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FORM

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FORM

    Assessment Year INDIAN INCOME TAX RETURN

    ( For individuals and HUFs having income from a proprietory business or profession) ITR-4 (Please see rule 12 of the Income-tax Rules,1962) FORM (Also see attached instructions) 2 0 0 9 - 1 0

    GENERAL

    First name Middle name Last name PAN

    Flat/Door/Block No Name Of Premises/Building/Village Status (Tick)

    ? Individual ? HUF Road/Street/Post Office Area/locality Date of Birth (DD/MM/YYYY) ( in case of individual)

     / / Town/City/District State Pin code Sex (in case of individual) (Tick)

     ? Male ? Female PERSONAL INFORMATION Email Address (STD code)-Phone Number Employer Category (if in

    employment) (Tick)

    ( ) ? Govt ? PSU ? Others Designation of Assessing Officer (Ward/Circle) Return filed under Section [Please see instruction number9(i)] Whether original or Revised return? (Tick) ? Original ? Revised

     If revised, then enter Receipt No and Date of filing original / / return (DD/MM/YYYY) Residential Status (Tick) ? Resident ? Non-Resident ? Resident but Not Ordinarily Resident STATUS

    Whether this return is being filed by a representative assessee? (Tick) ? Yes ? No If yes, please furnish following information - FILING(a) Name of the representative

    (b) Address of the representative

    ( c) Permanent Account Number (PAN) of the representative

    Are you liable to maintain accounts as per section 44AA? (Tick) ? Yes ? No

    Are you liable for audit under section 44AB? (Tick) ? Yes ? No, If yes, furnish following information- (a) Name of the auditor signing the tax audit report (b) Membership no. of the auditor (c) Name of the auditor (proprietorship/ firm)

    AUDIT INFORMATION (d) Permanent Account Number (PAN) of the proprietorship/ firm (e) Date of audit report.

    For Office Use Only For Office Use Only Receipt No Date Seal and Signature of receiving official

Nature of business or profession, if more than one business or profession indicate the three main activities/ products

    Code Trade name of the S.No. Description [Please see instruction No.9(ii)] proprietorship, if any

     (i)

     (ii)

     NATURE OF BUSINESS (iii)

     ST DAY OF MARCH, 2009 OF THE PROPRIETORY BUSINESS BALANCE SHEET AS ON 31

    (fill items 1 to 5 in a case where regular books of accounts are maintained, otherwise fill item 6)

     1 Proprietor‟s fund

    a Proprietor‟s capital a b Reserves and Surplus

    bi i Revaluation Reserve

    bii ii Capital Reserve biii iii Statutory Reserve

    biv iv Any other Reserve

    SOURCES OF FUNDS bv v Total (bi + bii + biii + biv)

    1c c Total proprietor‟s fund (a + bv)

     2 Loan funds

    a Secured loans

    i ai Foreign Currency Loans

    ii Rupee Loans

    iiA From Banks A B iiB From others

    C iiC Total ( iiA + iiB) aiii iii Total (ai + iiC)

     b Unsecured loans (including deposits)

    i bi From Banks

    ii bii From others

    biii iii Total (bi + bii)

    2c c Total Loan Funds (aiii + biii)

    3 3 Deferred tax liability

    4 4 Sources of funds (1c + 2c +3)

     1 Fixed assets

    1a Gross: Block a

    b 1b Depreciation

     c 1c Net Block (a b) d 1d Capital work-in-progress

    1e e Total (1c + 1d)

     2 Investments

    a Long-term investments i ai Government and other Securities - Quoted ii aii Government and other Securities Unquoted aiii iii Total (ai + aii) b Short-term investments i bi Equity Shares, including share application money APPLICATION OF FUNDS ii bii Preference Shares Debentures iii biii biv iv Total (bi + bii + biii)

     2c c Total investments (aiii + biv)

