Monogram
Government of the People’s Republic of Bangladesh
National Board of Revenue
Taxes
Sub Division
CERTIFICATE OF
INCOME TAX
Description of the Tax
Payer:
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A.
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Name
: Mr/Mrs/ M/S.
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:
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MD. QUAMRUN
HASAN
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B
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Father’s/
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:
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Late
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C
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Permanent Address
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:
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Plot No- 11 , Road-3, Block-A, Chayabithi, Eastern Housing
,
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D
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Present
Address
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:
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C/O Meghna Petroleum Ltd,
58-59 Agrabad C/A,
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E
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Status
: Person/Firm/Association/Hindu Joint Family/ Local Authority/Company…… Firm/ Association/ Hindu Joint Family/ Local Authority/ Company
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:
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Person
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F
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Tax
Identification Number (T.I.N)
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:
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380-102-0689/Circle-58 (SA)
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G
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Business
Identification Number (B.I.N)
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:
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……………………………………………………………………….
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This is to certify
that Mr. Md. Quamrul Hasan, Chittagong
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Date: 24/09/2012 Ad
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Round Seal
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Sd/Illegible
24-09-12
(…………………………..)
Asstt. Commissioner of Taxes
Chittagong Tax Zone 03, Tax Circle-58(SA),
Phone : ……………………
Sd/ Illegible
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5
I.T.-10B
Particulars of
assets, liabilities and expenses (As on 30/06/2012AD)
Name
of taxpayer Md.
(a) Capital in business
(Balance of capital). TK. ………………
(b) Share invest of limited company as director (Purchase value)
TK.
........................
Name of company Number
of Share
2. Non-agricultural property (Purchase value of legal cost) :
Previous Balance TK.
……………
Land/houses
(Particulars & Situation of property)
(i) 30Decimal land -------------(As before) ……………………….....................................................Old
snide............
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1
2
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(iii) Land &
5 Storied Building (50% share)
.............................(As
before).................................................Tk45,03,689/-
3. Agricultural property (Purchase value of legal cost) : TK. ..................
Land/houses
(Particulars & Situation of property)
Bf, A/c
4. Investment :
(a) Share/Debenture As per B/O
account............................................TK. 13,87,506/-
(b) Savings certificate/unit certificate/bond Bf/ A/c TK.
.....................
(c) Prize bond/Savings Scheme
TK. ....................
(d) Loan providing TK. .....................
(e) Other Investment
Tk------------------
Total
: TK13,87,506/-
5. Motor Vehicle (Purchase Value).....................................................(As
before)............................................... TK. 700,000/-
Sort &
registration of the Motor Vehicles
6. Ornaments (Quantity and purchase value)......................................(As
before)................................................TK. (As before)
7. Furniture (Purchase value)...................................................................Do........................................................
TK. 60,000/-
8. Electric goods (Purchase value) TK. ………….
9. Finance & Assets
out of business
(a) Cash TK. 77,209/-
(b) Bank Deposit (As
per statement ) TK. 509,590/-
(c) Others TK.68,00,000/- Tk73,86,799/-
Total = TK.133,37,994/-
6
10. Other assets (Please specify) TK133,37,994/-
Tk….X
Total
Assets TK. 133,37,994/-
11. Less : Liabilities
(a) Mortgage of property or land . DBA Loan (As per Statement )TK.....nil.........
(b) Loan without security money. Loan by Crossed cheque ........ TK 400,000/-
(c) Bank Loan............................................................(As
before) TK. ...................
(d) Others. Foreign
Remittance (As before) ................................ TK. 38,40,039/-
Total Liability = TK-42,40,039/-
12. This income is net asset of the last date of year TK.
90,97,955/-
(Difference from
total assets of total liabilities)
13. Net assets of last date of previous income year TK.
77,58,833/-
14. Increasing of assets (Difference between Sl. No. 12 &
13)
TK 13,39,122/-
15. (a) Family Cost : [Total cost as per form No. IT-10]
TK. 300,000/-
(b) Number of
dependent member in the family:
Adult 2 Children 01
16. Total increasing of assets : (Total of Sl. No. 14 & 15) TK.16,39,122/-
17. Gained funds :-
(1) Shown return income TK. 928,410/-
(2) Tax rebated & tax free income. Allowance s TK. 204,000/-
(3) Other receipts . Received per welfare fund TK. 5,06,712/-
(As per
Statement )
Total gained fund = TK.16,39,122/-
18. Difference *Difference between Sl. No. 16 & 17)=
TK. .......nil......
I do hereby declare with faith that the provided information in
IT-10B is entirely true & correct to the best of my knowledge & faith.
|
Sd/ Illegible
25-09-2012
Chief Asstt.
Salary Circle-58,
Tax Zone -3
Chottagong
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Sd/- Illegible
26-09-12
Md. Quamrul Hasan
(Name in clear
letter)
Date
:----------------------------
Designation
and Seal (If not person)
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·
The assets and liabilities of the taxpayer, his
wife/husband (If he is not applicant of return), monir & dependent children
should be shown in these particulars.
·
Please use separate paper in applicable field.
