PERSONAL INFORMATION
First name Middle name Last name PAN
Flat/Door/Block No Name Of Premises/Building/Village Status (Tick)
Individual HUF
Road/Street/Post Office Area/locality Date of Birth (DD/MM/YYYY)
( in case of individual)
/ /
Town/City/District State Pin code Sex (in case of individual) (Tick)
Country
Male Female
Residential/Office Phone Number with STD code /
Mobile No. 1
Mobile No. 2 Employer Category (if in
employment) (Tick)
Govt. PSU Others
Email Address-1 (self) Income Tax Ward/Circle
Email Address-2
FILING STATUS
Return filed (Tick)[Please see instruction number-7] Before due date -139(1) After due date -139(4) Revised Return- 139(5)
or In response to notice 139(9)-Defective 142(1) 148 153A/153C OR 92CD
If revised/Defective, then enter Receipt No. and Date of
filing original return (DD/MM/YYYY)
/ /
Residential Status (Tick) Resident Non-Resident Resident but Not Ordinarily Resident
Are you governed by Portuguese Civil Code? Tick) Yes No (If “YES” please fill Schedule 5A)
Whether this return is being filed by a representative assessee? (Tick) Yes No
If yes, please furnish following information -
(a) Name of the representative
(b) Address of the representative
( c) Permanent Account Number (PAN) of the representative
FORM
ITR-4
INDIAN INCOME TAX RETURN
( For individuals and HUFs having income from a proprietary business or profession)
(Please see rule 12 of the Income-tax Rules,1962)
(Also see attached instructions)
Assessment Year
2 0 1 3 - 1 4
Part A-GEN GENERAL
AUDIT INFORMATION
Are you liable to maintain accounts as per section 44AA? (Tick) Yes No
Are you liable for audit under section 44AB? (Tick) Yes No, If yes, furnish following information-
(a) Date of furnishing of the audit report (DD/MM/YYYY) / /
(b) Name of the auditor signing the tax audit report
(c) Membership no. of the auditor
(d) Name of the auditor (proprietorship/ firm)
(e) Permanent Account Number (PAN) of the proprietorship/ firm
(f) Date of report of the audit
Whether taxpayer is liable to furnish a report under section 92E? (Tick) Yes
No
For Office Use Only
For Office Use Only
Receipt No
Date
Seal and Signature of receiving official

NATURE OF
BUSINESS
NATURE OF BUSINESS OR PROFESSION, IF MORE THAN ONE BUSINESS OR PROFESSION
INDICATE THE THREE MAIN ACTIVITIES/ PRODUCTS
S.No.
Code
[Please see instruction No.7(i)]
Trade name of the
proprietorship, if any
Description
(i)
(ii)
(iii)
Part A-BS
BALANCE SHEET AS ON 31ST DAY OF MARCH, 2013 OF THE PROPRIETORY BUSINESS OR
PROFESSION (fill items below in a case where regular books of accounts are maintained, otherwise fill item 6)
SOURCES OF FUNDS
1 Proprietor’s fund
a Proprietor’s capital a
b Reserves and Surplus
i Revaluation Reserve bi
ii Capital Reserve bii
iii Statutory Reserve biii
iv Any other Reserve biv
v Total (bi + bii + biii + biv) bv
c Total proprietor’s fund (a + bv) 1c
2 Loan funds
a Secured loans
i Foreign Currency Loans ai
ii Rupee Loans
A From Banks iiA
B From others iiB
C Total ( iiA + iiB) iiC
iii Total (ai + iiC) aiii
b Unsecured loans (including deposits)
i From Banks bi
ii From others bii
iii Total (bi + bii) biii
c Total Loan Funds (aiii + biii) 2c
3 Deferred tax liability 3
4 Sources of funds (1c + 2c +3) 4
APPLICATION OF FUNDS
1 Fixed assets
a Gross: Block 1a
b Depreciation 1b
c Net Block (a – b) 1c
d Capital work-in-progress 1d
e Total (1c + 1d) 1e
2 Investments
a Long-term investments
i Government and other Securities - Quoted ai
ii Government and other Securities – Unquoted aii
iii Total (ai + aii) aiii
b Short-term investments
i Equity Shares, including share application money bi
ii Preference Shares bii
iii Debentures biii

iv Total (bi + bii + biii) biv
c Total investments (aiii + biv) 2c
3 Current assets, loans and advances
a Current assets
i Inventories
A
Stores/consumables including packing
material
iA
B Raw materials iB
C Stock-in-process iC
D Finished Goods/Traded Goods iD
E Total (iA + iB + iC + iD) iE
ii Sundry Debtors aii
iii Cash and Bank Balances
A Cash-in-hand iiiA
B Balance with banks iiiB
C Total (iiiA + iiiB) iiiC
iv Other Current Assets aiv
v Total current assets (iE + aii + iiiC + aiv) av
b Loans and advances
i
Advances recoverable in cash or in kind or for
value to be received
bi
ii
Deposits, loans and advances to corporates and
others
bii
iii Balance with Revenue Authorities biii
iv Total (bi + bii + biii ) biv
c Total of current assets, loans and advances (av + biv) 3c
d Current liabilities and provisions
i Current liabilities
A Sundry Creditors iA
B Liability for Leased Assets iB
C Interest Accrued on above iC
D Interest accrued but not due on loans iD
E Total (iA + iB + iC + iD) iE
ii Provisions
A Provision for Income Tax iiA
B Provision for Wealth Tax iiB
C
Provision for Leave
encashment/Superannuation/Gratuity
iiC
D Other Provisions iiD
E Total (iiA + iiB + iiC + iiD ) iiE
iii Total (iE + iiE) diii
e Net current assets (3c – diii) 3e
4 a Miscellaneous expenditure not written off or adjusted 4a
b Deferred tax asset 4b
c Profit and loss account/ Accumulated balance 4c
d Total (4a + 4b + 4c) 4d
5 Total, application of funds (1e + 2c + 3e +4d) 5
NO ACCOUNT
CASE
6 In a case where regular books of account of business or profession are not maintained -
(furnish the following information as on 31st day of March, 2013, in respect of business or profession)
a Amount of total sundry debtors 6a
b Amount of total sundry creditors 6b
c Amount of total stock-in-trade 6c
d Amount of the cash balance 6d

Part A-P& L
Profit and Loss Account for the previous year 2012-13 of the proprietary business or profession
(fill items 1 to 50 in a case where regular books of accounts are maintained, otherwise fill item 51)
CREDITS TO PROFIT AND LOSS ACCOUNT
1 Sales/ Gross receipts of business or profession (Net of returns and refunds and duty or tax, if any) 1
2 Duties, taxes and cess, received or receivable, in respect of goods and services sold or supplied
a Union Excise duties 2a
b Service tax 2b
c VAT/ Sales tax 2c
d Any other duty, tax and cess 2d
e Total of duties, taxes and cess, received or receivable(2a+2b+2c+2d) 2e
3 Other income
a Rent 3a
b Commission 3b
c Dividend 3c
d Interest 3d
e Profit on sale of fixed assets 3e
f
Profit on sale of investment being securities chargeable
to Securities Transaction Tax (STT)
3f
g Profit on sale of other investment 3g
h Profit on account of currency fluctuation 3h
i Agriculture income 3i
j Any other income 3j
k Total of other income (3a to 3j) 3k
4 Closing Stock 4
5 Total of credits to profit and loss account (1+2e+3k+4) 5
DEBITS TO PROFIT AND LOSS ACCOUNT
6 Opening Stock 6
7 Purchases (net of refunds and duty or tax, if any) 7
8 Duties and taxes, paid or payable, in respect of goods and services purchased
a Custom duty 8a
b Counter veiling duty 8b
c Special additional duty 8c
d Union excise duty 8d
e Service tax 8e
f VAT/ Sales tax 8f
g Any other tax, paid or payable 8g
h Total (8a+8b+8c+8d+8e+8f+8g) 8h
9 Freight 9
10 Consumption of stores and spare parts 10
11 Power and fuel 11
12 Rents 12
13 Repairs to building 13
14 Repairs to machinery 14
15 Compensation to employees
a Salaries and wages 15a
b Bonus 15b
c Reimbursement of medical expenses 15c
d Leave encashment 15d
e Leave travel benefits 15e
f Contribution to approved superannuation fund 15f
g Contribution to recognised provident fund 15g
h Contribution to recognised gratuity fund 15h
i Contribution to any other fund 15i

