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(A1) PAN (A2) First Name (A2a) Middle Name (A3) Last Name
AYEPK5799E URJIT SATCHIT KAVI
(A5) Aadhaar Number(12 digits)/Aadhaar Enrolment Id(28 digits) (if
(A4) Date of Birth (A6) Mobile No
eligible for Aadhaar No.)
01/10/1988 +91 9558581088
9xxx xxxx 4131
(A9) Name of (A10) Road/Street/Post Office,
(A7) Email Address (A8) Flat/Door/Block No.
Premises/Building/Village Area/Locality
dr.urjitkavi@gmail.com E-402, Phase - 1, Savvy Swaraaj
Opp. Godrej Garden City, jAGATPUR AHMEDABAD
(A11) Town/City/District (A12) State (A13) Country/Region (A14) PIN Code/ZIP Code
Jagatpur B.O 11-Gujarat 91-INDIA 382470
(A15)(a) Filed u/s (Tick)[Please see instruction] 139(1)-On or before due date
*If the return is verified after 30 days of transmission of return data electronically, then date of verification will be considered as date of filing the
return (Notification No.05 of 2022 dated 29-07-2022 issued by the DGIT (Systems), CBDT).”
Acknowledgement Number : Date of Filing :
Less allowances to the extent exempt u/s 10 [Ensure that it is included in salary income u/s
ii ii 7,20,000
17(1)/17(2)/17(3)]
Sl.
Nature of Exempt Allowances Description ( If Any Other selected) Total Amount
No.
iia Less : Income claimed for relief from taxation u/s 89A iia 0
Income chargeable under the head 'House Property' (iii - iv - v) + vi (If loss, put the figure in
vii B2 0
negative)
*If the return is verified after 30 days of transmission of return data electronically, then date of verification will be considered as date of filing the
return (Notification No.05 of 2022 dated 29-07-2022 issued by the DGIT (Systems), CBDT).”
Acknowledgement Number : Date of Filing :
Sl.
Nature of Income Description ( If Any Other selected) Total Amount
No.
2 Dividend 240
Quarterly breakup of Dividend Income Quarterly breakup of Income from retirement benefit
account maintained in a notified country u/s 89A
(taxable portion)
Gross Total Income (B1+B2+B3) (If loss, put the figure in negative) Note: To avail the benefit
B4 B4 18,37,172
of carry forward and set off of loss, please use ITR-2
*If the return is verified after 30 days of transmission of return data electronically, then date of verification will be considered as date of filing the
return (Notification No.05 of 2022 dated 29-07-2022 issued by the DGIT (Systems), CBDT).”
Acknowledgement Number : Date of Filing :
C10 80EE - Interest on loan taken for residential house property 2,42,946 50,000
C14 80GG - Rent paid (Please submit form 10BA to claim deduction) 0 0
*If the return is verified after 30 days of transmission of return data electronically, then date of verification will be considered as date of filing the
return (Notification No.05 of 2022 dated 29-07-2022 issued by the DGIT (Systems), CBDT).”
Acknowledgement Number : Date of Filing :
Total 0
D6 Relief u/s 89 (Please ensure to submit Form 10E to claim this relief) D6 0
D11 Total Tax, Fee and Interest (D5 + D7 + D8 + D9 + D10 - D6) D11 0
D14 Refund (D12 - D11) (if D12 > D11) D14 2,75,820
PART E - OTHER INFORMATION DETAILS OF ALL BANK ACCOUNTS HELD IN INDIA AT ANY TIME DURING THE PREVIOUS YEAR
(EXCLUDING DORMANT ACCOUNTS)
Sl.
IFS Code of the Bank Name of the Bank Account Number Type of account
No.
SCHEDULE 80D
1 Whether you or any of your family member (excluding parents) is a senior citizen? Yes
*If the return is verified after 30 days of transmission of return data electronically, then date of verification will be considered as date of filing the
return (Notification No.05 of 2022 dated 29-07-2022 issued by the DGIT (Systems), CBDT).”
Acknowledgement Number : Date of Filing :
(a) Parents 0
Sl. Date of filing of Form Ack. No. of Form 10IA UDID Number (If
Nature of Disability Amount of Deduction
No. 10IA filed available)
1 0
Details of deduction in respect of maintenance including medical treatment of a dependent who is a person with
Schedule 80DD
disability.
Sl. Nature of Amount of Type of PAN of the Aadhaar of the Date of filing of Ack. No. of Form UDID Number (If
No. Disability Deduction dependent dependent dependent Form 10IA 10IA filed available)
1 0
SCHEDULE 80G DETAILS OF DONATIONS ENTITLED FOR DEDUCTION UNDER SECTION 80G
*If the return is verified after 30 days of transmission of return data electronically, then date of verification will be considered as date of filing the
return (Notification No.05 of 2022 dated 29-07-2022 issued by the DGIT (Systems), CBDT).”
