Form PDF 864984430300723
Form PDF 864984430300723
Form PDF 864984430300723
PART A-GENRAL
PERSONAL INFORMATION
(A1) First Name (A2) Middle Name (A3) Last Name (A4) PAN
RAMANBHAI VIRABHAI PATEL AMEPP8892M
(A5) Status (A6) Flat/Door/Block No. (A7) Name of Premises/Building/Village
Individual Nr Ramji Mandir At po- Vedancha ta palanpur
(A8) Road/Street/Post Office (A9) Area/locality (A10) Town/City/District
Vedancha B.O Vedancha BANASKANTHA
(A11) State (A12) Country/Region (A13) Pin code/Zip code
11-Gujarat 91-India 385510
(A16) Residential/Office Phone Number with Mobile No. 1
(A17) Mobile No. 2
STD/ISD code 91 9879191309
(A18) Email Address-1 (self)
(A19) Email Address-2
[email protected]
(A14) Date of Birth/Formation (DD/MM/YYYY) (A15) Aadhaar Number(12 digits)/Aadhaar Enrolment Id(28 digits) (if eligible for Aadhaar No.)
01/06/1972 3xxx xxxx 0495
139(1)-On or before due
(A20) (a1i) Filed u/s (Tick)[Please see instruction ] (a1ii) Or Filed in response to notice u/s
date
(a2) Are you opting for new tax regime u/s 115BAC ? Yes No
Are you filing return of income under Seventh proviso to section 139(1) but otherwise not required to furnish
(b) Yes No
return of income?
Have you deposited amount or aggregate of amounts exceeding Rs. 1 Crore in one or
(bi) Yes No 0
more current account during the previous year? (Yes/No)
Have you incurred expenditure of an amount or aggregate of amount exceeding Rs. 2
(bii) Yes No 0
lakhs for travel to a foreign country for yourself or for any other person? (Yes/No)
Have you incurred expenditure of amount or aggregate of amount exceeding Rs. 1
(biii) Yes No 0
lakh on consumption of electricity during the previous year? (Yes/No)
Are you required to file a return as per other conditions prescribed under clause (iv) of seventh proviso to
(biv) Yes No
section 139(1) (If yes, please select the relevant condition from the drop down menu)
If revised/defective/Modified, please enter Date of filling of original return (DD/MM/YYYY) and Receipt
(c)
No. -
Receipt No.
If filed, in response to a notice u/s 139(9)/142(1)/148/153C or order u/s 119(2)(b) enter unique
(d) number/ Document Identification Number (DIN) and date of such notice/order, or if filed u/s 92CD,
enter date of advance pricing agreement-
Date of such Notice or Order or if filed u/s 92CD enter date of advance pricing agreement
(I) PLEASE SPECIFY THE JURISDICTION(S) OF RESIDENCE DURING THE PREVIOUS YEAR -
Sl.
Jurisdiction(s) of Residence Taxpayer Identification Number(s)
No.
1 2 3
(ii) In case you are a Citizen of India or a Person of Indian Origin (POI), please specify -
*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 : 864984430300723 Date of Filing : 30-Jul-2023*
Total period of stay in India during the previous year (in days) 0
Total period of stay in India during the 4 preceding years (in days) 0
(f) Do you want to claim the benefit under section 115H? (applicable in case of resident) No
(g) Are you governed by Portuguese Civil Code as per section 5A?(If "YES" please fill Schedule 5A) No
(j) Whether you were Director in a company at any time during the previous year? Yes No
1 2 3 4 5 6
(k) Whether you have held unlisted equity shares at any time during the previous year? Yes No
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
*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 : 864984430300723 Date of Filing : 30-Jul-2023*
1 2 3 4
Income under the head “Income from house property” (1k) + 2 (if negative take the
3 3 0
figure to 2i of schedule CYLA)
A Short-term Capital Gains (STCG) (Sub-items 3 and 4 are not applicable for residents)
From sale of land or building or both (fill up details separately for each
1
property)
Note 1 : Furnishing of PAN is mandatory, if the tax is deduced under section 194-IA.
Note 2 : In case of more than one buyer, please indicate the respective percentage share and amount.
From sale of equity share or unit of equity oriented Mutual Fund (MF) or unit of a business trust on
2
which STT is paid under section 111A or 115AD(1) (ii) proviso (for FII)
For NON-RESIDENT, not being an FII- from sale of shares or debentures of an Indian company
3
(to be computed with foreign exchange adjustment under first proviso to section 48)
STCG on transactions on which securities transaction
a A3a 0
tax (STT) is paid
STCG on transactions on which securities transaction
b A3b 0
tax (STT) is not paid
For NON-RESIDENT- from sale of securities (other than those at A3) by an FII as per section
4
115AD
In case securities sold include shares of a company
a i
other than quoted shares, enter the following details
Full value of consideration received/receivable in
a ia 0
respect of unquoted shares
Fair market value of unquoted shares determined in
b ib 0
the prescribed manner
*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 : 864984430300723 Date of Filing : 30-Jul-2023*
ii Full value of consideration in respect of securities other than unquoted shares aii 0
Loss to be disallowed u/s 94(7) or 94(8)- for example if security bought/acquired within 3
d months prior to record date and dividend/income/bonus units are received, then loss arising d 0
out of sale of such security to be ignored (Enter positive value only)
e Short-term capital gain on sale of securities by an FII (other than those at A2) (c +d) e 0
ii Full value of consideration in respect of assets other than unquoted shares aii 0
In case of asset (security/unit) loss to be disallowed u/s 94(7) or 94(8)- for example if asset
d bought /acquired within 3 months prior to record date and dividend/income/bonus units are 5d 0
received, then loss arising out of sale of such asset to be ignored (Enter positive value only)
Whether any amount of unutilized capital gain on asset transferred during the previous
a years shown below was deposited in the Capital Gains Accounts Scheme within due date for
that year?
