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Check Refund State Status document sample
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**** Suri - 1.3 (27.06.10) ****
SARAL RETURN FORM F.YR 2009-10 (A.YR. 2010-11)
Fill Data in the GREEN CELLS in Basic Data sheet & Tax Details Sh
CHECK FINAL FIGURES in the Basic Data Sheet
If details are correct - Print the return for
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caused on this account.
(A.YR. 2010-11)
et & Tax Details Sheet
sic Data Sheet
he return form
mum users and is accurate as far as possible. However,
ol will be responsible for any loss or inconvenience
**** Suri - 1.3 (27.06.10) **** Downloaded from AllBankingSolutions.com
suri.ashwani@rediffmail.com Developed by : Ashwani Suri - suri.ashwani@rediffmail.com
Tax First Name
Details Middle Name
Last Name
Return Father's Name
Form PAN
Date of Birth
Sr. Citizen No
Flat/Door/Block No.
Name of Premises/Building/Village
Road/Street/Post Office
Area/Locality AMRITSAR
Town/City/District AMRITSAR
State PUNJAB
Pin Code 143001
Sex Male
Email Address
(STD Code) 0183
Phone Number
Designation of assessing officer(ward/circle) Ward
Return filed under Section 11
SALARY as per Form No. 16
Employers Category Govt
Income chargeable to salaries
Income (+)/Loss(-) Under Head House Property
Interest / Other Sources
80C 0 80DD 0 80GG 0
80CCC 0 80DDB 0 80GGA 0
80CCD 0 80E 0 80GGC 0
80D 0 80G 0 80U 0
Relief U/s 89 0.00
If refund
Refund Thru Chq(Y) / Direct in Bank(N)
Tax Account Number
Details MICR Code
Exempted Income
Return Place Amritsar
Form Date
Check final figures
Gross Total Income 0
Deductions Under Chapter VI-A 0
Total Income 0
Current Year loss (if any) 0
Net tax payable 0
Interest payable 0
Total tax and interest payable 0
Taxes paid 0
Advance Tax 0 0
TDS 0 0
TCS 0 0
Self Assessment Tax 0 0
Total Taxes Paid (7a+7b+7c+7d) 0 0
Tax Payable (6-7d) 0
Refund (7e-6) 0
Code
Other Information (transactions reported through Annual Information Return)
001 Cash deposits aggregating to ten lakh rupees or more in a year in any savings account by you
maintained in a banking company to which the Banking Regulation Act, 1949 (10 of 1949),
applied (including any bank or banking institution referred to in section 51 of that Act)
002 Payment made by you against bills raised in respect of a credit card aggregating to two lakh
rupees or more in a year.
003 Payment made by you of an amount of two lakh rupees or more for purchase of units of
Mutual Fund.
004 Payment made by you of an amount of five lakh rupees or more for acquiring bonds or
debentures issued by a company or institution.
005 Payment made by you of an amount of one lakh rupees or more for acquiring shares issued
by a company.
006 Purchase by you of any immovable property valued at thirty lakh rupees or more.
007 Sale by you of any immovable property valued at thirty lakh rupees or more.
008 Payment made by you of an amount of five lakh rupees or more in a year for investment in
bonds issued by Reserve Bank of India.
