Post on 18-Jun-2022
3
5
7
Statement of assets and liabilities for Salaried preson(as on 30/06/2016 )
Md. Sakir Hossain 5 5 1 1 4 2 1 0 5 9 0 8
11,556,000
Inharited 1,050,000
500,000
360,000860,000
2,600,000
40,000250,000
170,000
41,600689,400
731,000560,000
17,817,000
2,156,000
2,156,000
15,661,00014,088,650
1,572,350560,000
2,132,350
1,718,350414,000
2,132,350
50 TollaDhaka Metro Kha-2450 (15000cc)
Note-8
Note-9
Note-11
Note-10
4 katha land with 3 storied building of Badda
5 Acore land of Sirajganj
P.F Fund
(Including Tax)
16 17
ONLY FOR THE SALARIEDINDIVIDUAL
11UMA
12345678
9
Note-1
Note-3
Note-4
Note-5
Note-6
Note-7
Note-2
5 5 1 1 4 2 1 0 5 9 0 8
2 6 1 9 3 5 1 9 6 1 0 95
1,69,620
1,300,000256,350
12,000
1,718,3502,28,670
59,0501,69,620
1,50,000
Nil
Md. Sakir Hossain
551142105908
30 06
0 1 0 3 1 9 6 8
306 (salary) 14
Sunbulah Welfarre Association
House-13, Sector-13, Uttara, Dhaka
15
√
wZb cvZvi dig-IT-UMA
Md. Sakir Hossain 2016 2017
5 5 1 1 4 2 1 0 5 9 0 8
1,718,350 1,69,620
17,817,000 15,661,000
306 (salry) : 14:
Name of the Assessee: Md. Sakir Hossain
Amount of Amount of Net income exempted taxable
Income Income(Tk.) (Tk.) (Tk.)
Basic pay 960,000 - 960,000Special pay - - - Dearness allowance - - - Conveyance allowance 30,000 30,000 - House rent allowance 384,000 300,000 84,000 Medical allowance 84,000 84,000 - Servant allowance - - - Leave allowance/encashment - Honorarium/ Reward/ Fee - - - Overtime allowance - - - Bonus/Ex-gratia 160,000 - 160,000 Other allowances - - - Employer's Contribution to P.F (Recognised) Interest accrued on Recognised P. F. - - - Deemed income for transport facility - - - Deemed income for free accommodation - - - Others if any (give detail) - - - Net taxable income from salary 1,714,000 414,000 1,300,000
Working SheetSCHEDULES SHOWING DETAILS OF INCOME
Schedule - I (Salaries)
Schedule-I (Salaries)
Pay and Allowance
TIN: 551142105908
Note-1
Note-2Schedule-2 (House Property income)
Location and Particulars TK. Tk.description of property
1. Annual rental income 612,000 2. Claimed Expenses :Repair, Collection, etc. 153,000 Municipal or Local Tax 45,600 Land Revenue 450 Interest on Loan/Mortgage/Capital Charge 105,600 Insurance Premium - Vacancy Allowance 51,000 Other, if any - Total = 355,650 355,650 3. Net income ( difference between item 1 and 2) 256,350
