FORM OF RETURN OF INCOME UNDER THE INCOME TAX

ORDINANCE, 1984 (XXXVI OF 1984)

Data Entry Sheet
PIN:

1 Name of Assessee : SHANKAR SHARMA

2 National Id No (if any) : 2216638680458
3 UTIN (if any) : - -
4 TIN 5 9 2 8 5 9 6 6 8 2 2 8
6 (a) Circle : 48
(b) Taxes Zone : 03, DHAKA
6 Assesment Year : 2020-2021
9 Name of the Employer/ business BEACON CEPHALOSPHORIN LIMITED
10 Wife/Husband's Name (if assessee, please mention TIN) : MILI SHARMA
11 Father's Name : RABINDRA SHARMA
12 Mother's Name : SHANTI SHARMA
13 Date of Birth (in case of individual) : 1 0 0 8 1 9 8 8
Day Month Year
14 Address (a) Present :
Name: BHALUKA
House No./Village: BHALUKA PO./Road : BHALUKA
PS/Thana: BHALUKA
MYMENSHING
(b) Permanent :
Name: C/O RABINDRA SHAR
House No./Village: HOSPITAL PARA PO./Road : HOSPITAL ROAD
PS/Thana: KOTOWALI MODEL
MYMENSH

15 Family Member: Adult: 0 Child: 0

16 Telephone : Office/Business: Residential : 01404401210

17 VAT Registration Number (if Any) : N/A

 IT-11GA

FORM OF RETURN OF INCOME UNDER THE INCOME TAX

ORDINANCE, 1984 (XXXVI OF 1984)

FOR INDIVIDUAL AND OTHER TAXPAYERS

(OTHER THAN COMPANY)

Be a Respectable Photograph of the

Taxpayer submit return Assessee
in due time Avoid [to be attested on the
penalty photograph]

Put the tick (√) mark wherever applicable

Self Universal Self √ Normal PIN: 0

1 Name of Assessee : Shankar Sharma

2 National ID No (if any) : 2216638680458

3 UTIN (if any) : - -

4 TIN 5 9 2 8 5 9 6 6 8 2 2 8

5 (a) Circle : 48 (b) Taxes Zone : 03, Dhaka

6 Assessment Year : 2020-2021 7. Residential Status: Resident / Non-resident

8 Status : Individual √ Firm Association of Person Hindu Undivided Family

9 Name of the Employer/ business (where applicable) : Beacon Cephalosporin Limited

10 Wife/Husband's Name (if assessee, please mention TIN) : Mili Sharma

11 Father's Name : Rabindra Sharma

12 Mother's Name : Shanti Sharma

13 Date of Birth (in case of individual) : 1 0 0 8 1 9 8 8

Day Month Year

14 Address (a) Present : Bhaluka , Mymenshing

Name:
House No./Village: Bhaluka PO./Road : Gyanir More
PS/Thana: Bhaluka
Mymenshing
(b) Permanent :
Name: C/O Rabindra Sharma
House No./Village: Hospital Para PO./Road : Hospital Road
PS/Thana: Joyariya nala, Ramu
Coxsbazar

15 Telephone : Office/Business: 0 Residential : 1404401210

16 VAT Registration Number (if Any) : N/A

1
1
 5

1
 Statement of income of the Assessee
Statement of income during the income year ended on 30.06.2020

Sl. Heads of Income Amount in Taka

1 Salaries'/s 21 (as per schedule 1 ) 455,240
2 Interest on securities :u/s 22 -
3 Income from house property :u/s 24(as per schedule 2) -
4 Agricultural income :u/s 26 -
5 Income from business or profession: u/s 28/ -
6 Share of profit in a firm: -
7 Income of the spouse or minor child as applicable :u/s 43(4) -
8 Capital Gain/s 31
9 Income from other source's/s 33, (Bank Interest)
10 Total (serial no. 1 to 9) 455,240
11 Foreign Income: -
12 Total income (serial no.10 and 11) 455,240
13 Tax leivable on total income 10,524
14 Tax rebate/s 44(2)(b) ( as per schedule 3) -
15 Tax payable (difference between serial no.13 and 14 10,524
16 Tax payments:
(a) Tax deducted/collected at source
(please attach supporting documents/statement)
By ORG : Tk. 5,000
By Bank : Tk.
By Divided : Tk. -
(b)Advance tax u/s 64/68 (please attach challan) (Dividend) Tk. -
(c)Tax paid on the basis of this return (u/s74 ) By FSP Tk. -
(please attach challan/pay order/bank draft/cheque)By Challan -
(d) (B=Sec:52DD
Adjustment of rule-16
tax Refund (if any) (ICB Unit Fund) Tk. - Tk
Challan No:T32 Dt.29.01.2019 )Total of (a),(b),(c) and
(d) . 5,000
17 Difference between serial no. 15and 16 (if any) Next year adjustable amount 5,524
18 Tax exempted and tax free income 128,917
19 Income tax paid in the last assessment year 5,000

*If needed, please use separate sheet.