    3 Current assets, loans and advances a Current assets

Inventories

    i Stores/consumables including packing iA A material

    B iB Raw materials

     C iC Stock-in-process

    D iD Finished Goods/Traded Goods

    iE E Total (iA + iB + iC + iD)

     aii ii Sundry Debtors

     iii Cash and Bank Balances

    iiiA Cash-in-hand A

     B iiiB Balance with banks

    iiiC C Total (iiiA + iiiB)

    aiv iv Other Current Assets

    av v Total current assets (iE + aii + iiiC + aiv)

     b Loans and advances

    Advances recoverable in cash or in kind or for bi i value to be received

    Deposits, loans and advances to corporates and ii bii others

    biii iii Balance with Revenue Authorities

    biv iv Total (bi + bii + biii )

    3c c Total of current assets, loans and advances (av + biv)

     d Current liabilities and provisions

    i Current liabilities

    A iA Sundry Creditors

    B iB Liability for Leased Assets

     C iC Interest Accrued on above

    D iD Interest accrued but not due on loans

    iE E Total (iA + iB + iC + iD)

     ii Provisions

    A Provision for Income Tax iiA

    B Provision for Wealth Tax iiB

    Provision for Leave C iiC encashment/Superannuation/Gratuity

    D Other Provisions iiD

    iiE E Total (iiA + iiB + iiC + iiD )

    diii iii Total (iE + iiE)

    3e e Net current assets (3c diii)

     4 a Miscellaneous expenditure not written off or adjusted 4a Deferred tax asset 4b b

     c Profit and loss account/ Accumulated balance 4c

    4d d Total (4a + 4b + 4c)

    5 5 Total, application of funds (1e + 2c + 3e +4d)

    6 In a case where regular books of account of business or profession are not maintained - st(furnish the following information as on 31 day of March, 2009, in respect of business or profession)

    6a a Amount of total sundry debtors

    6b b Amount of total sundry creditors

    6c CASE c Amount of total stock-in-trade NO ACCOUNT 6d d Amount of the cash balance

    Profit and Loss Account for the previous year 2008-09 of the proprietory business

    (fill items 1 to 50 in a case where regular books of accounts are maintained, otherwise fill item 51)

    1 Sales/ Gross receipts of business or profession 1 (Net of returns and refunds and duty or tax, if any)

     2 Duties, taxes and cess, received or receivable, in respect of goods and services sold or supplied

    2a Union Excise duties a

    b 2b Service tax c 2c VAT/ Sales tax AND LOSS ACCOUNTCREDITS TO PROFIT d 2d Any other duty, tax and cess

    2e e Total of duties, taxes and cess, received or receivable(2a+2b+2c+2d)

     3 Other income

     3a Rent ab 3b Commission c 3c Dividend d 3d Interest e 3e Profit on sale of fixed assets Profit on sale of investment being securities chargeable f 3f to Securities Transaction Tax (STT)

    g 3g Profit on sale of other investment h 3h Profit on account of currency fluctuation i 3i Agriculture income j 3j Any other income

    3k k Total of other income (3a to 3j)

    4 4 Closing Stock

    5 5 Total of credits to profit and loss account (1+2e+3k+4)

    6 6 Opening Stock

    7 7 Purchases (net of refunds and duty or tax, if any)

     8 Duties and taxes, paid or payable, in respect of goods and services purchased

     8a Custom duty ab 8b Counter vailing duty c 8c Special additional duty d 8d Union excise duty e 8e Service tax f 8f VAT/ Sales tax

     g 8g Any other tax, paid or payable

    8h h Total (8a+8b+8c+8d+8e+8f+8g)

     9 9 Freight

     10 10 Consumption of stores and spare parts

     11 11 Power and fuel

     12 12 Rents

     13 13 Repairs to building

     14 14 Repairs to machinery

     15 Compensation to employees

    a 15a Salaries and wages b 15b Bonus c 15c Reimbursement of medical expenses d 15d Leave encashment e 15e Leave travel benefits f 15f Contribution to approved superannuation fund

    g 15g Contribution to recognised provident fund DEBITS TO PROFIT AND LOSS ACCOUNT h 15h Contribution to recognised gratuity fund i 15i Contribution to any other fund Any other benefit to employees in respect of which an j 15j expenditure has been incurred 15k k Total compensation to employees (15a+15b+15c+15d+15e+15f+15g+15h+15i+15j)

     16 Insurance

    16a Medical Insurance a

    b 16b Life Insurance

     c 16c Keyman‟s Insurance d 16d Other Insurance

     e 16e Total expenditure on insurance (16a+16b+16c+16d)

