SAHAJ

FORM

ITR-1

INDIAN INCOME TAX RETURN

[For Individuals having Income from Salary / Pension / Income from One House Property (excluding
loss brought forward from previous years) /
Income from Other Sources (Excluding Winning from Lottery and Income from Race Horses)]

Assessment
Year

2014-15

PERSONAL INFORMATION

(Please see rule 12 of the Income-tax Rules,1962) (Also see attached instructions)

First Name

Middle Name

Last Name

PAN

Flat / Door / Building

Name of premises / building / village

Status
I - Individual
Date of birth Sex
00/00/0000
(Select)

Road / Street

Area / Locality

Town/City/District

State
(Select)

Email Address

Mobile no 1 (Std code) Phone No

Country (Select)
(Select)

Income Tax Ward / Circle

FILING STATUS

Are you Governed by Portugese Civil Code under Section 5A?

Whether original or
revised return?

Mobile no 2 EmployerCategor
y (Select)
Return filed under section
(Select)
Enter PAN of
Spouse if
applicable

If revised, defective, Modified then Enter

Receipt No

Date of Filing
Original Return

Notice No (Where the original return filed

was defective and a notice is issued to the
assessee to file a fresh return Sec 139(9)

If filed, in response
to a notice u/s
139(9)/142(1)/148/1
53A/153C enter
date of such notice
(Select)

1 Income from Salary / Pension (Ensure to fill Sch TDS1)

Income from one House Property
2
3

INCOME & DEDUCTIONS

Pin Code

(Select)

Residential Status

TAX COMPUTATION

(Select)

17
18

(Select)

Income from Other Sources (Ensure to fill Sch TDS2)

4 Gross Total Income (1+2+3)

5 Deductions under Chapter VI A (Section)
a 80 C
b 80 CCC
c 80 CCD (Employees / Self Employed Contrib
80 CCD (Employers Contribution)
d

6
7
8
9
10
11
12
13
14
15

Import Personal/Tax Details form

0
System Calculated

5a
5b
5c
5d

0
0
0
0

e 80 CCG
5e
0
f 80 D
5f
0
g 80 DD
5g
0
h 80 DDB
5h
0
i 80 E
5i
0
j 80 EE
5j
0
k 80 G
5k
#NAME?
l 80 GG
5l
0
m 80 GGA
5m
0
n 80 GGC
5n
0
o 80 QQB
5o
0
p 80 RRB
5p
0
q 80 TTA
5q
0
r 80 U
5r
0
Deductions (Total of 5a to 5r)
6
#NAME?
Taxable Total Income (4 - 6)
Tax payable on Total Income
Rebate u/s 87A
Tax payable after Rebate (8-9)
Surcharge if Taxable Total Income (7) exceeds 1 crore
Education Cess, including secondary and higher secondary cess on 10+11
Total Tax,Surcharge and Education Cess (Payable) (10+11+12)
Relief under Section 89
14
0
Balance Tax Payable (13 - 14 )
16 a
Interest payable u/s 234 A
b Interest payable u/s 234 B
c
Interest payable u/s 234 C
Total Interest u/s 234A 234B 234C
Total Tax and Interest Payable (15 + 17)

0
0
0
0

6
7
8
9
10
11
12
13

0
0
0
0
0
0
#NAME?
#NAME?
0
0
0
0
0
0
#NAME?
#NAME?
0
#NAME?
#NAME?
0
0
#NAME?

15
16a
16b
16c
17
18

#NAME?
0
0
0
0
#NAME?

Details of Tax Deducted at Source from SALARY

19
[As per FORM 16 issued by Employer(s)]
TDS1
SI.No

Tax Deduction
Account Number
(TAN) of the
Employer

Name of the
Employer

Income charg
eable under the
head Salaries

Total tax
Deducted

(1)

(2)
If no entry is made in
this column, then
columns (3) to (5) will
not be considered for
that row

(3)

(4)

(5)

1
2
3
(Click + to add more rows to 22) TDS on Salary above. Do not delete blank rows. )

20
Details of Tax Deducted at Source on Income OTHER THAN SALARY
TDS2 [As per FORM 16 A issued by Deductor(s)]

SI.No

Tax Deduction
Account Number
(TAN) of the
Deductor

Name of the
Deductor

Unique TDS
Certificate No.

