[Part I]
National Board of Revenue | IT-11GA2016
www.nbr.gov.bd | RETURN OF INCOME
For an Individual Assessee
The following schedules shall be the integral part of this return and | Photo
must be annexed to return in the following cases:
Schedule 24A if you have income from Salaries
Schedule 24B if you have income from house property
Schedule 24C if you have income from business or profession
Schedule 24D if you claim tax rebate
PART I
Basic information
1 | Assessment Year | 2 | Return submitted under section 82BB? (tick one)
2 | 0 | 2 | 0 | ─ | 2 | 1 | Yes | √ | No
3 | 4 | Gender (tick one)
Name of the Assessee: | TAKUYA WAKUTSU | M | √ | F
5 | Twelve-digit TIN: | 712401386233 | 6 | Old TIN
7 | Circle: | 0 | 227 (Company) | 8 | Taxes Zone:11, Dhaka.
9 | Resident Status (tick one)
Resident | √ | Non-resident
10 | Tick on the box(es) below if you are:
10A | 10B | A person with disability
A gazetted war-wounded freedom fighter | A person with disability
10C | 10D
Aged 65 years or more | A parent/legal guardian of a person with disability
11 | Date of birth (DD-MM-YYYY) | 12 | Income Year
0 | 5 | 0 | 2 | 1 | 9 | 7 | 1 | 2019 | to | 2020
13 | If employed, employer’s name: | Nippon Signal Company Limited
14 | Spouse Name: | 15 | Spouse TIN (if any):
16 | Father’s Name: Yoshiharu Wakutsu | 17 | Mother’s Name: Chieko Wakutsu
18 | Present Address: | Park Road, House-25, Apt-A4, Baridhara, Gulshan, Dhaka, PO : 121 | 19 | Permanent Address: | 1540-10, Horisaki-cho, Minuma-ku, Saitama-city, Saitama, Japan
20 | Contact Telephone: +8801847198851 | 21 | E-mail:
22 | National Identification : (Passport No) | TS0999060 | 23 | Business Identification Number(s)
[Part 2]
PART II
Particulars of Income and Tax
TIN: | 7 | 1 | 2 | 4 | 0 | 1 | 3 | 8 | 6 | 2 | 3 | 3
Particulars of Total Income | Amount ৳
24 | Salaries (annex Schedule 24A) | S.21 | 7,378,498
25 | Interest on securities | S.22
26 | Income from house property (annex Schedule 24B) | S.24
27 | Agricultural income | S.26
28 | Income from business or profession (annex Schedule 24C) | S.28 | -
29 | Capital gains | S.31
30 | Income from other sources(Interest Income) | S.33
31 | Share of income from firm or AOP
32 | Income of minor or spouse under section 43(4) | S.43
33 | Foreign income
34 | Total income (aggregate of 24 to 33) | 7,378,498 | -
Tax Computation and Payment | Amount ৳
35 | Gross tax before tax rebate | 1,639,624
36 | Tax rebate (annex Schedule 24D) | -
37 | Net tax after tax rebate | 1,639,624
38 | Minimum tax
39 | Net wealth surcharge
40 | Interest or any other amount under the Ordinance (if any)
41 | Total amount payable | 1,639,624
42 | Tax deducted or collected at source (attach proof) | -
43 | Advance tax paid (attach proof)
44 | Adjustment of tax refund [mention assessment year(s) of refund]
45 | Amount paid with return (attach proof)
46 | Total amount paid and adjusted (42+43+44+45) | -
47 | Deficit or excess (refundable) (41-46) | -
48 | Tax exempted income | -
[Part 3]
PART III
Instruction, Enclosures and Verification
TIN: | 7 | 1 | 2 | 4 | 0 | 1 | 3 | 8 | 6 | 2 | 3 | 3
Particulars of Total Income
49 | Instructions 1. Statement of assets, liabilities and expenses (IT-10B2016) and statement of life style expense (IT-10BB2016) must be furnished with the return unless you are exempted from furnishing such statement(s) under section 80. 2. Proof of payments of tax, including advance tax and withholding tax and the proof of investment for tax rebate must be provided along with return. 3. Attach account statements and other documents where applicable
50 | If you are a parent of a person with disability, has your spouse availed the extended tax exemption threshold? (tick one) | Yes | No
51 | Are you required to submit a statement of assets, liabilities and expenses (IT-10B2016) under section 80(1)? (tick one) | Yes | No
52 | Schedules annexed (tick all that are applicable)
53 | Statements annexed (tick all that are applicable)
IT-10B2016 | √ | IT-10BB2016 | √
54 | Other Statements, documents ect. Attached ;
(A) Copy of Work Permit;
(B) Copy of Passport with Visa;
(C) Copy of TIN Certificate;
(D) Payorder for TK. ; Vide No. ; Date: .