96,000 96,000
Note-7
Tax Deducted Paid in Advance/with Return:Tax Deducted at Source as Per Salary 108,000/-Tax Deducted at Source BRTA 15,000/-Tax Deducted at Source as Per Bank statement 17,500/-Advance Tax Paid As Per Challan Divident warent pay order 15,000/-Tax Paid with Return 14,120/- Total TK. 169,620/-
Note-8
Land/House property (Description and location of property)GB RvqMvq Avcbvi evox Ges †Kv_vq Aew¯’Z Zv _vK‡e GKvwaK evox _vK‡j RvqMv msKzjb
bv n‡j c„_K KvMR wjL‡Z n‡e |
Note-9
Land (Total land and location of land property)GB RvqMvq Avcbvi Rwg Ges †Kv_vq Aew¯’Z Zv _vK‡e GKvwaK evox _vK‡j RvqMv msKzjb
bv n‡j c„_K KvMR wjL‡Z n‡e|
Note-10
‡bvU 1 G D‡jøwLZ 3q Kjvg Amount of exempted income Gi Total UvKv GLv‡b
Avm‡e|
Note-11
Any other assets:
Md. Asraful Islam (Son)5 khata Land of Gazipur 3,85,000/-Mrs. Rasma (Doughter) 2 khata land of Gazipur 1,75,000/- 5,60,000/-
[wb‡Ri Dci wbf©ikxj †Q‡j, †g‡q, ¯¿xi †Kvb m¤úwË _vK‡j Ges Zv‡`i bv‡g †Kvb AvqKi
dvBj bv _vK‡j D³ Kjv‡g †`Lv‡Z n‡e|]
Note-3
Total Income from Agricultural 30,000/- ( -)Exempenses 60% 18,000/- Net Income tk. 12,000/-
wnmv‡ei LvZv cÎ bv ivLv n‡j 60% LiP Aby‡gv`b †hvM¨ |
Note-4
Income from Other Source: Dividend income from ICAB Unite Certificate 135,000/-Less: Exampted 25,000/- 110,000/-Bank Interest 40,000/- Total Income from Other Source 150,000/-
Note-5
CALCULATION OF TAX LIABILITY ON TOTAL INCOME1st Taka 250,000 NIL NILOn next Taka 400,000 10% 40,000 On next Taka 500,000 15% 75,000 On next Taka 568,350 20% 113,670
Tax rebate: 15% on allowable investment 59,050 Total gross tax 169,620 Tax paid at source + Advance payment 155,500 Balance payable
1,718,350 228,670
14,120
Note-6
Schedule-3 (Investment tax credit)(Section 44(2)(b) read with part ‘B’ of Sixth Schedule)
1. Life insurance premium Tk. 15,000 2. Contribution to deferred annuity Tk. - 3. Tk. - 4. Tk. 5. Contribution to Super Annuation Fund Tk. - 6. Tk.
192,000
7. Contribution to deposit pension scheme Tk. 8. Tk. - 9. Contribution to Zakat Fund Tk. -
10. Others, if any (Laptop computer ) Tk. - Total= 467,000
200,000
60,000
Contribution to Provident Fund to which Provident Fund Act, 1925 applies Self contribution and employer’s contribution to Recognized Provident Fund
Investment in approved debenture or debenture stock, Stock or Shares
Contribution to Benevolent Fund and Group Insurance premium