Deducted Year

(1)

(2)
If no entry is made in
this column, then
columns (3) to (7) will
not be considered for
that row

(3)

(4)

(5)

1
2
3
4
(Click + to add more rows ) TDS other than Salary above. Do not delete blank rows. )

21 IT

Details of Advance Tax and Self Assessment Tax Payments

Total tax
Deducted

Amount out of
(6) claimed for
this year

If covered by
Portugese Civil
Code, Amount
claimed in the
hands of spouse

(6)

(7)

(8)

Sl No

(1)
If no entry is
made in this
column, then
columns (2) to
(4) will not be
considered for
that row
BSR Code

(2)
Date of Credit into
Govt Account
(DD/MM/YYYY)

(3)
Serial
Number of
Challan

(4)
Tax Paid (Rs)

1
2
3
4
5
6
(Click '+' to add more rows ) Tax Payments. Do not delete blank rows. )

TAXES PAID

22 Taxes Paid PLEASE NOTE THAT CALCULATED FIELDS (IN WHITE) ARE PICKED UP FROM OTHER
SCHEDULES AND ARE NOT TO BE ENTERED. For ex : The taxes paid figures below will get filled up when the
Schedules linked to them are filled.
a Advance Tax (from item 21)
b TDS (Total from item 19 + item 20)

22a
22b

0
0

REFUND

0
c Self Assessment Tax (item 21)
22c
23 Total Taxes Paid (22a+22b+22c)
23
24 Tax Payable (18-23) (if 18 is greater than 23)
24
25 Refund (23-18) if 23 is greater than 18
25
26 Enter your Bank Account number (Refund if
any will directly credited into Bank Account)
IFSC Code
Type of Account(As applicable)
(Select)
29 Exempt income for reporting purposes only (If exempt income more than Rs 5000, use ITR2)
VERIFICATION

0
#NAME?
#NAME?

son/daughter of
I,
solemnly declare that to the best of my knowledge and belief, the information given in the return 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 2014-15
Place

Date

Sign here ->

PAN
26 If the return has been prepared by a Tax Return Preparer (TRP) give further details as below:
Identification No of TRP
Name of TRP

27

If TRP is entitled for any reimbursement from the Government, amount thereof (to be filled
by TRP)

Schedule 80G
A

Details of donations entitled for deduction under section 80G (PLEASE READ NOTE BELOW)

Donations entitled for 100% deduction without qualifying limit

If no entry is made in Name of Donee, then for such rows, any value
entered in other columns will be ignored. For 80GA to 80GD
Name of
donee

Address

City or Town or
District

State Code

PinCode

PAN of Donee Amount of

donation

(Select)
(Select)
(Select)
(Select)

1
2
3
4

0
0
0
0

Total 80GA

Donations entitled for 50% deduction without qualifying limit

Name of
Address
City or Town or State Code
donee
District
(Select)
1
(Select)
2
(Select)
3
(Select)
4

PinCode

PAN of Donee Amount of

donation

Donations entitled for 100% deduction subject to qualifying limit

Name of
Address
City Or Town Or State Code
donee
District
(Select)
1
(Select)
2
(Select)
3
(Select)
4
Total 80GC :

Eligible Amount
of Donation
0
0
0
0

Total 80GB :

Eligible Amount
of Donation

PinCode

PAN of Donee Amount of

donation

Eligible Amount
of Donation
#NAME?
#NAME?
#NAME?
#NAME?
0

#NAME?

Donations entitled for 50% deduction subject to qualifying limit

Name of
Address
City Or Town Or State Code
donee
District
(Select)
1
(Select)
2
(Select)
3
(Select)
4

PinCode

PAN of Donee Amount of

donation

Total 80GD

Donations (A + B + C + D)

NOTE : (IN CASE OF DONEE FUNDS SETUP BY GOVERNMENT AS DESCRIBED IN SECTION 80G(2),
PLEASE USE PAN AS "GGGGG0000G".

Eligible Amount
of Donation
#NAME?
#NAME?
#NAME?
#NAME?
0

#NAME?

#NAME?