ITR-4S SUGAM PRESUMPTIVE BUSINESS INCOME TAX RETURN PART B - GROSS TOTAL INCOME B1 Income from Business Whole-Rupee(`) only. Income from One House Property B2 B3 Income from other sources B4 Gross Total Income (B1 + B2 + B3 + B4) B5 B2 B3 B4 B5 (-) (-) (-) NOTEð Enter value from E6 of Schedule BP NOTE Ensure to fill Sch TDS2 given in Page 3 Income from Salary/Pension NOTE Ensure to fill Sch TDS1 given in Page 3 2012-13 ITR-4S, PAGE 1 Fill only one:STATUS 9 ;Individual 9 ; HUF C1 80C C2 80CCC C3 80CCD C1 to C13 C4 80CCF C5 80D C6 80DD C7 80DDB C8 80E C9 80G C10 80GG C11 80GGA C12 80GGC C13 80U PART C - DEDUCTIONS AND TAXABLE TOTAL INCOME AY 2012-13 A1 FIRST NAME A3 LAST NAME A5 SEX A8 A4 PERMANENT ACCOUNT NUMBER A6 DATE OF BIRTH D D M M Y Y Y Y EMAIL ADDRESS A18 Fill only one if you belong to 9 ; Government 9 ; PSU 9 ; Others FLAT/DOOR/BUILDING A9 ROAD/STREET A10 AREA/LOCALITY A12 STATE A13 PINCODE A14 A15 A16 A2 MIDDLE NAME A7 INCOME TAX WARD/CIRCLE A17 MOBILE NO. ; Male ; Female A11 TOWN/CITY/DISTRICT RESIDENTIAL/OFFICE PHONE NO. WITH STD CODE A19 Fill only one 9 ; Tax Refundable 9 ; Tax Payable 9 ; Nil Tax Balance A20 Fill only one 9 ; Resident 9 ; Non Resident 9 ; Resident but not ordinarily resident If revised and Receipt Number of Original Return Date of Filing Original Return A22 D D M M Y Y Y Y A21 Fill only one: filed 9 ; Before due date-139(1) 9 ; After due date-139(4) 9 ; Revised Return-139(5) OR in response to notice 9 ; 142(1) 9 ; 148 9 ; 153A/153C B1 7 If showing loss, mark the negative sign in bracket at left SEAL, DATE AND SIGNATURE OF RECEIVING OFFICIAL FOR OFFICIAL USE ONLY STAMP RECEIPT NO. HERE (Refer to Instructions for Limits on Amount of Deductions as per “Income Tax Act”) 2012-13 ITR-4S, PAGE 2 PART D—TAX COMPUTATION AND TAX STATUS Tax Payable On Total Income(C15) D1 Secondary & Higher Education Cess D2 D1
