Karnataka Gazette, Part Part-4, 12 December 2013

RNI No. KARBIL/2001/ 47147

ಕರ್ನಾಟಕ ರಾಜ್ಯಪತ್ರ

ಅಧಿಕೃತವಾಗಿ ಪ್ರಕಟಿಸಲಾದುದು

ಸಂಪುಟ ೧೪೮

ಸಂಚಿಕೆ ೪೯ ಬೆಂಗಳೂರು , ಗುರುವಾರ , ಡಿಸೆಂಬರ್ ೧೨ , ೨೦೧೩ ( ಮಾರ್ಗಶಿರ ೨೧ , ಶಕ ವರ್ಷ ೧೯೩೫ )

Issue49 Volume 148 Bangalore , Thursday , December 12, 2013 ( Margashira 21 , Shaka Varsha 1935 )

ಭಾಗ ೪

ಕೇಂದ್ರದ ವಿಧೇಯಕಗಳು ಮತ್ತು ಅವುಗಳ ಮೇಲೆ ಪರಿಶೀಲನಾ ಸಮಿತಿಯ ವರದಿಗಳು , ಕೇಂದ್ರದ ಅಧಿನಿಯಮಗಳು ಮತ್ತು ಅಧ್ಯಾದೇಶಗಳು , ಕೇಂದ್ರ ಸರ್ಕಾರದವರು ಹೊರಡಿಸಿದ ಸಾಮಾನ್ಯ ಶಾಸನಬದ್ಧ ನಿಯಮಗಳು ಮತ್ತು ಶಾಸನಬದ್ಧ ಆದೇಶಗಳು ಮತ್ತು ರಾಷ್ಟ್ರಪತಿಯವರಿಂದ ರಚಿತವಾಗಿ ರಾಜ್ಯ ಸರ್ಕಾರದವರಿಂದ ಪುನಃ ಪ್ರಕಟವಾದ ಆದೇಶಗಳು

ಸಂಸದೀಯ ವ್ಯವಹಾರಗಳು ಮತ್ತು ಶಾಸನ ರಚನೆ ಸಚಿವಾಲಯ

ಅಧಿಸೂಚನೆ

ಸಂಖ್ಯೆ : ಸಂವ್ಯಶಾಇ 75 ಕೇನಿಪ್ರ 2013 , ಬೆಂಗಳೂರು , ದಿನಾಂಕ : 13/21 ನೇ ಸೆಪ್ಟೆಂಬರ್ 2013 .

2013 ನೇ ಸಾಲಿನ 02-05-2013ನೇ ದಿನಾಂಕದ ಭಾರತ ಸರ್ಕಾರದ ಗೆಜೆಟ್‌ನ ವಿಶೇಷ ಸಂಚಿಕೆಯ ಭಾಗ -1 ಸೆಕ್ಷನ್ 3 (ii ) ರಲ್ಲಿ ಪ್ರಕಟವಾದ ಈ ಕೆಳಕಂಡ S.O. 1111 (E) ದಿನಾಂಕ : 01-05-2013 ಅನ್ನು ಸಾರ್ವಜನಿಕರ ಮಾಹಿತಿಗಾಗಿ ಕರ್ನಾಟಕ ರಾಜ್ಯಪತ್ರದಲ್ಲಿ ಮರು ಪ್ರಕಟಿಸಲಾಗಿದೆ.

MINISTRY OF FINANCE

(Department of Revenue )

(Central Board of Direct Taxes )

Notification

New Delhi , the 1st May, 2013

Income-tax

S.O. 1111 ( E ) .- In exercise of the powers conferred by section 295 of the Income- tax Act , 1961 (43 of 1961 ) , the Central Board ofDirect Taxes hereby makes the following rules further to amend the Income- tax Rules , 1962 , namely: -

1. (1) These rules may be called the Income - tax (3rd Amendment) Rules , 2013 .

(2) They shall be deemed to have come into force with effect from the 1st day ofApril , 2013

2. Inthe Income- tax Rules , 1962 ( hereinafter referred to as the said rules) , in rule 12, -

(a) insub- rule ( 1 ) , -

(A) for the figures "2012 " , the figures " 2013 " shall be substituted ;

(B) initem (a), -

(i ) insub- item ( iii ) , after the words " income from race horses " , the words " and does not have any loss under the head" shall be inserted ;

(ii) for the proviso , the following proviso shall be substituted , namely: -

(४५४) ಭಾಗ ೪ ಕರ್ನಾಟಕ ರಾಜ್ಯಪತ್ರ, ಗುರುವಾರ , ಡಿಸೆಂಬರ್ ೧೨ , ೨೦೧೩

"Provided that the provisons of this clause shall not apply to a person who, -

(1 ) is a resident , other than not ordinarily resident in India within the meaning of sub - section (6 ) of section 6 and has,-

(i ) assests (including financial interest in any entity) located ouside India; or

(ii ) signing authority in any account located outside India ;

(II ) has claimed any relief of tax under sections 90 or 90A or deduction of tax under section 91 ; or (III ) has income not chargeable to tax, exceeding five thousand rupees, " ;

"Provided that the provisions of this clause shall not apply to a person who, -

(1 ) is a resident , other than not ordinarily resident in India within the meaning of sub - section ( 6) of section 6 and has , - (i ) assests ( including financial interest in any entity) located outside India ; or

(ii ) Signing authority in any account located outside India ;

( II ) has claimed any relief of tax under sections 90 or 90A or deduction of tax under section 91 ; or

( III ) has income not chargeable to tax , exceeding five thousand rupees , " ;

(b) in sub- rule ( 2) , the following proviso shall be inserted , namely: -

"Provided that where an assessee is required to furnish a report of audit under section 44AB , 92E or 115JB of the Act, heshall furnish the same electronically." ;

(A) inclause (a ), -

(i ) for the words " an individual or a hindu undivided family" , the words " a person , other than a company and a person required to furnish the return in Form ITR - 7 " shall be substituted;

(ii ) for the words "ten lakh rupees " the words " five lakh rupees " shall be substituted;

( iii) For the figures " 2012-13 " , the figures " 2013-14 " shall be substituted;

(B) after clause ( aaa ) , the following clause shall be inserted, namely:-

"( aab ) a person claiming any relief of tax under section 90 or 90A or deduction of tax under section 91 of the Act, shall furnish the return for assessment year 2013-14 and subsequent assessment years in the manner specified in clause ( ii ) or clause ( iii ) ; "

(C) In Clause ( b ) , after the words , brackets and figure " in clause ( i ) " , the words , brackets and figures " or clause ( ii ) or clause ( iii ) " shall be inserted .

(d) in sub -rule 4, after the words , brackets and figures " of sub- rule ( 3 ) " , the words and figures " and the report of audit in the manner specified in provisio to sub - rule (2) " shall be inserted .

(e) in sub- rule ( 5) , for the figures " 2011 " , the figures " 2012 " shall be substituted .

3. In the said rules , in Appendix- II , for " Forms SAHAJ (ITR- 1 ) ITR-2 , ITR - 3 , SUGAM ( ITR - 4S ) , ITR - 4 AND ITR -V" , the " Forms SAHAJ ( ITR - 1 ) , ITR - 2 , ITR - 3 , SUGAM ( ITR - 4S ) , ITR - 4 AND ITR - V" shall be substituted .

ಭಾಗ ೪

ಕರ್ನಾಟಕ ರಾಜ್ಯಪತ್ರ, ಗುರುವಾರ , ಡಿಸೆಂಬರ್ ೧೨ , ೨೦೧೩

2013-14 ITR - 1 , PAGE 1

AY 2013-14

ITR - 1 SAHAJ INDIVIDUAL INCOME TAX RETURN

A1 FIRST NAME

A2 MIDDLE NAME

A3 LASTNAME

A4 PERMANENT ACCOUNT NUMBER

A7 INCOME TAX WARD/CIRCLE

A5 SEX

A6 DATE OF BIRTH

Male Female

AB FLAT/DOOR/BUILDING

AS ROAD/STREET

A10 AREA/LOCALITY

A11 TOWN/CITY /DISTRICT

A12 STATE

A13 COUNTRY

A14 PINCODE A15 EMAIL ADDRESS

A16 MOBILE NO.1 /RESIDENTIAL/OFFICE PHONE NO.WITH STD CODE A17 MOBILE NO.2

A18 Fill only one if you belong to PSU Others

Government

A19 Fill only one Tax Refundable Tax Payable Nil Tax Balance A20 FIll only one Resident Non Resident Resident but not ordinarily resident A21 Fill only one: filed Before due date - 139(1 ) After due date - 139( 4) Revised Return - 139(5) OR In response to notice 142(1 ) 148

153A/153C

139 (9 )

A22 Whether Person governed by Portugese Civil Code under section 5A

and►

A23If revised/ Defective ►

Receipt Number of Original Return

Data of Filing Original Return

PART B - GROSS TOTAL INCOME

Whole-Rupee ( ) only .

B1 Income from Salary/Pension NOTE Ensure to fill " Sch TDS1 " given in Page 2

▼If showing loss, mark the negative sign in bracket at left B2 Income from One House Property Self Occupied Lat out B2 (

B3 Income from other sources în case ofloss use ITR 2)

NOTE Ensure to fill " Sch TDS2 " given in Page 2

B4(

B4 Gross Total Income (B1 + B2 + B3)

PART C - DEDUCTIONS AND TAXABLE TOTAL INCOMBRefer to Instructions for Limits on Amount of Doductions as per " Income Tax Act " )

C3 80CCD (1 )

C1 80C

C2 80CCC

C5 80CCG

C6 80D

C4 80CCD( 2)

C880DDB

C7 80DD

C9 80E

C12 BOGGA

C11 80GG

C10 80G

C15 8000B

C14 80RRB

C13 8DGGE

C17

C16 80TTA

C17 800

C18

C18 Total Deductions (Add items C1 to C17)

C19 Taxable Total Income (B4 - C18)

C19 (

FOR OFFICIAL USE ONLY

STAMP RECEIPT NO. HERE

SEAL , DATE AND SIGNATURE OF RECEIVING OFFICIAL ಭಾಗ ೪ ಕರ್ನಾಟಕ ರಾಜ್ಯಪತ್ರ, ಗುರುವಾರ , ಡಿಸೆಂಬರ್ ೧೨ , ೨೦೧೩

PERMANENT ACCOUNT NUMBER

2013-14 ITR -1 , PAGE 2 PART D - TAX COMPUTATION AND TAX STATUS

TOTAL TAX AND CESS ( D1 + D2 ) D1 Tax Payable On Total Income( cr9) / Secondary & Higher Education Cess

D3 D1

Balance TaxAfter Rellef (D3-D4)

Total Interest u/s 234A

D4 Rellef u/s 89

D6 D4

D7 Total Interest u/s 234B

Total Interest u/s 234C

Total Tax And Interest ( D5 + D6 + 07 + D8 ) to

D9 D7

Total TDS Claimed

D10 Total Advance Tax Pald

Total Self Assessment Tax Paid

to D12D10

D11

D12

Refund (D13-D9,If D13>D9)

D13 Total Prepaid Taxes ( D10 + D11 + D12) Total Payable ( D9- D13 , If D9 > D13)

D15

D14

D15 D13

Bank Account Detalls ( Mandatory in all cases irrespective of refund due or not)

D16 ACCOUNT No.

D17 Type of account : Current Savings D18 IFSC CODE

D19 Fill only one: Refund by cheque or deposited directly into your bank account D20 Exempt income only for reporting purposes

VERIFICATION

_son/ daughter of

solemnly declare that to the best of my knowledge 1, ► and belief, the information given in the retum 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-taxAct 1961 , in respect of income chargeable to Income - tax for the previous year relevant to the Assessment Year 2013-14 Place ►

SIGN HERE

If the return has been prepared by a Tax Return Preparer ( TRP) give further detalls as below

Name of the TRP

Amount to be paid to TRP

TRP Signature

TRP PIN [ 10 Digit ]

Sch IT - DETAILS OF ADVANCE TAX AND SELF ASSESSMENT TAX PAYMENTS

TAX PAID(col.lv)

BSRCODE( col.i)

CHALLAN NO ( col.III)

DATE OF DEPOSIT( col.ii )

YYY

NOTES (1) Enter the totals of Advance Tax and Self Assessment Tax In D10 and D11 ( 2 ) Continue In Supplementary Schedule IT If you cannot fill within Sch IT SchTDS1 - DETAILS OF TAX DEDUCTED AT SOURCE FROM SALARY [As per Form 16 issued by Employer (s) ]

NAME OF THE EMPLOYER( col.ll )

TAX DEDUCTED ( col.lv)

TAN (col.1 )

INCOME UNDER SALARY ( col.III )

NOTE (1 ) Enter the total of column (lv ) of 8ch TD81 and column (vi) of Sch TD82 In D12 (2) Continue In Supplementary Schedule TD81 If you cannot fill within 8ch TD81

ANNT OUT OF CLAIMED THIS YR

DEDUCTED YEAR ( c ) TAX DEDUCTED ( col.v)

Sch TDS2- DETAILS OF TAX DEDUCTED AT SOURCE FROM INCOME OTHER THAN SALARYBA based byDeductor ) TAN(col.i) NAME OF THE DEDUCTOR ( cal.II) UNIQUE TDS CER . NO( col.iii)

NOTE (1) Entar the total of column ( lv) of Sch TDS1 and column ( vi )of Sel TDS2 In D12 (2) Continue In Supplementary Schedule TDS2 If you cannot fill within Sch TDS2 ಭಾಗ ೪

ಕರ್ನಾಟಕ ರಾಜ್ಯಪತ್ರ, ಗುರುವಾರ , ಡಿಸೆಂಬರ್ ೧೨ , ೨೦೧೩

PERMANENT ACCOUNT NUMBER

AY 2013-14 FIRST NAME

MIDDLE NAME

LAST NAME

SUPPLEMENTARY SCHEDULE TDS 1 (To be used only after exhausting items S1 -S3 of Schedule TD$ 1 in main form etc) TAN( col.l)

NAME OF THE EMPLOYER( col.ll )

INCOME UNDER SALARY( col.III ) TAX DEDUCTED ( col.lv)

$4▸

$10

$11

$12

$13

$14

$15

$16

$17

$18

$19

$20

$21

$22

$23

$24

$25

$26

$27

$28

$29

$30 ಭಾಗ ೪ ಕರ್ನಾಟಕ ರಾಜ್ಯಪತ್ರ, ಗುರುವಾರ , ಡಿಸೆಂಬರ್ ೧೨ , ೨೦೧೩

PERMANENT ACCOUNT NUMBER

AY 2013-14 FIRST NAME

MIDDLE NAME

LAST NAME

SUPPLEMENTARY SCHEDULE TDS 2 (To be used only after exhausting items T1 -T4 of Schedule TDS2 in main form etc )

ANT OUT OF CLAIMED THIS TAN( col.1)

NAME OF THE DEDUCTOR ( col.II) UNIQUE TDS CER . NO( Col.111) DEDUCTED YEAR ( cal.ly ) TAX DEDUCTED( col.v)

481

T10

T11

T12

T13

T14

T15

T16

T17

T18

T19

T20

T21

T22

T23

T24

T25

T26

T27

T28

T29

T30

T31 ಭಾಗ ೪

ಕರ್ನಾಟಕ ರಾಜ್ಯಪತ್ರ, ಗುರುವಾರ , ಡಿಸೆಂಬರ್ ೧೨ , ೨೦೧೩

PERMANENT ACCOUNT NUMBER

AY 2013-14 FIRST NAME

MIDDLE NAME

LAST NAME

SUPPLEMENTARY SCHEDULE IT(To be used only after exhausting items R1 - R5 of Schedule IT in main form etc ) BSR CODE(col 1)

CHALLAN NO ( col III)

DATE OF DEPOSIT( col II )

TAX PAID( col.lv)

DMMY

DDMMYYYY

R10

DDMMY

R11

DDMMYYYY

R12

DMMYY

R13

DMMY

R14

DDMMY

R15

MMY

R16

R17

R18

R19

R20

R21

R22

R23

R24

R25

R26

MMY

R27

DDMMYYYY

R28

DDMMYYYY

R29

DDMMYYYY

R30

DDMMYYYY

R31

DDMMYYYY

R32

DDMMYYYY ಭಾಗ ೪ ಕರ್ನಾಟಕ ರಾಜ್ಯಪತ್ರ, ಗುರುವಾರ , ಡಿಸೆಂಬರ್ ೧೨ , ೨೦೧೩

Assessment Year INDIAN INCOME TAX RETURN

[For Individuals and HUFs not having Income from Business or

FORM

ITR-2

Profession]

2013-14

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

GENERAL

Part A-GEN

PAN

First name

Lastname

Middle name

Flat/Door/Block No

NameOf Premises/Building/Village

Status (Tick)

Individual

HUF Road/Street/Post Office

Area/locality

Date ofBirth (DD/MM/YYYY) (in case of individual)

State

Pincode

Town/City/District

Sex (in case of individual) (Tick)

Male

Female

Country

PERSONALINFORMATION

Residential/Office Phone Number with STD code/

Mobile No. 2

Mobile No. 1

Employer Category( if in employment ) (Tick)

PSU Others

Govt.