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11 - Voluntarily before the due date under section 139
12 - Voluntarily after the due date under section 139
13 - In response to notice under section 142(1)
14 - In response to notice under section 148
15 - In response to notice under section 153A/ 153C
Code Amount
ccount by you
to two lakh
ares issued
Basic Details of Tax Deducted at Source from Salary [As per Form 16 issued by Employ(s)]
Data TAN Number Name & Address Income Chargeable Deduction under Tax Payable
Sl-No
of Employer of Employer Under Head Salaries Chapter- VI -A (incl edu cess)
Return (1) (2) (3) (4) (5) (6)
Form i
- - -
ii
Details of Tax Deducted at source other than salary
TAN Number Name & Address Amount Paid/ Date of Payment / Total Tax
Sl-No
of Deductor of Deductor Credited Credit Deducted
(1) (2) (3) (4) (5) (6)
i
0
ii
0
iii
0
Note > Enter the total of column (7) of 23 and column (7) of 24 in Sl No 17b of TAXES PAID
Details of Advance Tax
Date of Deposit
Sl-No Name of Bank & Branch BSR Code Sl-No of Challan
DD/ MM / YYYY
i
ii
iii
Basic
Data Details of Self Assessment Tax Payments
Date of Deposit
Sl-No Name of Bank & Branch BSR Code Sl-No of Challan
Return DD/ MM / YYYY
Form i
ii
iii
Tax Payable Total Tax Tax Payable/
(incl edu cess) Deducted Refundable
(6) (7) (8)
- - 0
0 0
Total Tax Amount out of (6)
Deducted Claimed for this Year
(6) (7)
0 0
0 0
0 0
Sl-No of Challan Amount (Rs)
0
0
0
Sl-No of Challan Amount (Rs)
0
0
0
**** Suri - 1.3 (27.06.10) ****
INDIAN INCOME TAX RETURN Assessment Year
SARAL-II [For Individuals having income from Salary / Pension / Income from One House
FORM
Property (excluding loss brought forward from previous years) /
(ITR-1) Income from Other Sources (excluding Winning from Lottery and Income from Race Horses)]
2 0 1 0− 1 1
(Please see rule 12 of Income-Tax Rule,1962) (Also see attached Instructions)
First name Middle name Last name PAN
PERSONAL INFORMATION
0 0 0
Flat / Door / Block No Name Of Premises / Building / Village Date of Birth (DD/MM/YYYY)
0 0 0
Road / Street / Post Office Area / Locality Employer Category (Tick) √
√ Govt PSU Others
0 AMRITSAR
Town / City / District Sate Pin Code Sex (Tick) √ Male
√ Male Female
AMRITSAR PUNJAB 143001
Email Address 0183
(STD Code)-Phone Number
0
Designation of Assessing Officer (Ward/Circle) Return Filed under section-
[Please see instruction number -9(i)] 1 1
Ward
FILING STATUS
Whether Original or revised return ? (Tick) √ √ Original Revised
DD / M M / Y Y Y Y
If Revised, enter receipt no and date of filing original return
Residential Status (Tick) √ √ Resident Non Resident Resident but Not Ordinarily Resident
1 Income Chargeable under the Head 'Salaries' (Salary/Pension) 1 -
2 Income Chargeable under the Head 'House Property' (enter -ve sign in case of loss, if any)
2 0
3 Income Chargeable under the Head 'Other Sources' (enter -ve in case of loss, if any)
3 -
INCOME & DEDUCTIONS
4 Gross Total Income (1+2+3) 4 -
5 Deductions under chapter VI A (Section)
a 80C 0 e 80DD 0 i 80GG 0
b 80CCC 0 f 80DDB 0 j 80GGA 0
c 80CCD 0 g 80E 0 k 80GGC 0
d 80D 0 h 80G 0 l 80U 0
6 Deductions (Total of 5a to 5l) 6 -
7 Total Income (4-6) 7 -
8 Tax Payable on Total Income 8 -
9 Secondary and Higher Education Cess on 8 9 -
TAX COMPUTATION
10 Total Tax and Education Cess Payable (8+9) 10 -
11 Relief under section 89 11 -
12 Relief under section 90 / 91 12 -
13 Balance Tax Payable (10-11-12) 13 -
14 Total Interest Payable u/s 234A / 234B / 234C 14 -
15 Total Tax and Interest Payable (12+13) 15 -
Do not write or stamp in this area
