m2 THE GAZETTE OF INDIA : EXTRAORDINARY. [ax Hse. 309) FORM ITR2 INDIAN INCOME TAX RETURN ‘Gpesnent Year {For Individuals and HUFs not having income ftom profits and gains of eee ea ft are ale 1962) 2]o|2\1|-]2]2 "Phe fr rin) PERSONAL INFORMATION FILING STATUS, Taian Tasman Faw DURGA, ae AIeop Teel i212 15} Fence Tame of oi a ae 3 SAKET "| ernst nur ona Pot Oice ais af ir Formation mDanenrr Teas ‘nur Number C1 digi Radar Eartnt (28 Fighter Nady Mp, “Road Wsaesi sa TL TTT Tritt titi tt “onli Dire Sere “DEL WL PN code nde DEKHT Comm THOT A 1.1 Tofo[é [s een Of aps gig ae NST NT Mabie Ro aL (isiabtetr 1 folate T TTI I I I L a Email Adres Gai)_oXphtver 14 grail Coro ie, IG9CH) Aer due dae, CII9@) Reved Return, | ied ws (Tick Plese se intraction} {D92CD Modified return, C1192Xb)-Atercondonation of de Tacresponse to notice we His9o), iad), Os, 1s CISC wy ping for new tax regis we TISHAC? C1 Yes BFNo Ting retro income under Seventh proviso to section T390) but otherwise no required to farish return afncome? (TER) J Yeuwne (6) | It yes pleae furnish lowing informatio [Note Tobe fled only if person b nt required f frnish a return of income under section 139(1) bu fling return of income due to falling one or more conditions mentioned in the seventh proviso to section 139), Have you deposited amount or aggregate of amounts exceeding Rs. 1 Crorein one or more | Amount (Rs) (I Ves) © | current account during the previows year? (Yes/No) Tiave you incurred expenditure of an amount or aggregate of amount exceeding RS DTaKhs | sou o 080 | for travel toa foreign country for yourself or for any other person? (Yes/No) Amer eae) Fave you incurred expenditure of amount or aggregate of amount exceeding Rs 1TaKhon | sunt qs (ves) consumption of electricity during the previous year? (¥ewNo) Tf Revised/Defective/Modifed, chen enter Receipt Ne. _and Date of fling original return DD/MMIYYYY), bt titi ti tt tt alae 5 tied in response tea notice ws L39Q)AR(DILANSSATEC oF order ws FTSGY) eter Unique Namber— | gg, @ | Document ldensteation Number DIN) sod date of such NotceOrder,or led ws 93CD,enterdateat |My Advance Pricing Agreement | Resdentiat YA ident Yo seni To TD geo mrs ring he previous yar foton DO] Status dla TE Ya wee in India fr 60 dys more during the previous Yes, and have boss Ta Tada Fox 365 (or indviduats) days ormoe within he &peseding years [sston (1X6) [where Explanation is ot aplicble (Mcceppcae [Resident but wot | You have been noo-resdentin India in 9 ou of 10 preseding yea [eeston 6G] ‘i Ordinarily Resident. [CI Youve bse nin for 79 ay reser ths 7 poseding ens eeton SOX] ‘C-Non-resident | You vere a nn-oridsat ding he previous Yer. (Plas apcify te jrsditon) of esideee during he previous SNe] Juiicton of “Tenpeyer Metfcation Nombar@) residence [eer 2 Tn sat you ars CHivn of Tin aa Pesca of Indi Origin POD, pleas py = "Tlal prod of stay in Indi “Tolal prod of tay in Inia daring te 4 proceding yous ering the previous year (in 695) ay) 1 Residential] D-C Resident Ch Reside bu not Ordinary Resident Tien resident Status in Toda (or UP) (ick applicable cose) | Do you want to alm the Benefit weer section ISH? (applicable in ave of resident) Dye Ne {@_| Are you governed by Portaguese Civil Code ax per seton SA? Ticl) Ul You GIN (H*VES” pene ll Schedule SAY ‘gy | Whether hs rear sing fed Iya Reprsentstve Asese? VE Yes RY/Nolf ye, pease rich owing Information - (@)_| Name ofthe Representative ‘@)_| Capacity ofthe Representative (hop damn tobe provided ‘G)_| Adress of the Representative (@)_[ Permanent Account Nember (PANDY Aadaar No_ of dhe Representative o “Whether you were Director ina company at anytime during the previous year? Tick) Ves (No Ir ya, please fersh allowing Informa(oer tae 3691 sare er: eT 23 Teneo? ‘Whether iv sharevare ated or remests ‘Type ofcompany PAN ay Drop down to he ‘provided ‘Wether you have held lsd equity shares a any tne daring the previous year? (Tian) Yes | reyes: please furnish allowing infermation fx respect of equity shares Type of T pax | Opening balance Shares acquired during the year Shares truserred | Cigsng balance Company during the year » Tie price | Parciane pre Drop Bae ral donate New acat | fe Jigar | Coerarete | sac] sae [saat | cat ® ie samen | her | Oucacat | cea | ors | comet | ste cin provided) stare | fam | Serbo i [as] sta ts [<é 7 s ° a1A : EXTRAORDINARY [Pager see 0) na [THE GAZETTE OF ale S| Details of come from Salary Name of Ener Tatar af employer HATE TaN aFinpiopor fmonioy Fare ep isonet prone deducted XYZ LINITED OTHERS R[t]k [Ale [5 |4]5 3 |p ‘Address of employer TowniCity ‘State IN code! ZAP code £-23, O@NOAVENT PLACE | connaverst PLACE DERN TItlofololr | 1 