Income Tax Ward/ Circle Email Address-1 (self)

Email Address-2

Return filled (Tick)[Please see instruction number -7] On or before due date - 139 ( 1 ), After due date -139(4), Revised Return-139(5) 148

153A/153C

142(1

or In response to notice

139(9)-Defective

Ifrevised/defective, then enter Receipt No and Date of filing original return (DD/MM/YYYY)

Resident

Non-Resident

Residential Status (Tick)

Resident but Not Ordinarily Resident Are you governed by Portuguese Civil Code ? Tick) Yes No (

If "YES " pleasefill Schedule 5A)

Yes

Whether this return is being filed by a representative assessee ? (Tick)

FILINGSTATUS

If yes, please furnish following information -

(a) Name of the representative

(b) Address of the representative

PART-B

PartB - TI

Computation of total income

1 Salaries (7 ofSchedule S)

2 Income from house property (3c ofSchedule HP) (enter nil if loss)

3 Capital gains

Shortterm

i Short-term (u/s 111A) (enter nil if loss) (Ala+A 2e of Schedule CG) 3ai

ii Short- term (others) (enter nil if loss) (A5 -Ala-A 2e) ofSchedule CG) 3 aii

3attl

iii Total short -term (3ai + 3aii) (A5 ofScheduleCG)

TOTALINCOME

3bi

i Long-term (B6 - B3e - B4 of Schedule CG) (enter nil if loss)

ii Long-term without indexation (B3e + B4 ofSchedule CG) (enter nil if loss) 3bii

3bill

iii Total Long - term (3bi +3bil)

c Total capital gains (3aiii + 3biii) (enter nil if 3c is a loss)

Do not write or stamp in this area (Space for bar code)

For OfficeUse Only

ReceiptNo

Date

Seal and Signature ofreceiving official ಭಾಗ ೪

ಕರ್ನಾಟಕ ರಾಜ್ಯಪತ್ರ, ಗುರುವಾರ , ಡಿಸೆಂಬರ್ ೧೨ , ೨೦೧೩

4 Income from other sources

a from sources other than from owning race horses and winnings from Lottery etc. (1g of Schedule OS)

b winnings from lotteries , crossword puzzles , races, games , gambling, betting etc. (2 of Schedule OS)

c from owning and maintaining race horses (4c of Schedule OS) (enter nil if loss)

d Total (4a + 4b + 4c) (enter nil if 4d is a loss)

5 Total (1+2+3 +4d)

6 Losses of current year set off against 5 (total of2vii and 3vii of Schedule CYLA)

7 Balance after set off current year losses (5-6) (also total ofcolumn 4 of Schedule CYLA + 4b )

Brought forward losses set off against 7 (2vii ofSchedule BFLA)

9 Gross Total income (7-8) (also 3viii of Schedule BFLA + 4b )

10 Income chargeable to tax at special rate under section 111A, 112 etc. included in 9

11 Deductions under Chapter VI - A [q of Schedule VIA and limited to (9-10)]

12 Total income (9-11)

13 Income which is included in 12 and chargeable to tax at special rates (total of (i) ofschedule SI)

14 Net agricultural income / any other income for rate purpose (4 ofSchedule EI)

15 Aggregate income ( 12-13 + 14) [ applicable if (12-13) exceeds maximum amount not chargeable to tax]

16 Losses of current year to be carried forward (total ofrow xi of Schedule CFL)

Part B - TTI

Computation of tax liability on total income

1 Tax payable on total income

a Tax at normal rates on 15 of Part B- TI

b Tax at special rates (total of(ii) ofSchedule SI)

c Rebate on agricultural income [applicable if(12-13) ofPart 1c B-TI exceeds maximum amount not chargeable to tax]

d Tax Payable on Total Income ( 1a + 1b - 1c)

2 Education cess , including secondary and higher education cess , on 1d

3 Gross tax liability (1d+ 2)

4 Tax relief

Section89

b Section 90/90A ( 3 ofSchedule TR)

c Section 91 ( 4 ofSchedule TR)

d Total (4a + 4b + 4c)

COMPUTATIONOFTAXLIABILITY

5 Net tax liability (3-4d)

6 Interest payable

ба

a For default in furnishing the return (section 234A)

b For default in payment of advance tax ( section 234B) 6b

c For deferment of advance tax ( section 234C)

d Total Interest Payable (6a+6b+6c)

7 Aggregate liability (5 + 6d)

8 Taxes Paid

a Advance Tax (from Schedule- IT)

b TDS (total ofcolumn 5 ofSchedule- TDS1 and column 7 8b ofSchedule- TDS2)

c Self-Assessment Tax (from Schedule-IT)

TAXESPAID

d Total Taxes Paid (8a + 8b+ 8c)

9 Amount payable (Enter if7 is greater than 8d, else enter 0)

10 Refund (If8d is greater than 7)

11 Enter your bank account number (mandatory and for direct

deposit ofrefund into bank, the number should be 11 digits or more

12 Do you want your refund by cheque , or deposited directly into your bank account ? ( tick as applicable )

REFUND

13 Give additional details of your bank account

IFSC Code

Type ofAccount (tick as applicable ) Savings Current ಭಾಗ ೪ ಕರ್ನಾಟಕ ರಾಜ್ಯಪತ್ರ, ಗುರುವಾರ , ಡಿಸೆಂಬರ್ ೧೨ , ೨೦೧೩

Do you have, -

Yes

No 1 any asset (Including financial interest in any entity) located outside India or (ii) signing authority in any account located outside India?

[applicable only in case ofa resident] [EnsureSchedule FA is filled up if the answer is Yes ]

VERIFICATION

son/daughter of

holding I, solemnlydeclare that to the best of my knowledge and belief, the informationgiven in permanent account number the return and schedules 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 2013-2014.

Signhere→

Place Date

15 If the return has been prepared by a Tax Return Preparer (TRP) give further details as below:

Identification No. of TRP

Name of TRP

CounterSignature ofTRP

IfTRP is entitled for any reimbursement from the Government, amount thereof

Schedule S

Details of Income from Salary

Name of Employer

PAN of Employer (optional)

State

Pin code

Town/City

Address of employer

1 Salary (Excluding all exempt/ non-exempt allowances, perquisites & profit in lieu ofsalary as they are shown 1 separatelybelow)

SALARIES

2 Allowances exempt under section 10 (Not to be included in 7 below) 2

3 Allowances not exempt ( refer Form 16from employer)

4 Value of perquisites (refer Form 16 from employer)

5 Profits in lieu of salary (refer Form 16from employer)

6 Deduction u/s 16 (Entertainment allowance by Government and tax on employment)

7 Income chargeable under the Head ' Salaries ' (1+3+4+5-6)

Schedule HP

Details of Income from House Property (Please refer to instructions)

State

PIN Code

Town/ City

Address ofproperty 1

No (if " YES " please enter following details)

Yes

Is the property co-owned ?

Your percentage of share in the property.

Name of Co- owner(s)

PAN of Co-owner ( s) ( optional )

Percentage Share in Property I

Name of Tenant

PAN ofTenant ( optional)

(Tick) if let out Π

Annual letable value or rent received or receivable (higher of the two , if let out for whole of theyear, lower of the two if let out for part of the year)

HOUSEPROPERTY

b The amount of rent which cannot be realized

c Tax paid to local authorities

d Total (1b + 1c)

section 23 (2) of the Act)

e Annual value (1a- 1d) (nil , if self -occupied etc. as per

f 30% of le

g Interest payable on borrowed capital

h Total(1f+1g)

i Income from house property 1 (le - 1h)

State

PIN Code Address ofproperty 2

Town/ City

Page3of10 ಭಾಗ ೪

೨೦೧೩

ಕರ್ನಾಟಕ ರಾಜ್ಯಪತ್ರ, ಗುರುವಾರ , ಡಿಸೆಂಬರ್ ೧೨ ,

Is the property co-owned? Yes

No (if " YES" please enter following details)

Your percentage of share in the property

Name of Co- owner(s)

PAN of Co -owner ( s) (optional )

Percentage Share in Property (optional) I

Name of Tenant

PAN of Tenant (optional) (Tick) if let out Π

Annual letable value or rent received or receivable (higher of the two, if let outfor whole of

theyear, lower ofthe two, if let out for part ofthe year)

b The amount of rent which cannot be realized

e Tax paid to local authorities

d Total (2b + 2c)

Annual value (2a -2d)

f 30% of20

g Interest payable on borrowed capital

h Total (2f + 2g )

1 Income from house property 2 (2e - 2h)

3 Income under the head " Income from house property"

a Rent of earlier years realized under section 25A/AA

b Arrears of rent received during the year under section 25B after deducting 30%

c Total (3a + 3b + 1i + 2i)

NOTE► Please include the income of the specified persons referred to in Schedule SPI while computing the income under this head

Schedule CG

Capital Gains

A Short-term capital gain

1 In case of NON -RESIDENT to which first proviso to section 48 is applicable

Fromassets (shares/units ) where section 111A is applicable ( STT paid)

Fromassetswhere section 111A is not applicable

2 From assets (shares / units ) in the case of others where section 111A is applicable ( STT paid)

a Full value of consideration

b Deductions under section 48

Costof acquisition

bii

Cost of Improvement

lii Expenditure on transfer

biv

iv Total (i + ii + iii)

c Balance (2a - 2biv)

d Loss, if any, to be ignored under section 94( 7) or 2d 94(8) (Enter positive value only)

e Short-term capital gain (2c +2d)

3 From assets in case of others where section 111A is not applicable

a Full value of consideration

b Deductions under section 48

Costofacquisition

bii

Costof Improvement

Expenditure on transfer

biv

iv Total (i + ii + iii)

c Balance (2a - biv)

d Loss, if any, to be ignored under section 94(7) or 3d

94(8) (Enter positive value only)

e Deduction under section 54B/ 54D

f Short-term capital gain (2c + 2d - 2e)

4 Amount deemed to be short term capital gains under sections 54B/54D/54G / 54GA

5 Total short term capital gain (1a+ 1b+2e + 3f + A4)

B Long term capital gain

1 From asset in case of non- resident to which first proviso to section 48 is applicable

2 From asset in the case of others where proviso under section 112(1 ) is not applicable

Full value of consideration

b Deductions under section 48

CAPITALGAINS

i Cost of acquisition after indexation

bil

ii Cost of improvement after indexation ಭಾಗ ೪ ಕರ್ನಾಟಕ ರಾಜ್ಯಪತ್ರ, ಗುರುವಾರ , ಡಿಸೆಂಬರ್ ೧೨ , ೨೦೧೩

bili

iii Expenditure on transfer

blv

iv Total (bi + bii +bili)

c Balance (2a -biv)

d Deduction under sections 54/ 54B/54D/54EC/54F 2d

54G/54GA/54GB

e Net balance (2c - 2d)

3 From asset where proviso under section 112 (1) is applicable (without indexation)

a Full value ofconsideration

Deductions under section 48

i Cost of acquisition without indexation

bii

if Cost of improvement without indexation

iii Expenditure on transfer

biv

iv Total (bi + bii +biii)

c Balance (3a - biv)

d Deduction under sections 54/548/540/54EC/54F/54GB

B3e

e Net balance (3c-3d)

4 From unlisted securities in case of non- resident as per section 112(1)(c)(iii )

5 Amount deemed to be long term capital gains under sections 54/54B/54D/54EC/54F/54GB B5

6 Total long term capital gain [ 1 +2e +B3e + B4 + B5]

7 In case ofdeduction u/s 54GB, furnish PAN of the company

C Income chargeable under the head " CAPITAL GAINS" (AS + B6) ( enter B6 as nil, ifloss)

D Information about accrual/receipt of capital gain

16/9 to 15/12

Date

Upto15/9

16/3 to 31/3 (iv)

16/12 to 15/3 (iii)

1 Long- term [ where proviso under section 112 (1) is applicable (Without Indexation) + non- residents asper section 112 (1)(c)( iii) ] - TaxRateis 10% ; Enter onlypositive value from Item B3e +B4 of Schedule CGAFTER loss adjustment under this category in Schedule CYLA and BFLA, ifany.

2 Long- term where proviso under section 112(1 ) is not applicable (With Indexation)- TaxRateis20%; Enteronlypositive valuefrom Item (B6 -B3e-B4) of Schedule CGAFTER loss adjustment under this category in Schedule CYLA and BFLA, ifany.

3 Short-term under 111A- Tax Rateis 15% ; Enter onlypositive valuefrom Item Ala+A 2e of Schedule CGAFTER loss adjustment under this category

inSchedule CYLA and BFLA, ifany. 4 Short-term OTHERS-

Taxed at normal rates; Enter only positive value from Item (A5 A 2e-Ala) of ScheduleCGAFTER loss adjustment under this category inSchedule CYLA and BFLA, if any.

NOTE► Please include the income ofthe specified persons referred to in Schedule SPI while computing the income under this head

Schedule OS

Income from other sources

1 Income

a Dividends , Gross

b Interest, Gross

c Rental income from machinery , plants , buildings,

d Others, Gross (excluding incomefrom owning race

horses)Mention the source

1di

1dit

1diil

OTHERSOURCES

Total (1di + 1dil+ 1dil)

e Total ( la + 1b + 1c + 1d)

f Deductions under section 57: -

1 Expenses / Deductions

fii

it Depreciation

fii

iii Total

g Balance (le- fiii) ಭಾಗ ೪

ಕರ್ನಾಟಕ ರಾಜ್ಯಪತ್ರ, ಗುರುವಾರ , ಡಿಸೆಂಬರ್ ೧೨ , ೨೦೧೩

2 Winnings from lotteries , crossword puzzles, races , games , gambling, betting etc. (Gross)

3 Income from other sources (other than from owning race horses ) (1g + 2) (enterlg as nil, if loss) 3

4 Income from owning and maintaining race horses

Receipts

b Deductions under section 57 in relation to (4)

c Balance(4a- 4b )

5 Income chargeable under the head " Income from other sources" (3 + 4c) (enter 4c as nil ifloss

and take4c loss figure to Schedule CFL)

NOTE► Please include the income ofthe specified persons referred to in Schedule SPIwhile computing the income under this head.

Schedule CYLA Details of Income after Set off of current year losses

Sl.No Head/ Source of Income

House property loss of the current year set off

Current year's Income remaining after set off

Other sources loss (other than loss from racehorses) of the current year set off

Total loss (3c of Schedule -HP) Total loss (1g of Schedule-OS)

Income of current year (Fill this column only if income is zero or positive)

4-1-2-3 Loss to be adjusted

i Salaries

11 House property

iii Short-term capital gain

iv Long term capital

CURRENTYEARLOSSADJUSTMENT

gain Other sources (excluding profit from owning race horses and winnings from lottery)

Profit from owning and maintaining race horses

vii Total loss set off

viii Loss remaining after set-off out of2 & 3

Schedule BFLA Details of Income after Set off of Brought Forward Losses of earlier years

Head/ Source of Income

Brought forward loss set off

Sl. No.

Current year's income remaining after set off Income after set off, ifany, of current year's losses as per 4 of Schedule CYLA

3 1 Salaries

ii House property

iii Short- term capital gain

iv Long-term capital gain

Other sources ( excluding profit from owning race horses and winnings from lottery)

vi Profit from owning and maintaining race horses

BROUGHTFORWARDLOSSADJUSTMENT

vii Total ofbrought forward loss set off

viii Current year's income remaining after set off Total ( i3 + 3 + 3 + iv3 + v3+vi3)

Schedule CFL Details of Losses to be carried forward to future years

Assessment Year

Date ofFiling

(DD/ MM/YYYY)

loss House property Short -term capital loss

Long-term Capital loss

Other sources loss (from owning race horses) i 2005-06

il 2006-07

Hi 2007-08

iv 2008-09

v 2009-10

vi 2010-11

CARRYFORWARDOFLOSS

vii 2011-12 ಭಾಗ ೪ ಕರ್ನಾಟಕ ರಾಜ್ಯಪತ್ರ, ಗುರುವಾರ , ಡಿಸೆಂಬರ್ ೧೨ , ೨೦೧೩

viii 2012-13

ix Total of earlier year losses

x Adjustment of above losses in Schedule BFLA

xi 2013-14 (Current year losses)

xii Total loss Carried Forwardto future years

Schedule VIA

Deductions under Chapter VI-A (Section)

80C

80RRB

80DDB

b 80CCC

80TTA

80E

i 80G

p 80U

c(i) 80CCD ( 1) ( assessees contribution)

80GG

c(il) 80CCD (2) ( employers contribution)

d 80CCG

k 80GGA

TOTALDEDUCTIONS

80D

1 80GGC

f 80DD

m 80QQB

१ Total deductions (total of a to p)

Details of donations entitled for deduction under section 80G

Schedule 80G

Donations entitled for 100 % deduction without qualifying limit

PAN ofDonee

Amount of donation

Name and address of donee

EligibleAmount of donation 1

v Total

Donations entitled for 50 % deduction without qualifying limit

PAN ofDonee

Amount of donation

Name and address ofdonee

EligibleAmount of donation 1

v Total

Donations entitled for 100 % deduction subject to C qualifying limit

PAN ofDonee

Amount of donation

Name and address of donee

Eligible Amount of donation DETAILSOFDONATIONS

v Total

Donations entitled for 50 % deduction subject to qualifying limit

PAN of Donее

Amount of donation

Name and address of donee

Eligible Amount of donation i

ⅲ

v Total

E Total donations ( Av + Bv + Cv + Dv) ಭಾಗ ೪

ಕರ್ನಾಟಕ ರಾಜ್ಯಪತ್ರ, ಗುರುವಾರ , ಡಿಸೆಂಬರ್ ೧೨ , ೨೦೧೩

Schedule SPI

Income of specified persons ( spouse, minor child etc ) includable in income of the assessee (income of the minor child, in excess of Rs . 1,500 per child, to be included)

Sl No

Nature of Income

Name ofperson

Relationship

PAN of person (optional)

Amount (Rs) 1

Schedule SI

Income chargeable to tax at special rates (please see instructions No. 9for rate of tax)

Section

Tax thereon (ii) No

Special rate (%)

Income (1)

1 111A (STCG on shares where STT pald)

2 112 proviso (LTCG on listed securitles/ units without indexation)

3 112 (LTCG on others)

4 112(1) (c)(iii) (LTCG on unlisted securities in case of non -residents)

5 115BB (Winnings from lotterles , puzzles , races, games etc.)

SPECIALRATE

Total

Schedule EI

Details ofExempt Income (Income not to be included in Total Income)

1 Interest income

2 Dividend income

3 Long-term capital gains from transactions on which Securities Transaction Tax is paid

INCOME

EXEMPT

4 Net Agricultural income ( other than income to be excluded under rule 7A, 7B or 8 of I.T. Rules )

5 Others , including exempt income of minor child

6 Total (1+2+3+4+5)

Schedule IT

Details of payments of Advance Tax and Self-Assessment Tax

BSR Code

Serial Number of Challan

Amount (Rs)

DateofDeposit (DD/MM/YYYY)

(1)

(3)

(4)

(2)

(5) iv

TAXPAYMENTS

NOTE Enter the totals ofAdvance tax and Self -Assessment tax in St No. 8a & 8c ofPartB-TTI

Schedule TDS1

Details of Tax Deducted at Source from Salary [ As per Form 16 issued by Employer(s) ]

Total tax deducted

Name of the Employer

Income chargeable under Salaries

TaxDeduction Account Number (TAN) of the Employer (2)

(3)

(4)

(5) (1)

TDSONSALARY

NOTE Please enter total of column 5 of Schedule- TDS1 and column 7 of Schedule - TDS2 in 8 (b) ofPartB-TTI ४८०

Schedule TDS2

ಭಾಗ ೪

ಕರ್ನಾಟಕ ರಾಜ್ಯಪತ್ರ, ಗುರುವಾರ , ಡಿಸೆಂಬರ್ ೧೨ , ೨೦೧೩

Details of Tax Deducted at Source on Income [As per Form 16 A issued by Deductor(s)]

Name of the Deductor

Total Tax Deducted Amount out of (6) claimed this Year

Unique TDS

Certificate

Number

(4) TaxDeduction No Account Number (TAN) ofthe Deductor (2)

(3)

(1)

TDSONOTHERINCOME

Financial Year in which TDS is Deducted

(5)

(6)

(7) Please enter total ofcolumn 5 ofSchedule-TDSI and column 7 of Schedule- TDS2 in 8 (b) ofPart B-TTI

NOTE

Schedule FSI

Details of Income accruing or arising outside India

1 Details of Income included in Total Income in Part - B- TI above Country Code

Taxpayer Identification Number

Income from Salary (included in PART B- TI) (A)

Total Income from Outside India ( F) =A+ B +C+ D +E

Income from

HouseProperty

(included in

PART B- TI)

(B)

Total

2 Total Income from outside India (Total of F as per item no.1 above)

3 Total Income from outside India where DTAA is applicable INCOMEACCRUINGORARISINGOUTSIDEINDIA

4 Total Income from outside India where DTAA is not applicable (2-3 )

Please refer to the instructions for filling out this schedule.

NOTE

Schedule TR

Details of Taxes Paid outside India 1 Details of Taxes Pald outside India

Country Code

Relevant article of DTAA

Taxpayer Identification Number

Business Income (included in PART B- TI)(C)

Capital Gain Income (included in PART B- TI) (D)

Other source Income (included in PART B- TI) (E)

Tax ReliefClaimed

(B)

Total taxes paid on

income declared in

Schedule FSI

(A)

TAXESPAIDOUTSIDEINDIA

Total 2 Total Taxes paid outside India (Total of 1A)

3 Total Taxes Paid outside India where DTAA is applicable 4 Total Taxes Paid outside India where DTAA is not applicable (2-3)

NOTE Please refer to the instructions for filling out this schedule.