First 250,000 15% = 37,500Rest 179,588 12% = 21,550 429,588 59,050
Note-6
2619351961095
2016-2017
†Mv‡ìb evsjv‡`k
5 5 1 1 4 2 1 0 5 9 0 4
AvU cvZvi dig-IT-GA6
13,00,000.00
15,000.00
-
-
6
2,56,350.00
12,000.00
1,69,620.00
1,25,000.00
1,40,500.00
14,120.00
1,50,000.00
17,18,350.00
17,18,350.00
2,28,670.00
59,050.00
1,69,620.00
2,00,000.00
4
Zdwmj-3 (wewb‡qvM RwbZ Ki †iqvZ)
AvqKi Aa¨v‡`‡ki Zdwmj-6 Gi we As‡ki mv‡_ cwVZe¨ aviv 44(2)(we)-
1| Rxeb exgvi cÖ` &Ë wKw¯Í UvKv 15,000.00
2| fwel¨‡Z cÖvc¨ evwl©K fvZv cÖvwßi D‡Ï‡k¨ cÖ`Ë Puv`v UvKv
3| fwel¨ Znwej AvBb, 1925 Abyhvqx cÖ‡hvR¨ fwel¨ Znwe‡j
cÖ`Ë Puv`v UvKv
4| ¯̂xK…Z fwel¨ Znwe‡j ¯̂xq I wb‡qvMKZ©v KZ©„K cª`Ë Puv`v UvKv 1,92,000.00
5| Aby‡gvw`Z eqmRwbZ Znwe‡j cÖ`&Ë Puv`v UvKv
6| Aby‡gvw`Z FYcÎ ev wW‡eÂvi ÷K, ÷K ev †kqvi G wewb‡qvM UvKv
7| wW‡cvwRU †cbkb ¯‹x‡g cÖ`Ë Puv`v UvKv 60,000.00
8| Kj¨vY Znwe‡j cÖ`Ë Puv`v Ges †Mvôx exgv ¯‹x‡gi Aaxb cÖ`Ë
wKw¯Í UvKv
9| hvKvZ Znwe‡j cÖ`Ë Puv`v UvKv
10| Ab¨vb¨, hw` _v‡K (weeiY w`b) UvKv
†gvU UvKv 4,67,000.00
* AbyMÖn K‡i wewb‡qvMmg~‡ni cÖZ¨qbcÎ/cÖgvYcÎ mshy³ Kiæb|
AvqKi wiUv‡Y©i mv‡_ `vwLjK…Z `wjjcÎvw`i ZvwjKv
1| †eZ‡bi weeiY
6| wW‡cvwRU †cbmb ¯‹x‡gi e¨vsK weeibxi
d‡UvKwc
2| e¨vsK weeibxi d‡UvKwc 7| mÂqcÎ µ‡qi mvwU©wd‡K‡Ui d‡UvKwc
3| wmwU Ki‡cv‡ik‡b Ki cÖ`v‡bi iwk‡`i d‡UvKwc 8|
4| f~wg ivR¯̂ Gi iwk‡`i d‡UvKwc| 9|
5| Rxeb exgvi wKw¯Íi iwk‡`i d‡UvKwc 10|
Am¤ú~Y© wiUvY© MÖnY‡hvM¨ n‡e bv|
3
Av‡qi we¯ÍvwiZ weeiYx m¤^wjZ Zdwmj
weeiYx m¤̂wjZ Zdwmj
Ki`vZvi bvgt- †gvt mvwKi †nv‡mb
Zdwmj-1 (†eZbvw`)
‡eZb I fvZvw`
Av‡qi
cwigvY (UvKv)
Ae¨vnwZcÖvß Av‡qi
cwigvY (UvKv)
bxU Ki‡hvM¨
Avq (UvKv)
g~j †eZb (80,000 x 12) 9,60,000.00 9,60,000.00
we‡kl †eZb
gnvN© fvZv
hvZvqvZ fvZv (2,500 x 12) 30,000.00 30,000.00 -
evwo fvov fvZv (32,000 x 12) 3,84,000.00 3,00,000.00
wPwKrmv fvZv (7,000 x 12) 84,000.00 84,000.00 -
cwiPviK fvZv
QzwU fvZv
m¤§vbx/cyi¯‹vi/wd
Ifvi UvBg fvZv
‡evbvm/G·-‡MÖwmqv (80,000 x 2) 1,60,000.00 1,60,000.00
Ab¨vb¨ fvZv
¯^xK…Z fwel¨ Znwe‡j wb‡qvMKZ©v KZ©„K cÖ`Ë Puv`v 96,000.00 96,000.00
¯^xK…Z fwel¨ Znwe‡j AwR©Z my`
hvbevnb myweavi Rb¨ we‡ewPZ Avq
webvg~‡j¨ mw¾Z ev A-mw¾Z evm ’̄v‡bi Rb¨ we‡ewPZ Avq
Ab¨vb¨, hw` _v‡K (weeiY w`b)
‡eZb n‡Z bxU Ki‡hvM¨ Avq 17,14,000.00 4,14,000.00 13,00,000.00
Zdwmj-2 (M„n m¤úwËi Avq)
M„n m¤úwËi Ae ’̄vb I eY©bv weeiY UvKv UvKv
