[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
U/S-91
1 | Assessment Year | 2 | Return submitted under section 82BB? (tick one)
2 | 0 | 2 | 2 | ─ | 2 | 3 | Yes | No | √
3 | 4 | Gender (tick one)
Name of the Assessee: | Dennis Chozas Alip | M | √ | F
5 | Twelve-digit TIN: | 548330423824 | 6 | Old TIN | N/A
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
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
2 | 7 | 1 | 0 | 1 | 9 | 7 | 3 | 2022 | to | 2023
13 | If employed, employer’s name: Sanyo Engineering & Construction Inc.
14 | Spouse Name | 15 | Spouse TIN (if any)
16 | Father’s Name: | 17 | Mother’s Name:
18 | Present Address: C/O:Sanyo Engineering & Construction Inc. Venture Tower (6th Floor), Plot- 03, Bir Uttam A.K. Khandakar Road, Mohakhali, C/A, Dhaka, PO : 1212 | 19 | Permanent Address: B- 7, L- 24, Tahiti St. Emerald Crest Ville, San Jose, Dasmarinas, Cavite
20 | Contact Telephone: | 21 | E-mail:
22 | Passport Number: P8927418A | 23 | Business Identification Number(s)
[Part 2]
PART II
Particulars of Income and Tax
TIN: | 5 | 4 | 8 | 3 | 3 | 0 | 4 | 2 | 3 | 8 | 2 | 4
Particulars of Total Income | Amount ৳
24 | Salaries (annex Schedule 24A) | S.21 | 1,532,155
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) | 1,532,155
Tax Computation and Payment | Amount ৳
35 | Gross tax before tax rebate | 181,431
36 | Tax rebate (annex Schedule 24D) | -
37 | Net tax after tax rebate | 181,431
38 | Minimum tax | -
39 | Net wealth surcharge | -
40 | Interest or any other amount under the Ordinance (if any) | -
41 | Total amount payable | 181,431
42 | Tax deducted or collected at source (attach proof) | 181,431
43 | Advance tax paid (attach proof) | -
44 | Adjustment of tax refund [assessment year 2021-2022] | -
45 | Amount paid with return (attach proof) | -
46 | Total amount paid and adjusted (42+43+44+45) | 181,431
47 | Deficit or excess (refundable) (41-46) | -
48 | Tax exempted income | 385,000
[Part 3]
PART III
Instruction, Enclosures and Verification
TIN: | 5 | 4 | 8 | 3 | 3 | 0 | 4 | 2 | 3 | 8 | 2 | 4
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) TIN Certificate;
(C) Copy of treasury challan;
(D) Copy of work Permit;
(E) Passport Copy ;
(F) Power of Attorney;
(G) Copy of last year tax clearance certificate;
(H) Copy of Resignation letter,
(I) Copy of Acceptance/NOC letter and,
(J) Copy of Departure seal.
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: | Dennis Chozas Alip | Signature:
Date of Signature (DD-MM-YYYY) | Place of Signature : Dhaka
0 | 9 | 2 | 0 | 2 | 3
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
U/S: 91
Assessment Year | Return under section 82BB? (tick one)
2 | 0 | 2 | 2 | ─ | 2 | 3 | Yes | No | √
Gender (tick one)
Name of the Assessee: | Dennis Chozas Alip | M | √ | F
Twelve-digit TIN: | 548330423824 | Old TIN
Circle : 222 (Company) | Taxes Zone-11, Dhaka.
Total income shown (serial 34) ৳ | 1,532,155
Amount payable (serial 41) ৳ | 181,431 | Amount paid and adjusted (serial 46)৳ | 181,431
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 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: 548330423824
2 | 0 | 2 | 2 | ─ | 2 | 3
Particulars | Amount | Tax exempted | Taxable
(A) | (B) | (C=A-B)
3 | Basic pay | 1,532,155 | - | 1,532,155
4 | Special pay | - | - | -
5 | Arrear pay (if not included in taxable income earlier) | - | - | -
6 | Dearness allowance | - | - | -
7 | House rent allowance | 275,000 | 275,000 | -
8 | Medical allowance | 110,000 | 110,000 | -
9 | Conveyance allowance | - | - | -
10 | Festival Allowance | - | - | -
11 | Allowance for support staff | - | - | -
12 | Leave allowance | - | - | -
13 | Honorarium/ Reward/Fee | - | - | -
14 | Overtime allowance (Overseas) | - | - | -
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 | Deemed income for free furnished/ unfurnished accommodation | - | - | -
21 | Other | - | - | -
22 | Total | 1,917,155 | 385,000 | 1,532,155
All figures of amount are in taka (৳)
Name : | Dennis Chozas Alip | 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 : 2022-2023 | 2 | TIN:548330423824
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 | 20 % of the total income (excluding any income for which | -
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 Crore | 10,000,000
15 | Amount of tax rebate calculated on eligible amount (Serial 14) | -
