
Basic Pay as on Jan-2013(for DA calculation) 25600
TREASURY ID No: AFGPB9002G0706764
EARNINGS
26300
26300
70
12
B. SANKAR SINGH
25600
SCHOOL ASSISTANT(SS)
DEDUCTIONS
NO
ZPPF AMOUNT (MAR 12)
JAN
GIS ENHANCEMENTMONTH (SELECT '0' IF
NOT ENHANCED)
HRA %
FILL IN THE DATA
APGLI ENHANCEMENTMONTH (SELECT '0' IFNOT ENHANCED)
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6LOANS(GPF/ZPPF/APG
LI)0
7 EWFLOAN 0
8 LIC(SALARY) 0
9 LIC(BYHAND) 48063
GROSS AMOUNTDA 1(47.936% to
54.784%) 8765
DA 1(54.784% to63.344%) 8764
DA 2(63.344%) CASHMONTH NOV
PAY AI DA HRA
1342 351 850
PAY AI DA HRA
0 0 0 0
0 DAYS
1 0
2 0
3 0
SELECT THE MONTH FROCASH ALONG
Tuition Fee
Housing Loan Principle
FEES REIMBURSEMENT 0
S.L. ENCASHMENT MONTH
DA ARREARS
JUL
LIC ENHANCEMENT MONTH(SELECT '0' IF NOT
ENHANCED)
OTHER DEDUCTIONS
SURRENDER LEAVE
INFRASTRUCTURAL BONDS(max. Rs. 20000/-)
GPF/ZPPF ADJUSTMENT
6573
6/12/18/24 YEARS SCALE/INCRE
PRC ARREARS/STE
7012
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4 0
5 0
6 0
7 0
8 0
9 0
10 0
11 0
12 0
13 0
14 0
15 0
16 0
Interest on Housing loan(U/S 24(L)(VI)
P.L.I/N.S.C.
C.M.Relief Fund
Exception on PHC dependent (80DD) Rs. 50000/-
Mediclaim Insurance (80-D)
interest on Education loan
Donations (80 G)
B. SANKAR SINGH
Any other
Deduction on to PHC Employees(80 U)
Health insurance(Max. 15000/-, Rs. 20000/- for Sr. citizens)
Exp. On Medical Treatment
Name of Premises/Building/Village
EMPLOYEE INFORMATION FO
Road/Post Office/Street
NAME OF THE EMPLOYEE
DATE OF BIRTH(mm/dd/yyyy)
HOUSE NO.
Bonds
FATHER'S NAME
RAJIV GANDHI EQUITY SHARE SCHEME(80CCG) MAX 50000
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S. No Month and Year Amount of Tax Paid
1 Mar-13 0
2 Apr-13 0
3 May-13 0
4 Jun-13 0
5 Jul-13 0
6 Aug-13 1500
7 Sep-13 1500
8 Oct-13 1500
9 Nov-13 1500
10 Dec-13 1500
11 Jan-14 5000
12 Feb-14 9830
22330
Rs. 22330
DDO FATHER'S NAME M. HANUMA NAIK
TOWN/CITY/DISTRICT
DDO INFORMA
PIN CODE
nineteen thousand two hundred and forty only
9830TOTAL
Bill ID No. Issued bytreasury
STATE
TAX DEDUCTION AT SOURCE(TDS) AND ADVANCE TAX PAID BY THE EMPLOYEER
DDO DESIGNATION GAZETTED HEAD MASTER
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GAZETTEDN.G.O N.G.O.
ENHANCEMENTMONTH
TOTAL
0 0
0 0
0
1
2
0
ELOW
ANY CORRECTIONS ORSUGGESTIONS PLEASE
CALL
TO PREFIX A ZERO HIT SINGLEINVERTED COMMA(') AND ENTER
THE NUMBER
IF YOU HAVEN'T GOT ANY BENEFITUNDER AAS OR STEP UP
SELECTED THE FIRST TWO BASICPAYS AS SAME , THEN SELECT
YOUR MONTH OF INCREMENT ANDSELECT YOUR BASIC PAY.