*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 : 864984430300723 Date of Filing : 30-Jul-2023*
1 2 3 4 5 6
Pass Through Income/ Loss in the nature of Short Term Capital Gain, (Fill up schedule PTI)
7 A7 0
(A7a + A7b + A7c)
Pass Through Income/ Loss in the nature of Short Term
a A7a 0
Capital Gain, chargeable @ 15%
Pass Through Income/ Loss in the nature of Short Term
b A7b 0
Capital Gain, chargeable @ 30%
Pass Through Income / Loss in the nature of Short Term
c A7c 0
Capital Gain, chargeable at applicable rates
Amount of STCG included in A1 – A7 but not chargeable to tax or chargeable at special rates
8 A8
in India as per DTAA
Rate as
Item No. per Applicabl
Whether
A1 to A7 Country Treaty Section Rate as e rate
Sl. Amount Article of TRC
above in Code & (enter of I. T. per I. T. [lower of
No. of income DTAA obtained
which Name NIL, if not Act Act (6) or
(Y/N)
included chargeabl (9)]
e)
1 2 3 4 5 6 7 8 9 10
a Total amount of STCG not chargeable to tax in India as per DTAA A8a 0
9 Total Short-term Capital Gain (A1e+ A2e+ A3a+ A3b+ A4e+ A5e+A6 + A7 - A8a) A9 0
B Long-term capital gain (LTCG) (Sub-items 5, 6, 7 & 8 are not applicable for residents)
From sale of land or building or both (fill up details separately for each
1
property)(in case of co-ownership, enter your share of Capital Gain)
Note 1 : Furnishing of PAN is mandatory, if the tax is deduced under section 194-IA.
Note 2 : In case of more than one buyer, please indicate the respective percentage share and amount.
2 From sale of bonds or debenture (other than capital indexed bonds issued by Government)
c Balance (a – biv) c 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 : 864984430300723 Date of Filing : 30-Jul-2023*
From sale of, (i) listed securities (other than a unit) or zero coupon bonds where proviso under section
3
112(1) is applicable
From sale of equity share in a company or unit of equity oriented fund or unit of a business
4
trust on which STT is paid under section 112A
For NON-RESIDENTS- from sale of, (i) unlisted securities as per sec. 112(1)(c), (ii) bonds or
6 GDR as referred in sec. 115AC, (iii) securities by FII as referred to in sec. 115AD (other than
securities referred to in section 112A for which column B7 is to be filled up)
For NON-RESIDENTS - From sale of equity share in a company or unit of equity oriented fund
7
or unit of a business trust on which STT is paid under section 112A
LTCG u/s 112A (column 14 of Schedule 115AD(1)(b)
a 7a 0
(iii))
Deduction under section 54F (Specify details in item D
b 7b 0
below)
Long-term Capital Gains on sale of capital assets at B7
c 7c 0
above (7a – 7b)
8 From sale of foreign exchange asset by NON-RESIDENT INDIAN (If opted under chapter XII-A)
*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 : 864984430300723 Date of Filing : 30-Jul-2023*
Whether any amount of unutilized capital gain on asset transferred during the previous year
a shown below was deposited in the Capital Gains Accounts Scheme within due date for that
year?