Verification

I Shankar Sharma father/husband Rabindra Sharma

TIN: 5 9 2 8 5 9 6 6 8 2 2 8 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.

DHAKA Signature
Date
SHANKAR SHARMA

Name in block letters

Designation and
Seal (for other than individual)

2
 SCHEDULES SHOWING DETAILS OF INCOME
Name of the Assessee: SHANKAR SHARMA TIN: 5 9 2 8 5 9 6 6 8 2 2 8
Schedule-1 (Salaries)
Pay & Allowance Amount of
Net taxable income
Amount of Income (TK.) exempted
(TK.)
income (TK.)
Basic pay 164,862 - 164,862
Special pay - - -
Dearness allowance - - -
Conveyance allowance 41,216 30,000 11,216
House rent allowance 82,431 82,431 -
Medical allowance 41,216 16,486 24,730
Servant allowance/ House Maintenance - - -
Leave allowance (LFA) - - -
Honorarium/ Reward / Fee - - -
Overtime allowance - - -
Bonus /Ex-gratia 34,616 - 34,616
Other allowances /Special 219,816 - 219,816

Employer's contribution to Recognized provident fund -

-
Interest accrued on Recognized provident fund. WPPF - - -
Deemed income for transport facility - - -
Deemed income for free furnished /unfurnished accommodation. - - -
Other if any (give detail) (Mobil Allowance) - - -
Net taxable income from salary 584,157 128,917 455,240

Schedule-2 (House property income)

Location and description of

Particulars Tk. TK.
property

1. Annual rental income

-

Repair.Collection.etc - N/A
Municipal or Local Tax -
Land Revenue - -
Interest on Loam/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)read with part B of Sixth Schedule)

1. Life insurance premium -

2. Contribution to deferred annuity -
3. Contribution to provident Fund to which provident fund Act.1925 applies . -
4. Self contribution and employer's contribution to Recognized provident fund . -
5. Contribution to Super Annuation Fund /DPS -
6. Investment in approved debenture or debenture stock'stock or Shares . -
7. Contributing to deposit pension scheme. -
8. Contribution to Benevolent Fund and Group Insurance premium . -
9. Contribution to zakat fund . -
10. others if any (give details) .Saving Certificate(Shanchoy Potro)2020-0069821 -
(KA-2699235,KA-2600964 ) Total -

* if pleas attach certificates/documents of investment.

List of documents furnished

1. Income Statement

2. NID Photocopy

3. TIN Certificate

4. Photo 1 Copy

5.Documents on Investment

6.TR Challan Photocopy

7| Suporting documents against tax deduction at source.

4
 IT-10B
Statement of Assets and Liabilities 30.06.2020

Name of the Assessee: SHANKAR SHARMA TIN: 5 9 2 8 5 9 6 6 8 2 2 8

1. (a) Business Capital (Closing balance) Tk. N/A

(b) Directors Shareholdings in Limited Companies ( at cost) Tk.
Name of Companies Number of shares
0 Tk. N/A
0 Tk. -
0 Tk. -

2. Non-Agricultural Property ( at cost with legal expense):

Land/House Property (Description and location of property)
Tk. N/A
Tk.
Tk. -
-
3. Agricultural property (at cost with legal expenses ):
Land (Total land location of land property)
Tk. N/A
0 Tk. -
0 Tk. -

4. Investments:
(a) Shares/Debentures Cost value of share Tk. -
(b) Saving Certificate/Unit Certificate/Bond /DPS Tk. -
(c) Prize bond /Savings Scheme / PF(Old+New) Tk. -
(d) Loans Given Tk. -
(e) Other Investment Tk. -
Total Tk. -

5. Motor Vehicles (at cost) : Tk. -

Type of motor vehile and Registration number N/A
6. Jewellery (quantity and cost) : As Per Last Year Tk. -
7. Furniture (at cost) : Tk. -
8. Electronic Equipment (at cost) : Tk. 105,000

9. Cash Asset Outside Business:

(a) Cash in Hand Tk. 40,000
(b) Cash at bank Tk. 300,000
('c) Other deposits (SAVINGS) Tk. -
(d) BO A/C Balance Tk.
Total Tk. 340,000

Balance Carry forward to the next page 1,214,055

5
 BF: 1,214,055

10. Any other assets (With Details)

0 Tk. -
0 Tk. -

Total Assets Tk. 1,214,055

11. Less Liabilities: N/A

(a) Mortgages secured on property or land (Housing Loan) Tk. -
(b) Unsecured loans from PF Tk.
© Bank loan Tk. 400,000
(d) Others Tk. -

Total Liabilities 400,000

12. Net wealth as on date of this income year Tk. 814,055

(Difference between total assets and total liabilities)

