FORM ITR-3 INDIAN INCOME TAX RETURN [For Individuals/HUFs being partners in firms and not carrying out business or profession under any proprietorship] (Please see rule 12 of the Income-tax Rules,1962) (Also see attached instructions) Assessment Year 2 0 1 1 - 1 2 ________________________________________ Part A-GEN GENERAL PERSONAL INFORMATION First name Middle name Last name PAN
Flat/Door/Block No Name Of Premises/Building/Village Status (Tick) Individual HUF Road/Street/Post Office Area/locality Date of Birth (DD/MM/YYYY) ( in case of individual) / / Town/City/District State Pin code Sex (in case of individual) (Tick) Male Female Residential/Office Phone Number with STD code Mobile No. Employer Category(if in employment) (Tick) Govt PSU Others FILING STATUS Email Address Income Tax Ward/Circle
Return filed (Tick)[Please see instruction number-7] Before due date -139(1) After due date -139(4) Revised Return- 139(5) OR In response to notice 142(1) 148 153A/153C If revised, then enter Receipt No and Date of filing original return (DD/MM/YYYY) / /
Residential Status (Tick) Resident Non-Resident Resident but Not Ordinarily Resident Whether this return is being filed by a representative assessee? (Tick) Yes No If yes, please furnish following information - (a) Name of the representative (b) Address of the representative (c) Permanent Account Number (PAN) of the representative PART-B Part B - TI Computation of total income TOTAL INCOME 1 Salaries (6 of Schedule S) 1 2 Income from house property (3c of Schedule HP) (enter nil if loss) 2 3 Profits and gains from business or profession (6vi of Schedule BP) (enter nil if loss) 3 4 Capital gains a Short term i Short-term (u/s 111A) (enter nil, if loss) (A5 of Schedule CG) 4ai ii Short-term (others) (A6 of Schedule CG) 4aii iii Total short-term (4ai + 4aii) (enter nil if loss) (A4 of Schedule CG) 4aiii b Long-term (B5 of Schedule CG) (enter nil if loss) 4b c Total capital gains (4aiii + 4b) (enter nil if 4c is a loss) 4c Do not write or stamp in this area (Space for bar code) For Office Use Only Receipt No Date Seal and Signature of receiving official 5 Income from other sources a from sources other than from owning race horses (3 of Schedule OS) (enter nil if loss) 5a b from owning race horses (4c of Schedule OS) (enter nil if loss) 5b c Total (5a + 5b) (enter nil if 5c is a loss) 5c 6 Total (1+2+3+4c+5c) 6 7 Losses of current year set off against 6 (total of 2vii,3vii and 4vii of Schedule CYLA) 7 8 Balance after set off current year losses (6-7) (also total of column 5 of Schedule CYLA) 8 9 Brought forward losses set off against 8 (2vii of Schedule BFLA) 9 10 Gross Total income (8-9)(also 3viii of Schedule BFLA) 10 11 Deductions under Chapter VI-A (o of Schedule VIA) 11 12 Total income (10 - 11) 12 13 Net agricultural income/ any other income for rate purpose (4 of Schedule EI) 13 14 'Aggregate income' (12+ 13) 14 15 Losses of current year to be carried forward (xi of Schedule CFL) 15 Part B - TTI Computation of tax liability on total income COMPUTATION OF TAX LIABILITY 1 Tax payable on total income a Tax at normal rates 1a b Tax at special rates (11 of Schedule SI) 10 Deductions under Chapter VI-A (o of Schedule VIA) 10 11 Total income 11 12 Net agricultural income/ any other income for rate purpose (4 of Schedule EI) 12 13 'Aggregate income' (8+ 9) 13 14 Losses of current year to be carried forward (total of 2viii and 3viii of Schedule CYLA) 14 1b c Tax Payable on Total Income (1a + 1b) 1c 2 Education cess, including secondary and higher education cess on 1c 2 3 Gross tax liability (1c+ 2) 3 4 Tax relief a Section 89 4a b Section 90 4b c Section 91 4c d Total (4a + 4b+4c) 4d 5 Net tax liability (3 - 4d) 5 6 Interest payable a For default in furnishing the return (section 234A) 6a b For default in payment of advance tax (section 234B) 6b c For deferment of advance tax (section 234C) 6c d Total Interest Payable (6a+6b+6c) 6d 7 Aggregate liability (5 + 6d) 7 TAXES PAID 8 Taxes Paid a Advance Tax (from Schedule-IT) 8a b TDS (total of column 7 of Schedule-TDS1 and column 7 of Schedule-TDS2) 8b
c Self Assessment Tax(from Schedule-IT) 8c d Total Taxes Paid (8a+8b+8c) 8d 9 Amount payable (Enter if 7 is greater than 8d, else enter 0) 9 REFUND 10 Refund (If 8d is greater than 7) 10 11 Enter your bank account number (mandatory in all cases) 12 Do you want your refund by cheque, or deposited directly into your bank account? (tick as applicable ) 13 Give additional details of your bank account MICR Code Type of Account (tick as applicable ) Savings Current VERIFICATION I, son/ daughter of , holding permanent account number ____________ solemnly declare that to the best of my knowledge and belief, the information given in the return and schedules thereto is correct and complete and that the amount of total income and other particulars shown therein are truly stated and are in accordance with the provisions of the Income-tax Act, 1961, in respect of income chargeable to Income-tax for the previous year relevant to the Assessment Year 2011-2012. Place Date Sign here 14 If the return has been prepared by a Tax Return Preparer (TRP) give further details below: Identification No. of TRP Name of TRP Counter Signature of TRP
If TRP is entitled for any reimbursement from the Government, amount thereof 15 Schedule S Details of Income from Salary SALARIES Name of Employer PAN of Employer (optional)
Address of employer Town/City State Pin code
1 Salary (Excluding all exempt/ non-exempt allowances, perquisites & profit in lieu of salary as they are shown separately below) 1 2 Allowances exempt under section 10 (Not to be included in 6 below) 2 3 Allowances not exempt (refer Form 16 from employer) 3 4 Value of perquisites (refer Form 16 from employer) 4 5 Profits in lieu of salary (refer Form 16 from employer) 5 6 Income chargeable under the Head 'Salaries' (1+3+4+5) 6 Schedule HP Details of Income from House Property (Please refer to instructions) HOUSE PROPERTY 1 Address of property 1 Town/ City State PIN Code
(Tick) if let out Name of Tenant PAN of Tenant (optional)
a Annual letable value/ rent received or receivable (higher if let out for whole of the year, lower if let out for part of the year) 1a b The amount of rent which cannot be realized 1b c Tax paid to local authorities 1c d Total (1b + 1c) 1d e Balance (1a - 1d) 1e f 30% of 1e 1f g Interest payable on borrowed capital 1g h Total (1f + 1g) 1h i Income from house property 1 (1e - 1h) 1i 2 Address of property 2