TK
928410/- (Tax)
Total Income Shown in the
Return : TK : 506,712/-
(Exempted) Paid up tax :
TK. 86,655/-
Net assets of the taxpayer : TK. :9097955
Date of receiving the income
statement : …………………… Serial
No. of return register : 416/12-13
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a
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Sort of income statement
: Self Assessing Universal General
Enclosed : P.O. vide No.2009/08-18020
F 14,00,000 Copy (C-25)2008..
Sd/- Illegible
Date : 24-09-12
Deputy Tax Commissioner
Tax Circle-58 , Tax Zone-3,
(Seal & Signature of receiving officer)
Ba: Sa:Su: 2009/10-18019F-30,00,000
Copies, (C-15)2010
………………………………………………………………………………………
( Income Statement Acknowledgement Certificate )
Taxpayer
Name : Md.
UTIN/
TIN 038-102-0689 Circler
: S/6, Tax Zone :3, Ctg.
Income Tax Return
Form under (36 No. Ordinance of 1984) 1984 AD
of Income Tax Ordinance
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I.T.-11Ga
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Please be honorable client, pay the return in time and pay
the fine.
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For Person Class and Others Tax Payers
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Photo of taxpayer
(Attested)
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RETURN U/S 82BB
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Self Assessing √Universal Self Assessing General
1. Name of taxpayer :
Md. Quamrul
Hasan
2. National Identity Card No. (If any) :
……………………………........................................................................
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3. UTIN (If any) :
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4. TIN (If any) :
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3
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8
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0
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-
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1
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0
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2
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-
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0
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6
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8
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9
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5. (a)
Salary : 6 Chittgong (b) Tax Zone : 03, Chittagong
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9. Name of
Business firm/Employeer (In applicable field) : MEGHNA PETROLEUM LTD
10. Name of wife/husband is taxpayer (If
taxpayer please mention TIN) : Saifun Nessa TIN: 156-102-9889/Chittagong
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-
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-
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11. Father’s Name : Late Md. Mubarak Ali
12. Mother’s Name : Mrs. Habibun Nessa
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13. Date of birth (In applicable field)
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0
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1
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0
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8
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1
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9
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5
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9
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day Month Year
14. Address : (a) Present : C/O. Meghna
Petroleum Ltd , 58-59 Agrabad C/A, Chittagong
(b) Permanent : Plot No-11, Road-3, Block-A, Chayabithi Eastern Housing, Bashabo , Dhaka
15. Telephone: Office/Residence: …………............................
Residential : .............................................................
16. VAT Registration No. (If any) : ..........................................................................................................................
2
INCOME PARTICULARS OF THE TAXPAYER
Particulars of income
of year ended on .30-06-2012AD
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Sl. No.
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Income Particulars
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Amount of Taka
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1.
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Salary : As per Section 21 (According to
schedule-1) (As per Statement )
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716069/-
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2.
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Interest on security deposit : As per section
22
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207632/-
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3.
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Income from houses : As per section 24
(According to schedule 2) (As per Statement )
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4.
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Agricultural Income : As section 26
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5.
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Income from business or profession ; As per
Section 28 (U/S. 8 2C)
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6.
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Part of income of firm :
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7.
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Income of husband/wife or minor boy/girl: As
per sectionb43(4)
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8.
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Capital Profit : As per section 31
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9.
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Income from other sources : As per Section 33
(Dividend Income) (As per Statement )
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4709/-
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10.
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Total (From Sl. 1 to 9)
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9,28,410/-
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11.
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Income from foreign courtiers
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---
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12.
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Total (From Sl. 10 & 11)
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9,28,410/-
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13.
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Imposable income tax on total income
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95,682/-
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14.
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Tax rebated : As per section 44(2)(b)
(According to the schedule 3)
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9,027/-
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15.
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Payable tax (Difference of Sl. No. 13 &
14)
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86,655/-
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16.
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Distributed tax :
Tax pair by the Employer
(a) Deducted/collected tax at the source of
income (Business Income U/S. 8C)
TK. 42,818/-
(Please enclose the deeds/particulars) Dividend
TK. 471/-
Tax
deducted by bank
(b) As per section 64/68 the paid up advance
tax (Please enclose the challan)
TK 43,366/-
(c) Paid up tax on the basis of this return
(As per section 74)
(Please enclose the Challan/Pay-Order/Bank Draft/Chaque) TK.
......................
(d) Adjustment of returnable tax (If
any)
TK. .....................
Total : (a), (b), (c)
& (d)
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TK. 86,655/-
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17.
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Difference of Sl. 15 & 16 (If any)
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TK. nil
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18.
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Amount of tax rebating and tax free income :
(Received as for Statement)
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TK..506,712/-
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19.
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Paid up income tax of the previous tax year
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TK. .................
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·
For details description or if it is required please use separate
paper.
CERTIFICATION
I, Md. Quamrul Hasan father / Husband : of Late Md. Mubarak Ali,
UTIN/TIN :380-102-0689//5-6 do hereby declare with sound body & mind that
the enclosed information provided in this return and particulars are true &
correct to the best of my knowledge & faith.
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Place :
Date :
.......................................................
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Sd/- Illegible
Md. Quamrul Hasan
(Name in clear letter)
Designation and Seal (If not person)
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3
Schedule with details particulars of income
Name of Taxpayer
: Md.
Schedule-1
(Salary)
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Salary &
allowance
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Amount of
income (TK.)
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Amount of
released income (TK.)
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Net Taxable
Income (TK.)
