Tax Year Zone Circle National Tax No. - ANNEX I PARTICULARS OF DIRECTORS / SHARE HOLDERS* Particulars / Descriptions Code Percentage of Shares held

Tax Year

Zone

Circle

National Tax No.

-NTN

-NIC

%

NTN

-NIC

%

NTN

-NIC

_%

NTN

-NIC

_%

* In case of Private Limited Companies, particulars of share holders with share holding of 10% or more. In case of Public Companies, details of directors only.

Signature of the Taxpayer

4.

Name

3.

Name

2.

Name

1

Name

Particulars / Descriptions

Code

Percentage of Shares held

Name Company

ANNEX I

Address and Description of the property

(Use extra sheets for more than 3 Properties)

Property No. 1

Address

Property No. 2

Address

Property No. 3

Address

1. 6. 7. 8. 11. 12. 15. 16. 17. 18. 19. 20. 21.

22. Total of income from all properties including extra sheets, if any

Signature of the Taxpayer

In case taxpayer is co-owner of property, percentage of share Net income from property chargeable

to tax

2199

Total [ 7 to 17]

₂₁₈₉

Net income / (loss) from property (6 -

18)

2190

Ground rent Legal service charges Provincial / local property tax 14. Interest on mortgage / capital charge

Interest on capital borrowed for investment in the property

13. Share in rental income paid to HBFC / Banks

Insurance premium

10. Payment of liabilities treated as

income at S.No. 5

2187

9. Amount claimed as irrecoverable rent

₂₁₃₉

Expenditure on collecting rent

2137

1/5th of rent of building for repairs

₂₁₃₁

Total [ 1 to 5 ]

2129

5. Unpaid liabilities exceeding three

years

2105

4. Recovery of unpaid irrecoverable rent allowed as deduction in earlier tax years

2104

3. Forfeited deposit under a contract for

sale of land or building

2103

2. 1/10th of the un-adjustable advance /

security deposit from the tenant

2102

Rent received or receivable

₂₁₀₁

INCOME FROM PROPERTY U/S 15

Description / Particulars

Code

_{Property No. 1}

_{Property No. 2}

_{Property No. 3}

Tax Year

Zone

Circle

National Tax No.

-Particulars and description of the Capital Asset disposed

(Use extra sheets for more than 3 Properties)

Capital Asset No. 1

Capital Asset No. 2

Capital Asset No. 3

1. Date of disposal 2. Date of acquisition 3. 4. Deductions (a) (c)

(e) Others (Specify) (f) Total deductions [ a to e ]

6. Gain/(loss) on disposal ( 3 minus 4(f))

7. Chargeable gain/(loss) ****

8. Total of capital gains from all assets including extra sheets, if any

**** (a) In case of disposal of capital asset held for upto one year 100% of the gain/(loss) on disposal (b) In case of disposal of capital asset held for more than one year:

(i) In case of (loss) 100% of the (loss) on disposal (ii) In case of gain 75% of the gain on disposal

(c) No capital loss can be set off against income under any other head of income.

Signature of the Taxpayer

4199

4190

4189

4188

(d) Cost incurred in producing or constructing

4134

Expenditure incurred to alter or improve

4133

(b) Incidental expenditure incurred in acquiring

and disposing

4132

Consideration at the time of acquisition

4131

Consideration received on disposal

4101

ANNEX III

CAPITAL GAINS U/S 37

Particulars / Description

Code

Capital Asset No. 1

Capital Asset No. 2

Capital Asset No. 3

Amount

Amount

Amount

(a) Dividend (From non-resident companies only)

(b) Royalty (Received by resident persons)

(c) Profit on debt

(d) Ground rent

(e) Rent from sub-lease of land or building

(f) Lease of building together with plant & machinery

(g)

Consideration or benefit received for the provision, use or exploitation of property

(h)

One-tenth of the consideration for vacating the possession of a building

(j) Others

(Specify)

(k) Total [ 1(a) to 1(j) ]

(a) Any expenditure paid to derive the income chargeable to tax

(i) Specify

(ii) Specify

(b) Zakat paid on debt of which profit is chargeable

(attach evidence)

(d) Total deduction [ 2(a) to 2(c) ]

3. Net income/(loss) from Other Sources [ 1(k) minus 2(d) ]

Signature of the Taxpayer

5189

5199

2.

5188

5187

(c) Depreciation & initial allowance in respect of plant, machinery or

building used to derive income at 1(e) and 1(f) above

5194

5128

5129

5111

(i)

Loan, advance, deposit or gift received otherwise than by a crossed cheque drawn

on a bank or through banking channel from a person holding NTN card

5125

5106

5109

1.

5101

5102

5103

5104

5105

Tax Year

Zone

Circle

National Tax No.

-1. Income from Property

2. Income from Business

3. Capital Gains

4. Income from Other Sources

5. Net foreign income [1 to 4]

Signature of the Taxpayer

4998

5998

2998

3998

ANNEX V

FOREIGN INCOME

Description / Particulars

Code

Amount

Income tax reductions

(a) Specify*

(b) Specify*

(c) Total income tax reductions [ (a) to (b) ]

Income tax credits

(a) Charitable donations U/S 61 (attach evidence)

(b) Investment in shares U/S 62 (attach evidence)

(c) (attach evidence)

(d) Total eligible amount [ (a) to (c) ]

(e) Income tax credits on total eligible amount

(f) Income tax credit on foreign source income (Attach prescribed application)

(g) Others* (attach evidence)

(h) Surrender of income tax credit on investments in shares disposed of within twelve months

(i) Total income tax credits [ 2(e) to 2(g) minus 2(h) ]

Note:-

*

Indicate the relevant provision of Law under which tax reduction or credit, if any, is claimed

Signature of the Taxpayer

9259

9260

9251

2.

Eligible Amount

9252

Profit or share in rent etc. on loan obtained

U/S 64

9254

1.

Particulars / Description

Code

Amount

ANNEX VI

Tax Year

Zone

Circle

National Tax No.

-1. Paid on imports (attach evidence)

2. Deducted from salary (attach evidence)

3. Deducted/collected from profit on debt (attach evidence)

4. Deducted from non-residents recipients (attach evidence)

5. Deducted from payments for goods and services (attach evidence)

6. Deducted from realization of foreign indenting commission (attach evidence)

7. Deducted from rent of immovable property (attach evidence)

8. Deducted from brokerage and commission (attach evidence)

9. Paid alongwith motor vehicle tax (attach evidence)

10. Paid on electricity consumption (attach evidence)

11. Paid on use of telephone (attach evidence)

12. Total [ 1 to 11 ]

Signature of the Taxpayer

ANNEX VII

TAX DEDUCTED/COLLECTED AT SOURCE (other than final tax)

Description / Particulars

Code

Amount