IT-11GA2016
RETURN OF INCOME
For an Individual Assesse
F
to
A parent of a person with
disability
Date of birth (DDMMYYYY) 11 12 Income Year
10
Tick on the box(es) below if you are: N/A
10A A gazetted war-wounded
freedom fighter 10B A person with disability
10C Aged 65 years or more 10D
Spouse TIN (if any): N/A
16 Father’s Name: Ramesh Chand Mother’s Name: Usha Rani
13 If employed, employer’s name: Nippon Signal Company Limited
23 Business Identification Numbers: N/A
18 Present Address: 24-25 Dilkhusha, 8th Floor, Shorif
Associate, Dilkhusha C/A, Motijheel, Dhaka, PO: 1000 19 Permanent Address: 222/1, Railway Colony,
Kishan Ganj, Delhi 110007.
20 Contact Telephone: N/A
06
07 Circle: 222 (Company) 08
22 NID/ Passport: J7498046
17
21
14 Spouse Name: N/A 15
09 Resident Status (tick one) Resident
E-mail: N/A
(Under Section - 91)
Name of the Assessee: Hanish Chand 04 Gender: M
-
01 02
The following schedules shall be the integral part of this return and
must be annexed to return in the following cases:
photo
Schedule 24D if you have investment and claim tax rebate
Non-resident
Schedule 24A if you have income from Salaries
Schedule 24B if you have income from h ouse property
Schedule 24C if you have income from business or profession
Return submitted under section 82BB? (tick
one)
Yes No
03
Old TIN: N/A
Zone: 11
PART I
Basic information
Assessment Year:
05 Twelve-digit TIN: 782588133855
2020 2021
2 0 2 1 2 2
1 3 1 0 1 9 7 9
P articulars of Total Income Amount Tk.
34
31
32
33
26
29
Income from house property (annex Schedule 24B) S.24 -
PART II
Particulars of Income and Tax
TIN
24 Salaries (annex Schedule 24A) S.21 1,950,000
25 Interest on securities S.22 -
Agricultural income S.26 -
28 Income from business or profession (annex Schedule 24C) S.28 -
27
Capital gains S.31 -
30 Income from other sources S.33 -
Share of income from firm or AOP -
Income of minor or spouse under section 43(4) S.43 -
Foreign income -
Total income (aggregate of 24 to 33) 1,950,000
Net wealth surcharge -
T ax Computation and Payment Amount Tk.
35 Gross tax before tax rebate 282,500
Tax rebate (annex Schedule 24D) -
39
36
38
37 Net tax after tax rebate 282,500
Minimum tax
45 Amount paid with return (attach proof) -
Interest or any other amount under the Ordinance (if any) -
Total amount payable 282,500
Tax deducted or collected at source (attach proof) 255,246
43
41
42
40
48 Tax exempted income (450,000)
46 Total amount paid and adjusted (42+43+44+45) 282,500
47 Deficit or excess (refundable) (41-46) -
Advance tax paid (attach proof) -
44 Adjustment of tax refund (from assessment year 2020-2021) 27,254
-
8 2 5 8 8 1 3 3 8 5 5 7
(A) Tax Calculation Sheet;
(B) Treasury Challan copy;
(C) Work Permit;
(D) Passport Copy;
(E) Tin Certificate;
(F) Power of Attorney;
(G) Resignation Letter & NOC; and
(F) Previous Tax Clearance Certificate.
