1 )
2)
3) TIN: 7 7 2 5 0 5 1 1 4 5 8 6
4)
5) 2 0 2 3 - 2 4 6) Residentail status: Resident √ Non Resident -
7) Assessee status (Tick one) : Normal Individual Firm - - Other -
8) Tick on the box(es) below if you are:
A gezetted war-wounded freedom fighter Female Third gender A person with disability
Aged 65 years or more A parent/legal guardian of a person with disability
9) Date of Birth (DD-MM-YY) 10) Spouse name:
1 9 - 0 2 - 1 9 8 7 Spouse TIN:
11) Contract Address:
Telephone:
e-mail:
12) If employed, employer's name:
13) (a) Name of Business:
(b) Business Identification Number (BIN):
14) Name of partners / members in case of firm and private partnership:
Period: From 1st July 2023 to 15th March 2024
Nippon Koei Bangladesh Ltd.
N/a
N/a
0
Hindu undivided
family
Assessment Year:
Mobile:
Name of Assessee :
National Identification Number / Passport Number (if NID not available):
(A) Circle: (B) Tax Zone:
√
11, Dhaka 221 (Company)
N/a
For official use
Serial number of Return register
Volume number of Return register
Date of Return submission
National Board of Revenue IT-11GA (2023)
www.nbr.gov.bd
RETURN OF INCOME TAX
For an Individual and
Other assessee (Other than company) US: 193
Buntaro Shiono
TZ2127029
N/a
N/a N/a
Concord Baksh Tower (5th Floor, Unit 5-A), Road # 48, Plot # 11-A, Block # CWN (A),
Gulshan-2, Gulshan, Dhaka, PO : 1212
Concord Baksh Tower (5th Floor, Unit 5-A), Road # 48, Plot #
11-A, Block # CWN (A), Gulshan-2,, Gulshan, Dhaka, PO : 1212
IT 11GA (2023) Page 1
Name of assessee: 7 7 2 5 0 5 1 1 4 5 8 6
Particulars of Total Income
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
18
19
17
Amount (Tk) Tax Computation
Income tax leviable on gross taxable income 71,339
Tax rebate (annex Schedule 5) -
Net tax after tax rebate (12-13) 71,339
Minimum tax -
Tax payable (between serial 14 and 15, whichever is greater) 71,339
(a) Surcharge payable for net wealth (if any) -
Income from House property (as in schedule 2) -
Income from Agricultural (as in schedule 3) -
Total income (aggregate of 1 to 10) 992,263
Income from financial resources (Bank interest / profit, dividend, securities etc) -
Income from Other sources (royality, license fee, honorarium, fee, cash incentive etc.) -
Income from Firm or private partnership -
Income of minor or spouse under section (if not a taxpayer) -
Foreign income -
(b) Environmental surcharge (if any) -
Deffered interest, penalty or any other amount under the income tax act (in any) -
Total amount payable (16 + 17 + 18) 71,339
Amount (Tk)
Income from Salary (as in schedule 1) 992,263
Buntaro Shiono TIN
Statement of Income and Income Tax for the Period ended 15.03.2024
Income from Business or Profession (as in schedule 4) -
Capital gains -
IT 11GA (2023) Page 2
Statement of Tax Payment
20
21
22
23
24
25
26
List of documents filed with the return:
1
2
3
4
5
6
7
8
9
10 Copy of departure seal.
I father / husband
TIN 7 7 2 5 0 5 1 1 4 5 8 6 solemnly declare that to the best of my knowledge and belief the
information given in this return and statements and documents annexed herewith is correct and complete.
Date: 0 3 2 0 2 4 Name: Buntaro Shiono
….....................................................
