ITR - V ACKNOWLEDGEMENT AY 2012-13 B1 COMPUTATION OF INCOME AND TAX RETURN B2 B3 B4 B5 Received with thanks from__________________________________________________________________________________a return of income in ITR No. 9 ; 1(SAHAJ) 9 ; 2 9 ; 3 9 ; 4S(SUGAM) 9 ; 4 9 ; 5 9 ; 6 for assessment year 2012-13, having the following particulars B6 B7 B8 B9 B10 B11 Deductions under Chapter VI-A B2 Total Income B3 Current Loss if any B4 Net Tax Payable B5 Interest Payable B6 Total Tax and Interest Payable B7 Total Advance Tax Paid B8 Total Self Assessment Tax Paid B9 Total TDS Deducted Total TCS Deducted B10 B11 Gross Total Income Whole-Rupee(`) only. B12 B13 Total Prepaid Taxes (B8+B9+B10+B11) B12 Tax Payable ( B7-B12, If B7 > B12) B13 B14 Refund ( B12-B7, If B12 > B7 ) B14 (-) (-) (-) A14 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 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 B1 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 FLAT/DOOR/BUILDING A9 ROAD/STREET A10 AREA/LOCALITY A12 STATE A13 PINCODE A2 MIDDLE NAME A7 INCOME TAX WARD/CIRCLE ; Male ; Female A11 TOWN/CITY/DISTRICT
