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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