     17 17 Workmen and staff welfare expenses

     18 18 Entertainment

     19 19 Hospitality

     20 20 Conference

     21 21 Sales promotion including publicity (other than advertisement)

     22 22 Advertisement

     23 23 Commission

     24 24 Hotel , boarding and Lodging

     25 25 Traveling expenses including foreign traveling

     26 26 Conveyance expenses

     27 27 Telephone expenses

     28 28 Guest House expenses

     29 29 Club expenses

     30 30 Festival celebration expenses

     31 31 Scholarship

     32 32 Gift

     33 33 Donation

     Rates and taxes, paid or payable to Government or any local body (excluding taxes on 34 income) a 34a Union excise duty b 34b Service tax c 34c VAT/ Sales tax

    d 34d Cess e 34e Any other rate, tax, duty or cess incl STT Paid

     f 34f Total rates and taxes paid or payable (34a+34b+34c+34d+34e)

     35 35 Audit fee

     36 36 Other expenses

     37 37 Bad debts

     38 38 Provision for bad and doubtful debts

     39 39 Other provisions

    Profit before interest, depreciation and taxes 40 40 [5 (6 + 7 + 8h + 9 to 14 + 15k + 16e + 17 to 33 + 34f + 35 to 39)]

     41 41 Interest

     42 42 Depreciation

     43 43 Profit before taxes (40-41-42)

     44 44 Provision for current tax

     45 45 Provision for Deferred Tax

     46 46 Profit after tax (43 44 45 )

     47 47 Balance brought forward from previous year

     48 48 Amount available for appropriation (46 + 47)

     49 49 Transferred to reserves and surplus APPROPRIATIONS TAX PROVISIONS AND 50 50 Balance carried to balance sheet in proprietor‟s account (48 49) In a case where regular books of account of business or profession are not maintained, 51 furnish the following information for previous year 2008-09 in respect of business or profession

    51a Gross receipts a

    b 51b Gross profit c 51c Expenses

    d 51d Net profit NO ACCOUNT CASE

    Other Information (optional in a case not liable for audit under section 44AB)

    1 Method of accounting employed in the previous year (Tick) ? mercantile ? cash

    2 Is there any change in method of accounting (Tick) ? Yes ? No

    Effect on the profit because of deviation, if any, in the method of accounting employed in the 3 3 previous year from accounting standards prescribed under section 145A INFORMATION OTHER 4 Method of valuation of closing stock employed in the previous year a Raw Material (if at cost or market rates whichever is less write 1, if at cost write 2, if at market rate write 3) ? b Finished goods (if at cost or market rates whichever is less write 1, if at cost write 2, if at market rate write 3) ?

    c Is there any change in stock valuation method (Tick) ? Yes ? No d Effect on the profit or loss because of deviation, if any, from the method of valuation 4d prescribed under section 145A 5 Amounts not credited to the profit and loss account, being -

     a the items falling within the scope of section 28 5a b the proforma credits, drawbacks, refund of duty of customs or excise or service tax, or refund of sales tax

    or value added tax, where such credits, drawbacks or 5b refunds are admitted as due by the authorities

    concerned

    c escalation claims accepted during the previous year 5c d any other item of income 5d e capital receipt, if any 5e f Total of amounts not credited to profit and loss account (5a+5b+5c+5d+5e) 5f

    6 Amounts debited to the profit and loss account, to the extent disallowable under section 36:-

     a Premium paid for insurance against risk of damage 6a or destruction of stocks or store

    b Premium paid for insurance on the health of 6b employees

    c Any sum paid to an employee as bonus or

    6c commission for services rendered, where such sum

    was otherwise payable to him as profits or dividend.

    d Any amount of interest paid in respect of borrowed 6d capital

    e Amount of discount on a zero-coupon bond 6e f Amount of contributions to a recognised provident 6f fund

    g Amount of contributions to an approved 6g superannuation fund

    h Amount of contributions to an approved gratuity 6h fund

    i Amount of contributions to any other fund 6i j Amount of bad and doubtful debts 6j k Provision for bad and doubtful debts 6k l Amount transferred to any special reserve 6l m Expenditure for the purposes of promoting family 6m planning amongst employees

    n Any sum received from employees as contribution to any provident fund or superannuation fund or any

    fund set up under ESI Act or any other fund for the 6n welfare of employees to the extent credited to the

    employees account on or before the due date

    o Any other disallowance 6o

    6p p Total amount disallowable under section 36 (total of 6a to 6o)