Schedule FA

Details of ForeignAssets

A Details of Foreign Bank Accounts

Name and Address of the Name mentioned

Sl No Country Name CountryCode

Bank

(3)

(4) (2)

(1)

(ii)

DETAILSOFFOREIGN ASSETS

B Details of Financial Interest in any Entity Relief claimed u/ s 90 /90A (B1)

Relief claimed u /s 91 (B2)

Account Number Peak Balance During the Year in the account

(inrupees)

(7) (5)

(6) ಭಾಗ ೪

ಕರ್ನಾಟಕ ರಾಜ್ಯಪತ್ರ, ಗುರುವಾರ , ಡಿಸೆಂಬರ್ ೧೨ , ೨೦೧೩

CountryCode (2)

Nature of entity

(3)

SI No Country Name (1)

Total Investment (at cost) (in rupees) 5

Name and Address oftheEntity (4)

(1)

(ii)

C Details of Immovable Property

SI No Country Name (2)

(1)

Country Code (3)

Address of the Property

(4)

Total Investment (at cost) (in rupees) (5)

(1)

(ii)

D Details of any other Asset in the nature of Investment

Country Name (2)

Nature ofAsset

(4)

Total Investment (at cost) (in rupees) (5)

SI No (1)

Country Code (3)

(1)

(ii)

E Details of account(s) in which you have signing authority and which has not been included in A to D above.

SI No (1)

AccountNumber (5)

Name of the Institution in which the account is held (2)

Address of the Institution (3)

Name of the account

holder

(4)

Peak Balance/Investment during the year (in rupees) (6) (1)

(ii)

F Detalls of trusts , created under the laws of a country outside India, in which you are a trustee

Name and address ofSettlor

SI No (1)

Country Name (2)

Country Code (3)

Name and address of other trustees (5)

Name and address of thetrust (4)

Name and address of Beneficiaries (7) (1)

(ii)

Schedule 5A

Information regarding apportionment of income between spouses governed by Portuguese Civil Code Name of the spouse

PAN of the spouse

Heads of Income

Amount apportioned in the hands of the spouse 1 House Property

2 Business or profession

3 Capital gains

4 Other sources

5 Total

Page 10 of10 ಭಾಗ ೪

ಕರ್ನಾಟಕ ರಾಜ್ಯಪತ್ರ, ಗುರುವಾರ , ಡಿಸೆಂಬರ್ ೧೨ , ೨೦೧೩

INDIAN INCOME TAX RETURN

ITR-3

FORM

[For Individuals /HUFs being partners in firms and not carrying out business orprofession under any proprietorship]

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

GENERAL

PartA-GEN

First name

Middle name Flat/Door/Block No

Assessment Year

2013-14 Last name

PAN

Status (Tick)

Name of Premises/Building/Village

Road/ Street/Post Office

Arca/locality

State Town/City/District

PERSONALINFORMATION

Country Residential/Office Phone Number with STD code/ Mobile No. 1

EmailAddress-1 (self)

Email Address -2

Return filled (Tick) [Please see instruction number- 7] Before due date - 139 (1)

139 (9 ) -Defective or In response to notice

Ifrevised/defective, then enter Receipt No and Date offiling original return (DD/MM/YYYY)

Resident Residential Status (Tick)

FILINGSTATUS

Are you governed by Portuguese Civil Code ? Tick) Yes

Whether this return is being filed by a representative assessee ? (Tick)

If yes, please furnish following information - (a) Name of the representative

(b) Address of the representative

PART-B

PartB - TI

Computation of total income 1 Salaries (7 ofSchedule S)

Incomefromhouse property (3c ofSchedule HP) ( enter nil ifloss)

INCOME

TOTAL

Profits and gains from business or profession (6vi ofSchedule BP) (enter nil ifloss)

Do notwrite or stamp in this area (Space for bar code)

Individual

HUF

Date of Birth (DD/MM/YYYY) (in case ofindividual)

Pin code

Sex(in case ofindividual) (Tick)

Male

Female Mobile No. 2

Employer Category(if in employment) (Tick)

Govt. PSU Others

Income Tax Ward/Circle

After due date -139(4) Revised Return- 139(5)

153A/153C 142(1)

148

Non-Resident

Resident but Not Ordinarily Resident No (If "YES " please fill Schedule 5A)

Yes

For Office Use Only

ReceiptNo.

Date

Sealand Signature of receiving official ಭಾಗ ೪

ಕರ್ನಾಟಕ ರಾಜ್ಯಪತ್ರ, ಗುರುವಾರ , ಡಿಸೆಂಬರ್ ೧೨ , ೨೦೧೩

4 Capital gains

a Short term

i Short-term (u/ s 111A) (entire nil, ifloss) (Ala+ A2e of Schedule CG) 4ai

ii Short-term (others ) (entire nil, if loss) (A5-Ala-A2e) of Schedule CG 4aii

iii Total short- term (4ai + 4aii) (entire nil , if loss ) (A5 ofSchedule CG) 4aili

b Long-term

4bi

i Long-term (B6 - B3e- B4 ofSchedule CG)

ii Long-term without indexation (B3e + B4 ofSchedule CG) ( entire nil, if loss) 4bil

iii Total Long-term ( 4bi + 4bii)

Total capital gains (4aiii + 4biii) (entire nil. if 4c loss)

5 Income from other sources

a from sources other than from owning race horses and winnings from Lottery etc. (1g ofSchedule OS)

b winnings from lotteries , crossword puzzles , races , games, gambling, betting etc. (2 of Schedule OS)

from owning race horses (4c ofSchedule OS) (enter nil ifloss)

d Total (5a + 56 + 5c) ( enter nil if 5d is a loss)

6 Total (1 + 2+3 +4c+5d)

7 Losses of current year set off against 6 (total of 2viii, 3viii and 4viii of Schedule CYLA)

8 Balance after set off current year losses (6-7) (also total ofcolumn 5 ofSchedule CYLA + 5b)

9 Brought forward losses set off against 8 (2viii of Schedule BFLA)

10 Gross Total income (8-9 ) (also 3ix ofSchedule BFLA +5b)

11 Income chargeable to tax at special rate under section 111A, 112 etc. included in 10

12 Deductions under Chapter VI -A [q of Schedule VIA and limited to (10-11)]

13 Total income (10-12)

14 Income which is included in 13 and chargeable to tax at special rates (total of(i) ofschedule SI)

15 Net agricultural income/ any other income for rate purpose (4 ofSchedule EI)

16 Aggregate income ( 13-14+15) [applicable if (13-14) exceeds maximum amount not chargeable to tax)

17 Losses of current year to be carried forward (total of row xi of Schedule CFL)

Part B - TTI

Computation of tax liability on total income

1 Tax payable on total income

a Tax at normal rates on 16 of Part B- TI

b Tax at special rates (total of( ii) of Schedule SI)

c Rebate on agricultural income [applicable if ( 13-14) ofPart 1c B-TI exceeds maximum amount not chargeable to tax]

d Tax Payable on Total Income (la + 1b - 1c)

2 Education cess , including secondary and higher education cess on 1d

3 Gross tax liability (1d+ 2)

4 Tax relief

a Section 89

b Section 90 or 90A ( 3 ofSchedule TR)

c Section 91 (4 ofSchedule TR)

COMPUTATIONOFTAXLIABILITY

d Total (4a +4b+4c)

5 Net tax liability (3 - 4d)

6 Interest payable

For default in furnishing the return (section 234A)

b For default in payment of advance tax ( section 234B)

c For deferment of advance tax ( section 234C)

d Total Interest Payable ( 6a+6b+6c) ಭಾಗ ೪ ಕರ್ನಾಟಕ ರಾಜ್ಯಪತ್ರ, ಗುರುವಾರ , ಡಿಸೆಂಬರ್ ೧೨ , ೨೦೧೩

7 Aggregate liability (5 + 6d)

8 Taxes Paid

a Advance Tax (from Schedule- IT)

b TDS (total of column 5 of Schedule- TDSI and column 7 of 8b Schedule-TDS2)

TAXESPAID

c Self-Assessment Tax (from Schedule- IT)

d Total Taxes Paid (8a+ 8b+ 8c)

9 Amount payable (Enter if 7 is greater than 8d, else enter 0)

10 Refund (If 8d is greater than 7)

11 Enter your bank account number (mandatory and for direct deposit ofrefund into bank, the number should be 11 digits or more)

REFUND

12 Do you want your refund by cheque , or deposited directly into your bank account ? (tick as applicable )

13 Giveadditional details of your bank account

IFSC Code

Type of Account (tick as applicable ) Savings ☐ Current Doyou have, -

Yes

No 14 (1) any asset (including financial interest in any entity) located outside India or (ii) signing authority in any account located outside India?

Japplicable only in case ofa resident] [Ensure Schedule FA is filled up ifthe answer is Yes]

VERIFICATION

son/ daughter of

,holding permanent account number I, solemnly declare that to the best of my knowledge and belief, the information given in the return and schedules 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 2013-2014 .

Sign here→

Place Date

14 If the return has been prepared by a Tax Return Preparer (TRP) give further details below:

Name of TRP

Identification No. of TRP

Counter Signature of TRP

If TRP is entitled for any reimbursement from the Government, amount thereof

Schedule S

Details of Income from Salary

Name ofEmployer

PAN of Employer (optional)

State

Pincode

Town/City

Address of employer

1 Salary (Excluding all exempt/ non -exempt allowances , perquisites & profit in lieu of salary as they are shown 1 separatelybelow)

SALARIES

2 Allowances exempt under section 10 (Not to be included in 7 below) 2

3 Allowances not exempt (refer Form 16from employer)

4 Value of perquisites (refer Form 16from employer)

5 Profits in lieu of salary (refer Form 16from employer)

6 Deduction u/ s 16 (Entertainment allowance by Government and tax on employment)

7 Income chargeable under the Head ' Salaries' (1+3 +4+5-6)

Schedule HP Details of Income from House Property (Please refer to instructions)

State

PIN Code

Town/ City

Address of property 1

No (if "YES" please enter following details)

Is the property co- owned? Yes

Your percentage of share in the property .

HOUSEPROPERTY

Percentage

Name of Co-owner(s)

Share in Property

PAN of Co - owner( s) (optional)

I ಭಾಗ ೪

ಕರ್ನಾಟಕ ರಾಜ್ಯಪತ್ರ, ಗುರುವಾರ , ಡಿಸೆಂಬರ್ ೧೨ , ೨೦೧೩

Name of Tenant

if let out

PAN of Tenant ( optional)

(Tick)

Annual letable value or rent received or receivable (higher of the two, if let out for whole of the year, lower ofthe two if let outforpart ofthe year)

b The amount of rent which cannot be realized

c Tax paid to local authorities

d Total (1b + 1e)

e Annual value (1a - 1d) (nil, if self -occupied etc. as per section 23(2)of theAct)

f 30% of le

g Interest payable on borrowed capital

h Total (1f + 1g)

i Income from house property 1( 1e - 1h)

State

PIN Code

Town/ City

Address ofproperty 2

Is theproperty co-owned ? Yes

No (if "YES " please enter following details)

Your percentage of share in the property.

Name of Co-owner(s)

Percentage Share in Property

PAN of Co -owner (s) (optional )

Name of Tenant

PAN ofTenant ( optional)

(Tick) if let out Π

Annual letable value or rent received/ receivable (higher of the two , if let out for whole ofthe year, lower ofthe two, iflet outfor part ofthe year)

b The amount of rent which cannot be realized

c Tax paid to local authorities

d Total (2b + 2c)

e Annual value (2a - 2d)

f 30% of2e

g Interest payable on borrowed capital

h Total (2f + 2g )

i Income from house property 2 (2e - 2h)

3 Income under the head "Income from house property"

a Rent of earlier years realized under section 25A/AA

b Arrears of rent received during the year under section 25B after deducting 30%

c Total (3a + 3b + li + 2i)

NOTE► Please include the income ofthe specified persons referred to in Schedule SPI while computing the income under this head

Schedule IF Information regarding partnership firms in which you are partner

Number of firms in which you are partner

Name of the Firm PAN of the firm

Amount of share inthe profit

Capital balance on 31 March in the firm No.

Whether the

firm is liable for

audit? (Y/N)

Percentage Share inthe profit ofthefirm

FIRMSINWHICHPARTNER

Total

ScheduleBP Details of Income from Firms ofwhich partner

Total

Net Income iv - v

Expenses in relation to iv

Firm PAN (From Schedule- IF)

Interest received

from the firm on the

capital

INCOME FROM FIRMS

SI. No.

iii

vi Salary, bonus, commission or remuneration received from the firm ii

iv 8RE_E_

ಭಾಗ ೪ ಕರ್ನಾಟಕ ರಾಜ್ಯಪತ್ರ, ಗುರುವಾರ , ಡಿಸೆಂಬರ್ ೧೨ , ೨೦೧೩

Total

NOTE► Please include the income of the specified persons referred to in Schedule SPI while computing the income under this head

Schedule CG

CapitalGains

A Short-term capital gain

1 In case ofNON -RESIDENT to which first proviso to section 48 is applicable

1日

a From assets (shares/units ) where section 111A is applicable ( STT paid)

b From assets where section 111A is not applicable

2 From assets (shares/ units) in the case of others where section 111A is applicable (STT paid)

a Full value of consideration

b Deductions under section48

Cost ofacquisition

bii

Cost of Improvement

Expenditure on transfer

blv

Total (i + fi + iii)

c Balance (2a - 2biv)

d Loss, if any, to be ignored under section 94 (7) or 2d

94(8) (enter positive values only)

e Short-term capital gain (2c + 2d)

3 From assets in case of others where section 111A is not applicable

a Full value of consideration

b Deductions under section 48

Cost of acquisition

bii

Costof Improvement

Expenditure on transfer

biv

Total (i + ii + iii)

c Balance (2a - 2biv)

d Loss , if any, to be ignored under section 94(7) or 3d

94(8) (enter positive values only)

e Deduction under section 54B/ 54D

f Short-term capital gain (3c + 3d - 3e)

CAPITALGAINS

4 Amount deemed to be short term capital gains under sections 54B/54D// 54G/ 54GA

5 Total short term capital gain (1a + 1b + 2e + 3f + A4)

B Long term capital gain

1 From asset in case of non- resident to which first proviso to section 48 is applicable

2 From asset in the case of others where proviso under section 112( 1) is not applicable

a Full value of consideration

b Deductions under section 48

i Cost of acquisition after indexation

bii

ii Cost of improvement after indexation

iii Expenditure on transfer

biv

iv Total (bi + bii +biii )

c Balance (2a - biv)

d Deduction under sections 54/54B/54D/54EC/54F 2d

54G/54GA/54GB

e Net balance (2c - 2d)

3 From asset where proviso under section 112 (1) is applicable (without indexation)

a Full value of consideration

b Deductions under section 48

i Cost of acquisition without indexation

bil

ii Cost of improvement without indexation

iii Expenditure on transfer

biv

iv Total (bi + bii +biii)

c Balance (3a - biv)

d Deduction under sections

54/54B/540/54EC /54F /54GB

Page5 of12 ಭಾಗ ೪

ಕರ್ನಾಟಕ ರಾಜ್ಯಪತ್ರ, ಗುರುವಾರ , ಡಿಸೆಂಬರ್ ೧೨ , ೨೦೧೩

B3e

e Net balance (3c-3d)

4 From unlisted securities in case of non - resident as per section 112(1)(c) (iii)

5 Amount deemed to be long term capital gains under sections 54/54B/54D/54EC/54F /54GB B5

6 Total long term capital gain [ 1 + 2e + 3e + B4]

7 In case of deduction u/ s 54GB, furnish PAN of the company

C Income chargeable under the head " CAPITAL GAINS" (A5 + B6) ( enter B6as nil, ifloss)

D Information about accrual/ receipt of capital gain

Date

16/9 to 15/12 (ii)

16/12 to 15/3 (iii)

16/3 to 31/3 (iv)

Upto15/9 (1)

1 Long- term [where proviso under section 112(1) is applicable (Without Indexation) + non - residents as per section 112(1)( c) (iii)] - TaxRate is 10% ; Enteronly positive valuefrom Item B3e+B4 of Schedule CGAFTER loss adjustment under this category in Schedule CYLA and BFLA, if any.

2 Long- termwhere proviso under section 112 ( 1) is NOT applicable (With Indexation)- TaxRate is20 %; Enteronlypositive valuefrom Item (B6-B3e-B4) of Schedule CGAFTER loss adjustment under this category in Schedule CYLA and BFLA, if any.

3 Short- term under 111A-

Tax Rate is 15 % ; Enter onlypositive value from Item Ala+A2e of ScheduleCG AFTER loss adjustment under this category in Schedule CYLA and BFLA, ifany.

4 Short -term OTHERS- Taxed at normal rates; Enteronlypositive valuefrom Item A5 - Ala-A2e of Schedule CGAFTER loss adjustment under this category In Schedule CYLA andBFLA, ifany.

NOTE► Please include the income ofthe specified persons referred to in Schedule SPIwhile computing the income under this head

Schedule OS

Income from other sources

1 Income

Dividends, Gross

b Interest, Gross

c Rental income from machinery, plants , buildings ,

Others, Gross (excluding incomefrom owning race

horses)Mention the source

1di

1dii

1diii

Total (1di + 1dii+ 1diti)

e Total (1a + 1b + 1c + 1d)

f Deductions under section 57:-

i Expenses / Deductions

OTHERSOURCES

fil

ii Depreciation

iii Total

g Balance (le - fiii)

2 Winnings from lotteries, crossword puzzles , races , games , gambling , betting etc. (Gross)

3 Income from other sources (other than from owning race horses) (1g + 2) (enter1g as nil, if loss) 3

4 Income from owning and maintaining race horses

a Receipts

b Deductions under section 57 in relation to (4)

c Balance (4a - 4b)

Income chargeable under the head " Income from other sources " (3 + 4c) (enter 4c as nil ifloss

and take4c loss figure to Schedule CFL)

NOTE► Please include the income of the specifiedpersons referred to in Schedule SPI while computing the income under this head.

ಭಾಗ ೪

ಕರ್ನಾಟಕ ರಾಜ್ಯಪತ್ರ, ಗುರುವಾರ , ಡಿಸೆಂಬರ್ ೧೨ , ೨೦೧೩

Schedule CYLA Details of Income after set -off of current years losses

Sl.No Head/ Source of Income

Business Loss

House property loss of

the current year set off

Income of current year (Fill this column only if income is zero or positive)

Current year's Income remaining after set off

Other sources loss (other than loss from race horses) of the current year set off

Total loss

Total loss (3 ofSchedule-OS)

Total loss

(3c of Schedule -HP)

2

Loss to be adjusted ->

i Salaries

H House property

iii Business or profession

iv Short-term capital gain

Long term capital

gain

CURRENTYEARLOSSADJUSTMENT

vi Other sources (excluding profit from owning race horses and winnings from lottery)

vii Profit from owning and maintaining race horses

viii Total loss set off

ix Loss remaining after set-off

Schedule BFLA Details of Income after Set off of Brought Forward Losses of earlier years

Sl . Head/ Source of Income

No.

Income after set off , if any, of current year's losses as per 4 of Schedule CYLA)

1 i Salaries

ii House property

iii Business or profession

iv Short -term capital gain

v Long -term capital gain

vi Other sources ( excluding profit from owning race horses and winnings from lottery)

vil Profit from owning and maintaining race horses

BROUGHTFORWARDLOSSADJUSTMENT

viil Total of brought forward loss set off

ix Current year's income remaining after set off Total (13 + 113 + 1113 + 1v3 + v3 +v13+vl13 )

Schedule CFL Details of Losses to be carried forward to future years

Assessment Year

Sl . No.