Amount not used for
Section under which New Asset acquired/constructed new asset or
Sl. Previous year in which
deduction claimed in remained unutilized in
No. asset transferred Year in which asset Amount utilised out of Capital gains account
that year
acquired/constructed Capital Gains account (X)
1 2 3 4 5 6
Pass Through Income/ Loss in the nature of Long Term Capital Gain,(Fill up schedule PTI)
11 B11 0
(B11a1+ B11a2 + B11b)
Pass Through Income/ Loss in the nature of Long Term
a1 B11a1 0
Capital Gain, chargeable @ 10% u/s 112A
Pass Through Income/ Loss in the nature of Long Term
a2 Capital Gain, chargeable @ 10% under sections other B11a2 0
than u/s 112A
Pass Through Income/ Loss in the nature of Long Term
a3 B11a3 0
Capital Gain, chargeable @ 20%
Amount of LTCG included in B1 - B11 but not chargeable to tax or chargeable at special rates
12
in India as per DTAA
Whether
Item No. B1 Rate as per
Tax Applicable
to B11 Country Treaty
Sl. Amount of Article of Residency Section of Rate as per rate [lower
above in Code & (enter NIL,
No. income DTAA Certificate I.T. Act I.T. Act of (6) or
which Name if not
obtained (9)]
included chargeable)
(Y/N)
1 2 3 4 5 6 7 8 9 10
b Total amount of LTCG chargeable to tax at special rates as per DTAA B12b 0
C1 Sum of Capital Gain Incomes (9ii + 9iii + 9iv + 9v + 9vi + 9vii + 9viii of table E below) C1 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 : 864984430300723 Date of Filing : 30-Jul-2023*
1 In case of deduction u/s 54 / 54B / 54EC / 54F / 54GB / 115F give following details
Amount deposited in
Date of purchase/
Sl. Date of Transfer of Cost of new Capital Gains Amount of deduction
construction of new
No. Original Asset residential house Accounts Scheme claimed
residential house
before due date
1 2 3 4 5 6
Amount deposited in
Sl. Date of Transfer of Cost of new Date of purchase of Capital Gains Amount of deduction
No. Original Asset agricultural land new agricultural land Accounts Scheme claimed
before due date
1 2 3 4 5 6
Amount invested in
Sl. Date of Transfer of Original specified/notified bonds Amount of deduction
Date of investment
No. Asset (not exceeding fifty lakh claimed
rupees)
1 2 3 4 5
1 2 3 4 5 6
Amount Amount
Cost of new
Date of utilised for deposited in
plant and Date of
transfer of PAN of the subscription Date of Capital Gains Amount of
Sl. machinery purchase of
original eligible of equity subscription Accounts deduction
No. purchased by plant and
residential company shares of of shares Scheme claimed
the eligible machinery
property eligible before due
company
company date
1 2 3 4 5 6 7 8 9
1 2 3 4 5
Set-off of current year capital losses with current year capital gains (excluding amounts included in
E
A8a & B12a which is not chargeable under DTAA)
*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 : 864984430300723 Date of Filing : 30-Jul-2023*
Capital
Current
Gain of
year's
current
capital
year (Fill Short- Short- Long-
gains
Sl. this Short- Short- Term Term Long- Long- Term
Type of Capital gain remaining
No. column Term15% Term 30% Applicable Covered Term 10% Term 20% Covered
after set
only if Rate By DTAA By DTAA
off
computed
(9=1-2-3-
figure is
4-5-6-7-8)
positive)
Short-term capital
gains taxable at the
1 rate of 15% Enter value 0 0 0 0 0
from item 3iii of
schedule BFLA, if any.
Short-term capital
gains taxable at the
2 rate of 30% Enter value 0 0 0 0 0
from item 3iv of
schedule BFLA, if any
Short-term capital
gains taxable at
3 applicable rates Enter 0 0 0 0 0
value from item 3v of
schedule BFLA, if any.
Short-term capital
gains taxable at DTAA
4 rates Enter value from 0 0 0 0 0
item 3vi of schedule
BFLA, if any.
Long- term capital
gains taxable at the
5 rate of 10% Enter value 0 0 0 0 0
from item 3vi of
schedule BFLA, if any.
Long- term capital
gains taxable at the
6 rate of 20% Enter value 0 0 0 0 0
from item 3vii of
schedule BFLA, if any.
*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 : 864984430300723 Date of Filing : 30-Jul-2023*
1 2 3 4 5 6 7
TotIncCapGain
0
SCHEDULE 112A FROM SALE OF EQUITY SHARE IN A COMPANY OR UNIT OF EQUITY ORIENTED FUND OR UNIT OF A BUSINESS TRUST
ON WHICH STT IS PAID UNDER SECTION 112A
Full
Value of
Conside
ration If
shares/u
nits are
acquired
on or
before
If the
31st
long Total
January,
Cost of term Fair Fair Expendi
2018 Balance
acquisiti capital Market Market ture
(Total (6- 13)
Sale- on asset Value Value of wholly
Name of Sale Total Item 4
Share/U No. of price without Cost of was per capital and
Sl. ISIN the Value) deducti (a) of
nit Shares per indexati acquisiti acquire share/u asset as exclusiv
No. Code Share (4*5) or ons LTCG
acquired /Units Share on on d before nit as per ely in
/Unit If (7+12) Schedul
/Unit (higher 01.02.2 on 31st section connecti
shares/u e of
of 8 or 018, - January, 55 (2) on with
nits are ITR2
9) Lower 2018 (ac)- transfer
acquired
of 6 or (4*10)
after
11
31st
January,
2018 -
Please
enter
Full
Value of
Conside
ration
1 1a 2 3 4 5 6 7 8 9 10 11 12 13 14
Total 0 0 0 0 0 0 0 0
SCHEDULE 115 AD(1)(B)(III) PROVISO : FOR NON-RESIDENTS - FROM SALE OF EQUITY SHARE IN A COMPANY OR UNIT OF EQUITY
ORIENTED FUND OR UNIT OF A BUSINESS TRUST ON WHICH STT IS PAID UNDER SECTION 112A
*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 : 864984430300723 Date of Filing : 30-Jul-2023*
Full
Value of
Conside
ration If
shares/u
nits are
acquired
on or
before
If the
31st
long Total
January,
Cost of term Fair Fair Expendi
2018 Balance
acquisiti capital Market Market ture
(Total (6-13)
Sale on asset Value Value of wholly
Name of Sale Total Item 7
Share/U No. of price without Cost of was per capital and
Sl. ISIN the Value) deducti (a) of
nit Shares per indexati acquisiti acquire share asset as exclusiv
No. Code Share (4*5) or ons LTCG
acquired /Units Share/U on on d before /unit as per ely in
/Unit If (7+12) Schedul
nit (higher 01.02.2 on 31st section connecti
shares/u e of
of 8 or 018, January, 55(2) on with
nits are ITR2
9) Lower 2018 (ac)- transfer
acquired
of 6 or (4*10)
after
11
31st
January,
2018 -
(Please
enter
Full
Value of
Conside
ration)
1 1a 2 3 4 5 6 7 8 9 10 11 12 13 14
Total 0 0 0 0 0 0 0 0
1 Gross income chargeable to tax at normal applicable rates (1a+ 1b+ 1c+ 1d + 1e) 1 2,72,653
B Interest, Gross (bi + bii + biii + biv + bv + bvi + bvii + bviii + bix) 1b 71,232
bix Others ix 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 : 864984430300723 Date of Filing : 30-Jul-2023*
Sl.
