Government of India INCOME-TAX DEPARTMENT ACKNOWLEDGEMENT Kumari Puja a return of income and/or return of fringe benefits in Form No. ITR - 4. for assessment year 2013-14, having the following particu PERSONAL INFORMATION Name PAN Kumari Puja Flat/Door/Block No Name of Premises/Building/Village Road/Street/Post Office Area/Locality Town/City/District State Designation of Assessing Officer (Ward/ Circle) ORIGINAL COMPUTATION OF INCOME AND TAX THEREON 1 Gross Total Income 1 - 2 Deductions Under Chapter VI-A 2 - 3 Total Income 3 - 4 Net tax payable 4 - 5 Interest payable 5 - 6 Total tax and interest payable 6 - 7 Taxes paid a Advance Tax 7a - b TDS 7b - c TCS 7c - d Self Assessment Tax 7d - e Total Taxes Paid (7a+7b+7c+7 7e - 8 Tax Payable (6-7d) 8 - 9 Refund (7e-6) 9 - 10 Value of Fringe Benefits 10 - 11 Total fringe benefit tax liability 11 - 12 Total interest payable 12 - 13 Total tax and interest payable 13 - 14 Taxes paid a Advance Tax 14a - b Self Assessment Tax 14b - c Total Taxes Paid (14a+14b) 14c - 15 Tax Payable (13-14c) 15 - 16 Refund (14c-13) 16 - Receipt No Seal and Signature of receiving official Date Received with thanks from Status (fill the code) I - Individual Original or Revised COMPUTATION OF FRINGE BENEFITS AND TAX THEREON
ACKGovernment of IndiaINCOME-TAX
DEPARTMENTACKNOWLEDGEMENTReceived with thanks fromKumari Pujaa
return of incomeand/or return of fringe benefits in Form No. ITR -
4. for assessment year 2013-14, having the following
particulars.PERSONAL INFORMATIONNamePANKumari PujaFlat/Door/Block
NoName of Premises/Building/VillageRoad/Street/Post
OfficeArea/LocalityTown/City/DistrictStateStatus (fill the code)I -
IndividualDesignation of Assessing Officer (Ward/ Circle)Original
or RevisedORIGINALCOMPUTATION OF INCOME AND TAX THEREON1Gross Total
Income10.02Deductions Under Chapter VI-A20.03Total Income30.04Net
tax payable40.05Interest payable50.06Total tax and interest
payable60.07Taxes paidaAdvance Tax7a0.0bTDS7b0.0cTCS7c0.0dSelf
Assessment Tax7d0.0eTotal Taxes Paid (7a+7b+7c+7d)7e0.08Tax Payable
(6-7d)80.09Refund (7e-6)90.0COMPUTATION OF FRINGE BENEFITS AND TAX
THEREON10Value of Fringe Benefits100.011Total fringe benefit tax
liability110.012Total interest payable120.013Total tax and interest
payable130.014Taxes paidaAdvance Tax14a0.0bSelf Assessment
Tax14b0.0cTotal Taxes Paid (14a+14b)14c0.015Tax Payable
(13-14c)150.016Refund (14c-13)160.0Receipt NoSeal and Signature of
receiving officialDate
