National Board of Revenue IT-11GA2016
www.nbr.gov.bd
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
Assessment Year
2 0 2 2 ─ 2 3 Yes No √
Name of the Assessee: M √ F
5 Twelve-digit TIN: 6 Old TIN
7 222 (Company) 8 Zone: 11 Dhaka.
Resident √ Non-resident
A person with
A gazetted war-wounded freedom fighter A person with disability
Aged 65 years or more A parent/legal guardian of a person with disability
Date of birth (DD-MM-YYYY) Income Year
2 1 9 8 9 2022 to
13
14 15
16 17
18 19
20 21
22 23
Contact Telephone: E-mail:
National Identification Number: Business Identification Number(s)
Spouse Name Spouse TIN (if any)
Father’s Name: Shahabuddin Bin Abdul Quddus Mother’s Name: Suraiya Khatoon
Present Address: Level 11, Sanmar Tower-2, Plot # 38A, Road-
35, Gulshan-2, Gulshan Model Town, Dhaka-1212.
Permanent Address: 10, Jolan Orkid 13, Taman Orkid,
86000 Kluang, Johor, Malaysia
If employed, employer’s name: MIURA SINGAPORE CO PTE. LTD
10
Tick on the box(es) below if you are:
10A 10B
10C 10D
11 12
1 0 0 2023
453495806350 N/A
Circle:
9 Resident Status (tick one)
3 4 Gender (tick one)
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
PART I
Basic information (Under Section- 91
1 2
Return submitted under section 82BB? (tick one)
Mohamad Rizwan Bin Shahabuddin
TIN: 4 5 3 4 9 5 8 0 6 3 5 0
Amount ৳
24 S.21 780,000
25 S.22 -
26 S.24 -
27 S.26 -
28 S.28 -
29 S.31 -
30 S.33 -
31 -
32 S.43 -
33 -
34 780,000
Amount ৳
35 47,000
36 -
37 47,000
38 -
39 -
40 -
41 47,000
42 93,498
43 -
44 -
45 -
46 93,498
47 (46,498)
48 180,000
Adjustment of tax refund [mention assessment year(s) of refund]
Amount paid with return (attach proof)
Total amount paid and adjusted (42+43+44+45)
Deficit or excess (refundable) (41-46)
Tax exempted income
Advance tax paid (attach proof)
Foreign income
Total income (aggregate of 24 to 33)
Tax Computation and Payment
Gross tax before tax rebate
Tax rebate (annex Schedule 24D)
Net tax after tax rebate
Minimum tax
Net wealth surcharge
Interest or any other amount under the Ordinance (if any)
Total amount payable
Tax deducted or collected at source (attach proof)
Income of minor or spouse under section 43(4)
PART II
Particulars of Income and Tax
Particulars of Total Income
Salaries (annex Schedule 24A)
Interest on securities
Income from house property (annex Schedule 24B)
Agricultural income
Income from business or profession (annex Schedule 24C)
Capital gains
Income from other sources
Share of income from firm or AOP
TIN: 4 5 3 4 9 5 8 0 6 3 5 0
49
50 Yes No
51 Yes No
52
IT-10B2016 IT-10BB2016
Other Statements, documents ect. Attached ;
(A) Tax Calculation Sheet;
(B) Copy of TIN certificate;;
(C) Copy of Treasury challans;
(D) Copy of Passport;
(E) Copy of work permits;
(F) Power of Attorney;
(G) Copy of last year tax clearance certificate;
(H) Copy of resignation letter;
(I) Copy of release order (NOC); and
(J) Copy of departure seal.
Signature:
Date of Signature (DD-MM-YYYY) Place of Signature : Dhaka
Date of Submission (DD-MM-YYYY) Tax Office Entry Number
For official use only
Return Submission Information
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.