j
Any other benefit to employees in respect of which an
expenditure has been incurred
15j
k Total compensation to employees (15a+15b+15c+15d+15e+15f+15g+15h+15i+15j) 15k
16 Insurance
a Medical Insurance 16a
b Life Insurance 16b
c Keyman’s Insurance 16c
d Other Insurance 16d
e Total expenditure on insurance (16a+16b+16c+16d) 16e
17 Workmen and staff welfare expenses 17
18 Entertainment 18
19 Hospitality 19
20 Conference 20
21 Sales promotion including publicity (other than advertisement) 21
22 Advertisement 22
23 Commission 23
24 Hotel , boarding and Lodging 24
25 Traveling expenses including foreign traveling 25
26 Conveyance expenses 26
27 Telephone expenses 27
28 Guest House expenses 28
29 Club expenses 29
30 Festival celebration expenses 30
31 Scholarship 31
32 Gift 32
33 Donation 33
34 Rates and taxes, paid or payable to Government or any local body (excluding taxes on income)
a Union excise duty 34a
b Service tax 34b
c VAT/ Sales tax 34c
d Cess 34d
e Any other rate, tax, duty or cess incl. STT Paid 34e
f Total rates and taxes paid or payable (34a+34b+34c+34d+34e) 34f
35 Audit fee 35
36 Other expenses 36
37 Bad debts 37
38 Provision for bad and doubtful debts 38
39 Other provisions 39
40
Profit before interest, depreciation and taxes
[5 – (6 + 7 + 8h + 9 to 14 + 15k + 16e + 17 to 33 + 34f + 35 to 39)]
40
41 Interest 41
42 Depreciation 42
43 Profit before taxes (40-41-42) 43
TAX PROVISIONS AND
APPROPRIATIONS
44 Provision for current tax 44
45 Provision for Deferred Tax 45
46 Profit after tax (43 – 44 – 45 ) 46
47 Balance brought forward from previous year 47
48 Amount available for appropriation (46 + 47) 48
49 Transferred to reserves and surplus 49
50 Balance carried to balance sheet in proprietor’s account (48 – 49) 50

NO ACCOUNT
CASE
51
In a case where regular books of account of business or profession are not maintained, furnish
the following information for previous year 2012-13 in respect of business or profession
a Gross receipts 51a
b Gross profit 51b
c Expenses 51c
d Net profit 51d
Part A- OI Other Information (optional in a case not liable for audit under section 44AB)
OTHER INFORMATION
1 Method of accounting employed in the previous year (Tick)  mercantile
cash
2 Is there any change in method of accounting (Tick)  Yes
No
3
Effect on the profit because of deviation, if any, in the method of accounting employed in the
previous year from accounting standards prescribed under section 145A
3
4 Method of valuation of closing stock employed in the previous year
a Raw Material (if at cost or market rates whichever is less write 1, if at cost write 2, if at market rate write 3) 
b Finished goods (if at cost or market rates whichever is less write 1, if at cost write 2, if at market rate write 3) 
c Is there any change in stock valuation method (Tick)  Yes
No
d Effect on the profit or loss because of deviation, if any, from the method of valuation
prescribed under section 145A
4d
5 Amounts not credited to the profit and loss account, being -
a the items falling within the scope of section 28 5a
b the pro forma credits, drawbacks, refund of duty of
customs or excise or service tax, or refund of sales tax
or value added tax, where such credits, drawbacks or
refunds are admitted as due by the authorities
concerned
5b
c escalation claims accepted during the previous year 5c
d any other item of income 5d
e capital receipt, if any 5e
f Total of amounts not credited to profit and loss account (5a+5b+5c+5d+5e) 5f
6 Amounts debited to the profit and loss account, to the extent disallowable under section 36:-
a Premium paid for insurance against risk of damage
or destruction of stocks or store
6a
b Premium paid for insurance on the health of
employees
6b
c Any sum paid to an employee as bonus or commission
for services rendered, where such sum was otherwise
payable to him as profits or dividend.
6c
d Any amount of interest paid in respect of borrowed
capital
6d
e Amount of discount on a zero-coupon bond 6e
f Amount of contributions to a recognised provident
fund
6f
g Amount of contributions to an approved
superannuation fund
6g
h Amount of contributions to an approved gratuity
fund
6h
i Amount of contributions to any other fund 6i
j Amount of bad and doubtful debts 6j
k Provision for bad and doubtful debts 6k
l Amount transferred to any special reserve 6l
m Expenditure for the purposes of promoting family
planning amongst employees
6m
n Any sum received from employees as contribution to
any provident fund or superannuation fund or any
fund set up under ESI Act or any other fund for the
welfare of employees to the extent credited to the
employees account on or before the due date
6n
o Any other disallowance 6o
p Total amount disallowable under section 36 (total of 6a to 6o) 6p
7 Amounts debited to the profit and loss account, to the extent disallowable under section 37

a Expenditure of personal nature; 7a
b
Expenditure on advertisement in any souvenir,
brochure, tract, pamphlet or the like, published by a
political party;
7b
c
Expenditure by way of penalty or fine for violation of
any law for the time being in force;
7c
d Any other penalty or fine; 7d
e
Expenditure incurred for any purpose which is an
offence or which is prohibited by law;
7e
f Amount of any liability of a contingent nature 7f
g
Amount of expenditure in relation to income which
does not form part of total income
7g
h Any other amount not allowable under section 37 7h
i Total amount disallowable under section 37(total of 7a to 7h) 7i
8 A. Amounts debited to the profit and loss account, to the extent disallowable under section 40
a
Amount disallowable under section 40 (a)(i),
40(a)(ia) and 40(a)(iii) on account of noncompliance
with the provisions of Chapter XVIIB
Aa
b
Amount of tax or rate levied or assessed on the
basis of profits
Ab
c Amount paid as wealth tax Ac
d
Amount of interest, salary, bonus, commission or
remuneration paid to any partner or member
Ad
e Any other disallowance Ae
f Total amount disallowable under section 40(total of Aa to Ae) 8Af
B.
Any amount disallowed under section 40 in any preceding previous year but allowable
during the previous year
8B
9 Amounts debited to the profit and loss account, to the extent disallowable under section 40A
a Amounts paid to persons specified in section
40A(2)(b)
9a
b Amount in excess of twenty thousand rupees paid to a
person in a day otherwise than by account payee
cheque or account payee bank draft under section
40A(3) – 100% disallowable
9b
c Provision for payment of gratuity 9c
d any sum paid by the assessee as an employer for
setting up or as contribution to any fund, trust,
company, AOP, or BOI or society or any other
institution;
9d
e Any other disallowance 9e
f Total amount disallowable under section 40A (total of 9a to 9e) 9f
10 Any amount disallowed under section 43B in any preceding previous year but allowable during
the previous year
a Any sum in the nature of tax, duty, cess or fee under
any law
10a
b Any sum payable by way of contribution to any
provident fund or superannuation fund or gratuity
fund or any other fund for the welfare of employees
10b
c Any sum payable to an employee as bonus or
commission for services rendered
10c
d Any sum payable as interest on any loan or
borrowing from any public financial institution or a
State financial corporation or a State Industrial
Investment Corporation
10d
e Any sum payable as interest on any loan or
borrowing from any scheduled bank
10e
f Any sum payable towards leave encashment 10f
g Total amount allowable under section 43B (total of 10a to 10f) 10g
11 Any amount debited to profit and loss account of the previous year but disallowable under
section 43B:-
a Any sum in the nature of tax, duty, cess or fee under
any law
11a
b Any sum payable by way of contribution to any
provident fund or superannuation fund or gratuity
fund or any other fund for the welfare of employees
11b