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IR TOTAL P. TAX ZPPF CASH
161 0 0
IR TOTAL ZPPF P. TAX CASH
0 0 0
0
WHICH THE NEW DA IS DRAWN INITH REGULAR SALARY
CASH
2191
0
1753
2704
0
.KRISHNA)
ENTAL ARREARS2704
P UP ARREARS
0
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DDO NAME
DDO TAN
TAX PAID BALANCE
DATE 22330 0
HYDZ-00398-G
PRAKASAM
ION
523001
OR EMPLOYEE
Andhra pradesh
L. SAMBASADA SIVA RAO
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Jan-13 25600 14025 12272 1753Feb-13 25600 14025 12272 1753Mar-13 25600 14025 12272 1753 Apr-13 25600 14025 12272 1753 8765 877 7888May-13 25600 14025 12272 1753 8765 7012 1753
Jun-13 25600Jul-13 25600 16216 14025 2191
Aug-13 25600 16216 14025 2191
Sep-13 25600 16216 14025 2191 8764 876 7888
Oct-13 25600 16216 14025 2191 8764 6573 2191
Nov-13 25600
Dec-13 25600
Jan-14 26300
Feb-14 26300
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OCTNOV
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PAY AI PP/FP CA WANC IR HMA DA HRA TOTAL ZPPF GIS APGLI P.TAX
1 Mar-13 25600 70 0 0 0 12272 3072 41014 3000 120 450 200 20
2 Apr-13 25600 70 0 0 0 12272 3072 41014 3000 120 450 200
3 May-13 25600 70 0 0 0 12272 3072 41014 3000 120 450 200
4 Jun-13 25600 70 0 0 0 14025 3072 42767 3000 120 450 200
5 Jul-13 25600 70 0 0 0 14025 3072 42767 3000 120 450 200
6 Aug-13 25600 70 0 0 0 14025 3072 42767 3000 120 450 200
7 Sep-13 25600 70 0 0 0 14025 3072 42767 3000 120 450 200
8 Oct-13 25600 70 0 0 0 14025 3072 42767 3000 120 450 200
9 Nov-13 25600 70 0 0 0 16216 3072 44958 3000 120 450 200
10 Dec-13 25600 70 0 0 0 16216 3072 44958 3000 120 450 200 20
11 Jan-14 26300 70 0 0 7101 0 16659 3156 53286 3000 120 450 200
12 Feb-14 26300 70 0 0 7101 0 16659 3156 53286 3000 120 450 200
DA ARREARS 1 8765 8765 7012
DA ARREARS 2 8764 8764 6573
PRC ARREARS 1342 0 161 351 850 2704 0 0 scae
arrears 0 0 0 0 0 0 0 0
CSS 0 0FEES
REIMBURSEMENT0 0 0 0
Surrender Leave 0 0 0 0 0 0 0 0 0
309942 840 0 0 161 14202 0 190571 37882 553598 49585 1440 5400 2400
S.NOD
STATEMENT OF EARNINGS AND DEDUCTIONS/SAVINGS IN RESPECT OF B. SANKAR SINGH,SCHOOL ASSISTANT(SS) FOR THE YEA
TOTAL
M O R E E A R N I N G S
EARNINGSMONTH&YEAR
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SIGNATURE OF THE D.D.O.
