[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 | 1 | ─ | 2 | 2 | Yes | √ | No
3 | 4 | Gender (tick one)
Name of the Assesse: | ESHWAR RAO KOTA | M | √ | F
5 | Twelve-digit TIN: | 620300459483 | 6 | Old TIN
7 | Circle: | 222 (Company) | 8 | 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
0 | A gazetted war-wounded freedom fighter | A person with disability
Adjustment of tax refund [mention assessment year(20-21 ) ] | 10D
Aged 65 years or more | A parent/legal guardian of a person with disability
Date of birth (DD-MM-YYYY) | 12 | Income Year
2 | 0 | 1 | 0 | 1 | 9 | 8 | 6 | 2021 | to | 2022
13 | If employed, employer’s name: Nippon Signal Company Limited
14 | Spouse Name | 15 | Spouse TIN (if any)
16 | Father’s Name: RAMA KOTESWARA RAO KOTA | 17 | Mother’s Name: LAXMI BHAVANI KOTA
18 | Present Address: CP-7 PROJECT OFFICE, Block I, Sector 16, Road:Sonargoan Janapath, Diabari, Uttara, Dhaka, PO : 1230 | 19 | Permanent Address: 44-18-1/5, TATICHETLAPALEM, VISAKHAPATNAM
20 | Contact Telephone: | 21 | E-mail:
22 | NID/ Passport No.: L8319448 | 23 | Business Identification Number(s)
[Part 2]
PART II
Particulars of Income and Tax
TIN: | 6 | 2 | 0 | 3 | 0 | 0 | 4 | 5 | 9 | 4 | 8 | 3
Particulars of Total Income | Amount ৳
24 | Salaries (annex Schedule 24A) | S.21 | 627,300
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 | 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) | 627,300
Tax Computation and Payment | Amount ৳
35 | Gross tax before tax rebate | 24,095
36 | Tax rebate (annex Schedule 24D) | -
37 | Net tax after tax rebate | 24,095
38 | Minimum tax | -
39 | Net wealth surcharge | -
40 | Interest or any other amount under the Ordinance (if any) | -
41 | Total amount payable | 24,095
42 | Tax deducted or collected at source (attach proof) | -
43 | Advance tax paid (attach proof) | -
44 | Adjustment of tax refund [mention assessment year(20-21 ) ] | -
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 | 418,200
[Part 3]
PART III
Instruction, Enclosures and Verification
TIN: | 6 | 0 | 2 | 0 | 0 | 0 | 3 | 0 | 0 | 0 | 0 | 0 | 4 | 0 | 5 | 0 | 9 | 0 | 4 | 0 | 8 | 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) Tax Calculation Sheet;
(B) Copy of Passport & VISA;
(C) Power of Attorney;
(D) TIN Certificate; and
(E) BIDA Work Permit;
(F) Treasury Challan.
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: | Md. Jasim Uddin, ITP | Signature:
Authorative Representative
Date of Signature (DD-MM-YYYY) | Place of Signature : Dhaka
2 | 0 | 2 | 2
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 | 1 | ─ | 2 | 2 | Yes | √ | No
Gender (tick one)
Name of the Assessee: | ESHWAR RAO KOTA | M | √ | F
Twelve-digit TIN: | 620300459483 | Old TIN
Circle- 222 (Company) | Taxes Zone-11, Dhaka.
Total income shown (serial 34) ৳ | 627,300
Amount payable (serial 41) ৳ | 24,095 | 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
1
[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: 620300459483
2 | 0 | 2 | 1 | ─ | 2 | 2
Particulars | Amount | Tax exempted | Taxable
(A) | (B) | (C=A-B)
3 | Basic pay | 627,300 | - | 627,300
4 | Special pay | - | - | -
5 | Arrear pay (if not included in taxable income earlier) | - | - | -
6 | Dearness allowance | - | - | -
7 | Conveyance allowance | 41,820 | 41,820 | -
8 | House rent allowance | 313,650 | 313,650 | -
9 | Medical allowance | 62,730 | 62,730 | -
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 | - | - | -
17 | Employer’s contribution to a recognized provident fund | - | - | -
18 | Interest accrued on a recognized provident fund | - | - | -
19 | Deemed income for transport facility | - | - | -
20 | Adjustment of tax refund [mention assessment year(20-21 ) ] | - | - | -
21 | Other, if any | - | - | -
22 | Total | 1,045,500 | 418,200 | 627,300
All figures of amount are in taka (৳)
Md. Jasim Uddin, ITP | Signature & Date:
Authorative Represntative
[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 : 2019-2020 | 2 | TIN : 214115218945
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 : Md. Tariqul Islam | Signature & Date
[Sch 25]
SCHEDULE 25
to be annexed to the Statement of Assets, Liabilities and Expenses (IT-10B)
1 | Assessment Year : 2019-2020 | 2 | TIN : 214115218945
3 | Shareholdings in limited companies as director | No. of shares | Value
1
2
3
4
4 | Non-agricultural property at cost | Value at the | increased/ | Value at the
value or any advance made for | start of | decreased | last date of
such property (description, | income year | during the | income year
location and size) | income year
1
-
2
3
5 | Agricultural property at cost value | Value at the | increased/ | Value at the
(description, location and size) | start of | decreased | last date of
income year | during the | income year
income year
1 | -
2
3
4
(Provide additional paper if necessary)
Name: Md. Tariqul Islam | Signature & Date.