c Any sum payable to an employee as bonus or
commission for services rendered
11c
d Any sum payable as interest on any loan or
borrowing from any public financial institution or a
State financial corporation or a State Industrial
investment corporation
11d
e Any sum payable as interest on any loan or
borrowing from any scheduled bank
11e
f Any sum payable towards leave encashment 11f
g Total amount disallowable under Section 43B(total of 11a to 11f) 11g
12 Amount of credit outstanding in the accounts in respect of
a Union Excise Duty 12a
b Service tax 12b
c VAT/sales tax 12c
d Any other tax 12d
e Total amount outstanding (total of 12a to 12d) 12e
13 Amounts deemed to be profits and gains under section 33AB or 33ABA or 33AC 13
14 Any amount of profit chargeable to tax under section 41 14
15 Amount of income or expenditure of prior period credited or debited to the profit and loss
account (net)
15
Part A – QD Quantitative details (optional in a case not liable for audit under section 44AB)
QUANTITATIVE DETAILS
(a) In the case of a trading concern
1 Opening stock 1
2 Purchase during the previous year 2
3 Sales during the previous year 3
4 Closing stock 4
5 Shortage/ excess, if any 5
(b) In the case of a manufacturing concern
6 Raw materials
a Opening stock 6a
b Purchases during the previous year 6b
c Consumption during the previous year 6c
d Sales during the previous year 6d
e Closing stock 6e
f Yield finished products 6f
g Percentage of yield 6g
h Shortage/ excess, if any 6h
7 Finished products/ By-products
a opening stock 7a
b purchase during the previous year 7b
c quantity manufactured during the previous year 7c
d sales during the previous year 7d
e closing stock 7e
f shortage/ excess, if any 7f
Part B - TI Computation of total income
TOTAL INCOME
1 Salaries (7 of Schedule S) 1
2 Income from house property (3c of Schedule-HP) (enter nil if loss) 2
3 Profits and gains from business or profession
i
Profit and gains from business other than speculative
business and specified business (A37 of Schedule-BP)
3i
ii
Profit and gains from speculative business (B41 of
Schedule BP) (enter nil if loss and take the figure to schedule CFL)
3ii
iii
Profit and gains from specified business (C47 of Schedule
BP) (enter nil if loss and take the figure to schedule CFL)
3iii

iv Total (3i + 3ii + 3iii) (enter nil if 3iv is a loss) 3iv
4 Capital gains
a Short term
i
Short-term (under section 111A) (A2a+A3e of
Schedule-CG)
4ai
ii
Short-term (others) (A7 – A2a-A3e of Schedule-
CG)
4aii
iii Total short-term (4ai + 4aii) 4aiii
b i Long-term (B7 – B4e – B5 of Schedule CG) 4bi
ii
Long-term without Indexation (B4e + B5 of
Schedule-CG)
4bii
iii
Total Long-Term (4bi + 4b(ii) (enter nil if loss and
take the figure to schedule CFL)
4biii
c
Total capital gains (4aiii + 4biii) (take the figure adjusted to Schedule CYLA)(In case of
negative figure enter nil and take the figure under respective head to schedule CFL)
4c
5 Income from other sources
a
from sources other than from owning race horses and winnings from Lottery etc.
(1g of Schedule OS)
5a
b
winnings from lotteries, crossword puzzles, races, games, gambling, betting etc. (2 of
Schedule OS)
5b
c from owning and maintaining race horses (4c of Schedule OS) (enter nil if loss) 5c
d Total (5a + 5b + 5c) 5d
6 Total (1 + 2 + 3iv +4c +5d) 6
7 Losses of current year to be set off against 6 (total of 2x,3x and 4x of Schedule CYLA) 7
8 Balance after set off current year losses (6 – 7) (also total of column 5 of Schedule CYLA+5b) 8
9 Brought forward losses to be set off against 8 (total of 2x, 3x and 4x of Schedule BFLA) 9
10 Gross Total income (8-9) (also 5xi of Schedule BFLA+ 5b) 10
11 Income chargeable to tax at special rate under section 111A, 112 etc. included in 10 11
12 Deductions under Chapter VI-A [v of Schedule VIA and limited to (10-11)] 12
13 Total income (10 - 12) 13
14 Income which is included in 13 and chargeable to tax at special rates (total of (i) of schedule SI) 14
15 Net agricultural income/ any other income for rate purpose (4 of Schedule EI) 15
16 Aggregate income (13-14+15) [applicable if (13-14) exceeds maximum amount not chargeable to tax] 16
17 Losses of current year to be carried forward (total of xi of CFL) 17
Part B - TTI Computation of tax liability on total income
COMPUTATION OF TAX LIABILITY
1
a Tax payable on deemed total income under section 115JC (4 of Schedule AMT) a
b Education Cess on (1a) above b
c Total Tax Payable c
2 Tax payable on total income
a Tax at normal rates on 16 of Part B-TI 2a
b Tax at special rates (total of (ii) of Schedule-SI) 2b
c Rebate on agricultural income [applicable if (13-14) of Part
B-TI exceeds maximum amount not chargeable to tax]
2c
d Tax Payable on Total Income (2a + 2b – 2c) 2d
3 Education cess, including secondary and higher education cess on 2d 3
4 Gross tax liability (2d+3) 4
5 Gross tax payable (higher of 4 or 1c) 5
6
Credit under section 115JD of tax paid in earlier years (if 4 is more than 1c) (5 of Schedule
AMTC)
6
7 Tax payable after credit under section 115JD (5-6) 7
8 Tax relief
a Section 89 8a
b Section 90/ 90A (total of 1B1 of Schedule TR) 8b
c Section 91 (total of 1B2 of Schedule TR) 8c
d Total (8a + 8b + 8c) 8d