Date of Filing (DD/MM/YYYY)

House property loss

1 2005-06

ii 2006-07

iii 2007-08

iv 2008-09

▼ 2009-10

vi 2010-11

vii 2011-12

viii 2012-13

CARRYFORWARDOFLOSS

ix Total of earlier year losses

x Adjustment of above losses in Schedule BFLA

2013-14 (Current year losses)

xii Total loss Carried Forwardto future years

(6vi of Schedule-BP) 3

5-1-2-3-4 Brought forward loss set off

Current year's income remaining after set off 2

3 Short-term capital loss

profession Business or

Long-term Capital loss

Other sources loss (from owning race horses) ಭಾಗ ೪

ಕರ್ನಾಟಕ ರಾಜ್ಯಪತ್ರ, ಗುರುವಾರ , ಡಿಸೆಂಬರ್ ೧೨ , ೨೦೧೩

Schedule VIA

Deductions under Chapter VI -A (Section)

a 80C

80DDB

n 80RRB

0 80TTA

b 80CCC

h 80E

i 80G

P 80U

c(i) 80CCD( 1) ( assessees contribution)

80GG

c( il) 80CCD(2) (employers contribution)

d 80CCG

k 80GGA

TOTALDEDUCTIONS

e 80D

L 80GGC

f 80DD

m 80QQB

Total deductions (total of a to p)

Details of donations entitled for deduction under section 80G

Schedule 80G

A Donations entitled for 100 % deduction without qualifying limit

PAN ofDonee

Amount of donation

Name and address of donee

EligibleAmount of donation i

vi Total

B Donations entitled for 50% deduction without qualifying limit

PAN of Donee

Amount ofdonation

Name and address of donee

Eligible Amount of donation 1

vi Total

C Donations entitled for 100 % deduction subject to qualifying limit

PAN of Donee

Amount of donation

Name and address of donee

Eligible Amount of donation DETAILSOFDONATIONS

vi Total

D Donations entitled for 50% deduction subject to qualifying limit

Amount of donation

PAN of Donee

Name and address of donee

Eligible Amount of donation i

iii

vi Total

Total donations (Avi + Bvi + Cvl + Dvl ) ಭಾಗ ೪ ಕರ್ನಾಟಕ ರಾಜ್ಯಪತ್ರ, ಗುರುವಾರ , ಡಿಸೆಂಬರ್ ೧೨ , ೨೦೧೩

Schedule SPI

Income of specified persons (spouse, minor child etc.) includable in income of the assessee (income of the minor child, in excess of Rs . 1,500 per child , to be included)

SI No

Nature of Income

Nameofperson

Relationship

PAN ofperson (optional)

Amount (Rs) 1

Schedule SI

Income chargeable to tax at special rates (please see instructions No. 9(ul) for rate oftax)

Income

Tax thereon Section

Special rate (%)

1 111A ( STCG on shares where STT paid)

2 112 proviso (LTCG on listed securities/ units without indexation)

3 112 (LTCG on others)

4 112(1) (c)( iii) (LTCG on unlisted securities in case of non- residents)

5 115BB (Winnings from lotteries , puzzles , races, games etc.)

SPECIAL ALRATE

Total

Schedule EI

Details of Exempt Income ( Income not to be included in Total Income)

1 Interest income

2 Dividend income

3 Long-term capital gains on which Securities Transaction Tax is paid

4 Net Agricultural income (other than income to be excluded under rule 7, 7A, 7B or 8)

5 Share in the profit of firm/AOP/BOI etc.

EXEMPTINCOME

6 Others , including exempt income of minor child

7 Total (1+2+3+4+5+6)

Schedule IT

Detalls of payments of Advance Tax and Self- Assessment Tax

BSR Code

Serial Number of Challan

Amount(Rs)

Dateof Deposit (DD/MM/YYYY)

TAXPAYMENTS

NOTE► Enter the totals ofAdvance tax and Self-Assessment tax in Sl No. 8a & 8c of PartB-TTI

Schedule TDS1

Details of Tax Deducted at Source from Salary [As per Form 16 issued by Employer (s) ]

Total tax deducted

Income chargeable under Salaries

Name of the Employer

TaxDeduction Account Number (TAN) of the Employer (2)

(3)

(4)

(1)

(5) 1

TDSONSALARY

NOTE Please enter total of column 5 of Schedule- TDS1 and column 7 ofSchedule- TDS2 in 8 (b) ofPart B-TTI 320 ಭಾಗ ೪

ಕರ್ನಾಟಕ ರಾಜ್ಯಪತ್ರ, ಗುರುವಾರ , ಡಿಸೆಂಬರ್ ೧೨ , ೨೦೧೩

Schedule TDS2

Details of Tax Deducted at Source on Income [As per Form 16 A issued by Deductor (s ) ]

Total Tax Deducted

Name of the Deductor

SI No

Amount out of (6) claimed This Year

Unique TDS Certificate Number

Financial Year in

which TDS is

Deducted

TaxDeduction Account Number (TAN) of the Deductor (2)

(3)

(4)

(5)

(6)

(7) (1)

TDSONOTHERINCOME

NOTE Please enter total of column 5 ofSchedule- TDSI and column 7 of Schedule - TDS2 in 8 (b) ofPart B -TTI Schedule FSI

Details of Income accruing or arising outside India

1 Details of Income included in Total Income in Part-B- TI above

Country Code

Taxpayer Identification Number

Total Income fromOutside India (F) =A+ B+ C+ D+E

Business Income (includedin PART B - TI) (C)

Income from Salary (included in PART B - TI) (A)

Capital Gain Income (included in PART B-TI) (D)

Other source Income (included in PART B- TI) (E)

Incomefrom

House

Property

(included in

PART B - TI)

(B)

Total

2 Total Income from outside India ( Total of F as per item no.1 above)

3 Total Income from outside India where DTAA is applicable

INCOMEACCRUINGORARISINGOUTSIDEINDIA

4 Total Income from outside India where DTAA is not applicable (2-3 )

NOTE Please refer to the instructionsfor filling out this schedule.

Schedule TR

Details of Taxes Paid outside India

1 Details of Taxes Paid outside India

Country Code

Tax Relief Claimed (B)

Relevant article of DTAA

Taxpayer Identification Number

Total taxes paid on

income declared in

Schedule FSI

(A)

Relief claimed u/s 90/ 90A (B1)

Relief claimed u/ s 91 (B2) TAXESPAIDOUTSIDEINDIA

Total

2 Total Taxes paid outside India (Total of 1A)

3 Total Taxes Paid outside India where DTAA is applicable

4 Total Taxes Paid outside India where DTAA is not applicable (2-3 )

NOTE Please refer to the instructions for filling out this schedule.

ಭಾಗ ೪

ಕರ್ನಾಟಕ ರಾಜ್ಯಪತ್ರ, ಗುರುವಾರ , ಡಿಸೆಂಬರ್ ೧೨ , ೨೦೧೩

Schedule FA

Details of ForeignAssets

A Details of Foreign Bank Accounts

SI Country Name CountryCode Name and Address of theBank No

(4) Account Number Peak Balance During the Year (in rupees)

Name mentioned

intheaccount

(5)

(3)

(2)

B Details of Financial Interest in any Entity

CountryName (1)

CountryCode (2)

(7)

(6)

Nature of entity

(3)

Details of Immovable Property

Country Name (2)

Total Investment (at cost) (in rupees) (5)

Name and Address of theEntity (4)

Address of the Property

(4)

CountryCode (3)

C SI (ii)

D Details of any other Asset in the nature of investment DETAILSOFFOREIGNASSETS

CountryCode (3)

CountryName (2)

Total Investment (at cost) (In rupees) (5)

Total Investment(at cost) (in rupees) (5)

Nature ofAsset

(4)

No (1)

E Details of account( s) in which you have signing authority and which has not been included in A to D above

Name of the Institution in which the

account is held (2)

AccountNumber (5)

Name ofthe

(4)

accountholder

Address ofthe Institution (3) SI No (1) (1)

(11)

PeakBalance/Investment during theyear(in rupees) (0

F Details of trusts , created under the laws of a country outside India, in which you are a trustee

Country Code (3)

Country Name (2)

SI No (1)

Name and address ofthe trust (4) Name and address of Settlor (6)

Name and address of Beneficiaries (7)

address of other

trustees

(5)

Name and

(11)

Schedule 5A

Information regarding apportionment of income between spouses governed by Portuguese Civil Code

Name of the spouse

PAN of the spouse

Heads of Income

1House Property 2 Business or profession

3 Capital gains

4 Other sources

5 Total

ScheduleAL

Amount apportioned in the hands of the spouse

Asset and Liability at the end of the year (other than those included in Part ABS of the return of the Firm in which partner) (Applicable in a case where total income exceeds Rs . 25 lakh)

A Particulars ofAsset

1 Immovable Asset

a Land

b Building

2Movable Asset

a Financial Asset

i Deposits in Bank (including balance in any account)

il Shares and securities

iii Insurance policies

iv Loans andAdvances given v Cash in hand

b Jewellery, bullion etc.

DETAILSOF ASSETANDLIABI ILITY

c Archaeological collections, drawings , painting, sculpture or any work of art

d Vehicles, yachts , boats and aircrafts 3

Liability in relation to Assets at A

Amount (Cost) (Rs.)

Total 822 ಭಾಗ ೪

ಕರ್ನಾಟಕ ರಾಜ್ಯಪತ್ರ, ಗುರುವಾರ , ಡಿಸೆಂಬರ್ ೧೨ , ೨೦೧೩

Assessment Year INDIAN INCOME TAX RETURN

FORM

ITR -4 ( For individuals and HUFs having income from a proprietary business or profession)

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

2013-14 PartA-GEN

GENERAL

Middle name

PAN

First name

Last name

Flat/Door/Block No

Name Of Premises/Building/Village

Status (Tick)

Individual

HUF Road /Street/Post Office

Date ofBirth (DD/MM/YYYY)

Area/locality

(incaseofindividual)

State

Pin code

Town/City/District

Sex(in case of individual) (Tick)

Male

Female

Country

PERSONALINFORMATION

Mobile No. 2

Residential/Office Phone Number with STD code /

Mobile No. 1

Employer Category ( if in employment) (Tick)

PSU Others

Govt.

Income Tax Ward/ Circle Email Address-1 (self)

EmailAddress -2

Revised Return- 139(5) Return filed (Tick) [Please see instruction number- 7] Before due date - 139( 1) After due date -139(4)

148

153A/153C OR 92CD 139(9)-Defective

142(1)

or In response to notice

If revised/Defective, then enter Receipt No. and Date of filing original return (DD/MM/YYYY)

Resident

Non-Resident

Residential Status (Tick)

Resident but Not Ordinarily Resident Are you governed by Portuguese Civil Code ? Tick) Yes No (If " YES " please fill Schedule 5A)

Yes

Whether this return is being filed by a representative assessee ? (Tick)

FILINGSTATUS

If yes , please furnish following information -

(a) Name of the representative

(b) Address of the representative

(Tick) Yes

Are you liable to maintain accounts as per section 44AA?

(Tick)

Yes

No, Ifyes, furnish following information- Are you liable for audit under section 44AB?

Date of furnishing of the audit report (DD/MM/ YYYY)

(a)

(b) Name of the auditor signing the tax audit report

(d) Name of the auditor (proprietorship/ firm)

AUDIT INFORMATION

(e) Permanent Account Number (PAN) of the proprietorship/ firm

(f) Date of report of the audit

(Tick)

Yes

Whether taxpayer is liable to furnish a report under section 92E ?

ForOfficeUse Only

ReceiptNo

Date

Seal and Signature of receiving official ಭಾಗ ೪ ಕರ್ನಾಟಕ ರಾಜ್ಯಪತ್ರ, ಗುರುವಾರ , ಡಿಸೆಂಬರ್ ೧೨ , ೨೦೧೩

NATURE OF BUSINESS

NATURE OF BUSINESS OR PROFESSION , IF MORE THAN ONE BUSINESS OR PROFESSION INDICATE THE THREE MAIN ACTIVITIES/ PRODUCTS

S.No.

Description

Code [Please see instruction No.7(1)]

Trade name of the proprietorship, if any

(1)

(ii)

PartA-BS

BALANCE SHEET AS ON 31ST DAY OF MARCH, 2013 OF THE PROPRIETORY BUSINESS OR PROFESSION (fill items below in a case where regular books of accounts are maintained, otherwise fill item 6) 1Proprietor's fund

a Proprietor's capital

b Reserves and Surplus

i RevaluationReserve

bii

ii Capital Reserve

bili

iii StatutoryReserve

biv

iv Any other Reserve

V Total (bi + bii + biii + biv)

c Total proprietor's fund (a + bv)

2Loan funds

a Secured loans

i Foreign Currency Loans

ii Rupee Loans

SOURCESOFFUNDS

AFrom Banks

iiB

B From others

C Total ( iiA + iiB)

iii Total (ai + iiC)

b Unsecured loans ( including deposits)

1 FromBanks

bil

ii From others

bili

iii Total (bi + bil)

c Total Loan Funds (aiii + biii)

3 Deferred tax liability

4Sources of funds ( 1c + 2c +3)

1Fixed assets

aGross:Block

b Depreciation

c Net Block (a - b)

d Capital work- in-progress

e Total (1c + 1d)

2 Investments

a Long-term investments

i Government and other Securities - Quoted

APPLICATIONOFFUNDS

i Government and other Securities - Unquoted ali

alii

iii Total (ai + aii )

b Short -term investments

i Equity Shares , including share application money bi

bii

ii Preference Shares

iii Debentures

bili ಭಾಗ ೪

ಕರ್ನಾಟಕ ರಾಜ್ಯಪತ್ರ, ಗುರುವಾರ , ಡಿಸೆಂಬರ್ ೧೨ , ೨೦೧೩

biv

iv Total (bi + bii + bili)

c Total investments (aiii + biv)

3 Current assets , loans and advances

a Current assets

i Inventories

A Stores/consumables including packing material

B Raw materials

CStock- in-process

D Finished Goods/TradedGoods

E Total ( iA + iB + IC + iD)

aii

ii Sundry Debtors

ili Cash and Bank Balances

A Cash - in-hand

BBalancewith banks

C Total (iiiA + iiiB)

aiv

iv Other Current Assets

Total current assets ( IE + aii + iiiC + aiv)

b Loans and advances

Advances recoverable in cash or in kind or for value to be received

bli

Deposits, loans and advances to corporates and others

biff

iii Balance with Revenue Authorities

biv

iv Total (bi + bii + biii )

e Total of current assets , loans and advances ( av + biv)

d Current liabilities and provisions

i Current liabilities

ASundry Creditors

B Liability for Leased Assets

C Interest Accrued on above

D Interest accrued but not due on loans

E Total (iA + IB + IC + ID)

ii Provisions

iiA

AProvisionfor Income Tax

BProvision for Wealth Tax

Provision for Leave C

iic

encashment/ Superannuation/Gratuity

iiD

D Other Provisions

E Total ( iiA + iiB + iiC + iiD )

diil

iii Total ( iE + iiE)

e Net current assets (3c - diii)

4 a Miscellaneous expenditure not written off or adjusted 4a

b Deferred tax asset

cProfit and loss account/ Accumulated balance

d Total (4a + 4b + 4c)

5 Total, application of funds ( le + 2c + 3e +4d)

6 In a case where regular books of account of business or profession are not maintained- furnish the following information as on 31 day ofMarch, 2013, in respect of business orprofession)

aAmount of total sundry debtors

b Amount of total sundry creditors

бе

c Amount of total stock - in -trade

NOACCOUNT CASE

d Amount of the cash balance 5888A8E_

ಭಾಗ ೪ ಕರ್ನಾಟಕ ರಾಜ್ಯಪತ್ರ, ಗುರುವಾರ , ಡಿಸೆಂಬರ್ ೧೨ , ೨೦೧೩

Part A - P& L

Profit and Loss Account for the previous year 2012-13 of the proprietary business or profession (fill items 1 to 50 in a case where regular books of accounts are maintained, otherwise fill item 51)

1 Sales/Gross receipts of business or profession (Net ofreturns and refunds and duty or tax, ifany) 1

2 Duties, taxes and cess, received or receivable , in respect of goods and services sold or supplied

a Union Excise duties

b Service tax

c VAT/ Sales tax

d Any other duty, tax and cess

e Total ofduties , taxes and cess , received or receivable(2a+ 2b+2c+2d)

3 Other income

a Rent

b Commission

c Dividend

d Interest

e Profit on sale of fixed assets

Profit on sale of investment being securities chargeable f to Securities Transaction Tax (STT)

CREDITSTOPROFITANDLOSSACCOUNT

g Profit on sale of other investment

h Profit on account of currency fluctuation

i Agriculture income

j Any other Income

k Total of other income ( 3a to 3j )

4 Closing Stock

5 Total of credits to profit and loss account (1+ 2e+3k+4)

6 Opening Stock

7 Purchases (net of refunds and duty or tax , if any)

8 Duties and taxes , paid or payable, in respect of goods and services purchased

a Customduty

b Counter veiling duty

c Special additional duty

d Union excise duty

e Service tax

f VAT/ Sales tax

Any other tax , paid or payable

h Total (8a+8b+ 8c +8d + 8e+ 8f+ 8g)

9 Freight

10Consumption of stores and spare parts

11 Power and fuel

12Rents

13 Repairs to building

14 Repairs to machinery

15 Compensation to employees

DEBITSTOPROFITANDLOSSACCOUNT

15a

a Salaries and wages

15b

b Bonus

15c

c Reimbursement of medical expenses

15d

d Leave encashment

15e

e Leave travel benefits

15f

f Contribution to approved superannuation fund

15g

g Contribution to recognised provident fund

15h

h Contribution to recognised gratuity fund

15i

i Contribution to any other fund 822 ಭಾಗ ೪

ಕರ್ನಾಟಕ ರಾಜ್ಯಪತ್ರ, ಗುರುವಾರ , ಡಿಸೆಂಬರ್ ೧೨ , ೨೦೧೩

15j

Any other benefit to employees in respect of which an expenditure has been incurred

15k

k Total compensation to employees (15a+ 15b+ 15c+ 15d+ 15 + 15 + 15g+ 15h+ 15i+ 15 )

16 Insurance

16a

a Medical Insurance

16b

b Life Insurance

16c

c Keyman's Insurance

16d

d Other Insurance

16e

e Total expenditure on insurance (16a+ 16b + 16c+ 16d)

17Workmen and staff welfare expenses

18 Entertainment

19 Hospitality

20Conference

21 Sales promotion including publicity (other than advertisement)

22 Advertisement

23 Commission

24Hotel,boarding and Lodging

25 Traveling expenses including foreign traveling

26 Conveyance expenses

27 Telephone expenses

28 Guest House expenses

29 Club expenses

30 Festival celebration expenses

31Scholarship

32Gift

33Donation

34Rates and taxes , paid or payable to Government or any local body ( excluding taxes on income)

34a

a Union excise duty

34b

b Service tax

34c

c VAT/ Sales tax

34d

d Cess

34e

e Any other rate, tax, duty or cess incl . STT Paid

345

f Total rates and taxes paid or payable (34a+ 34b+34c+34d+34e)

35Auditfee

36 Other expenses

37 Bad debts

38 Provision for bad and doubtful debts

39 Other provisions

Profit before interest, depreciation and taxes

5- (6 + 7 + 8h + 9 to 14 + 15k + 16e + 17 to 33 + 341 +35 to 39) ]