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37224
37244
37244
38997
38584
37497
37497
37497
39688
36168
44516
39686
1753
2191
2704
0
0
0
0
468490
NET
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mployee
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PAN1 Name of the Employee :2 Designation : SCHOOL ASSISTANT(SS)3 Name of the Office : ZPHS, KARUMANCHI4 Gross salary Income : Rs 5535985 HRA Exmpted :
i) Actual HRA Received : Rs 37882
ii) Rent paid in Excess of 10% of Salary (Pay+DA) : Rs 33949
iii) 40% of Salary : Rs 124060(Deduct least of the above three) : Rs 33949
6 Net salary Income(4-5) : Rs 5196497 Deductions :
a) Profession Tax(U/S 16(iii) : Rs 2400b) Interest on Housing loan(U/S 24(L)(VI) : Rs 0Total : Rs 2400
8 Total Income(6-7) : Rs 5172499 Deductions under chapter VI -A :
A)Savings(U/S 80C) (Max.Rs.1,00,000) :i)G.P.F/Z.P.P.F/C.P.S/C.S.S : Rs 49585ii)G.I.S : Rs 1440iii)L.I.C : Rs 48063iv)P.L.I/N.S.C. : Rs 0v) A.P.G.L.I : Rs 5400vi) Tution Fee : Rs 0vii) Housing loan principle amount : Rs 0viii) Bonds : Rs 0
ix) Any other : Rs 0Total (U/S 80C) : Rs 104488
B) INFRASTRUCTURE BONDS(MAX. 20000/-) : Rs 0C) Mediclaim Insurance (80-D) : Rs 0D) Expenditure on PHC dependent (80DD) : Rs 0E) Interest on Education Loan(80-E) : Rs 0F) Exp. On Medical Treatment(80-DDB) : Rs 0G) RAJIV GANDHI EQUITY SHARE SCHEME(80 CCG) : Rs 0F) Donations (80 G) : Rs 0
i) C.M.Relief Fund : Rs 413ii) Sainic welfare fund : Rs 20iii) Employees welfare fund : Rs 20iv) Other donations if any : Rs 0
G) Deduction on to PHC Employees(80 U) : Rs 0Total(Chapter VI-A) : Rs 453 Rs 104941
Rs 10045310 Taxable Income(8-9) : Rs 41679611 Tax on total Income :
-: Rs 0 -
: Rs 21680 -
: Rs 0 -
TOTAL DEDUCTIONS( ADMISSIBLE)
MALE/FEMALE SERVANT
10 00 001/-and above-Rs 1 30 000+30% of the amount
INCOME TAX CALCULATION FOR THE YEAR 2013-14
2,00,001 to 5,00,000-10 of the amount exceeding 5 lakhs
TAN :HYDZ-00398-G
2,00,000-Nil
[Actual Rent Paid 7000X12=84000-50051[(Pay+DA)*10%]=33949]
TDS PAID
AFGPB9002G
Rs. 5,00,001/-to 10,00,000/-Rs.30000+20 of the amount exceeding
5,00,000/-
B. SANKAR SINGH ID No:0706764
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Designation
Signature
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--
-
-
PAID
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SARAL-II
PSU
1 1
2 2
3 3
4 4
5
a 80 C 100000 e 80DD 0 i 80GG
b 80 CCC 2400 f 80DDB j 80GGA
c 80 CCD g 80E k 80GGC
d 80 D 0 h 80G 453 l 80U
6 6
7 7
8 8
9 9
10 10
11 11
12 12
13 13
14 14
15 15
D i i hi
I N C O M E & D E D U C T I O N S
T A X C O M P U T A T I O N
Relief under Section 89 0
Balance Tax Payable (10-11-12) 22330
Relief under Section 90/91 0
Total Tax and Education cess Payable(8+9) ROUNDED TO NEAREST 10 22330
Total Tax and Interest Payable (13+14) 22330
416796
Tax Payable on Total Income 21680
Secondary and Higher Education cess on 8 651
Total Interest Payable U/s 234A/B/C 0
0
Deductions ( Total of 5a to 5i) 102853
Total income(4-6)
Income Chargeable under the Head 'House Property'(enter -ve sign in case ofloss, if any)
Income Chargeable under the Head ' Other Sources '(enter -ve sign in case ofloss, if any)
Gross Total Income(1+2+3) 519649
Deductionsunderchapter VI A(Section)
Residential Status(Tick) Resident Non-Resident Resident but not ordinarily Resident F I L I N G
S T A T U S
Income Chargeable under the Head 'Salaries ' (Salary/Pension) 519649
Whether Original or Revised return?(Tick) Original Revised
If revised,enter Receipt No. and date of filing original return DD/MM/YY