9 Net tax liability (7 – 8d) 9
10 Interest payable
a For default in furnishing the return (section 234A)
10a
b For default in payment of advance tax (section 234B) 10b
c For deferment of advance tax (section 234C) 10c
d Total Interest Payable (10a+10b+10c) 10d
11 Aggregate liability (9 + 10d) 11
TAXES PAID
12 Taxes Paid
a Advance Tax (from Schedule-IT) 12a
b TDS (total of column 5 of Schedule-TDS1 and column 7 of
Schedule-TDS2)
12b
c TCS (column 5 of Schedule-TCS) 12c
d Self-Assessment Tax (from Schedule-IT) 12d
e Total Taxes Paid (12a+12b+12c+12d) 12e
13 Amount payable (Enter if 11 is greater than 12e, else enter 0) 13
REFUND
14 Refund (If 12e is greater than 11) 14
15
Enter your bank account number (mandatory and for direct
deposit of refund into bank, the number should be 11 digits or more )
16 Do you want your refund by cheque, or deposited directly into your bank account? (tick as applicable  )
17 Give additional details of your bank account
IFSC Code Type of Account (tick as applicable  ) Savings Current
18
Do you have, -
(i) any asset (including financial interest in any entity) located outside India or
(ii) signing authority in any account located outside India?
[applicable only in case of a resident] [Ensure Schedule FA is filled up if the answer is Yes]
Yes No
VERIFICATION
I, son/ daughter of , holding permanent
account number ____________ solemnly declare that to the best of my knowledge and belief, the information given in the return and
schedules thereto is correct and complete and that the amount of total income and other particulars shown therein are truly stated and are in
accordance with the provisions of the Income-tax Act, 1961, in respect of income chargeable to Income-tax for the previous year relevant to
the Assessment Year 2013-14.
Place
Date
Sign here 
19 If the return has been prepared by a Tax Return Preparer (TRP) give further details below:
Identification No. of TRP Name of TRP Counter Signature of TRP
If TRP is entitled for any reimbursement from the Government, amount thereof…………… 20
Schedule S Details of Income from Salary
SALARIES
Name of Employer PAN of Employer (optional)
Address of employer Town/City State Pin code
1
Salary (Excluding all exempt/ non-exempt allowances, perquisites & profit in lieu of salary as they are shown
separately below)
1
2 Allowances exempt under section 10 (Not to be included in 7 below) 2
3 Allowances not exempt (refer Form 16 from employer) 3
4 Value of perquisites (refer Form 16 from employer) 4
5 Profits in lieu of salary (refer Form 16 from employer) 5
6 Deduction u/s 16 (Entertainment allowance by Government and tax on employment) 6
7 Income chargeable under the Head ‘Salaries’ (1+3+4+5-6) 7

Schedule HP Details of Income from House Property (Please refer to instructions)
HOUSE PROPERTY
1
Address of property 1
Town/ City State PIN Code
Is the property co-owned? Yes No (if “YES” please enter following details)
Your percentage of share in the property.
Name of Co-owner(s) PAN of Co-owner (s) (optional ) Percentage Share in Property
I
II
(Tick)  if let out Name of Tenant
PAN of Tenant (optional)
a
Annual letable value or rent received or receivable (higher of the two, if let out for whole of
the year, lower of the two if let out for part of the year)
1a
b The amount of rent which cannot be realized 1b
c Tax paid to local authorities 1c
d Total (1b + 1c) 1d
e Annual value (1a – 1d) (nil, if self -occupied etc. as per section 23(2)of the Act) 1e
f 30% of 1e 1f
g Interest payable on borrowed capital 1g
h Total (1f + 1g) 1h
i Income from house property 1 (1e – 1h) 1i
2
Address of property 2
Town/ City State PIN Code
Is the property co-owned? Yes No (if “YES” please enter following details)
Your percentage of share in the property
Name of Co-owner(s) PAN of Co-owner (s) (optional ) Percentage Share in Property (optional)
I
II
(Tick)  if let out
Name of Tenant
PAN of Tenant (optional)
a
Annual letable value or rent received or receivable (higher of the two, if let out for whole of
the year, lower of the two, if let out for part of the year)
2a
b The amount of rent which cannot be realized 2b
c Tax paid to local authorities 2c
d Total (2b + 2c) 2d
e Annual value (2a – 2d) 2e
f 30% of 2e 2f
g Interest payable on borrowed capital 2g
h Total (2f + 2g) 2h
i Income from house property 2 (2e – 2h) 2i
3 Income under the head “Income from house property”
a Rent of earlier years realized under section 25A/AA 3a
b Arrears of rent received during the year under section 25B after deducting 30% 3b
c Total (3a + 3b + 1i + 2i) 3c
NOTE Please include the income of the specified persons referred to in Schedule SPI while computing the income under this head

Schedule BP Computation of income from business or profession
INCOME FROM BUSINESS OR PROFESSION
A From business or profession other than speculative business and specified business
1 Profit before tax as per profit and loss account (item 43 or item 51d of Part A-P&L ) 1
2a Net profit or loss from speculative business included in
1(enter –ve sign in case of loss)
2a
2b Net profit or Loss from Specified Business u/s 35AD
included in 1 (enter –ve sign in case of loss)
2b
3 Income/ receipts credited to profit and loss account
considered under other heads of income
3
4 Profit or loss included in 1, which is referred to in
section 44AD/44AE/44AF/44B/44BB/44BBA/44BBB/
44D/44DA Chapter-XII-G/ First Schedule of Income-tax
Act
4
5 Income credited to Profit and Loss account (included in 1)which is exempt
a share of income from firm(s) 5a
b Share of income from AOP/ BOI 5b
c Any other exempt income 5c
d Total exempt income 5d
6 Balance (1– 2a-2b – 3 – 4 – 5d)
6
7 Expenses debited to profit and loss account considered
under other heads of income
7
8 Expenses debited to profit and loss account which relate
to exempt income
8
9 Total (7 + 8) 9
10 Adjusted profit or loss (6+9) 10
11 Depreciation debited to profit and loss account 11
12 Depreciation allowable under Income-tax Act
i Depreciation allowable under section 32(1)(ii)
(column 6 of Schedule-DEP)
12i
ii Depreciation allowable under section 32(1)(i)
(Make your own computation refer Appendix-IA of IT
Rules)
12ii
iii Total (12i + 12ii) 12iii
13 Profit or loss after adjustment for depreciation (10 +11 - 12iii) 13
14 Amounts debited to the profit and loss account, to the
extent disallowable under section 36 (6p of Part-OI)
14
15 Amounts debited to the profit and loss account, to the
extent disallowable under section 37 (7i of Part-OI)
15
16 Amounts debited to the profit and loss account, to the
extent disallowable under section 40 (8Af of Part-OI)
16
17 Amounts debited to the profit and loss account, to the
extent disallowable under section 40A (9f of Part-OI)
17
18 Any amount debited to profit and loss account of the
previous year but disallowable under section 43B (11g of
Part-OI)
18
19 Interest disallowable under section 23 of the Micro,
Small and Medium Enterprises Development Act,2006
19
20 Deemed income under section 41 20
21 Deemed income under section 33AB/33ABA/35ABB/
72A/80HHD/80-IA
21
22 Any other item or items of addition under section 28 to
44DA
22
23 Any other income (including income from salary,
commission, bonus and interest from firms in which an
individual/ HUF/ Prop. concern is a partner) not included
in profit and loss
23
24 Total (14 + 15 + 16 + 17 + 18 + 19 + 20 + 21+22 +23) 24
25 Deduction allowable under section 32(1)(iii) 25
26 Amount of deduction under section 35 in excess of the
amount debited to profit and loss account (item vii(4) of
Schedule ESR)
26
27 Any amount disallowed under section 40 in any
preceding previous year but allowable during the
previous year(8Bof Part-OI)
27