Acknowledgement Number : Date of Filing :
A. DONATIONS ENTITLED FOR 100% DEDUCTION WITHOUT QUALIFYING LIMIT, (WHERE ANY ROW IS FILLED BY THE USER, ALL THE
FIELDS IN THAT ROW SHOULD BECOME MANDATORY)
(1) (2) (3) (4) (5) (6) (7) (9) (10) (11) (12)
National
1 Defence New Delhi New Delhi 09-Delhi 110001 AAAGN0009F 0 8,00,000 8,00,000 8,00,000
Fund
B. DONATIONS ENTITLED FOR 50% DEDUCTION WITHOUT QUALIFYING LIMIT (WHERE ANY ROW IS FILLED BY THE USER, ALL THE
FIELDS IN THAT ROW SHOULD BECOME MANDATORY)
(1) (2) (3) (4) (5) (6) (7) (9) (10) (11) (12)
Total B 0 0 0 0
C. DONATIONS ENTITLED FOR 100% DEDUCTION SUBJECT TO QUALIFYING LIMIT (WHERE ANY ROW IS FILLED BY THE USER, ALL THE
FIELDS IN THAT ROW SHOULD BECOME MANDATORY)
(1) (2) (3) (4) (5) (6) (7) (9) (10) (11) (12)
Total C 0 0 0 0
D. DONATIONS ENTITLED FOR 50% DEDUCTION SUBJECT TO QUALIFYING LIMIT (WHERE ANY ROW IS FILLED BY THE USER, ALL THE
FIELDS IN THAT ROW SHOULD BECOME MANDATORY)
(1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12)
Total D 0 0 0 0
*If the return is verified after 30 days of transmission of return data electronically, then date of verification will be considered as date of filing the
return (Notification No.05 of 2022 dated 29-07-2022 issued by the DGIT (Systems), CBDT).”
Acknowledgement Number : Date of Filing :
(1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12)
Total 0 0 0 0
Total 0 0 0 0
TAX PAYMENTS
Sl.
BSR Code Date of Deposit (DD/MM/YYYY) Serial Number of Challan Tax paid
No.
Total 0
SCHEDULE TDS1 - DETAILS OF TAX DEDUCTED AT SOURCE FROM SALARY [AS PER FORM 16 ISSUED BY EMPLOYER(S)]
Sl. Income chargeable under
TAN of the Deductor Name of the Deductor Total Tax Deducted
No. salaries
Total 2,69,971
SCHEDULE TDS2 - DETAILS OF TAX DEDUCTED AT SOURCE FROM INCOME OTHER THAN SALARY [AS PER FORM 16A ISSUED BY
DEDUCTOR(S)]
Gross receipt which
Sl. Name of the Year of tax TDS Credit out of
TAN of the Deductor is subject to tax Tax Deducted
No. Deductor deduction (5)claimed this year
deduction
THE AHMEDABAD
1 AHMT03029F UNIVERSITY 58,500 2023 5,850 5,850
Total 5,850
SCHEDULE TDS3 DETAILS OF TAX DEDUCTED AT SOURCE (AS PER FORM 16C FURNISHED BY THE PAYER(S))
TDS Credit out
Aadhaar Number Gross receipt
Sl. PAN of the Name of the Year of tax of (6) claimed
of the Tenant which is subject Tax Deducted
No. Tenant Tenant deduction this year
to tax deduction
*If the return is verified after 30 days of transmission of return data electronically, then date of verification will be considered as date of filing the
return (Notification No.05 of 2022 dated 29-07-2022 issued by the DGIT (Systems), CBDT).”
Acknowledgement Number : Date of Filing :
Total 0
SCHEDULE TCS
Tax Collection Gross payment
Sl. Name of the Year of tax TCS Credit out of (5)
Account Number of which is subject to Tax Collected
No. Collector collection claimed this year
the Collector tax collection
Total 0
VERIFICATION
I, URJIT SATCHIT KAVI son/ daughter of SATCHIT ANAND KAVI solemnly declare that to the best of my knowledge and belief, the information
given in the return is correct and complete and is in accordance with the provisions of the Income-tax Act, 1961. I further declare that I am making
this return in my capacity as Self and I am also competent to make this return and verify it. I am holding permanent account number AYEPK5799E
Place: 103.81.93.187
Date: 14-Jun-2024
If the return has been prepared by a Tax Return Preparer (TRP) give further details below:
If TRP is entitled for any reimbursement from the Government, amount thereof 0
*If the return is verified after 30 days of transmission of return data electronically, then date of verification will be considered as date of filing the
return (Notification No.05 of 2022 dated 29-07-2022 issued by the DGIT (Systems), CBDT).”