P E R S O N A L I N F O R M A T I O N
Designation of the Assessing Officer(Ward/circle)Returns filed under Section
[Please see instructionno.9(i)
E-mail Address
Sex(Tick)
Male F
STD Code-Phone Number( )
Town/City/District
Name of Premises/Building/Village
Road/Street/Post Office
ONGOLE
Area/Locality
PRAKASAM
State
Andhra pradesh
Pin Code
523001
First Name
BONDILI
8-292
Govt
Middle Name
SANKAR
Last Name
SINGH
Employer Category,(Tick
Date of Birth
1/8/1958VINNAKOTAVARI STREET
F O R M
(ITR-1)
INDIAN INCOME TAX RETURN
[For Individuals having Income from Salary/Pension/Income from One HouseProperty(excluding loss brought forward from previous years)/Income from other
sources(Excluding Winning from Lottery and Income from Race Horses)]
(Please see rule 12 of the Income-Tax Rules, 1962)(Also see attached instructions)
Assessment Year
Flat/Door/Block No
AFGPB9002G
2 0 1 4 -
PAN
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16
a 16 a
b 16 b
c 16c
17 17
18 18
19 19
22.MICRCODE
23
S.No
(1)
1
B
24
S.No
(1)
1
B
25
S. No
i
ii
iii
26Sl No Code Code Code
a 001 001 001
b 002 002 002
c 003 003 003
27 27
I B. SANKAR SINGH son/daughter of BHAVAN SINGH solemnly declare that to the best of my knowledgeand belief, the information given in the return thereto is correct and complete and that the amount of total income other particulars showntherein are truly stated and are in accordance with the provisions of Income Tax Act, 1961, in respect of income chargeable to Income-taxfor the previous year relevant to the Assessment year 2013-14.
Place Date Sign here
Details of Advance Tax and Self Assessment Tax Payments
Exempt income only for reporting purposes(from Dividend, Capital gains etc)
VERIFICATION
Other Information(transactions reported through Annual Information Return)(Please see instruction number 9(ii) for code) Amount Rs. Amount Rs. Amount Rs.
NOTE Enter the totals of Advance tax and self Assessment tax in sl . No. 17 a of TAXES PAID
Note
Name of Bank & BranchSerial Nof ChallaBSR CODE
Date of Deposit(dd/mm/yyyy)
Enter the total of column (7) of 23 and column (7) of 24 in S. No.(17b of Taxes Paid)
(5) (6)(3) (4)
517249 100453 22330HYDZ-00398-G GAZETTED HEADMASTER
T D S O N I N T E R E S T
Details of Tax Deducted at Source other than salaryTax Deduction
AccountNumber(TAN) of the
Employer
Name and address ofthe Employer
Income chargeableUnder the head
salaries
Deduction underChapter VI-A
TaxPayable(In
cl. edn.
Cess)(7)(2)
T A X E S P A I D
Type of Account(tick as appl
savings
Details of Tax Deducted at Source from salary(As per Form 16 issued by Employer(s)
T D S O N S A L A R Y
21. Do you want your refund by cheque or deposited directly into your bank account *(tick as applicalble)
Deduction underChapter VI-A
(5)
Tax Deduction Account
Number(TAN) of theEmployer
(2)
Total Taxdeducted
22. Give additional details of your bank account
(4)
TaxPayable(In
cl. edn.Cess)
Total Taxdeducted
(6)
22330
Taxes Paid
20. Enter your bank account number (mandatory in caseof refund)
Name and address ofthe Employer
Refund((17d-16) (enter if 17d is greater than 16, also give Bank account detailsbelow
Advance Tax (from item 25)
Income chargeableUnder the head
salaries
Total Taxes Paid(16a+16b+16c) 22330
Tax Payable(15-17) (Enter if 15 is greater than 17 else leave blank) 0
(3) (7)
TDS (Column 7 of item 23+Column 7 of item 24)
Self Assessment Tax (From item 25)
0
22330
0
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TO
ACKNOWLEDGEMENT No.