28 Any amount disallowed under section 43B in any
preceding previous year but allowable during the
previous year(10g of Part-OI)
28
29 Deduction under section 35AC
a Amount, if any, debited to profit and loss account 29a
b Amount allowable as deduction 29b
c Excess amount allowable as deduction
(29b – 29a)
29c
30 Any other amount allowable as deduction 30
31 Total (25 + 26 + 27+28 +29c +30) 31
32 Income (13 + 24 – 31) 32
33 Profits and gains of business or profession deemed to be under -
i Section 44AD 33i
ii Section 44AE 33ii
iii Section 44AF 33iii
iv Section 44B 33iv
v Section 44BB 33v
vi Section 44BBA 33vi
vii Section 44BBB 33vii
viii Section 44D 33
viii
ix Section 44DA 33ix
x Chapter-XII-G 33 x
xi First Schedule of Income-tax Act 33xi
xii Total (33i to 33xi) 33xii
34 Profit or loss before deduction under section 10A/10AA (32 + 33xii) 34
35 Deductions under sectioni
10A (e of Schedule-10A) 35i
ii 10AA (e of Schedule-10AA) 35ii
iii Total (35i + 35ii) 35iii
36 Net profit or loss from business or profession other than speculative business (34 – 35iii) 36
37 Net Profit or loss from business or profession (same as above in 36 except in case of specified
business, after applying rule 7A, 7B or 7C)
A37
B Computation of income from speculative business
38 Net profit or loss from speculative business as per profit or loss account 38
39 Additions in accordance with section 28 to 44DA 39
40 Deductions in accordance with section 28 to 44DA 40
41 Profit or loss from speculative business (38+39-40) B41
C Computation of income from specified business
42 Net profit or loss from specified business as per profit or loss account 42
43 Additions in accordance with section 28 to 44DA 43
44 Deductions in accordance with section 28 to 44DA (other than deduction u/s 35AD) 44
45 Profit or loss from specified business (42+43-44) 45
46 Deductions in accordance with section 35AD 46
47 Profit or loss from specified business (45-46) C47
D Income chargeable under the head ‘Profits and gains’ (A37+B41+C47) D
NOTE Please include the income of the specified persons referred to in Schedule SPI while computing the income under this head
Schedule DPM Depreciation on Plant and Machinery
DEPRECIATION ON PLANT
AND MACHINERY
1 Block of assets Plant and machinery
2 Rate (%) 15 30 40 50 60 80 100
(i) (ii) (iii) (iv) (v) (vi) (vii)
3 Written down value on the first day of
previous year
4 Additions for a period of 180 days or
more in the previous year

5 Consideration or other realization
during the previous year out of 3 or 4
6 Amount on which depreciation at full
rate to be allowed (3 + 4 -5) (enter 0, if
result is negative)
7 Additions for a period of less than 180
days in the previous year
8 Consideration or other realizations
during the year out of 7
9 Amount on which depreciation at half
rate to be allowed (7-8) (enter 0, if
result is negative)
10 Depreciation on 6 at full rate
11 Depreciation on 9 at half rate
12 Additional depreciation, if any, on 4
13 Additional depreciation, if any, on 7
14 Total depreciation (10+11+12+13)
15 Expenditure incurred in connection
with transfer of asset/ assets
16 Capital gains/ loss under section 50
(5 + 8 -3-4 -7 -15) (enter negative only if
block ceases to exist)
17 Written down value on the last day of
previous year (6+ 9 -14) (enter 0 if result
is negative)
Schedule DOA Depreciation on other assets
DEPRECIATION ON OTHER ASSETS
1 Block of assets Building Furniture and
fittings
Intangible
assets
Ships
2 Rate (%) 5 10 100 10 25 20
(i) (ii) (iii) (iv) (v) (vi)
3 Written down value on the first day of
previous year
4 Additions for a period of 180 days or
more in the previous year
5 Consideration or other realization
during the previous year out of 3 or 4
6 Amount on which depreciation at full
rate to be allowed (3 + 4 -5) (enter 0, if
result is negative)
7 Additions for a period of less than 180
days in the previous year
8 Consideration or other realizations
during the year out of 7
9 Amount on which depreciation at half
rate to be allowed (7-8) (enter 0, if
result is negative)
10 Depreciation on 6 at full rate
11 Depreciation on 9 at half rate
12 Additional depreciation, if any, on 4
13 Additional depreciation, if any, on 7
14 Total depreciation (10+11+12+13)
15 Expenditure incurred in connection
with transfer of asset/ assets
16 Capital gains/ loss under section 50
(5 + 8 -3-4 -7 -15) (enter negative only if
block ceases to exist)
17 Written down value on the last day of
previous year (6+ 9 -14) (enter 0 if
result is negative)

Schedule DEP Summary of depreciation on assets
SUMMARY OF DEPRECIATION ON ASSETS
1 Plant and machinery
a Block entitled for depreciation @ 15 per cent
( Schedule DPM - 14 i)
1a
b Block entitled for depreciation @ 30 per cent
( Schedule DPM - 14 ii)
1b
c Block entitled for depreciation @ 40 per cent
( Schedule DPM - 14 iii)
1c
d Block entitled for depreciation @ 50 per cent
( Schedule DPM - 14 iv)
1d
e Block entitled for depreciation @ 60 per cent
( Schedule DPM - 14 v)
1e
f Block entitled for depreciation @ 80 per cent
( Schedule DPM – 14 vi)
1f
g Block entitled for depreciation @ 100 per cent
( Schedule DPM - 14 vii)
1g
h Total depreciation on plant and machinery ( 1a + 1b + 1c + 1d+ 1e + 1f + 1g ) 1h
2 Building
a Block entitled for depreciation @ 5 per cent
(Schedule DOA- 14i)
2a
b Block entitled for depreciation @ 10 per cent (Schedule
DOA- 14ii)
2b
c Block entitled for depreciation @ 100 per cent
(Schedule DOA- 14iii)
2c
d Total depreciation on building (total of 2a + 2b + 2c) 2d
3 Furniture and fittings(Schedule DOA- 14 iv) 3
4 Intangible assets (Schedule DOA- 14 v) 4
5 Ships (Schedule DOA- 14 vi) 5
6 Total depreciation ( 1h+2d+3+4+5) 6
Schedule DCG Deemed Capital Gains on sale of depreciable assets
DEEMED CAPITAL GAINS
1 Plant and machinery
a Block entitled for depreciation @ 15 per cent
(Schedule DPM - 16i)
1a
b Block entitled for depreciation @ 30 per cent (Schedule
DPM – 16ii)
1b
c Block entitled for depreciation @ 40 per cent(Schedule
DPM - 16iii)
1c
d Block entitled for depreciation @ 50 per cent
(Schedule DPM - 16iv)
1d
e Block entitled for depreciation @ 60 per cent
(Schedule DPM – 16v)
1e
f Block entitled for depreciation @ 80 per cent (Schedule
DPM – 16vi)
1f
g Block entitled for depreciation @ 100 per cent
(Schedule DPM – 16vii)
1g
h Total ( 1a +1b + 1c + 1d + 1e + 1f + 1g) 1h
2 Building
a Block entitled for depreciation @ 5 per cent
(Schedule DOA- 16i)
2a
b Block entitled for depreciation @ 10 per cent (Schedule
DOA- 16ii)
2b
c Block entitled for depreciation @ 100 per cent
(Schedule DOA- 16iii)
2c
d Total ( 2a + 2b + 2c) 2d
3 Furniture and fittings ( Schedule DOA- 16iv) 3
4 Intangible assets (Schedule DOA- 16v) 4
5 Ships (Schedule DOA- 16vi) 5
6 Total ( 1h+2d+3+4+5) 6