[Tax Calculation]
Computation of Total Income and Income Tax Liability:
Name | : ESHWAR RAO KOTA
E-TIN | : 620300459483
Designation | : Installation Manager (Signaling)
Name of the employer | : Nippon Signal Company Limited
Address | : CP-7 PROJECT OFFICE, Block I, Sector 16
Road:Sonargoan Janapath, Diabari, Uttara
Dhaka, PO : 1230
Residential Status | :Resident
Employment period | : From 1st July 2021 to 30th January 2022.
Income Year | : 2021-2022
Assessment Year | : 2021-2022
A) Income from Salaries
Particulars | Salary Per Month | Month | Gross Salary | Exempted Income | Taxable Income | Month Calculation
Basic Salary | 90,000 | 6.97 | 627,300 | - | 627,300 | 0.9667
House Rent | 45,000 | 6.97 | 313,650 | 313,650 | - | 7.00
Conveyance Allowance | 6,000 | 6.97 | 41,820 | 41,820 | - | 7.9667 | -
Medical Allowance | 9,000 | 6.97 | 62,730 | 62,730 | -
Total | 1,045,500 | 418,200 | 627,300
B) Income from Other Sources: Bank Deposit Interest
Total Taxable income for the assessment year | 627,300
Income Tax Calculation
Particulars | Taxable Income | Tax rate | Income Tax
On First | 300,000 | 0% | Nill
On Second | 100,000 | 5% | 5,000
On Third | 300,000 | 10% | 30,000
On Above | (72,700) | 15% | (10,905)
627,300 | 24,095
Total gross tax | 24,095
Tax deducted from salary
Tax deducted from bank deposit interest
Balance/ (Excess Paid)
[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 : 2021-2022 | 2 | TIN: 620300459483
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 ( Laptop ) | -
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 | -
a tax exemption or a reduced rate is applicable under subsection | -
1 | 0 | -
mentioned in clause (a) of sub-section (2) of section 82C.) | -
Adjustment of tax refund [mention assessment year(20-21 ) ] | 1.5 crore | -
15 | Amount of tax rebate calculated on eligible amount (Serial 14) | -
under section 44(2)(b) | -
Name : | ESHWAR RAO KOTA | 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 | 1 | ─ | 2 | 2 | 3 | 0 | 0 | 6 | 2 | 0 | 2 | 1
3 | Name of the Assessee : | ESHWAR RAO KOTA | 4 | TIN: 620300459483
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. | -
Adjustment of tax refund [mention assessment year(20-21 ) ] | 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) (Life Insurance Policy) | -
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) | (75 Tola Value Unknown)
11 | Furniture, equipment and electronic items | -
12 | Other assets of significant value | -
Particulars | Amount (৳)
13 | Cash and fund outside business (13A+13B+13C+13D) | -
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) | 0
14 | Gross wealth (aggregate of 05 to 13) | -
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 | 0
16 | Net wealth (14-15) | -
17 | Net wealth at the last date of the previous income year | - | 4489247
18 | Change in net wealth (16-17) | -
19 | Other fund outflow during the income year (19A+19B+19C) | -
19A | Annual living expenditure and tax payments (as IT-10BB) | -
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) | -
21 | Sources of fund (21A+21B+21C) | 1,045,500
21A | Income shown in the return | 627,300
21B | Tax exempted income and allowance | 0 | 418,200
21C | Other receipts and sources | -
22 | Shortage of fund, if any (21-20) | 1,045,500
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 : | ESHWAR RAO KOTA | 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 | 1 | 2 | 2 | 3 | 0 | 0 | 6 | 2 | 0 | 2 | 1
3 | Name of the Assessee : | ESHWAR RAO KOTA | 4 | TIN: 620300459483
Particulars | Amount (৳) | Comment
5 | Expenses for food, clothing and other essentials | -
6 | Housing expense | -
7 | Auto and transportation expenses (07A+07B) | -
07A | Driver’s salary, fuel and maintenance
07B | Other transportation | -
8 | Household and utility expenses (08A+08B+08C+08D) | -
08A | Electricity | -
08B | Gas, water, sewer and garbage | -
08C | Phone, internet, TV channels subscription | -
08D | Home-support staff and other expenses | -
9 | Childrens education expense | -
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 | 1 | 0
12 | Total expense relating to lifestyle (05+06+07+08+09+10+11) | -
13 | Adjustment of tax refund [mention assessment year(20-21 ) ] | -
13A | Payment of tax at source | -
13B | Payment of tax, surcharge or other amount
Total amount of expense and tax (12+13) | -
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 : | ESHWAR RAO KOTA | Signature and date