Form It-11ga - Form Of Return Of Income Under The Income Tax Ordinance, 1984 (Xxxvi Of 1984) Page 2
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8Statement of income of the Assessee
Statement of income during the income year ended on ....................................................
Serial no.
Heads of Income
Amount in Taka
1
Salaries : u/s 21 (as per schedule 1)
2
Interest on Securities : u/s 22
3
Income from house property : u/s 24 (as per schedule 2)
4
Agricultural income : u/s 26
5
Income from business or profession : u/s 28
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Share of profit in a firm :
7
Income of the spouse or minor child as applicable : u/s 43(4)
8
Capital Gains : u/s 31
9
Income from other source : u/s 33
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Total (serial no. 1 to 9)
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Foreign Income:
12
Total income (serial no. 10 and 11)
13
Tax leviable on total income
14
Tax rebate: u/s 44(2)(b)(as per schedule 3)
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Tax payable (difference between serial no. 13 and 14)
16
Tax Payments:
(a) Tax deducted/collected at source
(Please attach supporting documents/statement) Tk ..............
(b) Advance tax u/s 64/68 (Please attach challan ) Tk .............
(c) Tax paid on the basis of this return (u/s 74)
(Please attach challan/pay order/bank draft/cheque)Tk ............
(d) Adjustment of Tax Refund (if any)
Tk ..............
Tk.
.................w
Total of (a), (b), (c) and (d)
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Difference between serial no. 15 and 16 (if any)
18
Tax exempted and Tax free income
Tk.
.................w
19
Income tax paid in the last assessment year
Tk.
.................w
*If needed, please use separate sheet.
Verification
I ........................................................... father/husband ........................................................
UTIN/TIN: ........................................................ solemnly declare that to the best of my knowledge and
belief the information given in this return and statements and documents annexed herewith is correct
and complete.
Place: .................................
Date : ................................
Signature
(Name in block letters)
Designation and
Seal (for other than individual)
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