Schedule ESR Deduction under section 35
DEDUCTION UNDER SECTION 35
Sl.
No.
Expenditure of the nature
referred to in section
(1)
Amount, if any, debited to profit and
loss account
(2)
Amount of deduction allowable
(3)
Amount of deduction in excess of the
amount debited to profit and loss
account
(4) = (3) - (2)
i 35(1)(i)
ii 35(1)(ii)
iii 35(1)(iii)
iv 35(1)(iv)
v 35(2AA)
vi 35(2AB)
vii total
Schedule CG Capital Gains
CAPITAL GAINS
A Short-term capital gain
1 From slump sale
a Full value of consideration 1a
b Net worth of the under taking or division 1b
c Short term capital gains from slump sale 1c
d Deduction under sections 54B/54D 1d
e Net short term capital gains from slump sale (1c – 1d) 1e
2 In case of NON-RESIDENT to which first proviso to section 48 is applicable
a From assets (shares/units) where section 111A is applicable (STT paid) 2a
b From assets where section 111A is not applicable 2b
3 From assets (shares/units) in the case of others where section 111A is applicable (STT paid)
a Full value of consideration 3a
b Deductions under section 48
i Cost of acquisition bi
ii Cost of Improvement bii
iii Expenditure on transfer biii
iv Total (i + ii + iii) biv
c Balance (3a – biv) 3c
d Loss, if any, to be ignored under section 94(7) or
94(8) (Enter positive value only)
3d
e Short-term capital gain (3c +3d) A3e
4 From assets in case of others where section 111A is not applicable
a Full value of consideration 4a
b Deductions under section 48
i Cost of acquisition bi
ii Cost of Improvement bii
iii Expenditure on transfer biii
iv Total (i + ii + iii) biv
c Balance (4a – biv) 4c
d Loss, if any, to be ignored under section 94(7) or
94(8) (Enter positive value only)
4d
e Deduction under section 54B/ 54D 4e
f Short-term capital gain (4c + 4d – 4e) 4f
5 Deemed short term capital gain on depreciable assets (6 of Schedule – DCG) A5
6 Amount deemed to be short term capital gains under sections 54B/54D/54G/ 54GA A6
7 Total short term capital gain (1e + 2a + 2b + A3e + 4f + A5 + A6) A7
B Long term capital gain
1 From slump sale
a Full value of consideration 1a
b Net worth of the under taking or division 1b
c Long term capital gains from slump sale 1c
d Deduction under sections
54/54B/54D/54EC/54F/54G/54GA/54GB
1d
e Net long term capital gain from slump sale (1c – 1d) 1e
2 From asset in case of non-resident to which first proviso to section 48 is applicable 2

3 From asset in the case of others where proviso under section 112(1) is not applicable
a Full value of consideration 3a
b Deductions under section 48
i Cost of acquisition after indexation bi
ii Cost of improvement after indexation bii
iii Expenditure on transfer biii
iv Total (bi + bii +biii) biv
c Balance (3a – biv) 3c
d Deduction under sections 54/54B/54D/54EC/54F
54G/54GA/54GB
3d
e Net balance (3c – 3d) B3e
4 From asset where proviso under section 112(1) is applicable (without indexation)
a Full value of consideration 4a
b Deductions under section 48
i Cost of acquisition without indexation bi
ii Cost of improvement without indexation bii
iii Expenditure on transfer biii
iv Total (bi + bii +biii) biv
c Balance (4a – biv) 4c
d Deduction under sections 54/54B/54D/54EC/54F/54GB 4d
e Net balance (4c-4d) B4e
5 From unlisted securities in case of non-resident as per section 112(1)(c)(iii) B5
6 Amount deemed to be long term capital gains under sections 54/54B/54D/54EC/54F/54GB B6
7 Total long term capital gain (1e + 2 + B3e + B4e + B5 + B6) B7
8 In case of deduction u/s 54GB, furnish PAN of the company
C Income chargeable under the head “CAPITAL GAINS” (A7 + B7) (enter B6 as nil, if loss) C
D Information about accrual/receipt of capital gain
Date
Upto 15/9
(i)
i)
16/9 to 15/12
(ii)
16/12 to 15/3
(iii)
16/3 to 31/3
(iv)
1 Long- term [where proviso under section 112(1) is
applicable (Without Indexation) + non-residents
as per section 112(1)(c)(iii)]-
Tax Rate is 10% ;
Enter only positive value from Item B4e+B5 of Schedule
CG AFTER loss adjustment under this category in
Schedule CYLA and BFLA, if any.
2 Long- term where proviso under section 112(1) is
NOT applicable (With Indexation)-
Tax Rate is 20%;
Enter only positive value from Item (B7-B4e - B5) of
Schedule CG AFTER loss adjustment under this category
in Schedule CYLA and BFLA, if any.
3 Short-term under 111A-
, Tax Rate is 15% ;
Enter only positive value from Item A2a+A3e of Schedule
CG AFTER loss adjustment under this category in
Schedule CYLA and BFLA, if any.
4 Short-term OTHERSTaxed
at normal rates;
Enter only positive value from Item (A7 – A2a - A3e) of
Schedule CG AFTER loss adjustment under this category
in Schedule CYLA and BFLA, if any.
NOTE Please include the income of the specified persons referred to in Schedule SPI while computing the income under this head
Schedule OS Income from other sources
OTHER SOURCES
1 Income
a Dividends, Gross 1a
b Interest, Gross 1b
c Rental income from machinery, plants, buildings, etc.,
Gross
1c
d
Others, Gross (excluding income from owning race
horses)Mention the source
i 1di
ii 1dii
iii 1diii

Total (1di + 1dii+ 1diii) 1d
e Total (1a + 1b + 1c + 1d) 1e
f Deductions under section 57:-
i Expenses / Deductions fi
ii Depreciation fii
iii Total fiii
g Balance (1e – fiii) 1g
2 Winnings from lotteries, crossword puzzles, races, games, gambling, betting etc. (Gross) 2
3 Income from other sources (other than from owning race horses) (1g + 2) (enter1g as nil, if loss) 3
4 Income from owning and maintaining race horses
a Receipts 4a
b Deductions under section 57 in relation to (4) 4b
c Balance (4a – 4b) 4c
5
Income chargeable under the head “Income from other sources” (3 + 4c) (enter 4c as nil if loss
and take 4c loss figure to Schedule CFL)
5
NOTE Please include the income of the specified persons referred to in Schedule SPI while computing the income under this head.
Schedule CYLA Details of Income after set-off of current years losses
CURRENT YEAR LOSS ADJUSTMENT
Sl.No
Head/ Source of
Income
Income of current
year
(Fill this column only
if income is zero or
positive)
House property loss of
the current year set off
Business Loss
(other than speculation
loss) of the current year
set off
Other sources loss (other
than loss from owning
race horses) of the
current year set off
Current year’s
Income
remaining after
set off
Total loss
(4c of Schedule –HP)
Total loss
(A37 of Schedule-BP)
Total loss
(1g of Schedule-OS)
1 2 3 4 5=1-2-3-4
Loss to be adjusted ->
i Salaries
ii House property
iii Business Income
(excluding speculation
profit and income
from specified
business)
iv Speculative Income
v Specified Business
Income
vi Short-term capital
gain
vii Long term capital
gain
viii Other sources
(excluding profit from
owning race horses
and winnings from
Lottery)
ix Profit from owning
and maintaining race
horses
x Total loss set off
xi Loss remaining after set-off
Schedule BFLA Details of Income after Set off of Brought Forward Losses of earlier years
BROUGHT FORWARD LOSS
ADJUSTMENT
Sl.
No.
Head/ Source of Income Income after set off, if
any, of current year’s
losses as per 5 of
Schedule CYLA)
Brought forward loss
set off
Brought forward
depreciation set off
Brought forward
allowance under
section 35(4) set off
Current year’s
income
remaining after
set off
1 2 3 4 5
i Salaries
ii House property
iii Business Income (excluding
speculation profit and income
from specified business)
iv Speculative Income

v Specified Business Income
vi Short-term capital gain
vii Long-term capital gain
viii Other sources (excluding profit
from owning race horses)
ix Profit from owning and
maintaining race horses
x Total of brought forward loss set off
xi Current year’s income remaining after set off Total (i5 + ii5 + iii5 + iv5+v5+vi5+vii5+viii5+ix5)
Schedule CFL Details of Losses to be carried forward to future years
CARRY FORWARD OF LOSS
Sl.
No.
Assessment Year Date of
Filing
(DD/MM/Y
YYY)
House
property loss
Loss from business
other than loss
from speculative
business including
unabsorbed
depreciation
allowance u/s 35(4)
Loss from
speculative
business
including
unabsorbed
depreciation
allowance u/s
35(4)
Loss from
specified
business
Short-term
capital loss
Long-term
Capital loss
Other sources
loss (from
owning race
horses)
i 2005-06
ii 2006-07
iii 2007-08
iv 2008-09
v 2009-10
vi 2010-11
vii 2011-12
viii 2012-13
ix Total of earlier year
losses
x Adjustment of above
losses in Schedule
BFLA (see instruction)
xi 2013-14 (Current year
losses)
xii Total loss Carried
Forward to future
years
Schedule UD Unabsorbed depreciation
UNABSORBED DEPRECIATION
Sl No
(1)
Assessment Year
(2)
Amount of brought forward
unabsorbed depreciation
(3)
Amount of depreciation set-off
against the current year income
(4)
Balance Carried forward to
the next year
(5)
i Current Assessment Year
ii
iii
iv
v
vi
vii Total
Schedule 10A Deduction under section 10A
DEDUCTION U/S
10A
DE
Deduction in respect of units located in Special Economic Zone
a Undertaking No.1 a
b Undertaking No.2 b
c Undertaking No.3 c
d Undertaking No.4 d
e Total deduction under section 10A (a+b+c+d) e