13. Net wealth as on date of previous income year Tk. 580,598

14. Accretion in wealth (Difference between serial no.12 and 13) Tk. 233,457

15. a) Family Expenditure:(Total expenditure as per Form IT 10 BB) Tk. 350,700

b) Number of dependant children of the family:

3 1
Adult Child

16. Total Accretion of wealth (Total of serial 14 and 15) Tk. 584,157

17. Sources of Fund :

i) Shown Income Tk. 455,240
ii) Tax exempted /Tax freeIncome Tk. 128,917
iii) Other receipts (Sale of Share) Tk. -
a) Realized Gain/(Loss) from sale of share Tk.
b) Dividend Income (Exempted Portion) Tk.
c) FSP Coupon Interest US 82© Tk. -
d) Gratuity Tk. -

Total source of Fund Tk. 584,157

18. Difference (Between serial 16 and 17 ) Tk. -

I solemnly declare that to the best of my knowledge and belief the information given in the IT-10B is correct and
complete.

SHANKAR SHARMA

Name & signature of the Assessee

Date…………………………………

*Assets and liabilities of self, spouse (if she*/he is not an assessee),minor children and dependant(s) to be shown in the
above statements.

6
*If needed, please use separate sheet.

6
 Form no IT - 10 BB
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.

Name of the Assessee: SHANKAR SHARMA TIN 5 9 2 8 5 9 6 6 8 2 2 8

Sl. Particulars of Expenditure Amount in Tk. Comments

No.
1 Personal and fooding expenses 120,000
2 Tax paid including. Deduction at source of the last financial year 5,000
3 Accommodation expenses 108,000
4 Transport expenses -
5 Electricity Bill for residence 6,000
6 WASA Bill for residence -
7 Gas Bill for residence 11,700
8 Telephone Bill for residence -
9 Education expenses for children -
10 Personal expenses for Foreign travel -
11 Festival and other special expenses if any 100,000
Total Expenditure :Family & Others Expenses 350,700

I solemnly declare that to the best of my knowledge and belief the information given in the IT-10B is correct and complete.

Shankar Sharma

Name & signature of the Assessee

Date…………………………………
*If needed, please use separate sheet.

Acknowledgement Receipt of Income Tax Return

PIN: 0

Name of the AssesseeSHANKAR SHARMA Assessment year: 2020-2021

UTIN/TIN 5 9 2 8 5 9 6 6 8 2 2 8 Circle: 48 Zone: 03, DHAKA

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 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 Ta
Ordinance,1984.
(2) Enclose where applicable:
(a) Salary statement for salary income: Bank statement for interest; Certificate for interest on savings instruments; Ren
agreement, receipts of municipal tax and land revenue, statement of house property loan interest, insurance premium fo
house property income; statement of professional income as per IT Rule-8; copy of assessment/income statement and balanc
sheet for partnership income; Documents in support of investments in savings certificates, LIP DPS,Zakat,stocl/share etc.

(b) Statement of income and expenditure; Manufacturing A/C,Trading and profit & Loss A/C and Balance sheet.
© Depreciation chart claiming depreciation as per THIRD SCHEDULE of the income Tax Ordinance ,1984.
(d) Computation of income according to income tax Law.
(3) Enclose separate statement for ;
(a) Any income of the spouse of the assessee (if she/he is not an assessee),minor children and dependant;
(b) Tax exempted tax free income .
(4) Fulfillment of the conditions laid down in rule-38is mandatory for submission of a return under "Self Assessment"
(5) Documents furnishes 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 and TIN of the partners if the assessee is a firm.
(b) Name of firm address and TIN if the assessee is a partner.
© Name of the company address and 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 and I.T-10BB,
(10) If needed please use separate sheet.

Total income shown in Return: Tk. 455,240 Tax Paid Tk.

Net Wealth of Assessee: Tk. 814,055
Date of receipt of return: Serial no. in return Register:
Nature of Return: Self Universal Self Normal

Signature of Receiving
officer with seal.

8
B.G.P-2009/10-18020F-5,00,000 Copy, (C-16)2010

8
ructions to fill up the Return Form

and verified by the individual assessee or person as prescribed u/s 75 of the Income Tax

: Bank statement for interest; Certificate for interest on savings instruments; Rent
x and land revenue, statement of house property loan interest, insurance premium for
professional income as per IT Rule-8; copy of assessment/income statement and balance
ents in support of investments in savings certificates, LIP DPS,Zakat,stocl/share etc.

; Manufacturing A/C,Trading and profit & Loss A/C and Balance sheet.
tion as per THIRD SCHEDULE of the income Tax Ordinance ,1984.

wn in rule-38is mandatory for submission of a return under "Self Assessment"

eclaration should be signed by the assessee or his/her authorized representative .

if she/he is not an assessee)minor children and dependant (s) to be shown

essee or his/her authorized representative ,For individual signature is also

5,000

Signature of Receiving
officer with seal.