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Basic Salary
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Special Salary
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Dearness
allowance
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Conveyance
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Medical
allowance
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Directorship
allowance
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Leave
allowance
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Honorarium/Reward/Fee
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Overtime
Allowance
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Bonus/Ex-Grecia
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Other
allowances
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Paid up subscription
by the employer in the admitted fund
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Gained
interest on admitted provident fund
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Considered
income for conveyance
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Considered
income for decorated or undecorated residence free of cost
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Others, if any
(Please give particulars)
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Net taxable
income from salary
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Schedule-2
(Income from houses)
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Situation
& particulars of houses
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Particulars
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TK.
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TK.
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(1) Yearly
income from rent 60,000 × 12
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(2) Claimed
costs :
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||||
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Repairing, collection etc. 1/3 portion
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||||
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Municipality Tax or Local Tax In a same residence
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Land Revenue In a same house
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Interest on loan/mortgage/Capital
Charge
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Insurance Installment
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Claimed rebate due to remaining vacant of
houses
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Others, if any
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Total =
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3. Net Income
(Difference of Sl. No. 1 & 2)
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||
Sd/ Illegible
Md. Quamrul Hasan
4
Readable section 44 (2)(b) with the part
of Scjedule-6 of Income Tax Ordinance
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1. Paid up installment of life insurance
2. Paid up subscription in view of receiving
the yearly allowance receivable in future
3. Paid up subscription to the applicable
provident fund as per Provident Act, 1925
4. In the admitted provident fund
subscription by self and employer
5. Paid up subscription to the fund of
approved age concerned.
6. Investment to approved debenture or
debenture stock, stock or share
7. Paid up subscription in deposit pension
scheme.
8. Paid up subscription to welfare fund and
paid up installment under group insurance.
9. Paid up subscription to Jakat fund.
10. Others, if any (Please specify)
Total :
|
TK. 8345/-
TK.
........................
TK.
.......................
TK. 81,920/-
TK.
.......................
TK.
.......................
TK.
.......................
TK.
.......................
TK.
.......................
TK. .......................
TK.
.......................
TK. 90,265/-
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* Please enclose
the certificate/proofs of investments
List
of the submitted deeds with income tax return
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1. Salary Certificate 6.
DBH Last Statement
2. Income Certificate 7.
Payment Receipt Certificate of W P W F
3. Bank Statement 8.
P.O No-0567667 Dt-20-09-12
Tk. 43,366/- of southeast Bank
Ltd, Agrabad Br. Ctg
4. L I P
Receipt 9.
5. B/O A/C Statement 10.
|
Incomplete
return is not acceptable
5 I.T.-10B
Particulars of
assets, liabilities and expenses (As on 30/06/2012AD)
Name
of taxpayer Md.
(a) Capital in business (Balance
of capital). TK. ………………
(b) Share invest of limited company as director (Purchase value)
TK.
........................
Name of company Number
of Share
2. Non-agricultural property (Purchase value of legal cost) :
Previous Balance TK.
……………
Land/houses
(Particulars & Situation of property)
(i)
30Decimal land -------------(As before) ……………………….......................................................Inherited
..........
|
1
2
|
(iii) Land &
5 Storied Building (50% share)
.............................(As before).................................................Tk45,03,689/-
3. Agricultural property (Purchase value of legal cost) : TK. ..................
Land/houses
(Particulars & Situation of property)
Bf, A/c
4. Investment :
(a) Share/Debenture As per B/O
account............................................TK. 13,87,506/-
(b) Savings certificate/unit certificate/bond Bf/ A/c TK. .....................
(c) Prize bond/Savings Scheme
TK. ....................
(d) Loan providing TK. .....................
(e) Other Investment Tk------------------
Total
: TK13,87,506/-
5. Motor Vehicle (Purchase Value).....................................................(As
before)............................................... TK. 700,000/-
Sort &
registration of the Motor Vehicles
6. Ornaments (Quantity and purchase value)......................................(As
before)................................................TK. (As before)
7. Furniture (Purchase value)...................................................................Do........................................................
TK. 60,000/-
8. Electric goods (Purchase value) TK. ………….
9. Finance & Assets
out of business
(a) Cash TK. 77,209/-
(b) Bank Deposit (As
per statement ) TK. 509,570/-
(c) Others TK.68,00,000/- Tk73,86,799
Total = TK.133,37,994/-
6
10. Other assets (Please specify) TK133,37,994/-
Tk….X
Total
Assets TK. 133,37,994/-
11. Less : Liabilities
(a) Mortgage of property or land . DBA Loan (As per Statement )TK.....nil.........
(b) Loan without security money. Land by Crossed Cheque .........TK
400,000/-
(c) Bank Loan............................................................(As
before) TK. ...................
(d) Others. Foreign
Remittance (As before) ................................ TK. 38,40,039/-
Total Liability = TK-42,40,039/-
12. This income is net asset of the last date of year TK.
90,97,955/-
(Difference from
total assets of total liabilities)
13. Net assets of last date of previous income year TK.
77,58,833/-
14. Increasing of assets (Difference between Sl. No. 12 &
13)
TK 13,39,122/-
15. (a) Family Cost : [Total cost as per form No. IT-10]
TK. 300,000/-
(b) Number of
dependent member in the family:
Adult 02 Children 01
16. Total increasing of assets : (Total of Sl. No. 14 & 15) TK.16,39,122/-
17. Gained funds :-
(1) Shown return income TK. 928,410/-
(2) Tax rebated & tax free income. Allowance s TK. 204,000/-
(3) Other receipts . Received from welfare fund TK. 5,06,712/-
(As per
Statement )
Total gained fund = TK.16,39,122/-
18. Difference *Difference between Sl. No. 16 & 17)=
TK. .......nil......