Schedule 10AA Deduction under section 10AA
DEDUCTION U/S
10AA
Deductions in respect of units located in Special Economic Zone
a Undertaking No.1 a
b Undertaking No.2 b
c Undertaking No.3 c
d Undertaking No.4 d
e Total (a + b + c + d) e
Schedule 80G Details of donations entitled for deduction under section 80G
DETAILS OF DONATIONS
A
Donations entitled for 100% deduction without
qualifying limit
Name and address of donee
PAN of Donee Amount of donation Eligible Amount of
donation
i
ii
iii
iv
v
vi Total
B
Donations entitled for 50% deduction without
qualifying limit
Name and address of donee
PAN of Donee Amount of donation Eligible Amount of
donation
i
ii
iii
iv
v
vi Total
C
Donations entitled for 100% deduction subject to
qualifying limit
Name and address of donee
PAN of Donee Amount of donation Eligible Amount of
donation
i
ii
iii
iv
v
vi Total
D
Donations entitled for 50% deduction subject to
qualifying limit
Name and address of donee PAN of Donee
Amount of donation Eligible Amount of
donation
i
ii
iii
iv
v
vi Total
E Total eligible amount of donations (Avi + Bvi + Cvi + Dvi)
Schedule 80-IA Deductions under section 80-IA
DEDUCTIONS
U/S 80-IA
a Deduction in respect of profits of an enterprise referred to
in section 80-IA(4)(i) [Infrastructure facility]
a
b Deduction in respect of profits of an undertaking referred
to in section 80-IA(4)(ii) [Telecommunication services]
b
c Deduction in respect of profits of an undertaking referred
to in section 80-IA(4)(iii) [Industrial park and SEZs]
c

d Deduction in respect of profits of an undertaking referred
to in section 80-IA(4)(iv) [Power]
d
e Deduction in respect of profits of an undertaking referred
to in section 80-IA(4)(v) [Revival of power generating plant]
and deduction in respect of profits of an undertaking
referred to in section 80-IA(4)(vi)[Cross-country natural
gas distribution network]
e
f Total deductions under section 80-IA (a + b + c + d + e) f
Schedule 80-IB Deductions under section 80-IB
DEDUCTIONS U/S 80-IB
DEDUCTIONS U/S 10A
a Deduction in respect of industrial undertaking referred to
in section 80-IB(3) [Small-scale industry]
a
b Deduction in respect of industrial undertaking located in
Jammu & Kashmir [Section 80-IB(4)]
b
c Deduction in respect of industrial undertaking located in
industrially backward states specified in Eighth Schedule
[Section 80-IB(4)]
c
d Deduction in respect of industrial undertaking located in
industrially backward districts [Section 80-IB(5)]
d
e Deduction in the case of multiplex theatre [Section 80-
IB(7A)]
e
f Deduction in the case of convention centre [Section 80-
IB(7B)]
f
g Deduction in the case of company carrying on scientific
research [Section 80-IB(8A)]
g
h Deduction in the case of undertaking which begins
commercial production or refining of mineral oil
[Section 80-IB(9)]
h
i Deduction in the case of an undertaking developing and
building housing projects [Section 80-IB(10)]
i
j Deduction in the case of an undertaking operating a cold
chain facility [Section 80-IB(11)]
j
k Deduction in the case of an undertaking engaged in
processing, preservation and packaging of fruits and
vegetables [Section 80-IB(11A)]
k
l Deduction in the case of an undertaking engaged in
integrated business of handling, storage and
transportation of foodgrains [Section 80-IB(11A)]
l
m Deduction in the case of an undertaking engaged in
operating and maintaining a rural hospital [Section 80-
IB(11B)]
m
n Deduction in the case of an undertaking engaged in
operating and maintaining a hospital in any area, other
than excluded area [Section 80-IB(11C)
n
o Total deduction under section 80-IB (Total of a to n) o
Schedule 80-IC or 80-IE Deductions under section 80-IC or 80-IE
DEDUCTIONS U/S 80-IC/IE
1 Deduction in respect of industrial undertaking located in Sikkim 1
2 Deduction in respect of industrial undertaking located in Himachal Pradesh 2
3 Deduction in respect of industrial undertaking located in Uttaranchal 3
4 Deduction in respect of industrial undertaking located in North-East
a Assam 4a
b Arunachal Pradesh 4b
c Manipur 4c
d Mizoram 4d
e Meghalaya 4e
f Nagaland 4f
g Tripura 4g
h Total of deduction for undertakings located in North-east (Total of 5a to 5g) 4h
5 Total deduction under section 80-IC or 80-IE (1 + 2 + 3 + 4h) 5

Schedule VI-A Deductions under Chapter VI-A (Section)
TOTAL DEDUCTIONS
a 80C l 80-IA (f of Schedule 80-IA)
b 80CCC m 80-IAB
c(i) 80CCD(1) (assessees
contribution)
n 80-IB (o of Schedule 80-IB
c(ii) 80CCD(2) (employers
contribution)
o 80-IC/ 80-IE (5 of Schedule
80-IC/ 80-IE)
d 80CCG p 80-ID
e 80D q 80JJA
f 80DD r 80QQB
g 80DDB s 80RRB
h 80E t 80TTA
i 80G u 80U
j 80GG
k 80GGC
v Total deductions under Chapter VI-A (Total of a to u) v
Schedule AMT Computation of Alternate Minimum Tax payable under section 115JC
1 Total Income as per item 13 of PART-B-TI 1
2 Adjustment as per section 115JC(2)
a Deduction Claimed under any section included in
Chapter VI-A under the heading “C.—Deductions in
respect of certain incomes”
2a
b Deduction Claimed u/s 10AA 2b
C Total Adjustment (2a+ 2b) 2c
3 Adjusted Total Income under section 115JC(1) (1+2c) 3
4 Tax payable under section 115JC [18.5% of (3)] (if 3 is greater than Rs. 20 lakhs) 4
Schedule AMTC Computation of tax credit under section 115JD
1 Tax under section 115JC in assessment year 2013-14 (1c of Part-B-TTI) 1
2 Tax under other provisions of the Act in assessment year 2013-14 (4 of Part-B-TTI) 2
3 Amount of tax against which credit is available [enter (2 – 1) if 2 is greater than 1, otherwise
enter 0]
3
4 Utilisation of AMT credit Available (Sum of AMT credit utilized during the current year is subject to maximum of amount
mentioned in 3 above and cannot exceed the sum of AMT Credit Brought Forward)
S.
No
Assessment
Year
(A)
AMT Credit AMT Credit Utilised
during the Current
Year
(C)
Balance AMT Credit
Carried Forward
(D)= (B3) –(C)
Gross
(B1)
Set-off in
earlier years
(B2)
Balance brought
forward
(B3) = (B1) – (B2)
i Current AY
(enter 1 -2, if
1>2 else enter 0)
ii Total
5 Amount of tax credit under section 115JD utilised during the year [total of item no 4 (C)] 5
6 Amount of AMT liability available for credit in subsequent assessment years [total of 4 (D)]
6
Schedule
SPI
Income of specified persons (spouse, minor child etc) includable in income of the assessee (income of the minor child, in excess of
Rs. 1,500 per child, to be included)
Sl No Name of person PAN of person (optional) Relationship Nature of Income Amount (Rs)
1
2
3