Verification and signature
55 | Verification I solemnly declare that to the best of my knowledge and belief the information given in this return and statements and documents annexed or attached herewith are correct and complete.
Name: | TAKUYA WAKUTSU | Signature:
Date of Signature (DD-MM-YYYY) | Place of Signature
1 | 2 | 2 | 0 | 2 | 0
For official use only
Return Submission Information
Date of Submission (DD-MM-YYYY) | Tax Office Entry Number
[ACK]
National Board of Revenue | IT-11GA2016
www.nbr.gov.bd
ACKNOWLEDGEMENT RECEIPT OF
RETURN OF INCOME
Assessment Year | Return under section 82BB? (tick one)
2 | 0 | 2 | 0 | ─ | 2 | 1 | Yes | √ | No
Gender (tick one)
Name of the Assessee: | TAKUYA WAKUTSU | M | √ | F
Twelve-digit TIN: | 712401386233 | Old TIN
Circle: | 227 (Company) | Taxes Zone:11, Dhaka.
Total income shown (serial 34) ৳ | 7,378,498
Amount payable (serial 41) ৳ | 1,639,624 | Amount paid and adjusted (serial 46)৳ | -
Date of Submission (DD-MM-YYYY) | Tax Office Entry Number
Signature and seal of the official receiving the return
Date of Signature | Contact Number of Tax Office
[Sch 24B]
SCHEDULE 24B
Particulars of income from house property
Annex this Schedule to the return of income if you have income from house property
1 | Assessment Year : 2016-17 | 2 | TIN :
For each house property
3 | Description of the house property
03A | Address of the property | 03B | Total area
03C | Share of the asessee (%)
Income from house property | Amount ৳
4 | Annual Value
5 | Deductions (aggregate of 05A to 05G)
05A | Repair, Collection, etc.
05B | Municipal or Local Tax
05C | Land Revenue
05D | Interest on Loan/Mortgage/Capital Charge
05E | Insurance Premium
05F | Vacancy Allowance
05G | Other, if any
6 | Income from house property (04-05) | -
7 | If case of partial ownership., the share of income
Provide information if income from more than one house property
8 | Aggregate of income of all house properties (1+2+3+- - - ) | ৳
(provide additional papers if necessary)
1 | (Income from house property 1) | ৳
2 | (Income from house property 2) | ৳
3 | (Income from house property 3) | ৳
Name : | Signature & Date
[Sch 24A]
SCHEDULE 24A
Particulars of income from Salaries
Annex this Schedule to the return of income if you have income from Salaries
1 | Assessment Year | 2 | TIN : | 712401386233
2 | 0 | 2 | 0 | ─ | 2 | 1
Particulars | Amount | Tax exempted | Taxable
(A) | (B) | (C=A-B)
3 | Basic pay | 5,870,160 | 5,870,160
4 | Special pay | -
5 | Arrear pay (if not included in taxable income earlier) | -
6 | Dearness allowance | -
7 | Conveyance allowance | - | - | -
8 | House rent allowance | - | - | -
9 | Medical allowance | - | - | -
10 | Festival Allowance | -
11 | Allowance for support staff | -
12 | Leave allowance | -
13 | Honorarium/ Reward/Fee | -
14 | Overtime allowance | -
15 | Bonus / Ex-gratia | -
16 | Other allowances | 1,508,338 | 1,508,338
17 | Employer’s contribution to a recognized provident fund | -
18 | Interest accrued on a recognized provident fund | -
19 | Deemed income for transport facility | -
20 | Deemed income for free furnished/ unfurnished accommodation | -
21 | Other, if any | - | - | -
22 | Total | 7,378,498 | - | 7,378,498
All figures of amount are in taka (৳)
Name : | TAKUYA WAKUTSU | Signature & Date:
[Sch 24D]
SCHEDULE 24D
Particulars of tax credit/rebate
To be annexed to return by an assessee claiming investment tax credit
(Attach the proof of claimed investment, contribution, etc.)
1 | Assessment Year : 2020-21 | 2 | TIN : | 712401386233
Particulars of rebatable investment, contribution, etc. | Amount ৳
3 | Life insurance premium
4 | Contribution to deposit pension scheme (not exceeding allowable limit)
5 | Investment in approved savings certificate
6 | Investment in approved debenture or debenture stock, Stock or Shares
7 | Contribution to provident fund to which Provident Fund Act, 1925
applies
8 | Self contribution and employer’s contribution to Recognized
Provident Fund
9 | Contribution to Super Annuation Fund
10 | Contribution to Benevolent Fund and Group Insurance Premium
11 | `Contribution to Zakat Fund
12 | Others, if any
13 | Total allowable investment, contribution etc. | -
14 | Eligible amount for rebate (the lesser of 14A, 14B or 14C) | -
14A | Total allowable investment, contribution, etc. (as in 13) | -
14B | 25 % of the total income (excluding any income for which | 1,844,624
a tax exemption or a reduced rate is applicable under subsection
(4) of section 44 or any income from any source or sources
mentioned in clause (a) of sub-section (2) of section 82C.)
