Name of Assessee SHYAM BABU RAWAT

Father's Name BHOGIRAM RAWAT

Address 01village kutrawali, sabalgarh,morena, madhyapradesh
GOVT. PRIMARY SCHOOL BHIYANA SABALGARH MORENA MADHYA
PRADESH 476229
Status Individual Assessment Year 2016-2017
Ward Year Ended 31.3.2016
PAN AXYPR0137L Date of Birth 10/07/1956
Residential Status Resident Sex Male
Filing Status Original
Bank Name State Bank of India, ,MICR:000000000, A/C NO:11230990809 ,Type: Saving
,IFSC Code: SBIN0001471
Tele: Mob:9165611488

Computation of Total Income

Income from Salary (Chapter IV A) 830329

Salary 491352
Arrear Salary 338977
830329

Gross Total Income 830329

Less: Deductions (Chapter VI-A)

u/s 80C
L.I.P. 16408
P.F. 36000
Tuition Fee 25000
Tuition Fee 25000
80C 100000
Total 202408
150000
u/s 80D (payment Rs. 15000/-) 15000
165000
Total Income 665329
Round off u/s 288 A 665330
Adjusted total income (ATI) is not more than Rs. 20 lakh hence AMT not applicable.

Tax Due 58066

Educational Cess 1742
59808
Relief u/s 89(1) 54004
5804
T.D.S. 9996
-4192
Refundable (Round off u/s 288B) 4190

T.D.S./ T.C.S. From

 NAME OF ASSESSEE : SHYAM BABU RAWAT A.Y. 2016-2017 PAN : AXYPR0137L Code :138490

Non-Salary(as per Annexure) 9996

Due Date for filing of Return July 31, 2016

Details of T.D.S. on Non-Salary(26 AS Import Date:25 Feb 2016)

S.No Name of the Deductor Tax deduction A/C Amount Date Of Total Tax Amount out of section
No. of the Paid/credited Payment/cr deducted (6) claimed for
deductor edited this year
1 STATE BANK OF INDIA BPLS06510A 10082 31/03/2012 1054 1054
,SABALGARH
2 STATE BANK OF INDIA BPLS06510A 15137 31/03/2013 1519 1519
,SABALGARH
3 STATE BANK OF INDIA BPLS06510A 2534 14/05/2015 272 272 194A
,SABALGARH
4 STATE BANK OF INDIA BPLS06510A 946 29/05/2015 95 95 194A
,SABALGARH
5 STATE BANK OF INDIA BPLS06510A 2192 01/07/2015 220 220 194A
,SABALGARH
6 STATE BANK OF INDIA BPLS06510A 1527 01/07/2015 153 153 194A
,SABALGARH
7 STATE BANK OF INDIA BPLS06510A 361 01/07/2015 37 37 194A
,SABALGARH
8 STATE BANK OF INDIA BPLS11865A 15087 31/03/2012 1883 1883
9 STATE BANK OF INDIA BPLS11865A 15057 31/03/2013 2377 2377
10 STATE BANK OF INDIA BPLS11865A 23845 31/03/2014 2386 2386
TOTAL 9996
FORM NO. 10E
[See rule 21AA]
Form for furnishing particulars of income under section 192(2A) for the year ending 31st March,
2016 for claiming relief under section 89(1) by a Government servant or an employee in a [company,
co-operative society, local authority, university, institution, association or body]

1. Name and address of the employee SHYAM BABU RAWAT

01 GOVT. PRIMARY SCHOOL BHIYAMA
SABALGARH MORENA 476229
2. Permanent Account Number AXYPR0137L
3. Residential status Resident

Particulars of income referred to in rule 21A of the Income-tax Rules,1962

during the previous year relevant to assessment year 2016-2017

1. (a) Salary received in arrears or in advance in accordance with the provisions Rs. 338977
of sub-rule (2) of rule 21A
(b) Payment in the nature of gratuity in respect of past services, extending over Rs. NIL
a period of not less than 5 years in accordance with the provisions of sub-
rule (3) of rule 21A
(c) Payment in the nature of compensation from the employer or former Rs. NIL
employer at or in connection with termination of employment after
continuous service of not less than 3 years or where the unexpired portion
of term of employment is also not less than 3 years in accordance with the
provisions of sub-rule (4) of rule 21A
(d) Payment in commutation of pension in accordance with the provisions of Rs. NIL
sub-rule (5) of rule 21A
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 NAME OF ASSESSEE : SHYAM BABU RAWAT A.Y. 2016-2017 PAN : AXYPR0137L Code :138490

2. Detailed particulars of payments referred to above may be given in Annexure I, II, As enclosed
IIA, III or IV, as the case may be