41 Interest

42Depreciation

43 Profit before taxes (40-41-42)

44 Provision for current tax

45 Provision for Deferred Tax

46 Profit after tax (43-44-45 )

47 Balance brought forward from previous year

48 Amount available for appropriation (46 +47)

49 Transferred to reserves and surplus

TAXPROVISIONSAND APPROPRIATIONS

50 Balance carried to balance sheet in proprietor's account (48-49) 325

ಭಾಗ ೪ ಕರ್ನಾಟಕ ರಾಜ್ಯಪತ್ರ, ಗುರುವಾರ , ಡಿಸೆಂಬರ್ ೧೨ , ೨೦೧೩

In a case where regular books of account of business or profession are not maintained, furnish the following information for previous year 2012-13 in respect of business or profession

51a

a Gross receipts

51b

b Gross profit

51c

NOACCOUNT CASE

Expenses

51d

d Net profit

Part A - OI

Other Information (optional in a case not liable for audit under section 44AB)

mercantile

cash

1 Method of accounting employed in the previous year (Tick)

Yes

2 Is there any change in method of accounting

(Tick)

Effect on the profit because of deviation, if any , in the method of accounting employed in the previous year from accounting standards prescribed under section 145A

4 Method ofvaluation of closing stock employed in the previous year

Π a Raw Material (if at cost or market rates whichever is less write 1, if at cost write 2, if at market rate write 3)

Π b Finished goods (if at cost or market rates whichever is less write 1, if at cost write 2 , if at market rate write 3)

Yes

c Is there any change in stock valuation method (Tick)

d Effect on the profit or loss because of deviation, if any, from the method of valuation prescribed under section 145A

5 Amounts not credited to the profit and loss account, being -

a the items falling within the scope of section 28

OTHERINFORMATION

b the pro forma credits , drawbacks , refund of duty of customs or excise or service tax , or refund of sales tax or value added tax, where such credits , drawbacks or 5b refunds are admitted as due by the authorities concerned

c escalation claims accepted during the previous year

d any other item of income

e capital receipt, if any

f Total of amounts not credited to profit and loss account (5a+5b+5c+5d+5e)

6 Amounts debited to the profit and loss account, to the extent disallowable under section 36: -

a Premium paid for insurance against risk of damage or destruction of stocks or store

b Premium paid for insurance on the health of employees

c Any sum paid to an employee as bonus or commission for services rendered , where such sum was otherwise 6c payable to him as profits or dividend.

d Any amount of Interest paid in respect of borrowed capital

бе

e Amount ofdiscount on a zero- coupon bond

f Amount of contributions to a recognised provident fund

g Amount ofcontributions to an approved superannuation fund

hAmount ofcontributions to an approved gratuity fund

i Amount of contributions to any other fund

j Amount of bad and doubtful debts

k Provision for bad and doubtful debts

1 Amount transferred to any special reserve

m Expenditure for the purposes of promoting family planning amongst employees

nAny sum received from employees as contribution to anyprovident fund or superannuation fund or any fundset up under ESI Act or any other fund for the welfare of employees to the extent credited to the employees account on or before the due date

o Any other disallowance

p Total amount disallowable under section 36 (total of 6a to 60)

7 Amounts debited to the profit and loss account, to the extent disallowable under section 37 ಭಾಗ ೪

ಕರ್ನಾಟಕ ರಾಜ್ಯಪತ್ರ, ಗುರುವಾರ , ಡಿಸೆಂಬರ್ ೧೨ , ೨೦೧೩

Expenditure of personal nature ;

Expenditure on advertisement in any souvenir ,

b brochure, tract, pamphlet or the like, published by a political party;

Expenditureby way of penalty or fine for violation of

anylaw for the time being in force;

d Any other penalty or fine;

Expenditure incurred for any purpose which is an offenceorwhich is prohibited by law;

f Amount of any liability of a contingent nature

Amount of expenditure in relation to income which does not form part of total income

h Any other amount not allowable under section 37

i Total amount disallowable under section 37 (total of 7a to 7h)

8 A. Amounts debited to the profit and loss account, to the extent disallowable under section 40

Amount disallowable under section 40 (a) (1), 40(a) (ia) and40(a) ( iii) on account of non- compliance with the provisions of Chapter XVII- B

Amount of tax or rate levied or assessed on the

basis ofprofits

c Amount paid as wealth tax

remuneration paid to any partner or member aAmount of Interest , salary, bonus , commission or

e Any other disallowance

8Af

f Total amount disallowable under section 40( total of Aa toAe)

Anyamount disallowed under section 40 in any preceding previous year but allowable during the previous year

9 Amounts debited to the profit and loss account, to the extent disallowable under section40A

a Amounts paid to persons specified in section 40A(2)(b)

b Amount in excess of twenty thousand rupees paid to a personin a day otherwise than by account payee cheque or account payee bank draft under section 40A(3) -100% disallowable

c Provision for payment of gratuity

d any sum paid by the assessee as an employer for setting up or as contribution to any fund, trust, company,AOP , or BOI or society or any other institution;

e Any other disallowance

9a to 9e)

f Total amount disallowable under section 40A (total of

10 Any amount disallowed under section 43B in any preceding previous year but allowable during

the previous year

10a

a Any sum in the nature of tax , duty, cess or fee under any law

10b

b Any sum payable by way of contribution to any provident fund or superannuation fund or gratuity fund or any other fund for the welfare of employees

10c

c Any sum payable to an employee as bonus or commission for services rendered

10d

d Any sum payable as interest on any loan oг borrowing from any public financial institution or a State financial corporation or a State Industrial Investment Corporation

10e

e Any sum payable as interest on any loan or borrowing from any scheduled bank

10f

f Any sum payable towards leave encashment

10g

g Total amount allowable under section 43B ( total of 10a to 101)

11 Any amount debited to profit and loss account of the previous year but disallowable under section 43B: -

a Any sum in the nature of tax , duty, cess or fee under

11a

anylaw

b Any sum payable by way of contribution to any provident fund or superannuation fund or gratuity 11b fund or any other fund for the welfare of employees ಭಾಗ ೪ ಕರ್ನಾಟಕ ರಾಜ್ಯಪತ್ರ, ಗುರುವಾರ , ಡಿಸೆಂಬರ್ ೧೨ , ೨೦೧೩

11c

c Any sum payable to an employee as bonus or commission for services rendered

11d

d Any sum payable as interest on any loan or borrowing from any public financial institution or a State financial corporation or a State Industrial Investment corporation

11e

e Any sum payable as interest on any loan or borrowing from any scheduled bank

11f

f Any sum payable towards leave encashment

11g

g Total amount disallowable under Section 43B (total of 11a to 11f)

12 Amount of credit outstanding in the accounts in respect of

12a

a Union Excise Duty

b Service tax

12b

c VAT/ sales tax

12c

d Any other tax

12d

12e

e Total amount outstanding (total of 12a to 12d)

13 Amounts deemed to be profits and gains under section 33AB or 33ABA or 33AC

14 Any amount of profit chargeable to tax under section 41

15 Amount of income or expenditure of prior period credited or debited to the profit and loss

account(net)

Quantitative details (optional in a case not liable for audit under section 44AB)

Part A - QD

(a) In the case of a trading concern

1Opening stock

2Purchase during the previous year

3 Sales during the previous year

4 Closing stock

5 Shortage/ excess , if any

(b) In the case of a manufacturing concern

6 Raw materials

a Opening stock

b Purchases during the previous year

c Consumption during the previous year

d Sales during the previous year

бе

e Closing stock

QUANTITATIVEDETAILS

f Yield finished products

g Percentage of yield

h Shortage/ excess , if any

7 Finished products / By -products

a opening stock

b purchase during the previous year

c quantity manufactured during the previous year

d salesduring the previous year

e closing stock

f shortage/ excess, ifany

Part B - TI

Computation oftotal income

1 Salaries (7 of Schedule S)

2 Income from house property (3c of Schedule-HP) (enter nil if loss)

3 Profits and gains from business or profession

business and specified business (A37 ofSchedule-BP) 1 Profit and gains from business other than speculative

3ii

Profit and gains from speculative business (B41 of ScheduleBP) (enter nil if loss and take the figure to schedule CFL)

TOTALINCOME

Profit and gains from specified business (C47 of Schedule

iii BP)(enter nil ifloss and take the figure to schedule CFL) 350 ಭಾಗ ೪

ಕರ್ನಾಟಕ ರಾಜ್ಯಪತ್ರ, ಗುರುವಾರ , ಡಿಸೆಂಬರ್ ೧೨ , ೨೦೧೩

3iv

iv Total (31 + 311 + 31ll) (enter nil if 3iv is a loss)

4 Capital gains

a Short term

4ai

Short-term(under section 111A) (A2a+A3e of Schedule-CG) ( enter nil if loss)

4aH

Short-term(others) (A7 - A2a-A3e of Schedule- CG)(enter nil if loss)

4aiii

iii Total short -term (4ai + 4aii)

bi Long-term (B7 - B4e - B5 ofSchedule CG) (enter nil if loss) 4bi

4bli

Long-term without Indexation (B4e + B5 of Schedule- CG) (enter nil if loss)

Total Long-Term (4bi + 4b (ii)

4bili

Total capital gains (4aiii + 4biii) (enter nil if 4e is a loss)

5 Income from other sources

from sources other than from owning race horses and winnings from Lottery etc.

(1g ofScheduleOS)

winnings from lotteries , crossword puzzles , races , games , gambling , betting etc. (2 of b Schedule OS)

c from owning and maintaining race horses (4c ofSchedule OS) (enter nil if loss)

d Total (5a + 5b + 5c)

6 Total ( 1 + 2 + 3iv + 4c +5d)

7 Losses of current year to be set off against 6 (total of 2x,3x and 4x of Schedule CYLA)

8 Balance after set off current year losses (6-7) (also total ofcolumn 5 ofSchedule CYLA+ 5b)

9 Brought forward losses to be set off against 8 (total of2x, 3x and 4x of Schedule BFLA)

10 Gross Total income (8-9) ( also 5xi of Schedule BFLA+ 5b)

11 Income chargeable to tax at special rate under section 111A, 112 etc. included in10

12Deductions under Chapter VI -A [v ofSchedule VIA and limited to (10-11)]

13 Total income ( 10-12)

14 Incomewhich is included in 13 and chargeable to tax at special rates (total of (i) of schedule SI) 14

15 Net agricultural income/ any other income for rate purpose (4 of Schedule EI)

16 Aggregate income (13-14+ 15) [ applicable if(13-14) exceeds maximum amount not chargeable to tax]

17Losses of current year to be carried forward (total ofxi of CFL)

Part B - TTI

Computation of tax Hability on total income

a Tax payable on deemed total income under section 115JC (4 of Schedule AMT)

1 b Education Cess on (1a) above

c Total Tax Payable

2 Tax payable on total income

a Tax at normal rates on 16 of Part B -TI

b Tax at special rates (total of (i) ofSchedule-SI)

B-TI exceeds maximum amount not chargeable to tax] c Rebate on agricultural income [applicable if (13-14) ofPart

d Tax Payable on Total Income (2a + 2b - 2c)

3 Education cess, including secondary and higher education cess on 2d

4Gross tax liability (2d+3)

5 Gross tax payable (higher of 4 or 1c)

Credit under section 115JD of tax paid in earlier years (if 4 is more than 1c) (5 of Schedule

COMPUTATIONOFTAXLIABILITY

AMTC)

7 Tax payable after credit under section 115JD (5-6)

8 Tax relief

a Section 89

b Section 90/ 90A (total of 1B1 ofSchedule TR)

c Section91 (total of 1B2 ofSchedule TR)

d Total (8a + 8b + 8c) ಭಾಗ ೪ ಕರ್ನಾಟಕ ರಾಜ್ಯಪತ್ರ, ಗುರುವಾರ , ಡಿಸೆಂಬರ್ ೧೨ , ೨೦೧೩

9 Net tax liability (7-8d)

10 Interest payable

108

Fordefault in furnishing the return ( section 234A)

10b

b For default in payment of advance tax (section 234B)

10c

c For deferment of advance tax (section 234C)

10d

d Total Interest Payable (10a+ 10b+10c)

11 Aggregate liability (9 + 10d)

12 Taxes Paid

128

a Advance Tax (from Schedule- IT)

b TDS (total ofcolumn 5 ofSchedule- TDSI and column 7 o 12b

Schedule- TDS2)

12c

e TCS (column 5 of Schedule- TCS)

TAXESPAID

12d

d Self-Assessment Tax (from Schedule-IT)

12e

e Total Taxes Paid (12a +12b+12c+ 12d)

13 Amount payable (Enter if 11 is greater than 12e, else enter 0)

14 Refund (If 12e is greater than 11)

Enter your bank account number (mandatory andfor direct 15 deposit ofrefund into bank, the number should be 11 digits or more)

16 Do you want your refund by cheque , or deposited directly into your bank account ? (tick as applicable )

REFUND

17 Giveadditional details of your bank account

IFSC Code

Current

Savings

Type of Account (tick as applicable )

Do you have, -

Yes

No (ii) signing authority in any account located outside India?

(1) any asset (including financial interest in any entity) located outside India or [applicable only in case of a resident] [Ensure Schedule FA is filled up if the answer is Yes]

VERIFICATION

son/ daughter of

holding permanent I, account number solemnly declare that to the best of my knowledge and belief, the information given in the return and schedules 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 2013-14.

Signhere→

Place Date

19 If the return has been prepared by a Tax Return Preparer (TRP) give further details below:

IdentificationNo. of TRP

Name of TRP

Counter Signature of TRP

If TRP is entitled for any reimbursement from the Government, amount thereof...............

Schedule S

Details of Income from Salary

Name of Employer

PAN of Employer (optional)

State

Pincode

Town/City

Address ofemployer

1 Salary (Excluding all exempt/ non -exempt allowances, perquisites & profit in lieu of salary as they are shown

separatelybelow)

SALARIES

2 Allowances exempt under section 10 (Not to be included in 7below) 2

3 Allowances not exempt (refer Form 16from employer)

4 Value of perquisites (refer Form 16from employer)

5 Profits in lieu of salary (refer Form 16from employer)

6 Deduction u/s 16 (Entertainment allowance by Government and tax on employment)

7 Income chargeable under the Head ' Salaries ' (1+3 +4+5-6) ಭಾಗ ೪

೨೦೧೩

ಕರ್ನಾಟಕ ರಾಜ್ಯಪತ್ರ, ಗುರುವಾರ , ಡಿಸೆಂಬರ್ ೧೨ ,

Schedule HP

Details of Income from House Property (Please refer to instructions)

State

PIN Code

Town/ City

Address of property 1

Yes

Is the property co-owned ?

No (if "YES" please enter following details)

Your percentage of share in the property.

PAN of Co -owner (s) ( optional )

Percentage Share in Property Name of Co-owner(s)

Name of Tenant

PAN ofTenant (optional )

(Tick) if let out

Annual letable value or rent received or receivable (higher ofthe two, iflet out for whole of theyear, lower of the two if let out for part ofthe year)

The amount of rent which cannot be realized

c Tax paid to local authorities

d Total (1b + 1c)

HOUSEPROPERTY

e Annual value (1a - 1d) (nil , if self - occupied etc. as per section 23 (2)of the Act)

f 30% ofle

g Interest payable on borrowed capital

h Total ( 1f +1g)

i Income from house property 1 (1e - 1h)

PIN Code

State

Town/ City

Address of property 2

Is the property co -owned? Yes

No ( if "YES " please enter following details)

Your percentage of share in the property

Name of Co-owner(s)

PAN of Co -owner (s) (optional )

Percentage Share in Property (optional) Π

PAN of Tenant (optional) (Tick) if let out Π

Name of Tenant

Annual letable value or rent received or receivable (higher of the two, iflet outfor whole of

theyear, lower of the two , if let out for part of the year)

b The amount of rent which cannot be realized

Tax paid to local authorities

c d Total (2b + 2c)

e Annual value (2a - 2d)

f 30% of2e

g Interest payable on borrowed capital

h Total (2f + 2g)

i Income from house property 2 (2e - 2h)

3 Income under the head " Income from house property"

a Rent of earlier years realized under section 25A/AA

b Arrears of rent received during the year under section 25B after deducting 30%

e Total (3a + 3b + 1i + 2i)

NOTE► Please include the income of the specified persons referred to in Schedule SPI while computing the income under this head ಭಾಗ ೪ ಕರ್ನಾಟಕ ರಾಜ್ಯಪತ್ರ, ಗುರುವಾರ , ಡಿಸೆಂಬರ್ ೧೨ , ೨೦೧೩

Schedule BP

Computation of income from business or profession

A From business or profession other than speculative business and specified business

1 Profit before tax as per profit and loss account ( item 43 or item 51d of Part A- P & L )

2a Net profit or loss from speculative business included in 2a 1(enter-ve sign in case of loss)

2b Net profit or Loss from Specified Business u/ s 35AD included in 1( enter -ve sign in case of loss)

3 Income/ receipts credited to profit and loss account considered under other heads of income

4 Profit or loss included in 1, which is referred to in section 44AD/44AE /44AF /44B/44BB /44BBA/44BBB/ 44D/44DA Chapter- XII- G/ First Schedule of Income-tax Act

5 Income credited to Profit and Loss account (included in 1)which is exempt

a share of income from firm(s)

b Share of income from AOP/ BOI

c Any other exempt income

d Total exempt income

6 Balance ( 1-2a -2b - 3-4-5d)

INCOMEFROMBUSINESSORPROFESSION

7 Expenses debited to profit and loss account considered under other heads of income

8 Expenses debited to profit and loss account which relate 8 to exempt income

9 Total (7 + 8)

10 Adjusted profit or loss (6+9)

11 Depreciation debited to profit and loss account

12Depreciation allowable under Income -tax Act

121

i Depreciation allowable under section 32( 1 ) (ii ) (column 6 of Schedule-DEP)

12ii

ii Depreciation allowable under section 32(1 ) (1 ) (Makeyour own computation referAppendix-IA of IT Rules)

12iii

iii Total ( 121 + 12ii)

13 Profit or loss after adjustment for depreciation ( 10 + 11-12iii)

14 Amounts debited to the profit and loss account, to the extent disallowable under section 36 (6p of Part-OI)

15 Amounts debited to the profit and loss account, to the extent disallowable under section 37 (7i of Part- OI)

16 Amounts debited to the profit and loss account, to the extent disallowable under section 40 ( 8Af of Part -OI)

17 Amounts debited to the profit and loss account, to the extent disallowable under section 40A (9f of Part-OI)

18 Any amount debited to profit and loss account of the previous year but disallowable under section 43B ( 11g of Part-ON

19 Interest disallowable under section 23 of the Micro, Small andMedium Enterprises Development Act, 2006

20 Deemed income under section 41

21 Deemed income under section 33AB/33ABA/35ABB/ 72A/80HHD/80- IA

22 Any other item or items of addition under section 28 to 44DA

23 Any other income (including income from salary , commission, bonus and interest from firms in which an individual/ HUF/ Prop . concern is a partner ) not included inprofit and loss

24 Total (14 + 15 + 16 + 17 + 18 + 19 + 20 + 21 +22 +23 )

25Deduction allowable under section 32(1 ) (iii)

26Amount of deduction under section 35 in excess of the amount debited to profit and loss account (item vii(4) of ScheduleESR)

27 Any amount disallowed under section 40 in any preceding previous year but allowable during the previous year(8Bof Part -OI) ಭಾಗ ೪

28 Any amount disallowed under section 43B in any preceding previous year but allowable during the previous year(10g of Part -OI)

29 Deduction under section 35AC

a Amount, if any, debited to profit and loss account 29a

b Amount allowable as deduction

c Excess amount allowable as deduction (29b- 29a)