Country/Region Amount
No.
1 2 3
2 Income chargeable at special rates (2a+ 2b+ 2c+ 2d + 2e +2f elements related to Sl. No.1) 2 0
1 2 3 4
Total 0 0
Sl.
Nature Amount
No.
1 2 3
*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 : 864984430300723 Date of Filing : 30-Jul-2023*
Pass through income in the nature of income from other sources chargeable
e 2e 0
at special rates (drop down to be provided)
Sl.
Nature Amount
No.
1 2 3
1 2 3 4 5 6 7 8 9 10
Deductions under section 57 (other than those relating to income chargeable at special rates under
3 3
2a, 2b & 2d)
Expenses / Deductions other than "aii" (in case other than family
ai 3ai 0
pension)
Interest expenditure u/s 57(i) on dividend (available only if
aii income offered in 1a) - entered amount Interest expenditure 3aii 0
claimed
aiii Deduction u/s. 57(iia) (in case of family pension only) 3aiii 0
b Depreciation 3b 0
c Total 3c 0
INCOME FROM RETIREMENT BENEFIT ACCOUNT MAINTAINED IN A NOTIFIED COUNTRY U/S 89A
Sl.
Country/Region Amount
No.
1 2 3
Total 0
Income taxable during the previous year on which relief u/s 89A was claimed in any earlier
2 2 0
previous year
Net Income from other sources chargeable at normal applicable rates(1 ( after reducing income
6 6 2,72,653
related to DTAA portion) - 3 + 4 + 5 - 5a ) (if negative take the figure to 3i of Schedule CYLA)
*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 : 864984430300723 Date of Filing : 30-Jul-2023*
7 Income from other sources (other than from owning race horses) (2 + 6) (enter 6 as nil, if negative) 7 2,72,653
a Receipts 8a 0
e Balance (8a - 8b + 8c + 8d) (if negative take the figure to 6xii of Schedule CFL) 8e 0
9 Income under the head "Income from other sources" (7 + 8e) (take 8e as nil if negative) 9 2,72,653
*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 : 864984430300723 Date of Filing : 30-Jul-2023*
Sl.
Other Source Income Upto 15/6 From 16/6 to 15/9 From 16/9 to 15/12 From 16/12 to 15/3 From 16/3 to 31/3
No.
Income by way of
winnings from lotteries,
crossword puzzles,
1 races, games, 0 0 0 0 0
gambling, betting etc.
referred to in section
2(24)(ix)
Dividend Income
2 1,421 0 0 0 0
referred in Sl.no.1a(i)
Dividend Income u/s
3 115A(1)(a)(i) @ 20% 0 0 0 0 0
(Including PTI Income)
Dividend Income u/s
4 0 0 0 0 0
115AC @ 10%
Dividend Income u/s
5 115ACA (1)(a) @ 10% 0 0 0 0 0
(Including PTI Income)
Dividend Income (other
than units referred to
6 in section 115AB) u/s 0 0 0 0 0
115AD(1) (i) @ 20%
(Including PTI Income)
Dividend income
7 0 0 0 0 0
taxable at DTAA rates
Income from
retirement benefit
account maintained in
8 a notified country u /s 0 0 0 0 0
89A (Taxable portion
after reducing relief u/s
89A)
SCHEDULE CYLA DETAILS OF INCOME AFTER SET OFF OF CURRENT YEAR LOSSES
Net loss from Other
Income of current year sources chargeable at
Sl. Head / Source of (Fill this column only if House property loss of normal applicable rates Current year’s income
No. Income income is zero or the current year set off (other than loss from remaining after set off
positive) race horses) of the
current year set off
1 2 3 4
ii Salaries 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 : 864984430300723 Date of Filing : 30-Jul-2023*
SCHEDULE BFLA DETAILS OF INCOME AFTER SET OFF OF BROUGHT FORWARD LOSSES OF EARLIER YEARS
Income after set off, if any, of
Sl. Current year’s income
Head/Source of income current year’s losses as per 5 Brought forward loss set off
No. remaining after set off
of Schedule CYLA)