    7 Amounts debited to the profit and loss account, to the extent disallowable under section 37

     Expenditure of personal nature; a 7a Expenditure on advertisement in any souvenir, b 7b brochure, tract, pamphlet or the like, published by a political party; Expenditure by way of penalty or fine for violation of c 7c any law for the time being in force; Any other penalty or fine; d 7d

     Expenditure incurred for any purpose which is an e 7e offence or which is prohibited by law;

    Amount of any liability of a contingent nature f 7f Amount of expenditure in relation to income which g 7g does not form part of total income

    Any other amount not allowable under section 37 h 7h

    7i Total amount disallowable under section 37(total of 7a to 7h) i

    8 Amounts debited to the profit and loss account, to the extent disallowable under section 40 A.

     Amount disallowable under section 40 (a)(i), 40(a)(ia) and 40(a)(iii) on account of non-a Aa compliance with the provisions of Chapter XVII-B Amount paid as fringe benefit tax b Ab Amount of tax or rate levied or assessed on the c Ac basis of profits

    Amount paid as wealth tax d Ad

    Amount of interest, salary, bonus, commission e Ae or remuneration paid to any partner or member

    Any other disallowance f Af

    g Total amount disallowable under section 40(total of Aa to Af) 8Ag

    Any amount disallowed under section 40 in any preceding previous year but allowable 8B B. during the previous year 9 Amounts debited to the profit and loss account, to the extent disallowable under section 40A

     a Amounts paid to persons specified in section 9a 40A(2)(b)

    b Amount in excess of twenty thousand rupees paid to

    a person in a day otherwise than by account payee 9b cheque or account payee bank draft under section

    40A(3) 100% disallowable

    c Provision for payment of gratuity 9c

    d any sum paid by the assessee as an employer for

    setting up or as contribution to any fund, trust, 9d company, AOP, or BOI or society or any other

    institution;

    e Any other disallowance 9e

    9f Total amount disallowable under section 40A (total of 9a to 9e) f

    10 Any amount disallowed under section 43B in any preceding previous year but allowable during the previous year a Any sum in the nature of tax, duty, cess or fee under 10a any law

    b Any sum payable by way of contribution to any

    provident fund or superannuation fund or gratuity 10b

    fund or any other fund for the welfare of employees

    c Any sum payable to an employee as bonus or 10c commission for services rendered

    d Any sum payable as interest on any loan or

    borrowing from any public financial institution or a 10d State financial corporation or a State Industrial

    investment corporation

    e Any sum payable as interest on any loan or 10e borrowing from any scheduled bank

    f Any sum payable towards leave encashment 10f g Total amount allowable under section 43B (total of 10a to 10f) 10g

    11 Any amount debited to profit and loss account of the previous year but disallowable under

    section 43B:- a Any sum in the nature of tax, duty, cess or fee under 11a any law

    b Any sum payable by way of contribution to any

    provident fund or superannuation fund or gratuity 11b

    fund or any other fund for the welfare of employees

    c Any sum payable to an employee as bonus or 11c commission for services rendered

    d Any sum payable as interest on any loan or

    borrowing from any public financial institution or a 11d State financial corporation or a State Industrial

    investment corporation

    e Any sum payable as interest on any loan or 11e borrowing from any scheduled bank

    f Any sum payable towards leave encashment 11f

    g Total amount disallowable under Section 43B(total of 11a to 11f) 11g

    12 Amount of credit outstanding in the accounts in respect of

     a Union Excise Duty 12a b Service tax 12b c VAT/sales tax 12c

    d Any other tax 12d

    12e Total amount outstanding (total of 12a to 12d) e

    13 13 Amounts deemed to be profits and gains under section 33AB or 33ABA or 33AC 14 14 Any amount of profit chargeable to tax under section 41