30 Any other amount allowable as deduction 31 Total (25 + 26 + 27+28 +29 +30)

32 Income (13 + 24-31)

33 Profits and gains of business or profession deemed to be under -

i Section 44AD

ii Section 44AE

iii Section 44AF

Iv Section44B

v Section 44BB

vi Section 44BBA

vii Section44BBB

vill Section44D

ix Section 44DA

* Chapter -XII -G

xi First Schedule of Income - tax Act xii Total (331 to 33xl)

34 Profit or loss before deduction under section 10A/ 10AA (32 + 33xii)

35 Deductions under section-

1 10A ( e ofSchedule- 10A)

ü 10AA (e ofSchedule-10AA)

iii Total (351+ 35ii)

ಕರ್ನಾಟಕ ರಾಜ್ಯಪತ್ರ, ಗುರುವಾರ , ಡಿಸೆಂಬರ್ ೧೨ , ೨೦೧೩

29b

29c

331

33ii

33lv

33v

33vi

33vil

viil

33x

33 x

33xi

351

35ii

35iii

36 Net profit or loss from business or profession other than speculative business ( 34-35lii )

37Net Profit or loss from business or profession ( same as above in 36 except in case of specified A37 business, after applying rule 7A, 7B or 7C) B Computation of income from speculative business 38 Net profit or loss from speculative business as per profit or loss account

39 Additions in accordance with section 28 to 44DA 40 Deductions in accordance with section 28 to 44DA 41 Profit or loss from speculative business (38+39-40) C Computation of income from specified business 42 Net profit or loss from specified business as per profit or loss account

43 Additions in accordance with section 28 to 44DA

B41

44 Deductions in accordance with section 28 to 44DA (other than deduction u/s 35AD)

45 Profit or loss from specified business (42+43-44) 46 Deductions in accordance with section 35AD 47 Profit or loss from specified business (45-46) D Income chargeable under the head ' Profits and gains' ( A37+B41+C47)

NOTE►

C47

Please include the income of the specified persons referred to in Schedule SPI while computing the income under this head

Schedule DPM

Depreciation on Plant and Machinery 1 Block of assets

15 2Rate(%)

(i) ANDMACHINERY DEPRECIATIONONPLANT

3 Written down value on the first day of previous year

4 Additions for a period of 180 days or more in the previous year

Plantand machinery

80 40

100

(v)

(iii)

(ii)

(iv)

(vi) (vii) ಭಾಗ ೪ ಕರ್ನಾಟಕ ರಾಜ್ಯಪತ್ರ, ಗುರುವಾರ , ಡಿಸೆಂಬರ್ ೧೨ , ೨೦೧೩

5 Consideration or other realization during the previous year out of 3 or 4

6 Amount on which depreciation at full rate to be allowed (3 + 4-5) (enter 0, if result is negative)

7 Additions for a period of less than 180 days in the previous year

8 Consideration or other realizations during the year out of 7

9 Amount on which depreciation at half rate to be allowed (7-8) (enter 0, if result is negative)

10 Depreciation on 6 at full rate

11 Depreciation on 9 at half rate

12Additional depreciation, if any, on 4

13 Additional depreciation, if any, on 7

14 Total depreciation ( 10+ 11 + 12+13)

15 Expenditure incurred in connection with transfer of asset/ assets

16 Capital gains / loss under section 50 (5+ 8-3-4-7-15) ( enter negative only if block ceases to exist)

17 Written down value on the last day of previous year (6+ 9-14) (enter 0 if result isnegative)

Schedule DOA

Depreciation on other assets

1 Block of assets

Building

Ships

InIntangible assets

Furniture and Fittings

100

2 Rate (%)

(ii)

(iii)

10 (iv)

(v)

(vi) 3 Written down value on the first day of previous year

4 Additions for a period of 180 days or more in the previous year

5 Consideration or other realization during the previous year out of 3 or 4

6 Amount on which depreciation at full rate to be allowed (3 + 4-5) (enter 0, if result isnegative)

7 Additions for a period of less than 180 days in the previous year

8 Consideration or other realizations during the year out of 7

9 Amount on which depreciation at half rate to be allowed (7-8) (enter 0, if

DEPRECIATIONONOTHERASSETS

result is negative) 10 Depreciation on 6 at full rate

11 Depreciation on 9 at half rate

12 Additional depreciation, if any, on 4

13 Additional depreciation, if any, on 7

14 Total depreciation (10+ 11 + 12+13)

15 Expenditure incurred in connection with transfer of asset/ assets

16 Capital gains/ loss under section 50 (5+ 8-3-4-7-15) (enter negative only if block ceases to exist)

17 Written down value on the last day of previous year (6+ 9-14) (enter 0 if result isnegative) 352 ಭಾಗ ೪

ಕರ್ನಾಟಕ ರಾಜ್ಯಪತ್ರ, ಗುರುವಾರ , ಡಿಸೆಂಬರ್ ೧೨ , ೨೦೧೩

Schedule DEP

Summary of depreciation on assets

1 Plant and machinery

a Block entitled for depreciation @ 15 per cent (Schedule DPM - 141)

b Block entitled for depreciation @ 30 per cent (Schedule DPM - 14 ii)

c Block entitled for depreciation @ 40 per cent (Schedule DPM - 14 ⅲ)

d Block entitled for depreciation @ 50 per cent (Schedule DPM - 14 iv)

e Block entitled for depreciation @ 60 per cent (Schedule DPM - 14 v)

f Block entitled for depreciation @ 80 per cent (Schedule DPM- 14 vi)

g Block entitled for depreciation @ 100 per cent (Schedule DPM - 14vii)

h Total depreciation on plant and machinery ( la + 1b + 1c + 1d+ le + 1f + 1g )

2Building

a Block entitled for depreciation @ 5 per cent (Schedule DOA- 14i)

SUMMARYOFDEPRECIATIONONASSETS

b Block entitled for depreciation @ 10 per cent (Schedule 2b DOA- 14ii)

c Block entitled for depreciation @ 100 per cent (Schedule DOA - 14ii)

d Total depreciation on building (total of 2a + 2b + 2c)

3 Furniture and fittings (Schedule DOA- 14 iv)

4 Intangible assets (Schedule DOA- 14 v)

5 Ships (Schedule DOA- 14 vi)

6 Total depreciation ( 1h+ 2d+3+4+5)

Schedule DCG

Deemed Capital Gains on sale of depreciable assets

1 Plant and machinery

a Block entitled for depreciation@ 15 per cent (Schedule DPM - 16i)

b Block entitled for depreciation@ 30 per cent (Schedule 1b DPM- 16ii)

c Block entitled for depreciation @ 40 per cent(Schedule 1c DPM - 16 )

d Block entitled for depreciation @ 50 per cent (Schedule DPM - 16iv)

e Block entitled for depreciation @ 60 per cent (Schedule DPM - 16v)

f Block entitled for depreciation @ 80 per cent (Schedule 11 DPM - 16vi)

g Block entitled for depreciation @ 100 per cent (Schedule DPM - 16vii)

h Total( la +1b + 1c + 1d + le + 1f + 1g)

2Building

DEEMEDCAPITALGAINS

a Block entitled for depreciation @ 5 per cent (Schedule DOA- 16i)

b Block entitled for depreciation @ 10 per cent (Schedule 2b

DOA- 16ii)

c Block entitled for depreciation@ 100 per cent (Schedule DOA- 16 )

d Total ( 2a + 2b + 2c)

3 Furniture and fittings ( Schedule DOA- 16iv)

4 Intangible assets (Schedule DOA- 16v)

5 Ships (Schedule DOA- 16vi)

6 Total ( 1h+2d+3+4+5) ಭಾಗ ೪ ಕರ್ನಾಟಕ ರಾಜ್ಯಪತ್ರ, ಗುರುವಾರ , ಡಿಸೆಂಬರ್ ೧೨ , ೨೦೧೩

Schedule ESR

Deduction under section 35

No.

Amount of deduction in excess of the amount debited to profit and loss account

Amount of deduction allowable (3)

Expenditure of the nature referred to in section (1)

Amount , if any , debited to profit and loss account (2)

(4) -(3) -(2) 35(1) (i)

35(1) (ii)

35(1)( iii)

35(1)( iv)

35(2AA)

DEDUCTION UNDERSECTION35

35(2AB)

vii

total

Schedule CG

Capital Gains

A Short-term capital gain

1 From slump sale

a Full value of consideration

b Net worth of the under taking or division

c Short term capital gains from slump sale

d Deduction under sections 54B/54D

e Net short term capital gains from slump sale (1c - 1d)

2In case of NON- RESIDENT to which first proviso to section 48 is applicable

a From assets ( shares/ units) where section 111A is applicable ( STT pald)

b From assets where section 111A is not applicable

3 From assets (shares /units ) in the case of others where section 111A is applicable ( STT paid)

a Full value of consideration

b Deductions under section48

Cost ofacquisition

bil

Π Cost of Improvement

iii Expenditure on transfer

Iv Total ( i + ii + iii)

biv

c Balance (3a - blv)

d Loss, ifany, to be ignored under section 94(7) or 3d 94(8) (Enter positive value only)

A3e

e Short-term capital gain ( 3c +3d)

4 From assets in case of others where section 111A is not applicable

a Full value of consideration

b Deductions under section 48

Cost of acquisition

bii

i Cost of Improvement

iii Expenditure on transfer

biv

iv Total (i + ii + iii)

c Balance (4a - biv)

d Loss, ifany, to be ignored under section 94(7) or 4d 94(8) (Enterpositive value only)

e Deduction under section 54B/ 54D

f Short-term capital gain (4c + 4d - 4e)

5Deemed short term capital gain on depreciable assets (6 of Schedule - DCG)

6 Amount deemed to be short term capital gains under sections 54B/540/54G/ 54GA

7 Total short term capital gain ( 1e + 2a + 2b + A3e + 4f + A5 + A6)

B Long term capital gain

1 From slump sale

a Full value of consideration

b Net worth of the under taking or division

c Long term capital gains from slump sale

d Deduction under sections

54/54B/540/54EC/ 54F/ 54G /54GA/ 54GB

CAPITALGAINS

e Net long term capital gain from slump sale ( 1c - 1d)

2 From asset in case of non - resident to which first proviso to section 48 is applicable ಭಾಗ ೪

ಕರ್ನಾಟಕ ರಾಜ್ಯಪತ್ರ, ಗುರುವಾರ , ಡಿಸೆಂಬರ್ ೧೨ , ೨೦೧೩

3 From asset in the case of others where proviso under section 112(1) is not applicable

a Full value of consideration

b Deductions under section 48

1 Cost of acquisition after indexation

bii

ii Cost of improvement after indexation

bill

iii Expenditure on transfer

biv

iv Total (bi + bii +biii)

c Balance (3a - blv)

d Deduction under sections 54/54B/54D /54EC /54F 3d 54G/54GA/54GB

B3e

e Net balance (3c -3d)

4 From asset where proviso under section 112 ( 1) is applicable (without indexation)

aFull value of consideration

b Deductions under section 48

i Cost of acquisition without indexation

biü

ii Cost of improvement without indexation

iii Expenditure on transfer

biy

iv Total (bi + bii +biii)

c Balance(4a-bív)

d Deduction under sections 54/ 54B/ 54D /54EC/54F /54GB 4d

B4e

e Net balance (4c-4d)

5 From unlisted securities in case of non-resident as per section 112(1)(c) (iii)

6 Amount deemed to be long term capital gains under sections 54/54B/54D /54EC /54F/54GB B6

7 Total long term capital gain (le + 2 + B3e + B4e + B5 + B6)

8 In case ofdeduction u/s 54GB, furnish PAN of the company

C Income chargeable under the head " CAPITAL GAINS " (A7 + B7) (enter B6 as nil, ifloss)

D Information about accrual/receipt of capital gain

Date

Upto15/9

16/12 to 15/3 (i)

16/3 to31/3 (iv)

16/9 to 15/12 (H)

1 Long- term [where proviso under section 112(1) is applicable (Without Indexation ) + non- residents as per section 112(1)(c) (iii) ] - Tax Rate is 10% ; Enteronlypositive valuefrom Item B4e+B5 ofSchedule CG AFTER loss adjustment under this category in

Schedule CYLA and BFLA, if any.

2 Long- term where proviso under section 112 (1 ) is NOT applicable ( With Indexation)- TaxRate is 20%;

Enteronlypositive value from Item (B7-B4e - B5) of

Schedule CG AFTER loss adjustment under this category

in Schedule CYLA and BFLA, if any.

3 Short-term under 111A-

TaxRate is 15% ; Enter onlypositive valuefrom Item A2a +A3e ofSchedule CGAFTER loss adjustment under this category in Schedule CYLA and BFLA, ifany.

4 Short-term OTHERS-

Taxed at normal rates; Enter onlypositive value from Item (A7 -A2a - A3e) of Schedule CG AFTER loss adjustment under this category inSchedule CYLA and BFLA, if any.

NOTE► Please include the income of the specified persons referred to in Schedule SPI while computing the income underthis head

Schedule OS

Income from other sources

1 Income

a Dividends, Gross

b Interest, Gross

c Rental income from machinery , plants, buildings , etc. le

Others, Gross (excluding incomefrom owning race d horses)Mention the source

OTHERSOURCES

1di

1dli

1diil ಭಾಗ ೪ ಕರ್ನಾಟಕ ರಾಜ್ಯಪತ್ರ, ಗುರುವಾರ , ಡಿಸೆಂಬರ್ ೧೨ , ೨೦೧೩

Total (1di + 1dii + 1diii)

e Total (1a + 1b + 1c +1d)

f Deductions under section 57:-

i Expenses / Deductions

fii

ii Depreciation

frii

iii Total

gBalance(le- fiii)

2 Winnings from lotteries , crossword puzzles , races , games, gambling, betting etc. (Gross)

3 Income from other sources (other than from owning race horses) (1g + 2) ( enterlg as nil, if loss)

4 Income from owning and maintaining race horses

a Receipts

b Deductions under section 57 in relation to (4)

c Balance (4a - 4b)

5 Income chargeable under the head " Income from other sources " (3 + 4c) (enter 4c as nil if loss and take4c loss figure to Schedule CFL)

NOTE► Please include the income of the specified persons referred to in Schedule SPI while computing the income under this head.

Schedule CYLA

Details of Income after set- off of current years losses

Current year's SI.No Head/ Source of Income

Houseproperty loss of the current year set off

Income remaining after set off Income of current year (Fill this column only if income is zero or positive)

Business Loss (other than speculation loss) of the current year set off Total loss

(A37 of Schedule -BP)

Total loss (4c of Schedule -HP)

Other sources loss ( other than loss from owning racehorses) of the current year set off Total loss (1g of Schedule-OS)

5-1-2-3-4 Loss to be adjusted ->

i Salaries

ii House property

ili Business Income (excluding speculation profit and income from specifled business)

iv Speculative Income

Specified Business Income

vi Short-term capital gain

CURRENTYEARLOSSADJUSTMENT

vii Long term capital gain

viii Other sources (excluding profit from owning race horses and winnings from Lottery)

ix Profit from owning and maintaining race horses

Total loss set off

xi Loss remaining after set- off

Schedule BFLA Details of Income after Set off of Brought Forward Losses of earlier years

Head/ Source of Income

SL No.

Brought forward loss setoff

Brought forward depreciation set off

Brought forward allowance under section 35(4) set off

Currentyear's income remaining after setoff Income after set off, if any, of current year's losses as per 5 of Schedule CYLA)

5 1 Salaries

ii House property

BROUGHTFORWARDLOSS ADJUSTMENT

iil Business Income (excluding speculation profit and income from specified business )

iv Speculative Income ಭಾಗ ೪

ಕರ್ನಾಟಕ ರಾಜ್ಯಪತ್ರ, ಗುರುವಾರ , ಡಿಸೆಂಬರ್ ೧೨ , ೨೦೧೩

v Specified Business Income

vi Short-term capital gain

vii Long-term capital gain

vili Other sources (excluding profit from owning race horses)

ix Profit from owning and maintaining racehorses

x Total ofbrought forward loss set off

xi Current year's income remaining after set off Total ( i5 + ii5 + iii5 + iv5+v5+vi5 +vii5+ viii5+ix5)

Schedule CFL

Details ofLosses to be carried forward to future years

Assessment Year

SL No.

Short -term capital loss

Long-term Capital loss

House property loss

Loss from specified business

Dateof Filing (DD/MM/Y

Other sources loss(from owning race horses)

Loss from business other than loss from speculative business including unabsorbed depreciation allowance u/s 35(4 )

Loss from speculative business including unabsorbed depreciation allowance u/s 35(4)

i 2005-06

11 2006-07

1il 2007-08

iv 2008-09

▼ 2009-10

vi 2010-11

vii 2011-12

CARRYFORWARDOFLOSS

viii 2012-13

ix Total ofearlier year losses

x Adjustment of above losses in Schedule BFLA ( see instruction)

xi 2013-14 (Current year losses)

xil Total loss Carried Forward to future years

Schedule UD

Unabsorbed depreciation

Assessment Year (2)

SI No (1)

Balance Carried forward to the next year (5)

Amount ofbrought forward

unabsorbed depreciation

(3)

Amount of depreciation set -off against the current year income (4)

i Current Assessment Year

iii

UNABSORBEDDEPRECIATION

Total

vii

Deduction under section 10A

Schedule 10A

Deduction in respect of units located in Special Economic Zone

a Undertaking No.1

10A b Undertaking No.2

DEDUCTIONU/S

c Undertaking No.3

d Undertaking No.4

e Total deduction under section 10A (a + b + c+d) ಭಾಗ ೪ ಕರ್ನಾಟಕ ರಾಜ್ಯಪತ್ರ, ಗುರುವಾರ , ಡಿಸೆಂಬರ್ ೧೨ , ೨೦೧೩

Schedule 10AA

Deduction under section 10AA Deductions in respect of units located in Special Economic Zone

a Undertaking No.1

b Undertaking No.2

10AA

DEDUCTIONU/S

e Undertaking No.3

d Undertaking No.4

e Total (a + b + c + d)

Details ofdonations entitled for deduction under section 80G

Schedule 80G

A Donations entitled for 100% deduction without qualifying limit

PAN ofDonee

Amount of donation

Name and address of donee

Eligible Amount of donation

▼

vi Total

Donations entitled for 50% deduction without qualifying limit

PAN of Donee

Amount of donation

Name and address of donee

Eligible Amount of donation i

vi Total

Donations entitled for 100 % deduction subject to C qualifying limit

PAN of Donee

Amount of donation

Name and address of donee

DETAILSOFDONATIONS

Eligible Amount of donation ii

vi Total

D Donations entitled for 50 % deduction subject to qualifying limit

Amount of donation

Name and address of donee

PAN of Donee

Eligible Amount of donation i

iii

vi Total

E Total eligible amount of donations (Avi + Bvi + Cvi + Dvi)

Schedule 80- IA

Deductions under section 80- IA

Deduction in respect of profits of an enterprise referred to a insection 80- LA(4)(i) [Infrastructure facility]

b Deduction in respect of profits of an undertaking referred b to in section 80-IA(4)(ii) (Telecommunication services]

DEDUCTIONS U/S80-LA

e Deduction in respect of profits of an undertaking referred to in section80-LA(4) (iii) [Industrial park and SEZs] ಭಾಗ ೪

ಕರ್ನಾಟಕ ರಾಜ್ಯಪತ್ರ, ಗುರುವಾರ , ಡಿಸೆಂಬರ್ ೧೨ , ೨೦೧೩

d Deduction in respect of profits of an undertaking referred d to in section 80 - IA (4) (iv) [Power]

e Deduction in respect of profits of an undertaking referred e to in section 80 - IA(4)(v) [Revival ofpower generating plant] and deduction in respect of profits of an undertaking referred to in section 80-IA(4)(vi ) [Cross-country natural gas distribution network]

f Total deductions under section 80 - IA ( a + b + c + d + e)

