[भाग II—खण्ड 3(i)] भारतकाराजपत्र:असाधारण 483
INDIAN INCOME TAX RETURN ACKNOWLEDGEMENT Assessment Year
[Where the data of the Return of Income in Form ITR-1 (SAHAJ), ITR-2, ITR-3, ITR-
4(SUGAM), ITR-5, ITR-6, ITR-7 filed and verified] 2020-21
(Please see Rule 12 of the Income-tax Rules, 1962)
PAN
Name
Address
Status Form Number
Filed u/s e-Filing Acknowledgement Number
Current Year business loss, if any 1
Taxable Income and Tax
Total Income
Book Profit under MAT, where applicable 2
Adjusted Total Income under AMT, where applicable 3
details
Net tax payable 4
Interest and Fee Payable 5
Total tax, interest and Fee payable 6
Taxes Paid 7
(+)Tax Payable /(-)Refundable (6-7) 8
Dividend Tax Payable 9
Distribution Tax
Interest Payable 10
Dividend
details
Total Dividend tax and interest payable 11
Taxes Paid 12
(+)Tax Payable /(-)Refundable (11-12) 13
Accreted Income as per section 115TD 14
Accreted Income
& Tax Detail
Additional Tax payable u/s 115TD 15
Interest payable u/s 115TE 16
Additional Tax and interest payable 17
Tax and interest paid 18
(+)Tax Payable /(-)Refundable (17-18) 19
Income Tax Return submitted electronically on DD-MM-YYYY [Link] from IP address __________________ and verified
*
by__________________________ having PAN_________________ on ______________________using paper ITR-Verification
Form /Electronic Verification Code _____________________ generated through
_______________________________________________mode
System Generated Barcode/QR Code
*Strike of whichever is not applicable
DO NOT SEND THIS ACKNOWLEDGEMENT TO CPC, BENGALURU
Uploaded by Dte. of Printing at Government of India Press, Ring Road, Mayapuri, New Delhi-110064
and Published by the Controller of Publications, Delhi-110054.