Signature of the employee

VERIFICATION
I, SHYAM BABU RAWAT ,do hereby declare that what is stated above is true to the best of my knowledge
and belief.
Verified today, the 1 day of March ,2016
Place : AJMER
Date : 01/03/2016 Signature of the employee
ANNEXURE I
ARREARS OR ADVANCE SALARY
[See item 2 of Form No.10E]

1. Total income (excluding salary received in arrears or advance) Rs. 326353

2. Salary received in arrears or advance Rs. 338977
3. Total income (as increased by salary received in arrears or advance) Rs. 665330
4. Tax on total income (as per item 3) Rs. 59808
5. Tax on total income (as per item 1) Rs. 5804
6. Tax on salary received in arrears or advance Rs. 54004
(Difference of item 4 and 5)
7. Tax computed in accordance with Table "A" Rs. 0
[Brought from column 7 of table "A"]
8. Relief under section 89(1) Rs. 54004
[Indicate the difference between the amounts mentioned against items 6 and 7]

TABLE "A"
[See item 7 of Annexure I]
Previous Total Salary Total Income (as Tax on total Tax on total Difference in
year(s) income of received in increased by salary income [as per income [as per tax [Amount
the arrears or received in arrears column (2)] column(4)] under
relevant advance or advance) of the column (6)
previous relating to the relevant previous minus
year relevant year mentioned in amount
previous year column (1) [Add under
as mentioned column (2) and (3)] column (5)]
in column (1)
(Rs.) (Rs.) (Rs.) (Rs.) (Rs.) (Rs.)
1 2 3 4 5 6 7
2011-2012 93960 67703 161663 0 0 0
2010-2011 20630 44283 64913 0 0 0
2009-2010 30077 63884 93961 0 0 0
2008-2009 30077 58124 88201 0 0 0
2007-2008 30077 41474 71551 0 0 0
2006-2007 30077 34154 64231 0 0 0
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 NAME OF ASSESSEE : SHYAM BABU RAWAT A.Y. 2016-2017 PAN : AXYPR0137L Code :138490

2005-2006 30077 29355 59432 0 0 0

A.Y. 2012-2013 (F.Y. 2011-2012)

A.Tax on total Income as per Column No. 2
Total Income : 93960
Tax on Total Income : 0
Tax Payable : 0
B.Tax on Total Income as per Column No. 4
Total Income : 93960
Add Arrear : 67703
161663
Tax on above 0
Tax 0
A.Y. 2011-2012 (F.Y. 2010-2011)
A.Tax on total Income as per Column No. 2
Total Income : 20630
Tax on Total Income : 0
Tax Payable : 0
B.Tax on Total Income as per Column No. 4
Total Income : 20630
Add Arrear : 44283
64913
Tax on above 0
Tax 0
A.Y. 2010-2011 (F.Y. 2009-2010)
A.Tax on total Income as per Column No. 2
Total Income : 30077
Tax on Total Income : 0
Tax Payable : 0
B.Tax on Total Income as per Column No. 4
Total Income : 30077
Add Arrear : 63884
93961
Tax on above 0
Tax 0
A.Y. 2009-2010 (F.Y. 2008-2009)
A.Tax on total Income as per Column No. 2
Total Income : 30077
Tax on Total Income : 0
Tax Payable : 0
B.Tax on Total Income as per Column No. 4
Total Income : 30077
Add Arrear : 58124
88201
Tax on above 0

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 NAME OF ASSESSEE : SHYAM BABU RAWAT A.Y. 2016-2017 PAN : AXYPR0137L Code :138490

Tax 0
A.Y. 2008-2009 (F.Y. 2007-2008)
A.Tax on total Income as per Column No. 2
Total Income : 30077
Tax on Total Income : 0
Tax Payable : 0
B.Tax on Total Income as per Column No. 4
Total Income : 30077
Add Arrear : 41474
71551
Tax on above 0
Tax 0
A.Y. 2007-2008 (F.Y. 2006-2007)
A.Tax on total Income as per Column No. 2
Total Income : 30077
Tax on Total Income : 0
Tax Payable : 0
B.Tax on Total Income as per Column No. 4
Total Income : 30077
Add Arrear : 34154
64231
Tax on above 0
Tax 0
A.Y. 2006-2007 (F.Y. 2005-2006)
A.Tax on total Income as per Column No. 2
Total Income : 30077
Tax on Total Income : 0
Tax Payable : 0
B.Tax on Total Income as per Column No. 4
Total Income : 30077
Add Arrear : 29355
59432
Tax on above 0
Tax 0

Signature
(SHYAM BABU RAWAT)
CompuTax : 138490 [SHYAM BABU RAWAT]
ADVANCED TAXWAY SERVICES LIMITED

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