14C | 1.5 crore
15 | Amount of tax rebate calculated on eligible amount (Serial 14)
under section 44(2)(b); | -
Name: | TAKUYA WAKUTSU | Signature & Date
[Assets]
National Board of Revenue | IT-10B2016
www.nbr.gov.bd
STATEMENT OF ASSETS, LIABILITIES AND EXPENSES
under section 80(1) of the Income Tax Ordinance, 1984 (XXXVI of 1984)
1 | Mention the amount of assets and liabilities that you have at the last date of the income year. All items shall be at cost value include legal, registration and all other related costs;
2 | If your spouse or minor children and dependent(s) are not assessee, you have to include their assets and liabilities in your statement;
3 | Schedule 25 is the integral part of this Statement if you have business capital or agriculture or non-agricultural property. Provide additional papers if necessary
1 | Assessment Year | 2 | Statement as on (DDMMYYYY)
2 | 0 | 2 | 0 | ─ | 2 | 1 | 3 | 0 | 0 | 6 | 2 | 0 | 2 | 0
3 | Name of the Assessee : | TAKUYA WAKUTSU | 4 | TIN: | 712401386233
Particulars | Amount (৳)
5 | Business capital (05A+05B) | -
05A | Business capital other than 05B
05B | Director’s shareholdings in limited companies (as in Schedule 25) | -
6 | 06A | Non-agricultural property (as in Schedule 25) | -
06B | Advance made for non-agricultural property (as in Schedule 25)
7 | Agricultural property (as in Schedule 25) | -
8 | Financial assets value (08A+08B+08C+08D+08E) | -
08A | Share, debentures etc.
08B | Savings certificate, bonds and other government securities
08C | Fixed deposit, Term deposits and DPS
08D | Loans given to others (mention name and TIN)
08E | Other financial assets (give details)
9 | Motor car (s) (use additional papers if more than two cars)
Sl | Brand name | Engine (CC) | Registration No.
1
2
10 | Gold, diamond, gems and other items (mention quantity) | -
11 | Furniture, equipment and electronic items
12 | Other assets of significant value
Particulars | Amount (৳)
13 | Cash and fund outside business (13A+13B+13C+13D) | 5,034,580
13A | Notes and currencies | -
13B | Banks, cards and other electronic cash | -
13C | Provident fund and other fund
13D | Other deposits, balance and advance (other than 08) (Salary Receivable) | 0 | 5,034,580
14 | Gross wealth (aggregate of 05 to 13) | 5,034,580
15 | Liabilities outside business (15A+15B+15C) | -
15A | Borrowings from banks and other financial institutions
15B | Unsecured loan (mention name and TIN) | 0
15C | Other loans or overdrafts (Credit Card) | 0
16 | Net wealth (14-15) | 5,034,580
17 | Net wealth at the last date of the previous income year | -
18 | Change in net wealth (16-17) | 5,034,580
19 | Other fund outflow during the income year (19A+19B+19C) | 2,343,918
19A | Annual living expenditure and tax payments (as IT-10BB) | 2,343,918
19B | Loss, deductions, expenses, etc. not mentioned in IT-10BB
19C | Gift, donation and contribution (mention name of recipient) | -
20 | Total fund outflow in the income year (18+19) | 7,378,498
21 | Sources of fund (21A+21B+21C) | 7,378,498
21A | Income shown in the return | 7,378,498
21B | Tax exempted income and allowance | 0 | -
21C | Other receipts and sources (opening Balance)
22 | Shortage of fund, if any (21-20) | -
Verification and signature
23 | Verification
I solemnly declare that to the best of my knowledge and belief the information given in this statement and the schedule annexed herewith are correct and complete.