Schedule 80- IB

Deductions under section 80- IB

a Deduction in respect of industrial undertaking referred to a in section 80- IB (3 ) [Small-scale industry]

b Deduction in respect of industrial undertaking located in Jammu & Kashmir [Section 80- IB(4)]

e Deduction in respect of industrial undertaking located in industrially backward states specified in Eighth Schedule [Section 80-IB(4)]

d Deduction in respect of industrial undertaking located in industrially backward districts [ Section 80 - IB (5 )

e Deduction in the case of multiplex theatre [Section 80- IB(7A) ]

f Deduction in the case of convention centre [ Section 80- IB(7B)]

g Deduction in the case of company carrying on scientific research [ Section 80 -IB(8A) ]

Deduction in the case of undertaking which begins commercial production or refining of mineral oil [Section 80-IB(9)]

DEDUCTIONSU/S80-IB

i Deduction in the case of an undertaking developing and building housing projects [ Section 80 -IB( 10) ]

j Deduction in the case of an undertaking operating a cold chain facility [ Section 80- IB( 11)]

k Deduction in the case of an undertaking engaged in processing, preservation and packaging of fruits and vegetables [Section 80- IB ( 11A) ]

1 Deduction in the case of an undertaking engaged in integrated business of handling , storage and transportation of foodgrains [ Section 80 - IB (11A) ]

m Deduction in the case of an undertaking engaged in operating and maintaining a rural hospital [ Section 80- IB(11B)]

Deduction in the case of an undertaking engaged in operating and maintaining a hospital in any area, other than excluded area [ Section 80 - IB (11C)

Total deduction under section 80- IB (Total of a to n)

Schedule 80 - IC or 80 - IE

Deductions under section 80- IC or 80- IE

1 Deduction in respect of industrial undertaking located in Sikkim

2 Deduction in respect of industrial undertaking located in Himachal Pradesh

3 Deduction in respect of industrial undertaking located in Uttaranchal

4 Deduction in respect of industrial undertaking located in North -East

a Assam

b Arunachal Pradesh

c Manipur

d Mizoram

DEDUCTIONSU/S80-IC/IE

e Meghalaya

f Nagaland

g Tripura

h Total ofdeduction for undertakings located in North-east (Total of 5a to 5g)

5 Total deduction under section 80- IC or 80- IE (1 + 2 + 3 + 4h) ಭಾಗ ೪ ಕರ್ನಾಟಕ ರಾಜ್ಯಪತ್ರ, ಗುರುವಾರ , ಡಿಸೆಂಬರ್ ೧೨ , ೨೦೧೩

Schedule VI -A

Deductions under Chapter VI -A (Section)

a 80C

180- IA (fofSchedule 80 -LA)

b 80CCC

m80- LAB

n80- IB (o ofSchedule 80-IB

c(i) 80CCD (1) ( assessees contribution)

80- IC/ 80- IE (5 of Schedule

80-IC/80-IE)

c (ii) 80CCD(2) (employers contribution)

d 80CCG

p 80-ID

e 80D

q 80JJA

f 80DD

r 80QQB

$ 80RRB

g 80DDB

TOTALDEDUCTIONS

h 80E

t80TTA

u 80U

180G

j 80GG

k 80GGC

v Total deductions under Chapter VI- A (Total of a to u)

Schedule AMT

Computation of Alternate Minimum Tax payable under section 115JC

1 Total Income as per item 13 of PART-B - TI

2 Adjustment as per section 115JC(2)

a Deduction Claimed under any section included in Chapter VI -A under the heading " C.-Deductions in respect of certain incomes "

b Deduction Claimed u/s 10AA

C Total Adjustment (2a+ 2b)

3 Adjusted Total Income under section 115JC(1 ) (1 +2c)

4 Tax payable under section 115JC [ 18.5% of (3 ) ] ( if 3 is greater than Rs . 20 lakhs)

Schedule AMTC

Computation of tax credit under section 115JD

1 Tax under section 115JC in assessment year 2013-14 ( 1c of Part-B - TTI)

2 Tax under other provisions of the Act in assessment year 2013-14 (4 of Part-B- TTI)

3 Amount of tax against which credit is available [ enter (2-1) if 2 is greater than 1, otherwise 3

enter01

4 Utilisation of AMT credit Available (Sum of AMT credit utilized during the current year is subject to maximum of amount mentioned in 3 above and cannot exceed the sum of AMT Credit Brought Forward)

AMT Credit

S. No

Assessment Year (A)

Balance AMT Credit Carried Forward (D)= (B3) -(C)

Gross (B1)

AMT Credit Utilised during the Current Year (C)

Balance brought

forward

(B3) = (B1) - (B2)

Set-off in earlier years (B2)

CurrentAY (enter 1-2, if 1>2 else enter 0) Total

5 Amount of tax credit under section 115JD utilised during the year [ total of item no 4 (C) ]

6 Amount ofAMT liability available for credit in subsequent assessment years [ total of 4 (D) ]

Schedule Income of specified persons ( spouse , minor child etc) includable in income of the assessee ( income of the minor child, in excess of SPI

Rs. 1,500 per child, to be included)

SINo

Nature of Income

Amount (Rs) Name of persоп

Relationship

PAN of person(optional)

3 ಭಾಗ ೪

ಕರ್ನಾಟಕ ರಾಜ್ಯಪತ್ರ, ಗುರುವಾರ , ಡಿಸೆಂಬರ್ ೧೨ , ೨೦೧೩

Schedule SI

Income chargeable to tax at special rates (please see instructions No. 9(ll) for rate oftax)

Section

SI No

Tax thereon (ii)

Special rate (%)

Income (1

1 111A (STCG on shares where STT paid)

2 112 proviso (LTCG on listed securities / units without indexation)

3 112 (LTCG on others)

4 112(1)(c) (iii ) (LTCG on unlisted securities in case of non - residents )

5 115BB (Winnings from lotteries , puzzles , races , games etc.)

SPECIALRATE

Total

Schedule IF Information regarding partnership firms in which you are partner

Detail of firms in which you are partner

Amount of share intheprofit

Capital balance on 31March in the firm

PAN of the firm

Nameof the Firm

Percentage Share in the profit ofthe firm

123

FIRMSINWHICHPARTNER

Total

Schedule EI

Details of Exempt Income (Income not to be included in Total Income)

1 Interest income

2 Dividend Income

3 Long-term capital gains on which Securities Transaction Tax is paid

4 Net Agricultural income (other than income to be excluded under rule 7 , 7A, 7B or 8)

EXEMPTINCOME

5 Share in the income of firm/AOP /BOI etc.

6 Others, including exempt income of minor child

7 Total (1+2+3+4+5+6)

Schedule IT

Details of payments of Advance Tax and Self-Assessment Tax

SI No

BSR Code

Serial Number of Challan

Amount(Rs)

DateofDeposit (DD/MM/YYYY)

TAXPAYMENTS

NOTE Enter the totals ofAdvance tax and Self-Assessment tax in Sl No. 12a & 12d ofPartB-TTI ಕರ್ನಾಟಕ ರಾಜ್ಯಪತ್ರ, ಗುರುವಾರ , ಡಿಸೆಂಬರ್ ೧೨ , ೨೦೧೩

Schedule TDS1

ಭಾಗ ೪

Details of Tax Deducted at Source from Salary [As per Form 16 issued by Employer( s)]

Name of the Employer No

SI TaxDeduction Account Number (TAN) of the Employer

(1)

(2)

(3) if

TDSON ONSALARY

Schedule TDS2

Total tax deducted Income chargeable under Salaries

(5)

(4)

Details of Tax Deducted at Source on Income [As per Form 16 A issued by Deductor(s) ]

Name of the Deductor Unique TDS Certificate Number TaxDeduction No Account Number (TAN) ofthe Deductor

(3)

(4) (2)

iii

TDSDSONOTHERINCOME

Total Tax Deducted Amount out of (6) claimed this Year

Financial Year in which TDS is Deducted

(7) (5)

(6)

Please enter total of column 5of Schedule- TDS1 and column 7 of Schedule-TDS2 in 12b ofPartB-TTI

NOTE

Schedule TCS

Details of Tax Collected at Source [ As per Form 27D issued by the Collector(s ) ]

Name of the Collector No

SI Tax Deduction and Tax Collection Account Number of the Collector

(1)

(2)

(3)

TCSONINCOME

NOTE Enter the total of column (5) in Sl No. 12c ofPartB-TTI Schedule FSI

Details of Income accruing or arising outside India

1 Details of Income included in Total Income in Part -B - TI above Country Code

Taxpayer Identification Number

Income from Salary (included in PART B-TI) (A)

Total tax collected

Amount out of (4) claimed during the year

(4)

(5)

Total Income from Outside India ( F) =A + B+C + D+E

Income from

HouseProperty

(included in

PART B - TI)

(B)

Total

2 Total Income from outside India (Total of F as per item no.1 above)

3 Total Income from outside India where DTAA is applicable INCOMEACCRUINGORARISINGOUTSIDEINDIA

4 Total Income from outside India where DTAA is not applicable (2-3 )

Please refer to the instructions forfilling out this schedule.

NOTE

Business Income (included in PART B- TI) (C)

CapitalGain Income (included in PART B -TI) (D)

Other source Income (included in PART B - TI) (E)

4 ಭಾಗ ೪

ಕರ್ನಾಟಕ ರಾಜ್ಯಪತ್ರ, ಗುರುವಾರ , ಡಿಸೆಂಬರ್ ೧೨ , ೨೦೧೩

Schedule TR

Details of Taxes Paid outside India

1 Details of Taxes Paid outside India

Country Code

Tax Relief Claimed (B)

Relevant articleof DTAA

Taxpayer Identificati on Number

Total taxes paid on

income declared in

Schedule FSI

(A)

Relief claimed u/s 90/90A (B1)

Relief claimed u/s 91 (B2) TaxesPaidoutsideIndia

Total

2 Total Taxes paid outside India (Total of 1A)

3 Total Taxes Paid outside India where DTAA is applicable

4 Total Taxes Paid outside India where DTAA is not applicable (2-3 )

NOTE Please refer to the instructions for filling out this schedule.

Schedule FA

Details of ForeignAssets

A Details of Foreign Bank Accounts

Account Number

Name and Address of Name mentioned in

PeakBalance During the Year CountryName CountryCode

S1 No (1)

(2)

(3)

the account (5)

(6)

(in rupees) (7)

theBank (4)

B Details of Financial Interest in any Entity

S1 No

Country Code (2)

Country Name (1)

Nature of entity

(3)

Total Investment (at cost) (in rupees) (5)

Name and Address oftheEntity (4)

C Details of Immovable Property

Country Name (2)

Country Code (3)

Address oftheProperty

(4)

Total Investment (at cost) (in rupees) (5)

S1 No (1)

D Details of any other Asset in the nature of Investment

Nature ofAsset

(4)

Country Name (2)

Country Code (3)

Total Investment (at cost) (in rupees) (5)

S1 No (1)

DETAILSOFFOREIGNASSETS

E Details of account( s ) in which you have signing authority and which has not been included in A to D above .

Account Number (5)

S1 No (1)

Name of the Institution in which the account is held (2)

Name ofthe

account holder

(4)

Peak Balance/Investment during the year(in rupees) (6

Address of the Institution (3)

F Details of trusts , created under the laws of a country outside India , in which you are a trustee

Name and address of

Name and address of the trust

S1 Country Name (2)

Country Code (3)

Settlor (6)

Name and address of Beneficiaries (7)

Name and address of other trustees (5)

(4)

No (1) ಭಾಗ ೪ ಕರ್ನಾಟಕ ರಾಜ್ಯಪತ್ರ, ಗುರುವಾರ , ಡಿಸೆಂಬರ್ ೧೨ , ೨೦೧೩

Schedule 5A

Information regarding apportionment of income between spouses governed by Portuguese Civil Code Name of the spouse

PAN of the spouse

Heads of Income

Amount apportioned in the hands of the spouse 1House Property

2Business or profession

3 Capital gains

4 Other sources

5Total

Asset and Liability at the end of the year ( other than those included in Part A -BS) ( Applicable in a case where Schedule AL

total income exceeds Rs . 25 lakh)

Particulars of Asset

Amount (Cost) (Rs .) 1 Immovable Asset

a Land

b Building

2Movable Asset

a Financial Asset

i Bank ( including all deposits)

ii Shares and securities

iii Insurance policies

iv Loans andAdvances given

v Cash in hand

DETAILSOFASSETANDLIABILITY

b Jewellery, bullion etc.

c Archaeological collections , drawings, painting , sculpture or any work of art

d Vehicles, yachts , boats and aircrafts

Total

Liability in relation to Assets at A ಭಾಗ ೪

ಕರ್ನಾಟಕ ರಾಜ್ಯಪತ್ರ, ಗುರುವಾರ , ಡಿಸೆಂಬರ್ ೧೨ , ೨೦೧೩

2013-14 ITR -4S , PAGE 1 ITR - 4S SUGAM PRESUMPTIVE BUSINESS INCOME TAX RETURN AY 2013-14 A1 FIRST NAME

A2 MIDDLE NAME

A3 LASTNAME

AA PERMANENT ACCOUNT NUMBER

AZ INCOME TAX WARD /CIRCLE

A5 SEX

A6 DATE OF BIRTH

O Male Female D

ADROAD /STREET

AB FLAT/DOOR/BUILDING

A11 TOWN/CITY/DISTRICT

A1D AREA/LOCALITY

A12 STATE & COUNTRY

A13 PINCODE

A14 STATUS Individual▸ HUF A15 EMAIL ADDRESS

A16 MOBILE NO.1 /RESIDENTIAL/OFFICE PHONE NO.WITH STD CODE A17 MOBILE NO.2

A1B Fill only one If you belong to

Others

Government PSU A19 Fill only one Tax Refundable Tax Payable Nil Tax Balance A20 Fill only one Resident Non Resident Resident but not ordinarily resident A21 Fill only one: filed Before due date-139(1 ) After due date - 139 (4) Revised Return -139( 5) OR In response to notice 142( 1 ) 148

139 (9 )

153A/ 153C A22Whether Person governed by Portugese Civil Code under section 5A▸

and ►

A23If revised/ Defective ►

Receipt Number of Original Retum

Dateof Filing Original Return PART B - GROSS TOTAL INCOME

Whole-Rupee( ) only.

B1 Income from Business

NOTE Enter value from E6 of Schedule BP

B2 Income from Salary/Pension

NOTES Ensure to fill " Sch TDS1 " given In Page 3

▼If showing loss , mark the negative sign in bracket at left B3 Income from One House Property Self Occupied ▸ Let out B3 ( )

B4 Income from other sources

B4 ( )

NOTE Ensure to fill " Sch TDS2" given In Page 3 Gross Total Income (B1 + B2 + B3 + B4)

( )

PART C - DEDUCTIONS AND TAXABLE TOTAL INCOMERefer Is Instructices for Limits on Amount of Deductions as per " Income Tax Act") C1 80C

C2 80CCC

C3 80CCD( 1)

C5 80CCG

C6 80D

C4 80CCD(2)

C8 80DDB

to C7 BODD

C9 BOE

C11 80GG

C12 80GGC

C10 80G

C16

C14 8000B

C15 80TTA

C13 BORRB

C16 80U

FOR OFFICIAL USE ONLY

STAMP RECEIPT NO . HERE

SEAL , DATE AND SIGNATURE OF RECEIVING OFFICIAL ಭಾಗ ೪ ಕರ್ನಾಟಕ ರಾಜ್ಯಪತ್ರ, ಗುರುವಾರ , ಡಿಸೆಂಬರ್ ೧೨ , ೨೦೧೩

PERMANENT ACCOUNT NUMBER

2013-14 ITR -4S , PAGE 2

C17

C17 Total Deductions ( Add items C1 to C16)

C18 Taxable Total Income ( B5 - C17)

C18(

PART D-TAX COMPUTATION AND TAX STATUS

TOTAL TAX AND CESS ( D1 + D2 ) Tax Payable On Total Income( 618) / Secondary & Higher Education Cess

D1 to D3 D1

Total Interest u/ s 234A

Relief u/s 89

Balance Tax After Rellef (D3-04)

D4 10 D6 D4

D7 Total Interest u/ s 234B

Total Interest u/ s 234C

Total Tax And Interest ( D5 + D6 + 07 + D8 )

to D9 D7

D10 Total Advance Tax Paid

Total TDS Claimed

Total Self Assessment Tax Paid

D12D10

D11

D12

D13 Total TCS Collected

Total Prepaid Taxes ( D10 + D11 + D12 + D13 )Total Payable( D9 - D14,If D9> D14) to

D15D13

D15

D14

Refund ( D14 -D9,If D14 >D9)

D16 D16

BankAccount Detalls ( Mandatory in all cases irrespective of refund due or not)

D17 ACCOUNTNo.

