Form_pdf_802904360020125
Form_pdf_802904360020125
(A1) PAN (A2) First Name (A2a) Middle Name (A3) Last Name
AKIPR7119P RAVI KUMAR PRAKASAM
(A5) Aadhaar Number(12 digits)/Aadhaar Enrolment Id(28 digits) (if
(A4) Date of Birth (A6) Mobile No
eligible for Aadhaar No.)
28/04/1981 +91 9739369261
9xxx xxxx 4430
(A8) Flat/Door/Block No. (A9) Name of (A10) Road/Street/Post Office,
(A7) Email Address
55 7TH CROSS 7TH C Premises/Building/Village Area/Locality
ravikumar198162@yahoo.co.in
MAINDEVASANDRA Geetha Clinic Bangalore North
(A11) Town/City/District (A12) State (A13) Country/Region (A14) PIN Code/ZIP Code
BANGALORE 15-Karnataka 91-INDIA 05660036
*If the return is verified after 30 days of transmission of return data electronically, then date of verification will be considered as date of filing the
return (Notification No.05 of 2022 dated 29-07-2022 issued by the DGIT (Systems), CBDT).”
Acknowledgement Number : 802904360020125 Date of Filing : 02-Jan-2025*
Sl.
Nature of Exempt Allowances Description ( If Any Other selected) Total Amount
No.
iia Less : Income claimed for relief from taxation u/s 89A iia 0
Income chargeable under the head 'House Property' (iii - iv - v) + vi (If loss, put the figure in
vii B2 0
negative)
Sl.
Nature of Income Description ( If Any Other selected) Total Amount
No.
Quarterly breakup of Dividend Income Quarterly breakup of Income from retirement benefit
account maintained in a notified country u/s 89A
(taxable portion)
*If the return is verified after 30 days of transmission of return data electronically, then date of verification will be considered as date of filing the
return (Notification No.05 of 2022 dated 29-07-2022 issued by the DGIT (Systems), CBDT).”
Acknowledgement Number : 802904360020125 Date of Filing : 02-Jan-2025*
Gross Total Income (B1+B2+B3) (If loss, put the figure in negative) Note: To avail the benefit
B4 B4 6,65,857
of carry forward and set off of loss, please use ITR-2
0
C8 80DDB - Medical treatment of specified disease - 0
*If the return is verified after 30 days of transmission of return data electronically, then date of verification will be considered as date of filing the
return (Notification No.05 of 2022 dated 29-07-2022 issued by the DGIT (Systems), CBDT).”
Acknowledgement Number : 802904360020125 Date of Filing : 02-Jan-2025*
C14 80GG - Rent paid (Please submit form 10BA to claim deduction) 0 0
*If the return is verified after 30 days of transmission of return data electronically, then date of verification will be considered as date of filing the
return (Notification No.05 of 2022 dated 29-07-2022 issued by the DGIT (Systems), CBDT).”
Acknowledgement Number : 802904360020125 Date of Filing : 02-Jan-2025*
Total 0
D6 Relief u/s 89 (Please ensure to submit Form 10E to claim this relief) D6 0
D11 Total Tax, Fee and Interest (D5 + D7 + D8 + D9 + D10 - D6) D11 0
D14 Refund (D12 - D11) (if D12 > D11) D14 50,390
PART E - OTHER INFORMATION DETAILS OF ALL BANK ACCOUNTS HELD IN INDIA AT ANY TIME DURING THE PREVIOUS YEAR
(EXCLUDING DORMANT ACCOUNTS)
Sl.
IFS Code of the Bank Name of the Bank Account Number Type of account
No.
SCHEDULE 80D
1 Whether you or any of your family member (excluding parents) is a senior citizen? No
*If the return is verified after 30 days of transmission of return data electronically, then date of verification will be considered as date of filing the
return (Notification No.05 of 2022 dated 29-07-2022 issued by the DGIT (Systems), CBDT).”
Acknowledgement Number : 802904360020125 Date of Filing : 02-Jan-2025*
(a) Parents 0
Sl. Date of filing of Form Ack. No. of Form 10IA UDID Number (If
Nature of Disability Amount of Deduction
No. 10IA filed available)
1 0
Details of deduction in respect of maintenance including medical treatment of a dependent who is a person with
Schedule 80DD
disability.