1 2 3
1 Salaries 0 0
2 House property 0 0 0
1 2 3 4 5 6
i 2015-16 0 0 0
ii 2016-17 0 0 0
iii 2017-18 0 0 0
iv 2018-19 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 : 864984430300723 Date of Filing : 30-Jul-2023*
v 2019-20 0 0 0 0
vi 2020-21 0 0 0 0
vii 2021-22 0 0 0 0
viii 2022-23 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 : 864984430300723 Date of Filing : 30-Jul-2023*
SCHEDULE 80G DETAILS OF DONATIONS ENTITLED FOR DEDUCTION UNDER SECTION 80G
1 2 3 4 5 6 7 8 9 10 11
Total 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 : 864984430300723 Date of Filing : 30-Jul-2023*
1 2 3 4 5 6 7 8 9 10 11
Total 0 0 0 0
1 2 3 4 5 6 7 8 9 10 11
Total 0 0 0 0
1 2 3 4 5 6 7 8 9 10 11 12
Total 0 0 0 0
1 2 3 4 5 6 7 8 9 10 11 12
Total Donations 0 0 0 0
SCHEDULE AMT - COMPUTATION OF ALTERNATE MINIMUM TAX PAYABLE UNDER SECTION 115JC
Deduction claimed under any section included in Chapter VI-A under the
a 2a 0
heading "C.— Deductions in respect of certain incomes"
4 Tax payable under section 115JC [18.5% of (3)] (if 3 is greater than Rs. 20 lakhs) 4 0
2 Tax under other provisions of the Act in assessment year 2023-24 (7 of Part-B-TTI) 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 : 864984430300723 Date of Filing : 30-Jul-2023*
Utilisation of AMT credit Available (Sum of AMT credit utilized during the current year is subject to maximum of amount mentioned
4
in 3 above and cannot exceed the sum of AMT Credit Brought Forward)
AMT Credit
AMT Credit
Balance AMT
Sl. Balance brought Utilised during the
Assessment Year Credit Carried
No. Set-off in earlier forward to the Current
Gross Forward
assessment years current Assessment Year
assessment year
(A) (B1) (B2) (B3) = (B1) – (B2) (C) (D)= (B3) - (C)
Current AY (enter 1 -
11 0 0
2, if 1>2 else enter 0
Total 0 0 0 0 0
Amount of tax credit under section 115JD utilised during the year [total of item No. 4
5 0
(C)]
Amount of AMT liability available for credit in subsequent assessment years [total of 4
6 0
(D)]
SCHEDULE SPI - INCOME OF SPECIFIED PERSONS (SPOUSE, MINOR CHILD ETC.) INCLUDABLE IN INCOME OF THE ASSESSEE AS PER
SECTION 64
Sl. PAN of person Aadhaar of person Head of Income in
Name of person Relationship Amount (Rs)
No. (optional) (optional) which included
1 2 3 4 5 6
SCHEDULE SI - INCOME CHARGEABLE TO TAX AT SPECIAL RATES (PLEASE SEE INSTRUCTIONS NO. 9 FOR RATE OF TAX) INCOME
CHARGEABLE TO TAX AT SPECIAL RATES
Sl.
Section/Description Special rate (%) Income (i) Tax thereon (ii)
No.
1 2 3 4 5
*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 : 864984430300723 Date of Filing : 30-Jul-2023*
*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 : 864984430300723 Date of Filing : 30-Jul-2023*
*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 : 864984430300723 Date of Filing : 30-Jul-2023*
Total 0 0
TotSplRateInc
0
TotSplRateIncTax
0
SCHEDULE EI - DETAILS OF EXEMPT INCOME (INCOME NOT TO BE INCLUDED IN TOTAL INCOME OR NOT CHARGEABLE TO TAX)
1 Interest Income 1 0
iv Net Agricultural income for the year (i – ii – iii) (enter nil if loss) 2 2,40,000
In case the net agricultural income for the year exceeds Rs.5 lakh, please furnish the
v
following details (Fill up details separately for each agricultural land)
Wherther the
Measurement of Wherther the
Sl. agricultural land is
Name of District Pin code agricultural land in agricultural land is
No. owned or held on
Acre irrigated or rain fed
lease
1 2 3 4 5 6
Sl.
Nature Of Income Description Amount
No.