ros Saiey Gat Tht TQ TL —Satiteo a alary as per section 170 hop down to be provided i [SoCo 1 Wal of perquisites as pr section 172) (drop down 0 Be provided) [1b | _[ePeotit ini of salary as per section 17) (hop down to be provided) [1 i [ost cy eof or on 3 ; | 2 [rotat Grose Salary rom al employers) 2| 5061600 [as allowances fo he extent exempt wh 1 Grp dow fo Be rowed nen wily (ease 3 instructions) 3 2400 (Note: Ensure that tis included in Total Gross salary in (2) above) et Salary @-3) +[ 5084200 5 Pedacton ws 16 Gav Sb +50) 3 50000 “A Btandard deduction ws 1603) = Entertainment allowance ws 1660) * Professional tx ws 1661) = © fone chargeable under the head Saar 5) | 5 004.25 EEPEITTIIBIINN <2 Ortocome From tome Property (Pleas Rr htt) (Drop don ob prone cians oonera of ener) res af proper Tovai Gey ae IN Codel IF Cole 1] FLAT NO-43, SAKET, E fe: = 43, SAKET, MB ROAD DEKHT o9-DELNE AT TTSPOe TS] the property commnet? Over 9Ke. (“YB ple nero dt our percentage of care athe property) ken efibemeste JPAN/Aadhaar No. of Co-owner) Persentaze Share In Property T 7 [FA ape in not TaN Aaron aoe FANTTAN/ Raia Rao Toa OFT fa tstout ou. iene) [Bsat-occupied E [2 Deemed tet out ir E a | Gross rent received or receivable or lettable value da | [Te fe amouns tren wiih canmo be etal 0 rasa 8 | [_piemitnotantore Te E| [a frosianeto ia B | [e Tarn sae a= 18) Ye cepa oso por ton 2p Te AED ie S| Pema ae fe property onned own percentage sare x10) 1 [re hove oti tg Th foteret payable on Borrowed ep th] 200,505 : Tot 18) 1 | 2,00,000 Tres reatind Fat ced Gring te YerWan 39% m1 1 frome from ous property f= H+ I) [2300000 > Padres of propery? orcs IN Comer 71F Cae a Te propery cowed Cl Yeu —CINe G°VES ae citer fling detaley a TTT ITOH | [Name of Co-owner) JPAN/ Andhaar No. of Co-owner(s) trcentage Share la Property T 7(one eee 341 sre sr ere: eT 25 Fk ve apical oon} ae) of Tenant” PANTAnhaar No af Tent) PAN7TANT Ania Na of Tosev TTS [atatout fica) he) fds ea Sat occupied FE Dewna rut T 7 | _ rove ret reel rca eee ae a gar of to ent ort ef ter, ver oft eo et cut fr part of he ear) ft amount teat which ant be ealed ab © [Tx pi o lo authorities 2 freutavs20. 2 fanmal value Ga=20) 2 Pn val of propay oval va parang TTD 2 pore rar 3 1 fers patio reed 2h 7 est ea) a TPrer/Caread rt eccied drag tear ev 30% rT i come from howe propery 2 F212) ey 3 Ps through incomes any * > ov under te hed “Income om House Proper* GK 2K) 4 Vigan le thie oe shel CLA + | ~2,00,000 Tee Dc he on of We sped persons Tera Tae SP nd ass Wah reams re Teds PT won Te Income der shad Paring of PAN rN ot mo aT AT won TOE Paik of Te oan mandy, Fe deed nde ston 196 CE ‘A Bhortterm Capital Gals (STCG) Gud toms Sand 4 are ot applicable for resides) 7 From sale of land or building or both (fill up details separately for each property) 63) [= Prats contrat rervareceabie a eg ale of property as pe tmp vation authority ‘ait A I value of consideration adopted as per section SOC for the purpose g sa frcapea Gate fcc a) docnteneed 13a kee | al prs yee ke 1 Pataconrander con 1 fost of acqbton witout nezton ny 1 Cost of onprovement without indexation Bi ispendstere wholly aad exelusvely a connection with traneior Bill is [ot ib) Bi = Patan t=) 1c d_Dedecton wer secon 50 Spica tom D Bw) id ‘+ order Capital Gal on Inova property eT) fas of transfer fm atl proper, plese ar cl in aema se, ame ot baer] PANAtane] prentage sre [Annet | Adie of reper "NOTE — Faring of PAN ada Normandy ew eid ner sean TTA os qa yer nthe document. J case of more than one buyer, please indicate the respective percentage share and amount, ale of equity share or unit of equity oriented Mutual Fund (MI) or unit ofa business trust on which STT paid section 11A or 11SADCIXt) proviso (for FI) Full value ofconsderation Fa 1 Dedoctons under secon 48 1 [eon of acquisition without indexation BL W [cost oftmproverent without indexation bt Ti Fxpendiare wholly and exchavely tn connection with anti cH iv [rood i= i om © Balance Ga— bin) ae [ims wersges teats paar 4 Brmonts petor to record date and dlvdend/acome/bonus units are received, then| 24 arising ou of sal of such ase to be ignored Enter peste value oly) ‘= Birt term capital gain on equify share or equity orkented ME aa) Azo for NON-RESIDENT, not being an FI- from sleof shares or debentores of an Indian company Go be computed with exchange adjustment under rt proviso to section (8) [CG on transactions on which scurites transaction az STE) paid rasa] 3 a Aga & 7 For NON-KESIDENT-trom sale of securities (other than those at AZ) by an FIL ss por section TIEAD “| E Pnease secures sold include shares of a company other than quoted shares, ete following details