I do hereby declare with faith that the provided information in
IT-10B is entirely true & correct to the best of my knowledge & faith.
|
|
|
Sd/- Illegible
Md. Quamrul Hasan
(Name in clear
letter)
Date
:----------------------------
Designation
and Seal (If not person)
|
·
The assets and liabilities of the taxpayer, his
wife/husband (If he is not applicant of return), monir & dependent children
should be shown in these particulars.
·
Please use separate paper in applicable field.
7
Form No.: IT-10BB
FORM
As per section
75(2)(d)(i) and 80 of Income Tax Ordinance of 1984 AD
Information
Particulars of Individual Taxpayer.
Name of taxpayer : Md.
|
Sl. No.
|
Particulars of
cost
|
Amount (TK.)
|
Remarks
|
|
1.
|
Personal &
Traveling Cost
|
TK. 80,000
|
|
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2.
|
Paid up income
tax of last financial year with cutting tax at the source of income
|
TK. 30,493
|
(20,011+10,000+471)
|
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3.
|
Residential
cost
|
TK.
.X....
|
Own House
|
|
4.
|
Entire costs
regarding using of personal vehicle
|
TK. 90,000.
|
|
|
5.
|
Residential
Electricity Bill
|
TK
.8,000
|
|
|
6.
|
Residential
Water Bill
|
TK
5,000,
|
|
|
7.
|
Residential
Gas Bill
|
TK
. 5,000
|
|
|
8.
|
Residential
Telephone Bill
|
TK
. 1500
|
|
|
9.
|
Cost for study
of children
|
TK
. 30,000
|
Govt. Collage
|
|
10.
|
Foreign travel
cost by own cost
|
TK
. ...X
|
|
|
11.
|
Other special
costs with festival cost, if any
|
TK
. 50,007
|
|
|
|
Total Cost :
|
TK.
300,000
|
|
I do hereby
declare with faith that the information provided in IT-10BB is true & correct
to the best of my knowledge.
|
|
|
Sd/- Illegible
Md. Quamrul Hasan
Name & Signature of Taxpayer
Date : ..............................
|
·
Please
use separate if it is required.
…………………………………………………………………………………………………………………………………………..
( Income Statement Acknowledgement Certificate )
Name of the Taxpayer : Md.
|
Circle:S/6,
Tax Zone: 3 Ctg
|
|
UTIN/
T.I.N:
|
3
|
8
|
0
|
-
|
1
|
0
|
2
|
-
|
0
|
6
|
8
|
9
|
Sd/ Illegible
8
RULES TO BE
FOLLOWED FOR FILLING RETURN FORM
Rules:
(1) The tax payer of income tax
return or income tax ordinance under the section of 75 of 1984 will be
signature and execute by particular person.
(2)
Attach in necessary cases:
(A) Salary description in salary
income, bank description in bank interest, bank certificate of interest paying
bank of deposit, rent agreement form in case of house property income, Receipt
of vat or municipal tax, description of loan payer organization in case of
interest on home loan, installment money receipt in case of having insurance,
income description as per income tax regulation of professional income, income/
expenditure copy of partner farm in case of availability, documents if any
capital profit, dividend payment certificate in case of dividend income, the
source of income or deposit if any the documents of that, L. I. P, D. P. S,
Zakat, Stock/ Share purchase, in case of investment there documents;
(B) In case of business income
the description of income- expenditure, production account, commercial account,
profit loss account and maturity stage;
(C) Income tax ordinance, waste
description according the demand of three of 1984;
(D) Income calculating according
to the income law.
(3)
Attach separate description:
(A) Wife or Husband of tax payer
(in case of not having tax payer) any income in the name of children or dependable
person.
(B) Tax free income in case of
have.
(4)Income tax regulation- 38
has to be followed in case of return submission in case of particulars.
(5) The submitted documents
have to be in signature of tax payer.
(6) Every five year the
picture has to be submitted.
(7) Provide the bellow description:
(A) Name and address of
partner farm of T.I.N.
(B) Name and Address with
T.I. N of partner of taxpayer.
(C) Name and Address with
TIN if the tax payer director of company.
(8) Tax payer himself
husband/ wife (if he is not tax payer), non adult and property of dependable,
as per IT 10 B has to be shown.
(9) The signature of tax
payer or his representative is mandatory. Signature in IT- 10 B and IT- 10BB is
mandatory of the tax payer.
(10) In case of space not
available separate paper will be able to be use.
…………………………………………………………………………………………………………..
TK 928410/-
Total Income Shown in the
Return : TK :
506,712/- (Tax Exempted)
Paid up tax : TK. 86,655/-
Net assets of the taxpayer : TK. :9097955
Date of receiving the income
statement : …………………… Serial
No. of return register : ……………..
|
a
|
Sort of income statement
: Self Assessing Universal General
Ba: Sa:Su:
2009/10-18019F-30,00,000 Copies, (C-15)2010
(Seal & Signature of receiving officer)
MEGHNA PETROLEUM LIMITED
58- 59, Agrabad Commercial
Area
Income
Description of Salary Section for 2011- 2012 fiscal year (2012- 2013 Fiscal
Year)
Name: Md.