1 2 3 4
1 2 3 4 5 6 7
*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 : 864984430300723 Date of Filing : 30-Jul-2023*
SCHEDULE PTI - PASS THROUGH INCOME DETAILS FROM BUSINESS TRUST OR INVENTMENT FUND AS PER SECTION 115UA, 115UB
Share the
Investment Name of current year
PAN of the
entity business loss Net TDS on such
Sl. business Sl. Current Year
covered by trust/ Head of Income distributed income/Loss( amount, If
No. trust/investm No. income
section investment by 7-8) any
ent fund
115UA/115UB fund investment
fund
(1) (2) (3) (4) (5) (6) (7) (8) (9) (10)
SCHEDULE FSI - DETAILS OF INCOME FROM OUTSIDE INDIA AND TAX RELIEF (AVAILABLE IN CASE OF RESIDENT)
Tax payable Tax relief
Relevant
Income from on such available in
Taxpayer article of
Sl. Sl. Head of outside Tax paid income under India(e) = ( c )
Country Code Identification DTAA if relief
No. No. Income India(included outside india normal or (d)
Number claimed u/s 90
in Part B-Ti) provision in whichever is
or 90A
India lower
SCHEDULE TR - SUMMARY OF TAX RELIEF CLAIMED FOR TAXES PAID OUTSIDE INDIA (AVAILABLE ONLY IN CASE OF RESIDENT)
1 2 3 4 5 6
Total 0 0
Total Tax relief available in respect of country where DTAA is applicable (section
2 2 0
90/90A) (Part of total of 1(d))
Total Tax relief available in respect of country where DTAA is not applicable (section
3 3 0
91) (Part of total of 1(d))
Whether any tax paid outside India, on which tax relief was allowed in India, has been
4 refunded/credited by the foreign tax authority during the year? If yes, provide the 4
details below
*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 : 864984430300723 Date of Filing : 30-Jul-2023*
SCHEDULE FA - DETAILS OF FOREIGN ASSETS AND INCOME FROM ANY SOURCE OUTSIDE INDIA
Details of Foreign Depository Accounts held (including any beneficial interest) at any time during the calendar year ending as on 31st
A1
December, 2022
Gross
interest
Peak
Country Name of Address of Account paid/credite
Sl. Account balance Closing
Name and financial financial Zip Code Status opening d to the
No. number during the balance
Code institution institution date account
period
during the
period
1 2 3 4 5 6 7 8 9 10 11
Details of Foreign Custodial Accounts held (including any beneficial interest) at any time during the calendar year ending as on 31st
A2
December, 2022
Gross
interest
paid/credit
ed to the
account
during the
period
(drop
down to
be
provided
Peak specifying
Country Name of Address of Account
Sl. Nature of Account balance Closing nature of
Name and financial financial ZIP code Status opening
No. Amount number during the balance amount
Code institution institution date
period viz.
interest/di
vidend
/proceeds
from sale
or
redemptio
n of
financial
assets/
other
income)
1 2 3 4 5 6 7 8 9 10 11 12
Details of Foreign Equity and Debt Interest held (including any beneficial interest) in any entity at any time during the calendar year ending as
A3
on 31st December, 2022
Total Total
gross gross
amount proceeds
Initial Peak value
Date of paid/credit from sale
Country value of of
Sl. Name of Address of Nature of acquiring Closing ed with or
Name and Zip code the investmen
No. entity entity entity the balance respect to redemptio
Code investmen t during
interest the n of
t the period
holding investmen
during the t during
period the period
1 2 3 4 5 6 7 8 9 10 11 12
Details of Foreign Cash Value Insurance Contract or Annuity Contract held (including any beneficial interest) at any time during the calendar
A4
year ending as on 31st December, 2022
Total gross
amount
Name of financial
Address of The cash value or paid/credited
Sl. Country Name institution in
financial Zip code Date of contract surrender value with respect to
No. and Code which insurance
institution of the contract the contract
contract held
during the
period
1 2 3 4 5 6 7 8
Details of Financial Interest in any Entity held (including any beneficial interest) at any time during the calendar year ending as on 31st
B
December, 2022
*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 : 864984430300723 Date of Filing : 30-Jul-2023*
Nature
Income taxable and offered
of
Total Income in this return
Country Interest-
Name of Address Date Investme accrued Nature
Sl. Name Nature Direct
Zip code the of the since nt (at from of Item
No. and of entity /Benefici Schedule
Entity Entity held cost) (in such Income number
Code alowner Amount where
rupees) Interest of
/Benefici offered
schedule
ary
1 2 3 4 5 6 7 8 9 10 11 12 13 14
C Details of Immovable Property held (including any beneficial interest) at any time during the calendar year ending as on 31st December, 2022
1 2 3 4 5 6 7 8 9 10 11 12
Details of any other Capital Asset held (including any beneficial interest) at any time during the calendar year ending as on 31st December,
D
2022
Ownership Income taxable and offered in
-Direct/ Total Income this return
Country
Sl. Nature of Beneficial Date of Investmen derived Nature of
Name and Zip code Schedule Item
No. Asset owner/ acquisition t (at cost) from the Income
Code Amount where number of
Beneficiar (in rupees) asset
y offered schedule
1 2 3 4 5 6 7 8 9 10 11 12
Details of account(s) in which you have signing authority held (including any beneficial interest) at any time during the calendar year ending
E
as on 31st December, 2022 and which has not been included in A to D above.
Name of Peak If (7) is yes, Income offered in
Whether If (7) is
the Balance/ this return
Address Name of income yes,
Institutio Country Investme
Sl. of the the Account accrued Income Item
n in Name Zip code nt during Schedule
No. Institutio account Number is taxable accrued number
which the and Code the year Amount where
n holder in your in the of
account (in offered
hands? account schedule
is held rupees)
1 2 3 4 5 6 7 8 9 10 11 12 13
F Details of trusts, created under the laws of a country outside India, in which you are a trustee, beneficiary or settlor
Wheth
If (8) is yes, Income
er If (8) is
offered in this return
Countr income yes,
Addres Name Addres Name Addres Date
y Name Name Addres derive Income Schedu Item
Sl. Zip s of of s of of s of since
Name of the of s of d is derive le numbe
No. code the trustee trustee Benefic Benefic positio
and trust Settlor Settlor taxabl d from Amoun where r of
trust s s iaries iaries n held
Code e in the t
offere schedu
your trust d le
hands?