For Office Use Only
Seal and Signature of receiving official
Receipt No
Date
***Software By:- Ashwani Suri ***
16 Taxes Paid
TAXES PAID
a Advance Tax (from item 25) 16a -
b TDS (column 7 of item 23 +column 7 of item 24) 16b -
c Self Assessment Tax (from item 25) 16c -
17 Total Taxes Paid (16a+16b+16c) 17 -
18 Tax Payable (15-17) (Enter if 15 is greater than 17, else leave blank) 18 -
19 Refund (17d-16) (enter if 17d is greater than 16, also give Bank Account Details below) 19 -
20 Enter your bank account number (mandatory in case of refund) 0
REFUND
21 Do you want your refund by Cheque Deposited directly into your bank account? (tick as applicable) √
22 Give additional details of your bank account
MICR Code 0 Type of Account (tick as applicable √ √ Savings
23 Details of Tax Deducted at Source from Salary [As per Form 16 issued by Employ(s)]
TAN Number Name & Address Income Chargeable Deduction under Tax Payable Total Tax Tax Payable/
Sl-No
of Employer of Employer Under Head Salaries Chapter- VI -A (incl edu cess) Deducted Refundable
TDS ON SALARY
(1) (2) (3) (4) (5) (6) (7) (8)
i
0 0 0 - - - 0
ii
- 0
24 Details of Tax Deducted at source other than salary
TAN Number Name & Address Amount Paid/ Date of Payment / Total Tax Amount out of (6)
Sl-No
of Deductor of Deductor Credited Credit Deducted Claimed for this Year
TDS ON INTEREST
(1) (2) (3) (4) (5) (6) (7)
i
0 0
ii
0 0
iii
0 0
Note > Enter the total of column (7) of 23 and column (7) of 24 in Sl No 17b of TAXES PAID
25 Details of Advance Tax and Self Assessment Tax Payments
Date of Deposit
Sl-No Name of Bank & Branch BSR Code Sl-No of Challan Amount (Rs)
DD/ MM / YYYY
TAX PAYMENTS
i 0
ii 0
iii 0
iv 0
v 0
vi 0
Note > Enter the totals of Advance tax and Self Assessment tax in Sl No 17 a and 17 c of TAXES PAID
26 Other Information (transactions reported through Annual Information Return) (Please see instruction number-9(ii) for code)
Sl-No Code Amount (Rs) Sl-No Code Amount (Rs) Sl-No Code Amount (Rs)
- -
A 001 D 004 D 007 -
- -
B 002 F 005 F 008 -
- -
C 003 G 006
26 Exempt income only for reporting purposes (from Dividend, Capital Gains etc) 27
VERIFICATION
I, .son / daughter of 0 solemnly declare that
to the best of my knowledge and belief, the information given in the return 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 2010-11
Place: Amritsar Date: 0.00 Sign Here ----->
***Software By:- Ashwani Suri ***
**** Suri - 1.3 (27.06.10) **** Downloaded from AllBankingSolutions.com Developed by : Ashwani Suri - suri.ashwani@rediffmail.com
Government of India
INCOME-TAX DEPARTMENT
ACKNOWLEDGEMENT
Received with thanks from a return of income
and/or return of fringe benefits in Form No. SARAL-II (ITR - 1) for assessment year 2010-11, having the following particulars
Name PAN
0
PERSONAL INFORMATION
Flat/Door/Block No Name of Premises/Building/Village
0 0
Road/Street/Post Office Area/Locality
0 AMRITSAR
Town/City/District State
Status (fill the
11
code)
AMRITSAR PUNJAB
Designation of Assessing Officer (Ward/Circle) Original or Revised
1 Gross Total Income 1 -
COMPUTATION OF INCOME AND TAX THEREON
2 Deductions Under Chapter VI-A 2 -
3 Total Income 3 -
3a Current Year loss (if any) 3a
4 Net tax payable 4 -
5 Interest payable 5 -
6 Total tax and interest payable 6 -
7 Taxes paid
a Advance Tax 7a -
b TDS 7b -
c TCS 7c -
d Self Assessment Tax 7d -
e Total Taxes Paid (7a+7b+7c+7d) 7e -
8 Tax Payable (6-7d) 8 -
9 Refund (7e-6) 9 -
Receipt No Seal and Signature of receiving official
Date
***Software By:- Ashwani Suri ***
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