TIN: 380- 102- 0689
Circle: 58 (Boitanik) Tax Area: 3, Chittagong
(A) Total Income (Annual Salary
and Bonus):
|
|
Amount of Income
|
Adjusted Amount of Income
|
Net Tax Payable Income
|
|
|
1.
|
Basic
Salary
|
BDT 409,600.00
|
-
|
409, 600.00
|
|
2.
|
House
Rent
|
BDT 245,760.00
|
180,000.00
|
65,760.00
|
|
3.
|
Transportation
Rent
|
-
|
-
|
-
|
|
4.
|
Leave
Cashing
|
-
|
-
|
-
|
|
5.
|
Leave
Entertainment Bonus
|
-
|
-
|
-
|
|
6.
|
Bonus
|
131,400.00
|
-
|
-
|
|
7.
|
Utility
Bonus Etc
|
61,629.00
|
-
|
61,629.00
|
|
8.
|
Paid
by appointed for future fund
|
40, 960.00
|
-
|
40,960.00
|
|
9.
|
Consideration
Income for taking transport facility
|
30,720.00
|
-
|
30,720.00
|
|
10.
|
Consideration
Income For Having Accommodation
|
-
|
-
|
-
|
|
|
Net Tax Payable Income from Salary
|
740,069.00
|
||
(B) Net Imposable Income Tax from
Salary:
|
|
Level of Tax Payable Income
|
Percent of Tax
|
Amount of Tax
|
|
1st
|
BDT 2000,000.00
|
Zero
|
-
|
|
Next
|
BDT 3000,000.00
|
10%
|
30,000.00
|
|
Next
|
BDT 240,069.00
|
15%
|
36,010.00
|
|
Next
|
BDT
|
20
|
-
|
|
|
Total Imposable Income Tax
|
|
66,010.00
|
(C) Investment (Tax Traditional):
1. Installment of Life
Insurance (up- to 10% of insurance price) -
2. Future fund by self or
appointed paid amount BDT Tk. 81,920.00
3. Investment in approved
share or stock -
4. Paid amount for deposit
pension scheme -
5. Others (If any) BDT Tk.81,920.00
Total Investment:
(E)Tax as invested (10%) BDT Tk 8,192.00
(F) Payable Tax: (Different
in B and D) BDT Tk. 57,818.00
(G) Paid Advanced Income Tax
for Car 15,000.00
(H) Net Payable Tax:
(Different in E and G, but as low as 3,000.00)
BDT Tk. 42,818.00
(Seal)
Date: 1/ 7/ 2012
Sd/ Illegible
Pay- Master
Meghna Petroleum Limited
58- 59 Agrabad Ba/ A,
(Monogram)
MEGHNA
PETROLEUM LIMITED
WORKERS’ PARTICIPATION AND
WELFARE FUND
P.O BOX NO- 108
58/ 59, AGRABAD C/A,
PHONES: 711891-8 (PABX)
Date: 04/ 09/ 2012
CERTIFICATE
This is to Certify that , Meghna Petroleum Limited has paid in
total of BDT Tk. 5,06,712.13 (Five Lakhs Six Thousand Seven Hundred Twelve Taka
Thirteen Paisa) in fiscal year of 2011- 2012 from the part of the fund of
Meghna Petroleum Limited Workers Participation and Welfare Fund to Mr Md .
Quamrul Hasan. M- 104 by the Workers
Participation Fund as profit 5% of the company in five years from 2005- 2006
fiscal year to 2010- 2011 fiscal year. It is mentioned that income tax
ordinance, first part of 6th schedule of 1984 (section- 44, sub-
section- 21) and as per workers participation and welfare fund of levour law of
Bangladesh
Sd/
Illegible
Kazi
Monowar Dildar
Trustee
and Secretary
Meghna
Petroleum Limited
Workers
Participation and Welfare Fund
58-
59, Agrabad Ba/ A
END
( Income Statement Acknowledgement Certificate )
Taxpayer
Name : SAIFUN
NESSA Tax Years :
2012-2013
UTIN/
TIN 056-102-9889 Circler : 113, Tax Zone :5, Dhaka .
……………………………………………………………………………………………………
Total Income Shown in the
Return : TK : 464,055/-
(Example) Paid up tax :
TK. 23,906/-
Net assets of the taxpayer : TK. :80,31,356
Date of receiving the income
statement : …………………… Serial
No. of return register : 539
Sort of income statement
: Self Assessing Universal General
Sd/- Illegible
Date : 27-09-12
Md. Zahidul Islam
Asstt. Tax Commissioner
Tax Circle-103, Tax Zone-5,
(Seal & Signature of receiving officer)
Ba: Sa:Su:
2009/10-18019F-30,00,000 Copies, (C-15)2010
FIRST SECURITY ISLAMI BANK
LTD FSIB-PO 0699526
TOPKHANA (105276739 ) Date
25-09-2012
Pay Deputy Commissioner of
taxes, taxes circle-103, Zone-5 Or
order taka Twenty two thousand two hundred
sixty four only . for value received Tk-22264
FIRST SECURITY ISLAMI BANK LTD
Sd/ Illegible Sd/
Illegible
Authorized Officer Authorized Officer
1. Name of taxpayer :
Saifun Nessa
2. National Identity Card No. (If any) : ID
No-2696827872094………........................................................................
|
3. UTIN (If any) :
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
4. TIN (If any) :
|
1
|
5
|
6
|
-
|
1
|
0
|
2
|
-
|
9
|
8
|
8
|
9
|
5. (a) Circle :
103 (b) Tax Zone : 5, Dhaka
|
√
|
|
|
|
|
|
|
|
|
|
|
9. Name of
Business firm/Employeer (In applicable field) : ……………………………………………………..