`w¶b Lvb, DËiv, XvKv 1| fvov eve` evwl©K Avq 6,12,000.00 4_© Zjv evox 2| `vexK…Z e¨qmg~n t
1g Zjv (9,000 x 12)= 1,08,000 ‡givgZ, Av`vq, BZ¨vw` 1/4 1,53,000.00
‡cŠi Ki A_ev ¯’vbxq Ki 45,600.00
2q Zjv (11,000x
x
f~wg ivR¯̂ 450.00
F‡Yi Dci my`/eÜKx/g~jabx PvR© 1,05,600.00 exgv wKw¯—
M„n m¤úwË Lvwj _vKvi Kvi‡Y `vweK…Z †iqvZ
Ab¨vb¨, hw` _v‡K
†gvU = 3,55,650.00
3| bxU Avq (µwgK bs 1 n‡Z 2 Gi we‡qvMdj) 2,56,350.00
3q Zjv (10,000x
x
84,000.00
51,000.00
3,55,650.00
-
-
-
c~e©eZ©x c„ôvi †Ri UvKv 17,257,000.00
10| Ab¨vb¨ cwim¤c`
UvKv 5,60,000.00
5 KvVv Rwg MvRxcy‡i †Q‡ji bv‡g 3,85,000.00
2 KvVv Rwg MvRxcy‡i †g‡qi bv‡g 1,75,000.00
†gvU cwim¤c` = UvKv 1,78,17,000.00
11| ev`t `vqmg~n
(K) m¤c` A_ev Rwg eÜK UvKv -
(L) RvgvbZ wenxb FY`vq UvKv -
(M) e¨vsK FY UvKv 21,56,000.00
(N) Ab¨vb¨ UvKv -
†gvU `vq = UvKv 21,56,000.00
12|
GB Avq erm‡ii †kl Zvwi‡Li bxU m¤c` (†gvU cwim¤ú` n‡Z †gvU
`v‡qi we‡qvMdj) UvKv
13| weMZ Avq erm‡ii †kl Zvwi‡Li bxU m¤c` UvKv 1,40,88,650.00
14|
m¤ú‡`i cwie„w× (µwgK 12 n‡Z 13 Gi we‡qvMdj)
UvKv 5,60,000.00
UvKv 15,72,350.00
15|
(K) cvwievwiK e¨q t [ dig bs AvBwU-10wewe Abyhvqx †gvU LiP ]
(L) cwiev‡ii wbf©ikxj m`m¨ msL¨vt
c~Y© eq¯‹ wkï
16|
m¤ú‡`i †gvU cwie„w× (µwgK 14 Ges 15 Gi †hvMdj ) UvKv
21,32,350.00
17| AwR©Z Znwej mg~nt -
(1) cÖ`wk©Z wiUvb© Avq UvKv 17,18,350.00
(2) Ki Ae¨vnwZ cÖvß I Kigy³ Avq UvKv 4,14,000.00
(3) Ab¨vb¨ cÖvwß UvKv
†gvU AwR©Z Znwej = UvKv 21,32,350.00
18| cv_©K¨ (µwgK 16 n‡Z 17 Gi we‡qvMdj )= UvKv
Avwg wek¦¯’’Zvi mv‡_ †lvlYv KiwQ †h, Avgvi Ávb I wek¦vm g‡Z AvBwU-10we †Z cÖ`Ë Z_¨ mwVK I m¤c~Y©|
Ki`vZvi bvg I ¯̂v¶i
ZvwiLt
* Ki`vZvi wb‡Ri, Zuvi ¯Îx/¯^vgxi (wiUvb© `vwLjKvix bv n‡j),bvevjK I wbf©ikxj mšÍ vb‡`i cwim¤c` I `vq
* cÖ‡qvR‡b c„_K KvMR e¨envi Kiæb|
6
Dcwi-D³ weeiYx‡Z cÖ`k©b Ki‡Z n‡e|
1,56,61,000.00
01
02
AvBwU-10we
cwim¤c`, `vq I e¨q weeiYx (30-06-2016 Zvwi‡L)
Ki`vZvibvgt †gvt mvwKi †nv‡mb wUAvBGbt
1|
(K) e¨emvi cuywR (g~ja‡bi †Ri)
UvKv ---------------
(L) cwiPvjK wnmv‡e wjwg‡UW †Kv¤úvbx‡Z †kqvi wewb‡qvM (µq g~j¨)
UvKv -------------
†Kv¤úvbxi bvg
‡kqv‡ii msL¨v
2| A-K…wl m¤úwË (AvBb m¤§Z e¨qmn µq g~j¨)
t (Rwg/M„n m¤cwË (m¤cwËi weeiY I Ae ’̄vb)
UvKv 1,15,56,000.00
(4 KvVv Rwgi Dci 3q Zjv wewìs
evÇv, ¸jkvb, XvKv)
3|
K…wl m¤úwË (AvBb m¤§Z e¨qmn µq g~j¨) t c~‡e©i b¨vq
UvKv 10,50,000.00
( Rwg (†gvU Rwgi cwigvb I Rwgi Ae ’̄vb)
(5 weNv Rwg wmivRMÄ †PŠnvjx Dc‡Rjvq)
4| wewb‡qvMt
(K) †kqvi/wW‡eÂvi UvKv