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17
Details of any other income derived from any source outside India which is not included in,- (i) items A to F above and, (ii) income under the
G
head business or profession
If (6) is yes, Income offered in this
Name of Address of Whether return
Country
Sl. the person the person Income Nature of taxable in
Name and Zip code Schedule Item
No. from whom from whom derived income your
Code Amount where number of
derived derived hands?
offered schedule
1 2 3 4 5 6 7 8 9 10 11
SCHEDULE 5A - INFORMATION REGARDING APPORTIONMENT OF INCOME BETWEEN SPOUSES GOVERNED BY PORTUGUESE CIVIL CODE
*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 : 864984430300723 Date of Filing : 30-Jul-2023*
Sl. Receipts received under Amount apportioned in Amount of TDS deducted TDS apportioned in the
No. Heads of Income the head the hands of the spouse on income at (ii) hands of spouse
1 House Property 0 0 0 0
2 Capital gains 0 0 0 0
3 Other sources 0 0 0 0
4 Total 0 0 0 0
SCHEDULE AL ASSETS AND LIABILITIES AT THE END OF THE YEAR (APPLICABLE IN A CASE WHERE TOTAL INCOME EXCEEDS RS.50
LAKH)
AddressAL
Amount
Sl. Descriptio Name of
Road/ Town/ (cost) in
No. n Flat/ Door/ Premises / Area/
Street/Pos City/ State Country Pin Code Zip Code Rs.
Block No Building / Locality
t Office District
Village
1 2 3 4 5 6 7 8 9 10 11 12
SI Description Amount
*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 : 864984430300723 Date of Filing : 30-Jul-2023*
Has any of the following events occurred during the previous year
relevant to current assessment year
Forty-eight
Such specified security or months have
sweat equity shares were expired from
Ceased to be the employee the end of Balance
sold
of the employer who the relevant amount of tax
Amount of allotted or transferred assessment Amount of deferred to
Tax deferred such specified security or year in which tax payable be carried
Assesement
Sl.No. brought sweat equity share? specified in the current forward to
Year
forward from security or Assessment the next
earlier AY (ii) Total Year Assessment
sweat equity
Amount of years Col (3-
shares
(i) Option Tax 9)
referred to
Selected Attributed
in the said
out of the
(i) Option (ii) Date of *clause were
sale
Selected Ceasing allotted. If
yes, specify
date
(1) (2) (3) (4) (5) (6) (7) (8) (9) (10)
1. 2021-22 0 0 0 0
2. 2022-23 0 0 0 0
3. 2023-24 0
1 Salaries (6 of Schedule S) 1 0
3 Capital Gains 3
a ShortTerm
iii Short term chargeable at applicable rate (9iv of item E of Sch CG) aiii 0
b LongTerm
c Sum of Short-term / Long-term Capital Gains (3av + 3biv) (enter nil if loss) 3c 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 : 864984430300723 Date of Filing : 30-Jul-2023*
Net Income from Other sources chargeable to tax at Normal Applicable rates (6 of
a 4a 2,72,653
Schedule OS) (enter nil if loss)
Income from the activity of owning & maintaining race horses (8e of Schedule OS)
c 4c 0
(enter nil if loss)
Income chargeable to tax at special rate under section 111A, 112,, 112A etc. included
10 10 0
in 9
Income which is included in 12 and chargeable to tax at special rates (total of (i) of
13 13 0
schedule SI)
14 Net agricultural income/ any other income for rate purpose (2 of Schedule EI) 14 2,40,000
*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 : 864984430300723 Date of Filing : 30-Jul-2023*
5 Surcharge
11 TaxRelief
*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 : 864984430300723 Date of Filing : 30-Jul-2023*
15 TaxPaid
17 Refund (If 15e is greater than 14) (Refund, if any, will be directly credited into the bank account) 17 4,300
Do you have a bank account in India (Non-residents claiming refund with no bank account in India
18 Y
may select NO)
a Details of all bank accounts held in india at any time during the previous year(excluding dormant accounts)
1 2 3 4 5
Note:
1. Minimum one account should be selected for refund credit.
2. In case of Refund, multiple acccounts are selected for refund credit, then refund will be credited to
one of the account decided by CPC after processing the return.
b) Non- residents, who are claiming income-tax refund and not having bank account in India may, at their option, furnish the
ii
details of one foreign bank account:
Sl.
SWIFT Code Name of the Bank Country / Region of Location IBAN
No.
1 2 3 4 5
*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 : 864984430300723 Date of Filing : 30-Jul-2023*
TAX PAYMENTS
Sl.
BSR Code Date of Deposit (DD/MM/YYYY) Serial Number of Challan Amount (RS)
No.