10. Name of wife/husband is taxpayer (If
taxpayer please mention TIN) : MD. QUAMRUN HASAN TIN: 380-102-0689 /Chittagong
|
|
|
|
|
-
|
|
|
|
-
|
|
|
|
|
11. Father’s Name : …………………………………………………………………………………………………..
12. Mother’s Name : ………………………………………………………………………………………………….
|
13. Date of birth (In applicable field)
|
0
|
1
|
1
|
2
|
1
|
9
|
6
|
5
|
day Month Year
14. Address : (a) Present : Plot No-11, Road-3,
Block-A, Chauyabithi Eastern Housing Project , Bashabo ,
Dhaka-1214
(b) Permanent : DO
15. Telephone: Office/Residence:
…………............................ Residential : ………..............................................
16. VAT Registration No. (If any) :
..........................................................................................................................
2
INCOME PARTICULARS OF
THE TAXPAYER
Particulars of income
of year ended on .30-06-2012AD
|
Sl. No.
|
Income Particulars
|
Amount of Taka
|
|
1.
|
Salary : As per Section 21 (According to
schedule-1) (As per Statement )
|
240,000/-
|
|
2.
|
Interest on security deposit : As per section
22
|
207,632/-
|
|
3.
|
Income from houses : As per section 24
(According to schedule 2) (As per Statement )
|
|
|
4.
|
Agricultural Income : As section 26
|
|
|
5.
|
Income from business or profession ; As per
Section 28 (U/S. 82C)
|
|
|
6.
|
Part of income of firm :
|
|
|
7.
|
Income of husband/wife or minor boy/girl: As
per sectionb43(4)
|
|
|
8.
|
Capital Profit : As per section 31
|
|
|
9.
|
Income from other sources : As per Section 33
(Dividend Income) (As per Statement )
|
16,423/-
|
|
10.
|
Total (From Sl. 1 to 9)
|
464,055/-
|
|
11.
|
Income from foreign courtiers
|
---
|
|
12.
|
Total (From Sl. 10 & 11)
|
464,055/-
|
|
13.
|
Imposable income tax on total income
|
23,906/-
|
|
14.
|
Tax rebated : As per section 44(2)(b)
(According to the schedule 3)
|
-----------
|
|
15.
|
Payable tax (Difference of Sl. No. 13 &
14)
|
23906
|
|
16.
|
Distributed tax :
Tax pair by the Employer
(a) Deducted/collected tax
at the source of income
(b) (Please enclose the deeds/particulars) (Statement by Bank) TK. 1,642/-
Tax deducted by bank
(b) As per section 64/68 the paid up advance
tax (Please enclose the challan)
TK. ………………..
(c) Paid up tax on the basis of this return
(As per section 74)
(Please enclose the Challan/Pay-Order/Bank Draft/Chaque) TK. 22,264/-
(d) Adjustment of returnable tax (If
any)
TK.
.....................
Total : (a), (b), (c)
& (d)
|
TK.23,906/-
|
|
17.
|
Difference of Sl. 15 & 16 (If any)
|
TK. nil
|
|
18.
|
Amount of tax rebating and tax free income :
(Received as for Statement)
|
TK............
|
|
19.
|
Paid up income tax of the previous tax year
|
TK. 506712
|
·
For details description or if it is required please use separate
paper.
CERTIFICATION
I, Saifun Nessa daughter / Husband : of Md. Quamrul Hasan , UTIN/TIN :156-102-9889 do hereby declare with sound body & mind
that the enclosed information provided in this return and particulars are true
& correct to the best of my knowledge & faith.
|
Place :
Date :
.......................................................
|
|
Sd/- Illegible
(Name in clear letter)
Sd/ Illegible
Saifun Nessa
Designation and Seal (If not person)
|
3
Schedule with details particulars of income
Name of Taxpayer
: TIN:-----------------
Schedule-1
(Salary)
|
Salary &
allowance
|
Amount of
income (TK.)
|
Amount of
released income (TK.)
|
Net Taxable
Income (TK.)