    15 15 Amount of income or expenditure of prior period credited or debited to the profit and loss

    account (net)

    Quantitative details (optional in a case not liable for audit under section 44AB) (a) In the case of a trading concern

    Opening stock 1 1 Purchase during the previous year 2 2

     Sales during the previous year 3 3

    Closing stock 4 4

    5 5 Shortage/ excess, if any (b) In the case of a manufacturing concern Raw materials

    6 Opening stock a 6a

    Purchases during the previous year b 6b

    Consumption during the previous year c 6c

    Sales during the previous year d 6d e 6e Closing stock

    Yield finished products f 6f

    Percentage of yield g 6g QUANTITATIVE DETAILS Shortage/ excess, if any h 6h

    Finished products/ By-products 7

    opening stock a 7a

    purchase during the previous year b 7b

    quantity manufactured during the previous year c 7c sales during the previous year d 7d

    closing stock e 7e

    shortage/ excess, if any f 7f

    Computation of total income

    1 1 Salaries (6 of Schedule S) 2 2 Income from house property (4c of Schedule-HP) (enter nil if loss) 3 Profits and gains from business or profession

     i 3i Profit and gains from business other than speculative business (A37 of Schedule-BP)

    ii 3ii Profit and gains from speculative business (B41 of Schedule-BP) (enter nil if loss)

    iii 3iii Total (3i + 3ii) (enter nil if 3iii is a loss) 4 Capital gains

     a Short term

     i 4ai Short-term (under section 111A) (A7 of Schedule- CG) (enter nil if loss)

    ii 4aii Short-term (others) (A8 of Schedule-CG)

    iii 4aiii Total short-term (4ai + 4aii)

    b 4b Long-term (B6 of Schedule-CG) (enter nil if loss)

    c 4c Total capital gains (4aiii + 4b) (enter nil if 4c is a loss) 5 Income from other sources

     a 5a from sources other than from owning race horses (3 TOTAL INCOME of Schedule OS) (enter nil if loss)

    b 5b from owning race horses (4c of Schedule OS) (enter nil

    if loss)

    c Total (5a + 5b) 5c 6 Total (1 + 2 + 3iii +4c +5c) 6 7 7 Losses of current year to be set off against 6 (total of 2vii,3vii and 4vii of Schedule CYLA) 8 8 Balance after set off current year losses (6 7) 9 9 Brought forward losses to be set off against 6 (total of 2vii, 3vii and 4vii of Schedule BFLA) 10 10 Gross Total income (8-9) (also 5viii of Schedule BFLA) 11 11 Deductions under Chapter VI-A (s of Schedule VIA) 12 12 Total income (10 11) 13 13 Net agricultural income/ any other income for rate purpose (4 of Schedule EI) 14 14 „Aggregate income‟ (12 + 13)

    15 15 Losses of current year to be carried forward (total of xi of CFL)

    Computation of tax liability on total income

    1 Tax payable on total income

     a Tax at normal rates 1a

    Tax at special rates (11 of Schedule-SI) b 1b

    2 2 Tax Payable on Total Income (1a + 1b) 3 3 Surcharge on 2 4 4 Education cess, including secondary and higher education cess on (2+3) 5 5 Gross tax liability (2+ 3 + 4) 6 Tax relief

     6a a Section 89

    6b b Section 90

    6c c Section 91

    6d d Total (6a + 6b + 6c) 7 7 Net tax liability (5 6d) 8 Interest payable

    8a a For default in furnishing the return (section 234A) COMPUTATION OF TAX LIABILITY 8b b For default in payment of advance tax (section 234B)

    8c c For deferment of advance tax (section 234C)

    8d d Total Interest Payable (8a+8b+8c) 9 9 Aggregate liability (7 + 8d) 10 Taxes Paid

     10a Advance Tax (from Schedule-IT) a

    10b TDS (total of column 7 of Schedule-TDS1 and column 7 b of Schedule-TDS2) 10c TCS (column 7 of Schedule-TCS) c

    10d Self Assessment Tax (from Schedule-IT) d TAXES PAID 10e e Total Taxes Paid (10a+10b+10c + 10d) 11 11 Amount payable (Enter if 9 is greater than 10e, else enter 0) 12 12 Refund (If 10e is greater than 9, also give Bank Account details below) 13 Enter your bank account number (mandatory in case of refund)