Schedule SI Income chargeable to tax at special rates (please see instructions No. 9(iii) for rate of tax)
SPECIAL RATE
Sl
No
Section  Special rate
(%)
Income
(i)
Tax thereon
(ii)
1 111A (STCG on shares where STT paid) 15
2 112 proviso (LTCG on listed securities/ units without indexation) 10
3 112 (LTCG on others) 20
4 112(1)(c)(iii) (LTCG on unlisted securities in case of non-residents) 10
5 115BB (Winnings from lotteries, puzzles, races, games etc.) 30
6
7
8
9
10
11 Total
Schedule IF Information regarding partnership firms in which you are partner
FIRMS IN WHICH PARTNER
Detail of firms in which you are partner
Name of the Firm PAN of the firm
Percentage Share
in the profit
of the firm
Amount of share
in the profit
Capital balance on
31st March in the
firm
i ii
1
2
3
4
5
6 Total
Schedule EI Details of Exempt Income (Income not to be included in Total Income)
EXEMPT INCOME
1 Interest income 1
2 Dividend income 2
3 Long-term capital gains on which Securities Transaction Tax is paid 3
4 Net Agricultural income (other than income to be excluded under rule 7, 7A, 7B or 8) 4
5 Share in the income of firm/AOP/BOI etc. 5
6 Others, including exempt income of minor child 6
7 Total (1+2+3+4+5+6) 7
Schedule IT Details of payments of Advance Tax and Self-Assessment Tax
TAX PAYMENTS
Sl No BSR Code Date of Deposit (DD/MM/YYYY) Serial Number of Challan Amount (Rs)
i
ii
iii
iv
v
vi
NOTE Enter the totals of Advance tax and Self-Assessment tax in Sl No.12a & 12d of Part B-TTI

Schedule TDS1 Details of Tax Deducted at Source from Salary [As per Form 16 issued by Employer(s)]
TDS ON SALARY
Sl
No
Tax Deduction Account Number
(TAN) of the Employer
Name of the Employer Income chargeable under
Salaries
Total tax deducted
(1) (2) (3) (4) (5)
i
ii
Schedule TDS2 Details of Tax Deducted at Source on Income [As per Form 16 A issued by Deductor(s)]
TDS ON OTHER INCOME
Sl
No
Tax Deduction
Account Number
(TAN) of the
Deductor
Name of the Deductor Unique TDS
Certificate
Number
Financial Year in
which TDS is
Deducted
Total Tax Deducted Amount out of (6) claimed
this Year
(1) (2) (3) (4) (5) (6) (7)
i
ii
iii
NOTE Please enter total of column 5of Schedule-TDS1 and column 7 of Schedule-TDS2 in 12b of Part B-TTI
Schedule TCS Details of Tax Collected at Source [As per Form 27D issued by the Collector(s)]
TCS ON INCOME
Sl
No
Tax Deduction and Tax
Collection Account Number
of the Collector
Name of the Collector Total tax collected Amount out of (4) claimed during
the year
(1) (2) (3) (4) (5)
i
ii
NOTE Enter the total of column (5) in Sl No. 12c of Part B-TTI
Schedule FSI Details of Income accruing or arising outside India
INCOME ACCRUING OR ARISING OUTSIDE INDIA
1 Details of Income included in Total Income in Part-B-TI above
Country
Code
Taxpayer
Identification
Number
Income from
Salary
(included in
PART B-TI)
(A)
Income from
House Property
(included in
PART B-TI)
(B)
Business
Income
(included in
PART B-TI)
(C)
Capital Gain
Income
(included in
PART B-TI)
(D)
Other source
Income
(included in
PART B-TI)
(E)
Total Income
from Outside
India
(F)=A+B+C+
D+E
Total
2 Total Income from outside India (Total of F as per item no.1 above) 2
3 Total Income from outside India where DTAA is applicable 3
4 Total Income from outside India where DTAA is not applicable (2-3) 4
NOTE Please refer to the instructions for filling out this schedule.

Schedule TR Details of Taxes Paid outside India
Taxes Paid outside India
1 Details of Taxes Paid outside India
Country
Code
Taxpayer
Identificati
on Number
Relevant
article of
DTAA
Total taxes paid on
income declared in
Schedule FSI
(A)
Tax Relief Claimed
(B)
Relief claimed u/s 90/90A
(B1)
Relief claimed u/s 91
(B2)
Total
2 Total Taxes paid outside India (Total of 1A) 2
3 Total Taxes Paid outside India where DTAA is applicable 3
4 Total Taxes Paid outside India where DTAA is not applicable (2-3) 4
NOTE Please refer to the instructions for filling out this schedule.
Schedule FA Details of Foreign Assets
DETAILS OF FOREIGN ASSETS
A Details of Foreign Bank Accounts
Sl
No
Country Name Country Code Name and Address of
the Bank
Name mentioned in
the account
Account Number Peak Balance During the Year
(in rupees)
(1) (2) (3) (4) (5) (6) (7)
i
ii
B Details of Financial Interest in any Entity
Sl
No
Country Name
(1)
Country Code
(2)
Nature of entity
(3)
Name and Address
of the Entity
(4)
Total Investment (at cost) (in
rupees)
(5)
(i) i
(ii) Ii
C Details of Immovable Property
Sl
No
(1)
Country Name
(2)
Country Code
(3)
Address of the Property
(4)
Total Investment (at cost) (in rupees)
(5)
i
ii
D Details of any other Asset in the nature of Investment
Sl
No
(1)
Country Name
(2)
Country Code
(3)
Nature of Asset
(4)
Total Investment (at cost) (in rupees)
(5)
(i) i
(ii) ii
E Details of account(s) in which you have signing authority and which has not been included in A to D above.
Sl
No
(1)
Name of the Institution in which the
account is held
(2)
Address of the
Institution
(3)
Name of the
account holder
(4)
Account Number
(5)
Peak Balance/Investment during the
year (in rupees)
(6)
i
ii
F Details of trusts, created under the laws of a country outside India, in which you are a trustee
Sl
No
(1)
Country Name
(2)
Country Code
(3)
Name and address of
the trust
(4)
Name and address of
other trustees
(5)
Name and address of
Settlor
(6)
Name and address of
Beneficiaries
(7)
i
ii

Schedule 5A Information regarding apportionment of income between spouses governed by Portuguese Civil Code
Name of the spouse
PAN of the spouse
Heads of Income Amount apportioned in the hands of the spouse
1 House Property
2 Business or profession
3 Capital gains
4 Other sources
5 Total
Schedule AL
Asset and Liability at the end of the year (other than those included in Part A – BS) (Applicable in a case where
total income exceeds Rs. 25 lakh)
DETAILS OF ASSET AND LIABILITY
A
Particulars of Asset Amount (Cost) (Rs.)
1 Immovable Asset
a Land
b Building
2 Movable Asset
a Financial Asset
i Bank (including all deposits)
ii Shares and securities
iii Insurance policies
iv Loans and Advances given
v Cash in hand
b Jewellery, bullion etc.
c Archaeological collections, drawings, painting, sculpture or any work of art
d Vehicles, yachts, boats and aircrafts
3 Total
B Liability in relation to Assets at A