under section 44(2)(b)
Name : Dennis Chozas Alip | 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 | 2 | ─ | 2 | 3 | 3 | 1 | 0 | 5 | 2 | 0 | 2 | 3
3 | Name of the Assessee : Dennis Chozas Alip | 4 | TIN: 548330423824
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) (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) | -
11 | Furniture,Diamond,gems and other items | -
12 | Other assets of significant value | -
Particulars | Amount (৳)
13 | Cash and fund outside business (13A+13B+13C+13D) | 492,415
13A | Notes and currencies | 424,480
13B | Banks, cards and other electronic cash | 67,935
13C | Provident fund and other fund | -
13D | Other deposits, balance and advance (other than 08) | 0 | -
14 | Gross wealth (aggregate of 05 to 13) | 492,415
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) | 492,415
17 | Net wealth at the last date of the previous income year | 48,088
18 | Change in net wealth (16-17) | 444,327
19 | Other fund outflow during the income year (19A+19B+19C) | 1,472,828
19A | Annual living expenditure and tax payments (as IT-10BB) | 1,472,828
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) | 1,917,155
21 | Sources of fund (21A+21B+21C) | 1,917,155
21A | Income shown in the return | 1,532,155
21B | Tax exempted income and allowance | 0 | 385,000 | 0 | 0 | 0
21C | Other receipts and sources | -
22 | Shortage of fund, if any (21-20) | 0
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: Dennis Chozas Alip | 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 | 2 | 2 | 3 | 3 | 1 | 0 | 5 | 2 | 0 | 2 | 3
3 | Name of the Assessee : Dennis Chozas Alip | 4 | TIN: 548330423824
Particulars | Amount (৳) | Comment
5 | Expenses for food, clothing and other essentials | Including All Expenses
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 expenses
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
12 | Total expense relating to lifestyle (05+06+07+08+09+10+11) | 1,291,397
13 | Payment of tax, charges, etc. (13A+13B) | 181,431
13A | Payment of tax at source | 181,431
13B | Payment of tax, surcharge or other amount
14 | Total amount of expense and tax (12+13) | 1,472,828
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: Dennis Chozas Alip | Signature and date
[Tax Calculation After Increment]
Computation of total Incoame and Tax Liability
Name of the assessee | : | Dennis Chozas Alip
E-TIN : | : | 548330423824
Residential Status : | : | Resident
Income Year | : | 2022-2023
Assessment Year | : | 2022-2023
Pay & Allowance | Per Month | Month | Amount of Income TK. | Amount of Exempted income (TK.) | Net Taxable Income ( Tk.)
A | B | D=A*B* | E | F=D-E
Basic Salary | - | - | 1,532,155
House rent | 25,000 | 11.00 | 275,000 | 275,000 | -
Conveyance | - | 11.00 | - | - | -
Medical | 10,000 | 11.00 | 110,000 | 110,000 | -
Total Taxable Income | 385,000 | 385,000 | 1,532,155
Calculation of Tax Liability
Tax calculation:
On 1st | 300,000 | Nil | -
On Next | 100,000 | 5% | 5,000
On Next | 300,000 | 10% | 30,000
On Next | 400,000 | 15% | 60,000
On Next | 432,155 | 20% | 86,431
Total | 1,532,155 | 181,431
Gross Tax Liability | 181,431
Less: Tax Deposited | 105,413
Balance/(Excess) | 76,018
[Salary Structure after Incremen]
Pay & Allowance | Per Month | Month | Amount of Income TK.
A | B | D=A*B*
Basic Salary (Before Increment) | 100,000 | 4.87 | 486,667
Basic Salary (After Increment) | 170,460 | 6.13 | 1,045,488
Total Taxable Income | 1,532,155
[Tax Calculation]
Computation of total Incoame and Tax Liability
Name of the assessee | : | Dennis Chozas Alip
E-TIN : | : | 548330423824
Residential Status : | : | Resident
Income Year | : | 2022-2023
Assessment Year | : | 2022-2023
Pay & Allowance | Per Month | Month | Amount of Income TK. | Amount of Exempted income (TK.) | Net Taxable Income ( Tk.)
A | B | D=A*B* | E | F=D-E
Basic Salary | 100,000 | 11.00 | 1,100,000 | - | 1,100,000
House rent | 25,000 | 11.00 | 275,000 | 275,000 | -
Conveyance | - | 11.00 | - | - | -
Medical | 10,000 | 11.00 | 110,000 | 110,000 | -
Total Taxable Income | 1,485,000 | 385,000 | 1,100,000
Calculation of Tax Liability
Tax calculation:
On 1st | 300,000 | Nil | -
On Next | 100,000 | 5% | 5,000
On Next | 300,000 | 10% | 30,000
On Next | 400,000 | 15% | 60,000
Total | 1,100,000 | 95,000
Gross Tax Liability | 95,000
Less: Tax Deposited | 105,413
Balance/(Excess) | (10,413)