|
|
|
Basic Salary
|
|
|
|
|
|
Special Salary
|
|
|
|
|
|
Dearness
allowance
|
|
|
|
|
|
Conveyance
|
|
|
|
|
|
Medical
allowance
|
|
|
|
|
|
Directorship
allowance
|
|
|
|
|
|
Leave
allowance
|
|
|
|
|
|
Honorarium/Reward/Fee
|
|
|
|
|
|
Overtime
Allowance
|
|
|
|
|
|
Bonus/Ex-Grecia
|
|
|
|
|
|
Other
allowances
|
|
|
|
|
|
Paid up
subscription by the employer in the admitted fund
|
|
|
|
|
|
Gained
interest on admitted provident fund
|
|
|
|
|
|
Considered
income for conveyance
|
|
|
|
|
|
Considered
income for decorated or undecorated residence free of cost
|
|
|
|
|
|
Others, if any
(Please give particulars)
|
|
|
|
|
|
Net taxable
income from salary
|
|
|
|
Schedule-2
(Income from houses)
|
Situation
& particulars of houses
|
Particulars
|
TK.
|
TK.
|
|
|
(1) Yearly
income from rent 60,000 × 12
|
|
|
|
(2) Claimed
costs :
|
|||
|
Repairing, collection etc. 1/3 portion
|
|||
|
Municipality Tax or Local Tax In a same residence
|
|
|
|
|
|
|
|
|
Interest on loan/mortgage/Capital
Charge
|
|
|
|
|
Insurance Installment
|
|
|
|
|
Claimed rebate due to remaining vacant
of houses
|
|
|
|
|
Others, if any
|
|
|
|
|
Total
=
|
|
||
|
3. Net Income
(Difference of Sl. No. 1 & 2)
|
|
|
|
Sd/ Illegible
4
Schedule-3
Readable section 44 (2)(b) with the part
of Scjedule-6 of Income Tax Ordinance
|
1. Paid up installment of life insurance
2. Paid up subscription in view of receiving
the yearly allowance receivable in future
3. Paid up subscription to the applicable
provident fund as per Provident Act, 1925
4. In the admitted provident fund subscription
by self and employer
5. Paid up subscription to the fund of
approved age concerned.
6. Investment to approved debenture or
debenture stock, stock or share
7. Paid up subscription in deposit pension
scheme.
8. Paid up subscription to welfare fund and
paid up installment under group insurance.
9. Paid up subscription to Jakat fund.
10. Others, if any (Please specify)
Total :
|
TK. ………………
TK. ........................
TK. .......................
TK. ……………….
TK. .......................
TK. .......................
TK. .......................
TK. .......................
TK. .......................
TK. .......................
TK. .......................
TK. 90265/-
|
* Please enclose
the certificate/proofs of investments
List
of the submitted deeds with income tax return
|
1. Income Statement 6.
Salary Certificate
2. Bank Statement
..
. 7.
3. Statement of A/C
8.
4. DBS
lone Certificate …………………………………………………………………. 9.
.
5. Pay cash of 22,264
. 10.
No-0699526
Dated 25-09-12
Bank First
Secularity Bank Ltd , Topkhana
|
Incomplete
return is not acceptable
5
I.T.-10B
Particulars of
assets, liabilities and expenses (As on 30/06/2012AD)
Name
of taxpayer Saifun Nessa TIN No. : 156-102-9889
(a) Capital in business
(Balance of capital). TK. ………………
(b) Share invest of limited company as director (Purchase value)
TK.
........................
Name of company Number
of Share
2. Non-agricultural property (Purchase value of legal cost) :
Previous Balance TK.
180,000/-
Land/houses
(Particulars & Situation of property)
(1)22
Decmal land at Savar O/B
(2) 3 Khatha Land at Jowar Shahara O/B
TK-350,000/-
(3)
Land Building
3. Agricultural property (Purchase value of legal cost) : TK. ..................
Land/houses
(Particulars & Situation of property)
4. Investment :
(a) Share/Debenture
TK.
……………
(b) Savings certificate/unit certificate/bond Bf/ A/c TK.
.....................
(c) Prize bond/Savings Scheme TK.
....................
(d) Loan providing TK. .....................
(e) Other Investment . Other
Investment Tk
16,68,750/-
Total
: TK1668750
5. Motor Vehicle (Purchase Value) (as before) TK. 60,000
Sort &
registration of the Motor Vehicles
6. Ornaments (Quantity and purchase value). 60 tola / Gold
Ornaments as before TK (Bank as before)
7. Furniture (Purchase value) Do TK. 60,000/-
8. Electric goods (Purchase value) TK. ………
9. Finance & Assets out of business
(a) Cash TK. .5,604/-
(b) Bank Deposit (As
per sweat) (SB-533) TK. 775,063/-
(c) Others TK. 35,00,000/- Tk 42,80,667/-
Total
= TK.110,00,106/-
6
10. Other assets (Please specify) TK. 110,00,106/-
Tk….X
Total Assets TK. 110,00,106/-
11. Less : Liabilities
(a) Mortgage of property or land DBH lone TK. ..........nil........
Lone by Gassed Check (As before) .
(b) Loan without security money TK.
13,00,000/-
(c) Bank Loan TK. ...................
(d) Others : Other
Investment (For) (As before) TK. 16,68,750/-
Total
Liability = TK-29,68,750/-
12. This income is net asset of the last date of year TK.
80,31,356/-
(Difference from
total assets of total liabilities)
30-06-2007
13. Net assets of last date of previous income year TK.
75,13,30/-
14. Increasing of assets (Difference between Sl. No. 12 &
13) TK.
518,055/-
15. (a) Family Cost : [Total cost as per form No. IT-10] TK.
