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Make Necessary Changes in Only Orange Colored Fields.: Proceed To Calculation Will Be Initially "No"
Make Necessary Changes in Only Orange Colored Fields.: Proceed To Calculation Will Be Initially "No"
a
If Proceed to
Calculation is Yes
6/30/2017 then Investment
Male details inputted
in Misc Sheet
250000 will be
300000 populated
automatically in
02/Nov/17 PG5 and PG6 for
Yes the Current
Fiscal Year.
Title
TIN No * * * * * * * * * * * *
NID x x x x x x x x x x x x x x x x x
Date of Birth x x x x x x x x DDMMYYYY
If Proceed to
Calculation is Yes
then Investment
details inputted
in Misc Sheet
will be
populated
automatically in
PG5 and PG6 for
the Current
Fiscal Year.
Assessment Year :
Name of the Assessee: TIN : ************
Grand Total - -
Note: Input Monthwise salary breakup details using payslip (Match Grand total with HR provided Salary C
Row 19 by using Salary Certificate provided by HR
TIN No ************
Special Festival Provident TAX
Allowance Bonus Fund Deduction
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
Additional Tax Deduction 0.00
Tax Refund 0.00
-
Exemption Calculation
0.50 HR % of Basic
25,000.00 Fixed Monthly HRA
30,000.00 Conveyance
0.10 Medical % of Basic
120,000.00 Fixed Annual Medical
4. TIN: * * * * * * * * * * * *
11 Father's Name: 0
(b) Permanent: 0
0
15. Telephone: Office/ Business a Residential: 0
1
Statement of income of the Assessee
Verification
I 0 father/husband
UTIN/TIN: ************ solemnly declare that to the best of my knowledge and
belief the information given in this return and statements and documents annexed herewith is correct and
complete.
Place: Dhaka
Date : 02/Nov/17
0
Designation and
Seal (for other than individual)
2
Amount in Taka
-
-
-
-
-
-
(25,000.00)
-
5,000.00
If (Difference
between serial
no. 15 and 16) is
Positive then
Additional Tax to
be paid.
If (Difference
between serial
- no. 15 and 16) is
Negative then
5,000.00
Advance Tax
- paid.
-
wledge and
0
Designation and
l (for other than individual)
SCHEDULES SHOWING DETAILS OF INCOME
Schedule-1 (Salaries)
1. Annual Income
2. Claimed Expenses
Repair,Collection, etc.
Municipal or Local Tax
Land Revenue
Interest on Loan/Mortgage/Capital
Charge
Insurance premium
Vacancy Allowance
Other, If any
Total=
3. Net income (difference between item 1 and 2
3
-
Schedule-3 (Investment tax credit)
(Section 44(2)(b) read with part ‘B’ of Sixth Schedule)
4
Statement of assets and liabilities as on 6/30/2017
4. Investments:
(a) Shares/Debentures - - -
(b) Saving Certificate/Unit Certificate/Bond - - -
(c) Prize bond/Savings Scheme - - Tk. -
(d) Loan given - - Tk. -
(e) Other Investment (Deposit Pension Scheme) - - -
Provident Fund (PF) - - Tk. -
Life Insurance Premium - - -
FDR / DBS / TBS / MES - - -
- - -
Total of section 4= Tk. -
12. Net wealth as on last date of this income year Tk. 270,000.00
14. Accretion in wealth (Difference between serial no. 12 and 13) Tk. 270,000.00
15. (a) Family expenditure: (Total expenditure as per Form IT 10BB) Tk. -
I solemnly declare that to the best of my knowledge and belief the information given in the
IT-10B is correct and complete.
0
(Name & Signature of the assessee)
Date: 02/Nov/17
* Assets and liabilities of self, spouse (if she/he is not an assessee), minor children and
dependendant (s) to be shown in the above statements.
6
IT-10B
7
* *
Total (Tk.)
-
-
-
-
-
-
-
-
-
-
-
90,000.00
50,000.00
80,000.00
50,000.00
-
-
50,000.00
270,000.00
270,000.00
270,000.00
270,000.00
270,000.00
270,000.00
270,000.00
-
270,000.00
of the assessee)
Form No. IT-10BB
FORM
Statement under section 75(2)(d)(i) and section 80 of the Income Tax Ordinance, 1984 (XXXVI of
1984) regarding particulars of life style
I solemnly declare that to the best of my knowledge and belief the information given in the
IT-10BB is correct and complete.
0
Name and signature of the assessee
Date: 2-Nov-17
* If needed, please use separate sheet.
" .....................................................................................................................................................................................
7
No. IT-10BB
4 (XXXVI of
Comments
- -
e assessee
0
Instructions to fill up the Return Form
Instructions:
(1) This return of income shall be signed and verified by the individual assessee or person as prescribed u/s 75 of the Income
Tax Ordinance, 1984.
(2) Enclose where applicable:
(a) Salary statement for salary Income; Bank statement for interest; Certificate for interest on savings instruments; Rent
agreement, receipts of municipal tax & land revenue, statement of house property loan interest, insurance premium for
house property income; Statement of Professional income as per IT Rule-8; Copy of assessment/ income statement &
balance sheet for partnership income; Documents of capital gain; Dividend warrant for dividend income; Statement of
other income; Documents in support of investments in savings certificates, LIP, DPS, Zakat, stock/share etc.
(b) Statement of income and expenditure; Manufacturing A/C, Trading & Profit & Loss A/C and Balance sheet;
(c) Depreciation chart claiming depreciation as per THIRD SCHEDULE of the Income Tax Ordinance, 1984;
(4) Fulfillment of the conditions laid down in rule-38 is mandatory for submission of a return under "Self Assessment".
(5) Documents furnished to support the declaration should be signed by the assessee or his/her authorized representative.
(6) The assesse shall submit his/her photograph with return after every five year.
(7) Furnish the following
information :
(a) Name, address & TIN of the partners if the assessee is a firm;
(b) Name of firm, address & TIN if the assessee is a partner;
(c) Name of the company, address & TIN if the assessee is a director.
(8) Assets and liabilities of self, spouse (if she/he is not an assessee), minor children and dependant (s) to be shown in the IT-
10B.
(9) Signature is mandatory for all the assessee or his/her authorized representative. For individual, signature is also mandatory
in I.T-10B & I.T-10BB.
..................................................................................................................................................................
Signature of Receiving
8 Officer with seal
n as prescribed u/s 75 of the Income
.................................
5,000.00
…………………………
Signature of Receiving
Officer with seal