Employer Category	Select Government PSU Others
	Employer's Name
	Employer's Address
	Gross Salary
	Value of Prequisities as per Form 12BA
	Exempted Allowances U/S 10
	Entertainment Allowance
	Tax on Employment
	TDS Amount
	Family Pension

	A) Rent Received/Receivable
		I) Property Address
		II) Name of Tenant
		III) Municipality Tax Paid
		IV) Paid on	DD/MM/YYYY
	B) House Loan Interest accurued/paid
		I) Name of Bank/Institution
		II) Date of disbursement of Loan		DD/MM/YYYY
		III) Date of Acquisition/Completion		DD/MM/YYYY

	Nature Of Business	Select Retail Trading WholeSale Trading Manufacturer Profession Service Sector Others
	Name of Business/Profession
	Books of Accounts Maintained	Select Yes No
	Is Assessable U/S	Select Normal Business or Profession 44 AD(Civil Construction) 44AE(Goods Carriages) 44AF(Retail Trade)
	Gross Receipts
	Gross Profit
	Expenses
	Sundry Debtors
	Sundry Creditors
	Stock - in - hand
	Cash - in - hand

	Type of Asset	Select Land Building Shares and Securities Debentures and Bonds Others
	Date Of Purchase	DD/MM/YYYY
	Cost Of Purchase
	Date Of Improvement (if any)	DD/MM/YYYY
	Amount Of Improvement (if any)
	Date Of Sale	DD/MM/YYYY
	Receipt Of Sale
	Expenses On Sale
	Reinvestments in Assets/Exemptions claimed
	Sections		Select Section 54 Section 54B Section 54D Section 54EC Section 54F Section 54G Section 54GA

	I) INTEREST
		A) Bank Interest
		# Savings Account
		# Fixed Deposits
		B) Post Office Schemes
		#MIS
		#R.D.
		C) Other Interest
	II) DIVIDEND
		A) Amount
			1) Taxable
			2) TaxFree
			3) Don't Know
				# Name Of Company
				# Scheme
				# Amount
	III) RENTAL INCOME
	IV) LOTTERIES ETC.
	V) OTHER INCOME								Details
	VI) EXEMPTED INCOMES
		A) Maturity Of LIC Policy
		B) Bonus On LIC Policy
		C) Interest On PPF
		D) Share In Partnership Firm
		E) Dividend
		F) Others

	A)   80C		H)   80G
	B)   80CCC		I)   80GG
	C)   80CCD		J)   80GGA
	D)   80D		K)   80GGC
	E)   80DD		L)   80RRB
	F)   80DDB		M)   80U
	G)   80E		N)   OTHERS

	A) ON SALARY
		I) Name & Address of Employer
		II) TAN N o. (see Form16)
		III) Amount of TDS
	B) ON INTEREST & OTHER INCOME
		I) Name & Address of Deductor
		II) TAN No.
		III) Amount Credited/Paid
		IV) Date of Credit/Payment	DD/MM/YYYY
		V) Amount Deducted
		VI) TDS U/S	Select 192 193 194 194A 194B 194BB 194C 194D 194E 194EE 194F 194G 194H 194I 194J 194LA 195

	Agricultural Income Amount

1	Cash Deposit aggregating Rs.10 Lakhs or more in a year in any Saving Account.	Rs.
2	Credit card payments aggregating Rs.2 Lakhs or more in a year.	Rs.
3	Payments of Rs.2 Lakhs or more for purchase of units of MF.	Rs.
4	Payments of Rs.5 Lakhs or more for acquiring bonds or debentures.	Rs.
5	Payments of Rs.1 Lakh or more for acquiring shares of a company.	Rs.
6	Purchase of immovable property valued at Rs.30 Lakhs or more.	Rs.
7	Sale of immovable property valued at Rs.30 Lakhs or more.	Rs.
8	Payments of Rs.5 Lakhs or more for investments in RBI bonds in a year.	Rs.