1 2 3 4 5
Total 0
SCHEDULE TDS1 - DETAILS OF TAX DEDUCTED AT SOURCE FROM SALARY AS PER FORM 16 ISSUED BY EMPLOYER(S)]
Sl. Tax Deduction Account Income chargeable under
Name of the Employer Total tax deducted
No. Number (TAN) of the Employer Salary
1 2 3 4 5
Total 0
DETAILS OF TAX DEDUCTED AT SOURCE (TDS) ON INCOME [AS PER FORM 16A ISSUED OR FORM 16B/ 16C/16E FURNISHED BY
DEDUCTOR(S)]
TDS
TDS of the current
credit TDS credit being claimed this Year
Unclaimed Financial Year (TDS
relatin (only if corresponding income is
TDS brought deducted during FY Correspondin
g to being offered for tax this year. Not
Aadha forward (b/f) 2022-23) g Receipt
self PAN of TAN of applicable if TDS is deducted u/s
ar of /withdrawals
/other Other the 194N)
Other Deducted in offered TDS
person Person Deduc
Person credit
[spous (if TDS tor/PA the hands of
(if TDS spouse as per being
Sl. e as credit N/Aad
credit section 5A or Claimed in the hands of carrie
No. per relate haar Fin. Deduc
relate any other spouse as per section 5A or d
sectio d to of Year ted in
d to person as per Claime any other person as per rule forwar
n 5A other Tenan in TDS own
other rule 37BA(2) d in 37BA(2) (if applicable) Head d
/other person t/Buye which b/f hands Gross
person (if applicable) own Of
person ) r deduct Amou
) hands Incom
as per ed nt
Incom Aadha e
rule Incom TDS PAN
37BA( TDS e ar
e
2)]
(10) (10)
(1) (2) (3)(a) (3)(b) (4) (5) (6) (7) (8)(a) (8)(b) (9) (10)(a) (10)(c) (11) (12) (13)
(b) (d)
Income
from
MUMU0
1 Self 0 4,303 0 0 4,303 0 0 43,024 Other 0
5151G
Source
s
Total 4,303
*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 : 864984430300723 Date of Filing : 30-Jul-2023*
DETAILS OF TAX DEDUCTED AT SOURCE (TDS) ON INCOME [AS PER FORM 16B/16C FURNISHED BY DEDUCTOR(S)]
TDS
credit TDS of the current
relatin Unclaimed Financial Year (TDS TDS credit being claimed this
g to TDS brought deducted during FY Year (only if corresponding Correspondin
self PAN Aadha forward (b/f) 2022-23) income is being offered for tax g Receipt
/other of ar of this year) offered
perso Other Other Deducted in
Aadha TDS
n Perso Perso TAN the hands of
ar No. credit
[spou n (if n (if of the
of the spouse as being
Sl. se as TDS TDS Buyer per section Claimed in the hands of
Buyer carrie
No. per credit credit /Tena
/Tena Fin. Deduc 5A or any spouse as per section 5A d
sectio relate relate nt/De
nt/De Year ted in other person Claim or any other person as per forwa
n 5A d to d to ductor in TDS Head
/other other other
ductor own as per rule ed in rule 37BA(2) (if applicable) Gross rd
which b/f hands 37BA(2) (if Of
perso perso perso own Amou
deduc applicable) hands Incom
n as n) n) nt
ted e
per
Incom Aadha
rule Incom TDS PAN
TDS e ar
37BA( e
2)]
(10) (10) (10) (10)
(1) (2) (3)(a) (3)(b) (4)(a) (4)(b) (5) (6) (7) (8)(a) (8)(b) (9) (11) (12) (13)
(a) (b) (c) (d)
Total 0
SCHEDULE TCS - DETAILS OF TAX COLLECTED AT SOURCE [AS PER FORM 27D ISSUED BY THE COLLECTOR(S)]
TCS of the current
financial Year (TCS TCS credit being claimed this
collected during the year
TCS credit Unclaimed TCS FY 2022-23)
relating to brought forward (b/f) Collected
Tax
Self/Other PAN Of in the Claimed in the hand
Deduction
Person Other hands of
and Tax of spouse as per TDS credit
[Spouse as Person (If the section 5A or any
Sl. Collection being
per TCS Credit spouse as other person as per
No. Account carried
section related to Collected per Claimed in rule 37-I(1)(if
Number of forward
5A/Other other in own section 5A own hands applicable)
the Fin. Year
person as person) Amount hands or any
Collector in which
per Rule b/f other
37-I(1) deducte person as
per rule
TCS PAN
37-I(1)) (if
applicable)
1 (2)(i) (2)(ii) (3) (4) (5) (6)(i) (6)(ii) (7)(i) (7)(i)(a) (7)(i)(b) (8)
Total 0
SCHEDULE 80D
If you are individual, whether you or any of your family member(excluding parents) is a senior
1
citizen?If you are HUF, whether any member of HUF is a senior citizen?
*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 : 864984430300723 Date of Filing : 30-Jul-2023*
(a) Parents 0
VERIFICATION
I, RAMANBHAI VIRABHAI PATEL son/ daughter of VIRABHAI TALASHIBHAI PATEL solemnly declare that to the best of my knowledge and belief,
the information given in the return and the schedules thereto 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 AMEPP8892M. I further declare that the critical assumptions specified in the agreement have been satisfied and all the
terms and conditions of the agreement have been complied with. (Applicable in a case where return is furnished under section 92CD)
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
Note:
1. Submission date is the system date of e-Filing portal of Income Tax Department. The same is available in the Acknowledgement/ITR-V generated
after submission of return.
2. Verification Date is the date of e-Verification at e-Filing portal of Income Tax Department or the date of receipt of ITR-V at CPC, Bengaluru. The
same will be available in View Returns/Forms option of e-Filing portal. In case of e-Verification, it is available in Acknowledgement”.
*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).”