2 0 2 3
Name: Mohamad Rizwan Bin Shahabuddin
Verification and signature
PART III
Instruction, Enclosures and Verification
Particulars of Total Income
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
If you are a parent of a person with disability, has your spouse availed
the extended tax exemption threshold? (tick one)
Are you required to submit a statement of assets, liabilities and
expenses (IT-10B2016) under section 80(1)? (tick one)
Schedules annexed
(tick all that are applicable)
53 Statements annexed
(tick all that are applicable)
54
√
√
24A √ 24B 24C 24D
2 0 2 3
National Board of Revenue IT-11GA2016
Assessment Year
2 0 2 2 ─ 2 3 Yes No √
Name of the Assessee: M √ F
Twelve-digit TIN: Old TIN
Circle : 222 (Company)
Total income shown (serial 34) ৳ 780,000
Amount payable (serial 41) ৳ 47,000 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
93,498
www.nbr.gov.bd
ACKNOWLEDGEMENT RECEIPT OF
RETURN OF INCOME
Return under section 82BB? (tick one)
Gender (tick one) Mohamad Rizwan Bin Shahabuddin
453495806350
Taxes Zone-11, Dhaka.
(Under Section- 91)
2 0 2 3
Assessment Year
2 0 2 2 ─ 2 3
Particulars Amount Taxable
(A) (C=A-B)
1 780,000 780,000
2 - -
3 - -
4 - -
5 135,000 -
6 15,000 -
7 30,000 -
8 - -
9 - -
10 - -
11 - -
12 - -
13 - -
14 - -
15 - -
16 - -
17 - -
18 - -
19 - -
20 960,000 780,000
All figures of amount are in taka ( ৳ )
Signature & Date: Name : Mohamad Rizwan Bin Shahabuddin
Deemed income for free furnished/ unfurnished
accommodation -
Other, if any (give detail) -
Total 180,000
Employer’s contribution to a recognized provident fund -
Interest accrued on a recognized provident fund -
Deemed income for transport facility -
Overtime allowance -
Bonus / Ex-gratia -
Other allowances (Overseas) -
Allowance for support staff -
Leave allowance -
Honorarium/ Reward/Fee -
Medical allowance 15,000
Conveyance allowance 30,000
Festival Allowance -
Arrear pay (if not included in taxable income earlier) -
Dearness allowance -
House rent allowance 135,000
Tax exempted
(B)
Basic pay -
Special pay -
SCHEDULE 24A
Particulars of income from Salaries
Annex this Schedule to the return of income if you have income from Salaries
1
TIN: 453495806350
Name of the employer : Mohamad Rizwan Bin Shahabuddin
E-TIN : 453495806350
Designation : Country Manager
Name of the employer : MIURA SINGAPORE CO PTE. LTD.
Address
Residential Status : Resident
Employment period : 20th October, 2018 to 31st December 2022
Income Year : 2022-2023
Assessment Year : 2022-2023
A B C=A*B D E=C-D
Basic Salary 130,000 6.00 780,000 - 780,000
House Rent Allowance 22,500 6.00 135,000 135,000 -
Conveyance Allowance 2,500 6.00 15,000 15,000 -
Medical Allowance 5,000 6.00 30,000 30,000 -
Total Taxable Income 960,000 180,000 780,000
Tax calculation:
First 300,000 0% -
On Next 100,000 5% 5,000
On Next 300,000 10% 30,000
On Next 80,000 15% 12,000
On Next - 20% -
On Balance - 25%
Total 780,000 47,000
Total Tax Liability 47,000
Tax Already Paid 93,498
Net Tax Payable (46,498)
Previous Year Adjustment -
Balance/ (Excess Paid) (46,498)
Calculation of Tax Liability
Computation of Total Income and Income Tax Liability:
: Level 11, Sanmar Tower-2, Plot # 38A, Road-35, Gulshan-2, Gulshan Model
Town, Dhaka-1212.
Salary & Allowance BDT per
Month Month Amount of Income
TK.
Amount of
Exempted
Income
(TK.)
Net Taxable
Income ( Tk.)