Signature Place of Signature:
Demonstrate
Buntaro Shiono Hiroshi Shiono
Copy of Resignation Letter;
Copy of release order (NOC);
Total amount paid (20 + 21 + 22 + 23) 71,339
Excess paid (19-24) 0
Amount paid with return (attach proof) -
Tax exempted / Tax holiday income ( attach proof)
Return of Income
Copy of POA
Copy of TIN
Copy of Last Year Income Tax Certificate/ Acknowledgement (AY
2023-2024)
Copy of Passport;
Copy of Work Permits;
Copy of Deposited Tresuary Challans;
Advance tax paid (attach proof) -
Adjustment of tax refund [mention assessment year(s) of refund] -
Tax deducted or collected at source (attach proof) 71,339
IT 11GA (2023) Page 3
Name of Assessee 7 7 2 5 0 5 1 1 4 5 8 6
1 Salary
2
3
4
5
6
7
8
9
10
11
12
13
14
15
-
-
1,442,263
450,000
992,263
Exempted part (as part 1 of 6th schedule)
Total income from salary (13-14)
Schedule 1
A) This schedule is applicable to employee taxpayers under Government pay order
If you have income from salary, you have to fill the following schedule
Contribution paid by employer to recognized provident fund
Other, if any (give detail) Festival Bonus
Total salary receipts (aggregate of 1 to 12)
Car facilities
Other benefit provided by employer (Earned Leave Encashment) -
Income earned from employee share schemes
Residential facilities
Perquisite 212,098
Receipts or additional receipts in lieu of salary or wages
Advance salary
Gratuity, annuity, pension or supplement thereof
Allowances 148,468
Buntaro Shiono TIN
Special allowance
B) This part applies to salary-based taxpayers other than government employees
House rent allowance
Lampgrant
Total -
1,081,697
Tax exempted
income
Amount of
income
Particulars Net taxable
income
Arrear pay (if not included in taxable income earlier)
Basic pay
Medical allowance
Other, if any (give detail)
Interest accrued on a recognized provident fund
Gratuity
Baishakhi allowance
Others allowance
- -
Dearness allowance
Leave allowance (Rest and Recreation)
Conveyance allowance
Festival Allowance
Overtime allowance
Allowance for support staff
Honorarium/ Reward/Fee
Schedule 1 Page 4
2 0 2 3 - 2 4
7 7 2 5 0 5 1 1 4 5 8 6
Taxes Zone:
Seal of Office
The Peoples Republic of Bangladesh
National Board of Revenue
(Income Tax Office)
Signature and seal of the officer receiving the return
…..............................................................................
ASSESSMENT YEAR
BDT 71,339
BDT 992,258
ACKNOWLEDGEMENT RECEIPTS OF RETURN OF INCOME / CERTIFICATE
Name of assessee: Buntaro Shiono
National Identification Number /Passport Number: TZ2127029
Serial number of Return register
Volume number of Return register
Date of Return submission
Total Paid Tax:
TIN:
11, Dhaka Circle: 221 (Company)
Total Income
Name of the assessee
E-TIN
Name of the employer
Residential Status
Income Year
Assessment Year
A) Income From Salary:
Amounts Months Total
127,500 8.48 1,081,697
25,000 8.48 212,098
7,500 8.48 63,629
10,000 8.48 84,839
Total Income from Salary 1,442,263
Less: Exempted Income from Salary (As per schedule VI) 450,000
992,263
Tax calculation:
First 350,000 0% -
Next 100000 BDT 100,000 5% 5,000
Next 300000 BDT 300,000 10% 30,000
Next 400000 BDT 242,263 15% 36,339
Next 500000 BDT - 20% -
Balance amount - 25% -
Total Tax Liability 992,263 71,339
Investment rebate:
3% of Total Taxable Income -
15% of Actual Investment -
Investment Rebate amount -
Net Tax Liability after investment rebate 71,339
Tax Already Paid Through Challan 71,339
Previous Year Adjustment -
Total Tax Paid for AY 2023-2024 71,339
Balance/ (Excess Paid) -
2023-2024
Computation of Total Income and Income Tax Liability:
Buntaro Shiono
772505114586
Nippon Koei Bangladesh Ltd.
Resident
Medical Allowance
Total Taxable Income from Salary
Which ever is lower
2023-2024
Particulars
Basic Salary
House Rent
Conveyance Allowance