Name : | TAKUYA WAKUTSU | Signature and date
[Expense]
IT-10BB2016
STATEMENT OF EXPENSES RELATING TO LIFESTYLE
under section 80(2) of the Income Tax Ordinance, 1984 (XXXVI of 1984)
1 | Assessment Year | 2 | Statement as on (DDMMYYYY)
2 | 0 | 2 | 0 | 2 | 1 | 3 | 0 | 0 | 6 | 2 | 0 | 2 | 0
3 | Name of the Assessee : | TAKUYA WAKUTSU | 4 | TIN: | 712401386233
Particulars | Amount (৳) | Comment
5 | Expenses for food, clothing and other essentials | 240,000
6 | Housing expense | 1,200,000
7 | Auto and transportation expenses (07A+07B) | 354,426
07A | Driver’s salary, fuel and maintenance
07B | Other transportation (Local Trasportation cost)
8 | Household and utility expenses (08A+08B+08C+08D) | 120,000
08A | Electricity
08B | Gas, water, sewer and garbage
08C | Phone, internet, TV channels subscription
08D | Home-support staff and other expenses | -
9 | Educational Expenses of Child(s) | 0
10 | Special expenses (10A+10B+10C+10D) | -
10A | Festival, party, events and gifts
10B | Domestic and overseas tour, holiday, etc. | -
10C | Donation, philanthropy, etc. | -
10D | Other special expenses | -
11 | Any other expenses | 429,492
12 | Total expense relating to lifestyle (05+06+07+08+09+10+11) | 2,343,918
13 | Payment of tax, charges, etc. (13A+13B) | -
13A | Payment of tax at source | -
13B | Payment of tax, surcharge or other amount
14 | Total amount of expense and tax (12+13) | 2,343,918
Verification and signature
15 | Verification
I solemnly declare that to the best of my knowledge and belief the information given in this statement and the schedule annexed herewith are correct and complete.
Name : | TAKUYA WAKUTSU | Signature and date
[Tax Calculation]
Computation of Total Income and Income Tax Liability:
Name of the assessee | TAKUYA WAKUTSU
E-TIN | 712401386233
Name of the employer | Nippon Signal Company Limited
Residential Status | Resident
Income Year | 2019-20
Assessment Year | 2020-21
A) Income From Salary:
Particulars | Total | Exempted Income | Taxable Income
Basic Salary | 5,870,160 | - | 5,870,160 | 12.00 | 489,180 | 2,213,549.28 | 573,924.88
House Rent | - | 12.00
Conveyance Allowance | - | 12.00
Medical Allowance | - | 12.00
Other Allowance | 1,508,338 | - | 1,508,338 | 12.00 | 125,695 | 308,338
-
Total | 7,378,498 | - | 7,378,498
Total Taxable Income: | 7,378,498
Income Tax Calculation
Particulars | Taxable Income | Tax rate | Income Tax
First | 300,000 | 0% | Nill
On Second | 100,000 | 5% | 5,000
On Third | 300,000 | 10% | 30,000
On Fourts | 400,000 | 15% | 60,000
On Fifth | 500,000 | 20% | 100,000
On Rest | 5,778,498 | 25% | 1,444,624
7,378,498 | 1,639,624
Total tax liability for the year | 1,639,624
Less: Investment Rebate | -
Net Tax Liability | 1,639,624
Less: Tax Paid at source | -
Tax Payable | 1,639,624
[Cash Account]
TAKUYA WAKUTSU
712401386233
Income Year: 2019-20
Assessment Year: 2020-21
Cash Account
Sl. | Particulars | Dr. (TK) | Sl. | Particulars | Cr. (TK)
1 | Opening Balance(Cash) | - | 1 | Expenses | 2,343,918
2 | Opening Bank Balance | - | 2
3 | Salary Income (Received Part) | 2,343,918 | 3
4 | 4 | Closing Bank Balance
5 | 5 | Closing Balance (Cash) | -
Total | 2,343,918 | Total | 2,343,918
[Sch 24C]
SCHEDULE 24C
Summary of income from business or profession
To be annexed to return by an assessee having income from business or profession
01 | Assessment Year | 02 | TIN: | 712401386233
2 | 0 | 1 | 9 | - | 2 | 0
03 | Type of main business or profession: | Computer based Internet Service
04 | Name(s) of the business or profession (as in | 05 | Address(es): | Park Road, House-25, Apt-A4, Baridhara, Gulshan, Dhaka, PO : 121
trade licence):
Use serial numbers if more names and addresses
Summary of Income | Amount ৳
06 | Sales/ Turnover/ Receipts
07 | Gross Profit | 0
08 | General, administrative, selling and other expenses | 0
09 | Net Profit (07-08) | 0
Summary of Balance Sheet | Amount ৳
10 | Cash in hand & at bank | -
11 | Inventories | -
12 | Fixed assets
13 | Other assets | -
14 | Total assets (10+11+12+13) | -
15 | Opening capital | -
16 | Net profit | -
17 | Withdrawals in the income year
18 | Closing capital (15+16-17) | -
19 | Liabilities
20 | Total capital and liabilities (18+19) | -
Name: | TAKUYA WAKUTSU | Signature & Date