PART III
TIN
49 Instructions
1. Statement of assets, liabilities and expenses (IT-10B) and statement of life style expense (IT-10BB) 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
Instruction, Enclosures and Verification
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-10B) under
section 80(1)? (tick one)
Yes No
53 Statements annexed
(tick all that are applicable)
52 Schedules annexed
(tick all that are applicable)
Other statements, documents, etc. attached:
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 : Hanish Chand Signature:
Date of Signature (DDMMYY) Place of Signature:
54
For official use only
Return Submission Information
Date of Submission (DD– MM –YYYY) Tax Office Entry Number
24A
IT - 10BB IT - 10B
2 0 2 1
24B 24C 24D
7 8 2 5 8 8 1 3 3 8 5
✓
✓
5
Total income shown (serial 34): 19,50,000
Individual
ACKNOWLEDGEMENT RECEIPT OF
RETURN OF INCOME
Assessment Year
Return under section 82BB? (tick one)
Yes No
Name of the Assessee : Hanish Chand
Twelve-digit TIN : 782588133855 Old TIN : N/A
Circle: 222 (Companies) Taxes Zone : 11
Amount payable (serial 41): 2,82,500 Amount paid and adjusted (serial 46): Tk. 2,82,500
Amount of net wealth shown in IT10B:
N/A Amount of net wealth surcharge paid: Nil
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
(2) The return of income required to be filed by a company assessee under the Ordinance shall be in the
following form and verified in the manner indicated therein:
2 0 2 1 2 2
2 0 2 1
01 Assessment Year: 2021-2022 02
Tax exempted Taxable
(B) (C = A-B)
SCHEDULE 24A
Particulars of income from Salaries
Annex Schedule to the return of income if you have income from Salaries
Amount
(A)
TIN : 782588133855
Particulers
03 Basic pay
As per computation sheet
04 Special pay
As per computation sheet
05 Arrear pay (if not included in taxable income earlier)
As per computation sheet
06 Dearness allowance
As per computation sheet
07 House rent allowance / Rent free accommodation
As per computation sheet
08 Medical allowance
As per computation sheet 09 Pension contribution
As per computation sheet
10 Leave fare assisstance
As per computation sheet
11 Allowance for support staff
As per computation sheet
12 Leave allowance / Country allowance
As per computation sheet
13 Honorarium/Reward/Fee/ Recreation & Refreshment
As per computation sheet
14 Overtime allowance
As per computation sheet
15 Bonus / Ex-gratia / School Fees for Kids
As per computation sheet
16 Other allowance (Club members fee)
As per computation sheet
17 Employer's contribution to a recognized provident fund
As per computation sheet
18 Interest accrued on a recognized provident fund
As per computation sheet
19 Deemed income for transport facility
As per computation sheet
20 Deemed income for free furnished/ unfurnished
accommodation
As per computation sheet
21 Other, if any (give detail) : Leave fare assistance
As per computation sheet
22 Total
All figures of amount are in taka (Tk.)
As per computation sheet
Name: Hanish Chand Signature & Date:
21
Particulars M Taka
Income from salaries u/s 21 of the ITO, 1984:
Basic salary 1,560,000
House rent allowance 624,000
Less: Exempted (50% of basic) or 780,000
(Tk. 25,000 per month) whichever is lower 300,000 (300,000)
324,000
Conveyance allowance 60,000
Less: Exempted upto BDT 30,000 (30,000)
30,000
Medical 156,000
Less: Exempted (10% of basic) or 156,000
(Tk. 120,000) whichever is lower 120,000 (120,000)
36,000
Taxable income from salary 1,950,000
Bank interest -
Total taxable income for the period 1,950,000
Tax calculation:
Gross tax liability (below taxable limit) Tk. 300,000 @ 0% Nil
On next Tk. 100,000 @ 5% 5,000
On next Tk. 300,000 @ 10% 30,000
On next Tk. 400,000 @ 15% 60,000
On next Tk. 500,000 @ 20% 100,000
On balance Tk. 350,000 @ 25% 87,500
1,950,000 282,500
Total tax Liability 282,500
Less: Tax deduct at sources (TDS) from salary in BDT (as attached TDS challans) 255,246
Less: Previous Year Adjustment 27,254 282,500
Balance/ (Excess Paid) -
Income from other sources u/s 33 & 34 of the ITO, 1984:
HANISH CHAND
E-TIN # 782588133855
Employer: NIPPON SIGNAL COMPANY LIMITED
Computation of total income and income tax liability thereon
For the year ended 30 June 2021
Assessment Year 2021-2022
Work permit from BIDA: 22 September 2019