Sl. Nature of Amount of Type of PAN of the Aadhaar of the Date of filing of Ack. No. of Form UDID Number (If
No. Disability Deduction dependent dependent dependent Form 10IA 10IA filed available)
1 0
SCHEDULE 80G DETAILS OF DONATIONS ENTITLED FOR DEDUCTION UNDER SECTION 80G
A. DONATIONS ENTITLED FOR 100% DEDUCTION WITHOUT QUALIFYING LIMIT, (WHERE ANY ROW IS FILLED BY THE USER, ALL THE
FIELDS IN THAT ROW SHOULD BECOME MANDATORY)
(1) (2) (3) (4) (5) (6) (7) (9) (10) (11) (12)
Total A 0 0 0 0
*If the return is verified after 30 days of transmission of return data electronically, then date of verification will be considered as date of filing the
return (Notification No.05 of 2022 dated 29-07-2022 issued by the DGIT (Systems), CBDT).”
Acknowledgement Number : 802904360020125 Date of Filing : 02-Jan-2025*
B. DONATIONS ENTITLED FOR 50% DEDUCTION WITHOUT QUALIFYING LIMIT (WHERE ANY ROW IS FILLED BY THE USER, ALL THE
FIELDS IN THAT ROW SHOULD BECOME MANDATORY)
(1) (2) (3) (4) (5) (6) (7) (9) (10) (11) (12)
Total B 0 0 0 0
C. DONATIONS ENTITLED FOR 100% DEDUCTION SUBJECT TO QUALIFYING LIMIT (WHERE ANY ROW IS FILLED BY THE USER, ALL THE
FIELDS IN THAT ROW SHOULD BECOME MANDATORY)
(1) (2) (3) (4) (5) (6) (7) (9) (10) (11) (12)
Total C 0 0 0 0
D. DONATIONS ENTITLED FOR 50% DEDUCTION SUBJECT TO QUALIFYING LIMIT (WHERE ANY ROW IS FILLED BY THE USER, ALL THE
FIELDS IN THAT ROW SHOULD BECOME MANDATORY)
(1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12)
Total D 0 0 0 0
*If the return is verified after 30 days of transmission of return data electronically, then date of verification will be considered as date of filing the
return (Notification No.05 of 2022 dated 29-07-2022 issued by the DGIT (Systems), CBDT).”
Acknowledgement Number : 802904360020125 Date of Filing : 02-Jan-2025*
(1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12)
Total 0 0 0 0
Total 0 0 0 0
TAX PAYMENTS
Sl.
BSR Code Date of Deposit (DD/MM/YYYY) Serial Number of Challan Tax paid
No.
Total 0
SCHEDULE TDS1 - DETAILS OF TAX DEDUCTED AT SOURCE FROM SALARY [AS PER FORM 16 ISSUED BY EMPLOYER(S)]
Sl. Income chargeable under
TAN of the Deductor Name of the Deductor Total Tax Deducted
No. salaries
Total 50,388
SCHEDULE TDS2 - DETAILS OF TAX DEDUCTED AT SOURCE FROM INCOME OTHER THAN SALARY [AS PER FORM 16A ISSUED BY
DEDUCTOR(S)]
Gross receipt which
Sl. Name of the Year of tax TDS Credit out of
TAN of the Deductor is subject to tax Tax Deducted
No. Deductor deduction (5)claimed this year
deduction
Total 0
SCHEDULE TDS3 DETAILS OF TAX DEDUCTED AT SOURCE (AS PER FORM 16C FURNISHED BY THE PAYER(S))
Total 0
SCHEDULE TCS
*If the return is verified after 30 days of transmission of return data electronically, then date of verification will be considered as date of filing the
return (Notification No.05 of 2022 dated 29-07-2022 issued by the DGIT (Systems), CBDT).”
Acknowledgement Number : 802904360020125 Date of Filing : 02-Jan-2025*
Total 0
VERIFICATION
I, RAVI KUMAR PRAKASAM son/ daughter of NANDA PRAKASAM solemnly declare that to the best of my knowledge and belief, the information
given in the return is correct and complete and is in accordance with the provisions of the Income-tax Act, 1961. I further declare that I am making
this return in my capacity as Self and I am also competent to make this return and verify it. I am holding permanent account number AKIPR7119P
Place: 171.76.87.1
Date: 02-Jan-2025
If the return has been prepared by a Tax Return Preparer (TRP) give further details below:
If TRP is entitled for any reimbursement from the Government, amount thereof 0
*If the return is verified after 30 days of transmission of return data electronically, then date of verification will be considered as date of filing the
return (Notification No.05 of 2022 dated 29-07-2022 issued by the DGIT (Systems), CBDT).”