D18 Type of account : Current Savings D19 IFSC CODE

D20 FIll only one: Refund by cheque or deposited directly into your bank account D21 Exempt Income only for reporting purposes somet lacoms more than Rs.5000/- ( 4)

VERIFICATION

son/ daughter of

1, ► solemnly declare that to the best of my knowledge and belief, the information given in the retum 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 2013-14

Place►

DDMMYYYY

SIGN HERE →

If the return has been prepared by a Tax Return Preparer ( TRP) give further details as below

Name of the TRP

TRP PIN [ 10 Digit]

TRP Signatura

AmountAmount toto bebe paidpaid tot TRP

NATURE OF BUSINESS , if more than one business indicate the three main activities/ products S.No. Code

Name of the Business

Description

(1) ►

(ii ) ►

(iii) ►

SCHEDULE BP - DETAILS OF INCOME FROM BUSINESS

COMPUTATION OF PRESUMPTIVE INCOME UNDER 44AD

E1 Gross Turnover or Gross Receipts

E2 Total Presumptive Income under 44AD(8% of E1)

NOTE If Income is less than 8% of Gross Receipts ,It is mandatory to have a tax audit under 44AB & regular ITR 4 form has to be filled and not this form ಭಾಗ ೪

ಕರ್ನಾಟಕ ರಾಜ್ಯಪತ್ರ, ಗುರುವಾರ , ಡಿಸೆಂಬರ್ ೧೨ , ೨೦೧೩

PERMANENT ACCOUNT NUMBER

2013-14 ITR -4S , PAGE 3 COMPUTATION OF PRESUMPTIVE INCOME UNDER 44AE

E3 Presumptive Income from Heavy Vehicles E3

► E4

Presumptive Income from Other Vehicles

Total Presumptive Income under 44AE ( E3 + E4 )

NOTE If the profits are lower than prescribed under S44AE or the number of vehicles owned at any time exceed 10 then the regular ITR 4 form has to be filled and not thisform

E6 Income chargeable under Business ( E2+E5)

FINANCIAL PARTICULARS OF THE BUSINESS NOTE For Er to E10 furnish the Information as on 31st day of March , 2013

E7 Amount of Total Sundry Debtors

EB Amount of Total Sundry Creditors

E9 Amount of Total Stock - in -trade

E10

E10 Amount of the Cash Balance

Sch IT - DETAILS OF ADVANCE TAX AND SELF ASSESSMENT TAX PAYMENTS

TAX PAID( col.lv)

CHALLAN NO( col.III)

BSR CODE( col.i )

DATE OF DEPOSIT (col.ii)

DDMMY

NOTE (1) Enter the totals of Advance Tax and Self Assessment Tax In D10 and D11 (2) Continue In Supplementary Schedule IT If you cannot fill within Sch IT Sch TCS - DETAILS OF TAX COLLECTED AT SOURCE

TAX COLLECTED( col.III )

TAX COLLECTION ACCOUNT NO . ( col.i ) NAME OF THE COLLECTOR ( col.II)

AMOUNT IN ( III) CLAIMED THIS YEAR ( ) U1

NOTE (1 ) Enter the total of column ( lv) of Sch TCS In D13 (2) Continue in Supplementary Schedule TCS If you cannot fill within Sch TCS

Sch TDS1 - DETAILS OF TAX DEDUCTED AT SOURCE FROM SALARY[ As per Form 16 issuedby Employer(s) ] NAME OF THE EMPLOYER( col.ii )

TAN( col.i)

INCOME UNDER SALARY( col.iii ) TAX DEDUCTED( col.lv) S1

NOTE (1) Enter the total of column ( lv) of Sch TDS1 and column ( vl )of Sch TDS2 In D12 ( 2 ) Continue in Supplementary Schedule TDS1 If you cannot IIII within Sch TDS1 Sch TDS2- DETAILS OF TAX DEDUCTED AT SOURCE FROM INCOME OTHER THAN SALARY(As per Form 16A issued by Deductor( s) )

UNIQUE TDS CER . NO (col.iii)

ANIT OUT OF CLAIMED THIS YR (col ) NAME OF THE DEDUCTOR ( col.ii )

TAX DEDUCTED (cal.v)

TAN( col.i)

DEDUCTED YEAR ( col.lv)

NOTE (1 ) Entar the tolal of columa ( iv) of Sch TDS1 and column (vl ) of Sch TDS2 In D12 (2 ) Continue In Supplementary Schadula TDS2 If you cannot fill within Sch TD $2 L ಭಾಗ ೪ ಕರ್ನಾಟಕ ರಾಜ್ಯಪತ್ರ, ಗುರುವಾರ , ಡಿಸೆಂಬರ್ ೧೨ , ೨೦೧೩

PERMANENT ACCOUNT NUMBER

AY 2013-14 FIRST NAME

LAST NAME

MIDDLE NAME

SUPPLEMENTARY SCHEDULE TDS 1 (To be used only after exhausting items S1 - S3 of Schedule TDS1 in main form ote ) TAN ( col.l )

NAME OF THE EMPLOYER( col.ii )

INCOME UNDER SALARY( col.III) TAX DEDUCTED ( col.iv) $4

$10

$11

$12

$13

$14

$15

$16

$17

$18

$19

$20

$21

$22

$23

$24

$25

$26

$27

$28

$29

$30 ಭಾಗ ೪

ಕರ್ನಾಟಕ ರಾಜ್ಯಪತ್ರ, ಗುರುವಾರ , ಡಿಸೆಂಬರ್ ೧೨ , ೨೦೧೩

PERMANENT ACCOUNT NUMBER

AY 2013-14 FIRST NAME

LAST NAME

MIDDLE NAME

SUPPLEMENTARY SCHEDULE TDS 2 ( To be used only affør exhausting items T1 -T4 of Schedule TDS2 in main form ete ) TAN(col.1)

NAME OF THE DEDUCTOR ( col.II ) UNIQUE TDS CER . MO ( col.III) DEDUCTED YEAR( col.lv ) TAX DEDUCTED ( col.v)

ANT OUT OF ) CLAIMED THIS YR (c ) T5

T10

T11

T12

T13

T14

T15

T16

T17

T18

T19

T20

T21

T22

T23

T24

T25

T26

T27

T28

T29

T30

T31 ಭಾಗ ೪ ಕರ್ನಾಟಕ ರಾಜ್ಯಪತ್ರ, ಗುರುವಾರ , ಡಿಸೆಂಬರ್ ೧೨ , ೨೦೧೩

PERMANENT ACCOUNT NUMBER

AY 2013-14 FIRST NAME

LAST NAME

MIDDLE NAME

SUPPLEMENTARY SCHEDULE IT(To be used only after exhausting items R1 - R5 of Schedule IT in main form etc ) BSR CODE (col.I )

CHALLAN NO( col.III )

TAX PAID( col.lv)

DATE OF DEPOSIT( col.II )

DDMMYYYY

R10

R11

DDMMYYYY

R12

DDMMYYYY

R13

DDMMYYY

R14

D MYY

R15

R16

R17

R18

R19

R20

R21

R22

R23

R24

R25

R26

R27

DDMMYYYY

R28

DDMMYYYY

R29

DDMMYYYY

R30

DDMMYYYY

R31

DDMMYYYY

R32

DD YYY ಭಾಗ ೪

ಕರ್ನಾಟಕ ರಾಜ್ಯಪತ್ರ, ಗುರುವಾರ , ಡಿಸೆಂಬರ್ ೧೨ , ೨೦೧೩

PERMANENT ACCOUNT NUMBER

AY 2013-14 FIRST NAME

LAST NAME

MIDDLE NAME

SUPPLEMENTARY SCHEDULE TCS (To be used only after exhausting items U1 - U3 of Schedule TCS in main form ote )

TAX DEDUCTED ( col.III )

AMOUNT IN( III ) CLAIMED THIS YEAR ( iv) TAX COLLECTION ACCOUNT NO. ( col.1) NAME OF THE COLLECTOR ( col.II )

U10

U11

U12

U13

U14

015

U16

U17

U18

U19

U20

U21

U22▸

U23

U24

U25

U26

U27

U28

U29

U30 LOL

ಭಾಗ ೪

ಕರ್ನಾಟಕ ರಾಜ್ಯಪತ್ರ, ಗುರುವಾರ , ಡಿಸೆಂಬರ್ ೧೨ , ೨೦೧೩

ㄱ

ACKNOWLEDGEMENTAY 2013-14

return of income in

Receivedwith thanksfrom

ITR No. 1 SAHAJ ) 20 30 4S / SUGAM) 40 50 70 for assessment year 2013-14 , having the following particulars

A1 FIRST NAME

A2MIDDLENAME

A PERMANENT ACCOUNT NUMBER

A3 LAST NAME

AG DATE OF BIRTH

AS SEX

AZ INCOME TAXWARD/CIRCLE

Male Female DD

AS FLAT/DOOR/ BUILDING

AS ROAD/ STREET

A10 AREA/ LOCALITY

A11 TOWN/ C ISTRICT

A13 PIN

COUNTRY

A12STATE

A14Fill only one: filed Beforeduedate-139( 1 ) -1394) Revised t

COMPUTATION OF INCOME AND TAX RETURN Wh

B1 Gross Total Income

B1(

B2 Deductions under Chapter VI -A

B3 Total Income

B3(

B4 Current Loss if any

B4(

B5 Net Tax Payable

B6 Interest Payable

B7 Total Tax and Interest Payable

B8 Total Advance Tax Paid

B9 Total SelfAssessment Tax Paid

B10

B10 Total TDS Deducted

B11

B11 Total TCS Deducted

B12

B12 Total Prepaid Taxes ( B8 + B9 + B10 + B11 )

B13

313 Tax Payable ( B7 - B12 , If B7 > B12)

B14

B14 Refund( B12 - B7 , If B12 > B7 )

SIGN HERE

FOR OFFICIAL USE ONLY

→ STAMP RECEIPT NO. HERE

SEAL , DAE AND SIGNORE OF RECEIVING OFFICIAL

[Notification No. 34 /2013 / F.No . 142/5/2013- TPL ]

GAURAV KANAUJIA , Dy. Secy.

Note: The principal rules were published in the Gazette of India , Extraordinary , Part- II , Section 3. Sub- section ( ii) vide notification number S.O. 969(E ) , dated the 26th March , 1962 and last amended by income-tax (Second Amendment ) Rules , 2013 vide notification S.O. NO.410 ( E) dated 19 February , 2013 .

ಕರ್ನಾಟಕ ರಾಜ್ಯಪಾಲರ ಆಜ್ಞಾನುಸಾರ ಮತ್ತು ಅವರ ಹೆಸರಿನಲ್ಲಿ ,

ಸಹಾಯಕ ಪ್ರಾರೂಪಕಾರ ಮತ್ತು ಪದನಿಮಿತ್ತ ಸರ್ಕಾರದ ಉಪ ಕಾರ್ಯದರ್ಶಿ,

P.R. 88 SC- 20

ಸಂಸದೀಯ ವ್ಯವಹಾರಗಳು ಮತ್ತು ಶಾಸನ ರಚನೆ ಇಲಾಖೆ .

ಭಾಗ ೪

ಕರ್ನಾಟಕ ರಾಜ್ಯಪತ್ರ, ಗುರುವಾರ , ಡಿಸೆಂಬರ್ ೧೨ , ೨೦೧೩

ಸಂಸದೀಯ ವ್ಯವಹಾರಗಳು ಮತ್ತು ಶಾಸನ ರಚನೆ ಸಚಿವಾಲಯ

ಅಧಿಸೂಚನೆ

ಸಂಖ್ಯೆ: ಸಂವ್ಯಶಾಇ 82 ಕೇನಿಪ್ರ 2013 , ಬೆಂಗಳೂರು , ದಿನಾಂಕ : 19/23 ನೇ ಸೆಪ್ಟೆಂಬರ್ 2013 .

2013 ನೇ ಸಾಲಿನ 23-05-2013ನೇ ದಿನಾಂಕದ ಭಾರತ ಸರ್ಕಾರದ ಗೆಜೆಟ್‌ನ ವಿಶೇಷ ಸಂಚಿಕೆಯ ಭಾಗ- ಸೆಕ್ಷನ್ 3 (ii ) ರಲ್ಲಿ ಪ್ರಕಟವಾದ ಈ ಕೆಳಕಂಡ S.O. 1348 ( E ) ದಿನಾಂಕ 23-05-2013 ಅನ್ನು ಸಾರ್ವಜನಿಕರ ಮಾಹಿತಿಗಾಗಿ ಕರ್ನಾಟಕ ರಾಜ್ಯಪತ್ರದಲ್ಲಿ ಮರು ಪ್ರಕಟಿಸಲಾಗಿದೆ .

MINISTRY OF HEALTH AND FAMILY WELFARE (Department of Health and Family Welfare)

New Delhi , the 23rd May , 2013

NOTIFICATION

S.O. 1348 ( E ) . Whereas , on 15th May , 2010 , the Medical Council of India was superseded in exercise of the powers conferred by sub- section ( 1 ) of section 3A of the Indian Medical Council Act , 1956 (102 of 1956 ) ( hereinafter referred to as the said Act ) and the President, Vice- President and all other Members of the said Council vacated their offices ;

And whereas , on supersession of the Council , the Central Government constituted the Board of Governors vide notification of the Government of India , Ministry of Health and Family Welfare number S.O.1123 ( E) dated the 15th May, 2010 to perform the functions ofthe Council during the interregnum;

Andwhereas, the term of the Board of Governors had been extended to two years by the Indian Medical Council (Amendment) Act, 2011 ( 13 of 2011 ) and it was further extended upto three years by the Indian Medical Council ( Amendment ) Act , 2012 (20 of 2012) , with effect from the 15th May, 2010;

And whereas , the three year term of the Board of Governors had expired on the 14th May, 2013 and therefore, it has become necessary to go for reconstitution of the Board of Governors in accordance with the provisions of the Indian Medical Council (Amendment) Ordinance , 2013 (4 of 2013 ), which was promulgated by the President on the 21st May , 2013 , which came into force with effect from the 15th day of May 2013;

And whereas , section 3AA of the said Act , as inserted by the said Ordinance , requires the Central Government to reconstitute the Council under sub - section ( 1 ) of section 3 within a period of one hundred and eighty days with effect from the 15th day of May , 2013;

And whereas the proviso to section 3AA provides that the Board of Governors constituted under sub- section ( 4) of section 3A shall continue to exercise the powers and perform the functions of the Council till the new Council is reconstituted or for a period not exceeding one hundred and eighty days with effect from the 15th day of May, 2013 , whichever is earlier;

Now, therefore , in exercise of the powers conferred by sub- section ( 4) of section 3A of the said Act , the Central Government hereby reconstitutes the Board of Governors consisting of the following persons as its Chairperson and other Members , namely:-

(i) Dr. R.K. Srivastava , Former Director General of Health Service

Chairperson;

(!!)

Member;

Dr. K.S.Sharma , Director Academics ( TMC) and Professor Department of Anesthesiology, Critical Care & Pain , Tata Memorial Centre , Mumbai

Member;

(iii) Dr.K. Mohandas ,Vice -Chancellor , Kerala University of Health and Allied Sciences , Trissur

Member;

(iv)

(v)

Dr. Raja Babu Panwar , Vice - Chancellor , Rajasthan University of Health Sciences , Jaipur Dr. B. K. Rao , Chairman , Department of Critical

Member;

Careand Emergency Medicine , Sir Ganga Ram Hospital , New Delhi

(vi)

Member;

Dr.A. K. Bardhan , Medical Director, Dr. B. C. Roy Institute of Medical Science and Research , Indian Institute of Technology, Kharagpur

Member.

(vii) Dr.Manoj Singh , Professor of Pathology , All India Institute of Medical Sciences , New Delhi

2. The term of office of the Board of Governors shall be for a period of one hundred and eighty days with effect from the 15th day of May, 2013 or the reconstitution of the Council , whichever is earlier .

[ No. V.11011/1/2013-MEP - I ]

DR. VISHWAS MEHTA, JointSecretary.

ಕರ್ನಾಟಕ ರಾಜ್ಯಪಾಲರ ಆಜ್ಞಾನುಸಾರ ಮತ್ತು ಅವರ ಹೆಸರಿನಲ್ಲಿ , ಆರ್ . ಆಂಜಿನಿ ,

P.R. 95

ಸಹಾಯಕ ಪ್ರಾರೂಪಕಾರ ಮತ್ತು ಪದನಿಮಿತ್ತ ಸರ್ಕಾರದ ಉಪ ಕಾರ್ಯದರ್ಶಿ,

SC - 20

ಸಂಸದೀಯ ವ್ಯವಹಾರಗಳು ಮತ್ತು ಶಾಸನ ರಚನೆ ಇಲಾಖೆ .

ಭಾಗ ೪ ಕರ್ನಾಟಕ ರಾಜ್ಯಪತ್ರ, ಗುರುವಾರ , ಡಿಸೆಂಬರ್ ೧೨ , ೨೦೧೩

ಸಂಸದೀಯ ವ್ಯವಹಾರಗಳು ಮತ್ತು ಶಾಸನ ರಚನೆ ಸಚಿವಾಲಯ

ಅಧಿಸೂಚನೆ

ಸಂಖ್ಯೆ: ಸಂವ್ಯಶಾಇ 84 ಕೇನಿಪ್ರ 2013 , ಬೆಂಗಳೂರು , ದಿನಾಂಕ : 20/23 ನೇ ಸೆಪ್ಟೆಂಬರ್ 2013 .

2013 ನೇ ಸಾಲಿನ 02-05-2013ನೇ ದಿನಾಂಕದ ಭಾರತ ಸರ್ಕಾರದ ಗೆಜೆಟ್‌ನ ವಿಶೇಷ ಸಂಚಿಕೆಯ ಭಾಗ -11 ಸೆಕ್ಷನ್ 3 (i ) ರಲ್ಲಿ ಪ್ರಕಟವಾದ ಈ ಕೆಳಕಂಡ G.S.R. 277 ( E) ದಿನಾಂಕ 02-05-2013 ಅನ್ನು ಸಾರ್ವಜನಿಕರ ಮಾಹಿತಿಗಾಗಿ ಕರ್ನಾಟಕ ರಾಜ್ಯಪತ್ರದಲ್ಲಿ ಮರು ಪ್ರಕಟಿಸಲಾಗಿದೆ .

MINISTRY OF COMMUNICATIONS AND INFORMATION TECHNOLOGY

(Department of Telecommunications )

NewDelhi , the 2nd May, 2013

NOTIFICATION

G.S.R. 277 ( E) .-In exercise of the powers conferred by section 7 of the Indian Telegraph Act , 1885 ( 13 of 1885 ) , the Central Government hereby makes the following rules to amend the Indian Wireless Telegraphy (Commercial Radio Operator's Certificate of Proficiency and Licence to operate Global Maritime Distress and Safety System ) Rules , 1997 , namely :-

1. ( 1 ) These rules may be called the Indian Wireless Telegraphy ( Commercial Radio Operators Certificate of Proficiency and Licence to operate Global Maritime Distress and Safety System) Amendment Rules , 2013 .

(2) They shall come into force from the date of their publication in the Official Gazette .

2. In the Indian Wireless Telegraphy ( Commercial Radio Operator's Certificate of Proficiency and Licence to operate Global Maritime Distress and Safety System) Rules , 1997 ( hereinafter referred to as the said rules) ; in rule 8 , for sub - rule (2) ,the following sub rule shall be substituted , namely : -

"(2) On the expiry of the initial period of the validity of licence , it maybe renewed for a period of five years at a time , if the holder ofthe licence applies for renewal of the licence within a period of three months before the date of expiry of the period of licence except asprovided in rule 8A, and -

(0) pays a fee of one thousand rupees;

(ii) has a total experience of not less than six months within five years immediately preceeding the date of expiry of a licence ; and

(iii) satisfies the Central Government by re - examination or otherwise that he still possesses all of the eligibilities required for issue of the certificate " ;.

3. After rule 8 of the said rules , the following rule shall be inserted, namely: -

"8 A. Additional fees for late renewal :-

(1) In case the holder of the licence does not apply for its renewal prior to the date of expiry of the licence as under sub- rule ( 2) of rule 8 , he may apply for the renewal of licence within a period of two years after the date of expiry of the licence on payment of a additional fee at the rate of two percent of the renewal fee payable per month subject to a minimum of two hundred fifty rupees and if the delay in renewal is more than twelve months , then , the additional fees under this rule shall be compounded annually subject to condition that in such cases the licence shall be renewed only for a period of five years from the date of expiry of licence.

(2) In case the holder of the licence does not possess the requisite experience as laid down under sub - rule (2) of rule 8 , or applies for renewal of licence after two years from the expiry of the licence , he shall be required to pass Part II of the Global Maritime Distress and Safety System examination held by the Central Government in the Ministry of Communications and Information Technology at various centres and in such case the validity of the licence shall be five years commencing from the date of declaration of results of the said examination "

[F.No.P -14038/ 12 / 2012 - COP ]

MUNESH KUMAR ,

Dy. WirelessAdvisor.

Note : The principal rules were published in the Gazette of India , Part II , Section 3, sub - section ( i ) vide notification number G.S.R. 133 , dated the 6th July, 1998 , published in the Gazette of India , dated the 25th July, 1998 .

ಕರ್ನಾಟಕ ರಾಜ್ಯಪಾಲರ ಆಜ್ಞಾನುಸಾರ ಮತ್ತು ಅವರ ಹೆಸರಿನಲ್ಲಿ, ಆರ್. ಆಂಜಿನಿ ,

ಸಹಾಯಕ ಪ್ರಾರೂಪಕಾರ ಮತ್ತು ಪದನಿಮಿತ್ತ P.R. 97

ಸರ್ಕಾರದ ಉಪ ಕಾರ್ಯದರ್ಶಿ ,

SC - 20

ಸಂಸದೀಯ ವ್ಯವಹಾರಗಳು ಮತ್ತು ಶಾಸನ ರಚನೆ ಇಲಾಖೆ .

ಸರ್ಕಾರಿ ಕೇಂದ್ರ ಮುದ್ರಣಾಲಯ , ಘಟಕ -2 , ಬೆಂಗಳೂರು