150,000/-
(b) Number of
dependent member in the family:
Adult 2 Children 01
16. Total increasing of assets : (Total of Sl. No. 14 & 15) TK. 6,68,055/-
17. Gained funds :-
(1) Shown return income TK.
464,055/-
(2) Tax rebated & tax free income TK. 204,000/-
(3) Other receipts Allowance
TK. ------------
Total
gained fund = TK. 6,68,055/-
18. Difference *Difference between Sl. No. 16 & 17)= TK....nil................
I do hereby declare with faith that the provided information in
IT-10B is entirely true & correct to the best of my knowledge & faith.
|
|
|
Sd/- Illegible
Saifun Nessa
(Name in clear
letter)
Date
:----------------------------
Designation
and Seal (If not person)
|
·
The assets and liabilities of the taxpayer, his
wife/husband (If he is not applicant of return), monir & dependent children
should be shown in these particulars.
·
Please use separate paper in applicable field.
7
Form No.: IT-10BB
FORM
As per section
75(2)(d)(i) and 80 of Income Tax Ordinance of 1984 AD
Information
Particulars of Individual Taxpayer.
Name of taxpayer : SAIFUN NESSA TIN
: 156-102-9889
|
Sl. No.
|
Particulars of
cost
|
Amount (TK.)
|
Remarks
|
|
1.
|
Personal &
Traveling Cost
|
TK. Born by my husband
|
|
|
2.
|
Paid up income
tax of last financial year with cutting tax at the source of income
|
TK. 35448
|
(1642+33806)
|
|
3.
|
Residential
cost
|
TK. .Own house
...
|
Own House
|
|
4.
|
Entire costs
regarding using of personal vehicle
|
TK. .
|
|
|
5.
|
Residential
Electricity Bill
|
TK.
|
|
|
6.
|
Residential
Water Bill
|
TK. Born by my husband
|
Do
|
|
7.
|
Residential
Gas Bill
|
TK.
|
Do
|
|
8.
|
Residential
Telephone Bill
|
TK.
|
Do
|
|
9.
|
Cost for study
of children
|
TK.
|
Do
|
|
10.
|
Foreign travel
cost by own cost
|
TK. ...
|
|
|
11.
|
Other special
costs with festival cost, if any
|
TK. 102,351/-
|
|
|
|
Total Cost :
|
TK. 150,000/-
|
|
I do hereby
declare with faith that the information provided in IT-10BB is true &
correct to the best of my knowledge.
|
|
|
Sd/- Illegible
Saifun Nessa
Name & Signature of Taxpayer
Date : ..............................
|
·
Please
use separate if it is required.
·
…………………………………………………………………………………………………………………………………………..
( Income Statement Acknowledgement Certificate )
Name of the Taxpayer : SAIFUN NESSA Taxes Year : 2012-2013
|
Circle:103,
Tax Zone: 5,
|
|
UTIN/
T.I.N:
|
1
|
5
|
6
|
-
|
1
|
0
|
2
|
-
|
9
|
8
|
8
|
9
|
Sd/ I illegible
8
RULES TO BE
FOLLOWED FOR FILLING RETURN FORM
Rules:
(4) The tax payer of income tax
return or income tax ordinance under the section of 75 of 1984 will be
signature and execute by particular person.
(5) Attach in necessary cases:
(E) Salary description in salary
income, bank description in bank interest, bank certificate of interest paying
bank of deposit, rent agreement form in case of house property income, Receipt
of vat or municipal tax, description of loan payer organization in case of interest
on home loan, installment money receipt in case of having insurance, income
description as per income tax regulation of professional income, income/
expenditure copy of partner farm in case of availability, documents if any
capital profit, dividend payment certificate in case of dividend income, the
source of income or deposit if any the documents of that, L. I. P, D. P. S,
Zakat, Stock/ Share purchase, in case of investment there documents;
(F) In case of business income
the description of income- expenditure, production account, commercial account,
profit loss account and maturity stage;
(G) Income tax ordinance, waste
description according the demand of three of 1984;
(H) Income calculating according
to the income law.
(6) Attach separate description:
(C) Wife or Husband of tax payer
(in case of not having tax payer) any income in the name of children or
dependable person.
(D) Tax free income in case of
have.
(4)Income tax regulation- 38
has to be followed in case of return submission in case of particulars.
(5) The submitted documents
have to be in signature of tax payer.
(6) Every five year the
picture has to be submitted.
(7) Provide the bellow
description:
(A) Name and address of
partner farm of T.I.N.
(B) Name and Address with
T.I. N of partner of taxpayer.
(C) Name and Address with
TIN if the tax payer director of company.
(8) Tax payer himself
husband/ wife (if he is not tax payer), non adult and property of dependable,
as per IT 10 B has to be shown.
(9) The signature of tax
payer or his representative is mandatory. Signature in IT- 10 B and IT- 10BB is
mandatory of the tax payer.
(10) In case of space not
available separate paper will be able to be use.
…………………………………………………………………………………………………………..
Total Income Shown in the
Return : TK : 464,055/-
Paid up tax : TK. 23,906/-
Net assets of the taxpayer : TK. :80,31,356
Date of receiving the income
statement : …………………… Serial
No. of return register : ……………..
Sort of income statement
: Self Assessing Universal General
Ba: Sa:Su:
2009/10-18019F-30,00,000 Copies, (C-15)2010
(Seal & Signature of receiving officer)
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