1
(a) 553598
(b)
(c)
(d)2
3 5196494
24005 2400
6 517249
7
8 517249 9
A) Gross Amount Qualifying Amount
495851440
480630
540000
(iii) L.I.C. (ii) G.I.S
(vii) H/LOAN PRINCIPLE
Gross total income (6+7)Deductions under Chapter VIA
(a) Section 80C (i) Provident Fund
(v) A.P.G.L.I (vi) TUITION FEES
Add: Any other income reported by theemployee
(a)
Balance(1-2)
Deductions u/s 16:
(b) Aggregate of 4(a) to (b)Income chargeable under the head 'salaries' (3-5)
Salary as per provisions contained insec.17(1)
Value of perquisites u/s 17(2) (as per FormNo.12BB, wherever applicable)
Section 80C, 80CCC, and 80CCD
Entertainment allowanceTax on employment
Profits in lieu of salary under section17(3)(as per Form No.12BB, whereverapplicable)Total
Less: Allowance to the extent exempt u/s 10H.R.A 33949
FORM NO.16[See rule 31(1)(a)]
Certificate under section 203 of the Income-tax Act, 1961 for Tax deducted at source from income chargeable underthe head " Salaries"
NAME AND ADDRESS OF THE EMPLOYER NAME AND DESIGNATION OF THE EMPLOYEE
GAZETTED HEAD MASTER B. SANKAR SINGH ,SCHOOL ASSISTANT(SS)
QUARTER
PAN No. of the Employee
AFGPB9002G
PERIOD
PAN of Deductor TAN No. of the Deductor
ASSESMENTYEAR
FROM
Details of Salary paid and any other income and tax deducted
2014-15
HYDZ-00398-G
ACKNOWLEDGEMENT Nos of all quartelystatement of TDS under sub-section(3) of of section200 as provided by TIN facilitation Centre or NSDL
website
Mar-13 Feb-14
Gross Salary
(iv) P.L.I.C./N.S.C
(b) Section 80 CCC (c) Section 80 CCD
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0
(a) 413
(b) 20
(c) 20
(d) 0
(e)
100453
416796
21680
434
217
22331
0
#N/A
22330
#N/A
Gross Amount Qualifying Amount Deduction amount
17 Tax Payable(15-16)
Education Cess(on tax at S. No. 12 andsurcharge at S.No. 13)
14
16 Relief Under Section 87 A
15 Tax Payable(12+13+14)
10 Aggregate of deductible amount underChapter VIA
18 Less:
Section
12
19 Tax Payble/refundable (17-18)
Surcharge(on tax computed at S.No. 12)13
i) C.M.Relief Fund
(B) OTHER SECTIONS( for e.g., 80E, 80 G etc) UnderChapter VIA
ii) Sainic welfare fund
iii) Employees welfare fund
iv) Other donations if any
(b) Tax paid by the employer on behalf of theemployee u/s 192(IA) on perquisites u/s 17(2)
(a) Tax dedution at source u/s 192(1)
11 Total Income (8-10)
Tax on total income
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S. NO TDS Rs.Surcharge
Rs.EducationCess Rs.
Cheque /DDNo.(if any)
B.S.R.Codeof BankBranch
Date onwhich which
taxdeposited(dd/mm/yyyy)
Transfervoucher/challan identification
No.
1 0 0 02 0 0 03 0 0 04 0 0 05 0 0 06 1500 0 07 1500 0 08 1500 0 09 1500 0 0
10 1500 0 011 5000 0 012 9830 0 0
DETAILS OF TAX DEDUCTED AND DEPOSITED INTO CENTRAL GOVERNMENT ACCOUNT
Total tax deposited Rs.
0
1500
0
0
9830
5000
1500
1500
1500
0
0
1500
Designation Full Name
I L. SAMBASADA SIVA RAO,son/daughter of M. HANUMA NAIK working in the capacity of GAZETTED HEAD MASTER (designation)do hereby certify that a sum of Rs.22330 [Rupees nineteen thousand two hundred and forty only (in words)] has been deducted atsource and paid to the credit of the Central Government. I further certify that the information given above is true and correct based onthe books of accounts, documents and other available records.
Place
Date Signature of person responsible for deduction of tax
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Received a sum of Rs.84000@ Rs.7000 per month from March 2013 to
February 2014 in respect of House No:8-292 situated at VINNAKOTAVARI STREET
ONGOLE,PRAKASAM
(Affix Revenue Stamp of Rs.1/-)
Date:
Name:
Address:______________________ _____________________________ _____________________________
PAN______________________
RECEIPT OF HOUSE RENT
Under Section 1(13-A) of Income Tax Act)
Recommended