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Income - Tax - Return - NIAJ - 2018 - 2019 - 2020FINAL FORM
Income - Tax - Return - NIAJ - 2018 - 2019 - 2020FINAL FORM
Printing Guideline:
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SL Title
1 Name of the Assessee
2 Circle
3 Tax Zone
4 Assessment Year
5 Name of Employer
6 Wife / Husband Name
7 Father's Name
8 Mother's Name
9 Present Address
10
11 Permanent Address
12
13 Phone Office
14 Residential
15 End Date of Tax Year
16 Assessee Gender
17 Tax Free Income - Male
18 Tax Free Income - Female
19 Tax Submission Date
20 Proceed to Calculation
Input Values SL No
A M M Mostafizur Rahman 1
63 2
3 3
2018-2019
Eastern Housing ltd.
Not Applicable
Md. Nazrul Islam
Late Jarina Akhter
1140, Nurerchala, North Badda, Gulshan, Dhaka
01733563789
01966120490
6/30/2020
Male
300000
350000
….-11-2020
Yes
Title
TIN No 7 5 1 0 5 9 3 6 0 6 8 2
NID 3 7 4 9 7 3 7 6 1 9
Date of Birth 0 1 0 3 1 9 8 5 DDMMYYYY
#REF!
#REF! #REF!
-
-
-
-
-
8 Electronic Equipment (at Cost) -
Laptop -
-
-
-
-
10 Any other assets -
#REF!
Name of the Assessee: #REF!
Medical
SL No Month Gross Salary Basic Salary House Rent Conveyance Variable Pay
Allowance
1 Jul-19 76,025.83 43,500.00 21,750.00 2,460.00 4,350.00 -
2 Aug-19 76,025.83 43,500.00 21,750.00 2,460.00 4,350.00 -
3 Sep-19 76,025.83 43,500.00 21,750.00 2,460.00 4,350.00 -
4 Oct-19 76,025.83 43,500.00 21,750.00 2,460.00 4,350.00 -
5 Nov-19 76,025.83 43,500.00 21,750.00 2,460.00 4,350.00 -
6 Dec-19 76,025.83 43,500.00 21,750.00 2,460.00 4,350.00 -
7 Jan-20 76,025.83 43,500.00 21,750.00 2,460.00 4,350.00 -
8 Feb-20 76,025.83 43,500.00 21,750.00 2,460.00 4,350.00 -
9 Mar-20 76,025.83 43,500.00 21,750.00 2,460.00 4,350.00 -
10 Apr-20 76,025.83 43,500.00 21,750.00 2,460.00 4,350.00 -
11 May-20 76,025.83 43,500.00 21,750.00 2,460.00 4,350.00 -
12 Jun-20 76,025.83 43,500.00 21,750.00 2,460.00 4,350.00 -
Additiona
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 #REF!
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: 7 5 1 0 5 9 3 6 0 6 8 2
10. Wife/√Husband's Name (if assessee, please mention TIN): Not Applicable
14. Address (a) Present: 1140, Nurerchala, North Badda, Gulshan, Dhaka
(b) Permanent: House n-47, Road No-02, Shenpara Roy Road, Rangpur
0
1
Statement of income of the Assessee
Verification
Place: Dhaka
Date : ….-11-2020
A M M Mostafizur Rahman
Designation and
Seal (for other than individual)
2
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
633,777.00
Schedule-3 (Investment tax credit)
(Section 44(2)(b) read with part ‘B’ of Sixth Schedule)
4
IT-10B
Statement of assets and liabilities as on 6/30/2020
4. Investments:
(a) Shares/Debentures - -
(b) Saving Certificate/Unit Certificate/Bond - 5,000,000.00 5,000,000.00
(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. 5,000,000.00
5
B/F= Tk. 5,000,000.00
10. Any other assets
(Give details) (Last Year Balance of Schedule-3) - - Tk. -
12. Net wealth as on last date of this income year Tk. 5,000,000.00
14. Accretion in wealth (Difference between serial no. 12 and 13) Tk. 5,000,000.00
15. (a) Family expenditure: (Total expenditure as per Form IT 10BB) Tk. 9,544.00
Adult Child
16. Total Accretion in wealth (Total of serial no. 14 and 15) Tk. 5,009,544.00
I solemnly declare that to the best of my knowledge and belief the information given in the
IT-10B is correct and complete.
A M M Mostafizur Rahman
(Name & Signature of the assessee)
Date: ….-11-2020
* 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
###
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.
A M M Mostafizur Rahman
Name and signature of the assessee
Date: ….-11-2020
* If needed, please use separate sheet.
" .....................................................................................................................................................................................
7
9,544.00
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