    14 Do you want your refund by ? cheque, or ? deposited directly into your bank account? (tick as applicable ) 15 Give additional details of your bank account REFUND MICR Code Type of Account (tick as applicable ) ? Savings ? Current

    VERIFICATION

    I, son/ daughter of , holding permanent account number ____________ solemnly declare that to the best of my knowledge and belief, the information given in the return and schedules thereto is correct and complete and that

    the amount of total income and other particulars shown therein are truly stated and are in accordance with the provisions of the Income-tax Act, 1961, in respect of income chargeable to Income-tax for the previous year relevant to the Assessment Year 2009-10. Place Date Sign here

    If the return has been prepared by a Tax Return Preparer (TRP) give further details below: Identification No. of TRP Name of TRP Counter Signature of TRP

If TRP is entitled for any reimbursement from the Government, amount thereof……………

    Details of Income from Salary

    PAN of Employer (optional) Name of Employer

    Address of employer Town/City State Pin code

    1 1 Salary (Excluding all allowances, perquisites & profit in lieu of salary).. 2 2 Allowances exempt under section 10 SALARIES 3 3 Allowances not exempt 4 4 Value of perquisites 5 5 Profits in lieu of salary 6 6 Income chargeable under the Head „Salaries‟ (1+3+4+5)

    Details of Income from House Property (Please refer to instructions)

    Town/ City State PIN Code Address of property 1 1

    PAN of Tenant (optional) Name of Tenant if let out ? (Tick) Annual letable value/ rent received or receivable (higher if let out for whole of the year, lower a 1a if let out for part of the year)

    1b b The amount of rent which cannot be realized

    1c c Tax paid to local authorities 1d d Total (1b + 1c)

     e 1e Balance (1a 1d)

    1f f 30% of 1e 1g g Interest payable on borrowed capital

     h 1h Total (1f + 1g)

     i 1i Income from house property 1 (1e 1h)

    Town/ City State PIN Code Address of property 2 2

    Name of Tenant PAN of Tenant (optional) if let out ? (Tick) Annual letable value/ rent received or receivable (higher if let out for whole of the year, lower a 2a if let out for part of the year)

    2b b The amount of rent which cannot be realized

    2c c Tax paid to local authorities 2d d Total (2b + 2c)

     e 2e Balance (2a 2d)

    2f f 30% of 2e HOUSE PROPERTY 2g g Interest payable on borrowed capital

     h 2h Total (2f + 2g)

     i 2i Income from house property 2 (2e 2h)

    Address of property 3 Town/ City State PIN Code

    3

    Name of Tenant PAN of Tenant (optional) if let out ? (Tick) Annual letable value/ rent received or receivable (higher if let out for whole of the year, lower a 3a if let out for part of the year)

    3b b The amount of rent which cannot be realized

    3c c Tax paid to local authorities 3d d Total (3b + 3c)

     e 3e Balance (3a 3d)

    3f f 30% of 3e 3g g Interest payable on borrowed capital

     h 3h Total (3f + 3g)

     i 3i Income from house property 3 (3e 3h)

    4 Income under the head “Income from house property”

     4a Rent of earlier years realized under section 25A/AA a b 4b Arrears of rent received during the year under section 25B after deducting 30% c 4c Total (4a + 4b + 1i + 2i + 3i) Please include the income of the specified persons referred to in Schedule SPI while computing the income under this head Computation of income from business or profession A From business or profession other than speculative business 1 Profit before tax as per profit and loss account (item 43 or item 51d of Part A-P&L ) 1 2 2 Net profit or loss from speculative business included in 1 3 3 Income/ receipts credited to profit and loss account considered under other heads of income 4 4 Profit or loss included in 1, which is referred to in section 44AD/44AE/44AF/44B/44BB/44BBA/44BBB/ 44D/44DA Chapter-XII-G/ First Schedule of Income- tax Act 5 Income credited to Profit and Loss account (included in 1)which is exempt PROFESSION INCOME FROM BUSINESS OR a 5a share of income from firm(s) b 5b Share of income from AOP/ BOI

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