(L) mÂqcÎ/BDwbU mvwU©wd‡KU/eÛ
UvKv 5,00,000.00
(M) cÖvBR eÛ/mÂq ¯‹xg
UvKv
(N) FY cÖ`vb UvKv
(O) Ab¨vb¨ wewb‡qvM- fwel¨r Znwej
UvKv 3,60,000.00
†gvU = UvKv 8,60,000.00
5| †gvUi hvb (µqg~j¨) UvKv 26,00,000 .00
†gvUi hv‡bi cÖK…wZ I †iwR‡ó«kb b¤^i
(1500 wmwm U‡qvUv Kvi, bs XvKv g¨vUª-
N 5550)
6|
AjsKvivw` (cwigvb I µqg~j¨) 30 †Zvjv
we‡q‡Z `vbK…Z UvKv
7| AvmevecÎ (µqg~j¨) we‡q‡Z `vbK…Z c~‡e©i b¨vq UvKv 2,50,000.00
40,000.00
8| B‡jKUªwbK mvgMÖx (µqg~j¨) j¨vcUc UvKv 1,70,000.00
9|
e¨emv ewnf©~Z A_© m¤c`
UvKv
(K) bM` UvKv 41,600.00
(L) e¨vs‡K Mw”QZ
UvKv 6,89,400.00
(M) Ab¨vb¨
UvKv
†gvU = UvKv 7,31,000.00
7
dig
AvqKi Aa¨v‡`k, 1984 Gi aviv 75(2)(wW)(AvB) Ges aviv 80 Abymv‡i
e¨w³ Ki`vZvi Rxeb hvÎvi gvb m¤cwK©Z Z‡_¨i weeibx|
Ki`vZvi bvgt †gvt mvwKi †nv‡mb wUAvBGb
µwgK
b¤ ^i
Li‡Pi weeiY UvKvi cwigvY gšÍe¨
1 e¨w³MZ I fib‡cvlb LiP Uvt 180,000.00
2
Dr†m Ki KZ©bmn weMZ A_© erm‡i cwi‡kvwaZ AvqKi
Uvt 1,55,500.00
3
Avevmb msµvb LiP
Uvt
4
e¨w³MZ hvbevnb e¨envi msµvšÍ hveZxq LiP
Uvt 120,000.00
5
AvevwmK we` y¨r wej
Uvt 9,850.00
6
AvevwmK cvwbi wej
Uvt 4,600.00
7
AvevwmK M¨vm wej
Uvt 5,400.00
8
AvevwmK †Uwj‡dvb wej
Uvt
9
mšÍvb‡`i †jLvcov LiP
Uvt 47,000.00
10
wbR e¨‡q we‡`k ågb msµvšÍ LiP
Uvt
11
Drme e¨qmn Ab¨vb¨ we‡kl e¨q, hw` _v‡K
Uvt 30,000.00
‡gvU LiP
Uvt 5,60,000.00
cÖ`Ë Z_¨ mwVK I m¤ú~Y©|
Ki`vZvi bvg I ¯̂v¶i
ZvwiLt
* cÖ‡qvR‡b c„_K KvMR e¨envi Kiæb|
AvqKi wiUvb© cÖvwß ¯̂xKvi cÎ
Ki`vZvi bvgt †gvt mvwKi †nv‡mb Ki ermit 2016-2017
BDwUAvBGb
/wUAvBGbt
dig bs AvBwU-10 wewe
Avwg wek¦¯ÍZvi mv‡_ †lvlYv KiwQ †h, Avgvi Ávb I wek¦vm g‡Z GB AvBwU-10wewe †Z
wb‡R WªvBwfs Kwi
7,650.00
1,69,620.00
PART IIParticulars of Income and Tax
Particulars of Total Income Amount $
TIN
Salaries (annex Schedule 24A)24
25 Interest on securities
S.21
S.22
S.24
S.26
S.28
S.31
S.33
S.43
Income from house property (annex Schedule 24B)26
27 Agricultural income
28 Income from business or profession
(annex Schedule 24C)
29 Capital gains
30 Income from other sources
31 Share of income from firm or AOP
Income of minor or spouse under section 43(4)32
Foreign income33
34 Total income (aggregate of 24 to 33)
Tax Computation and Payment Amount $
Gross tax before tax rebate
Tax rebate (annex Schedule 24D)36
35
37 Net tax after tax rebate
38 Minimum tax
Net wealth surcharge39
40 Interest or any other amount under the Ordinance (if any)
41 Total amount payable
Tax deducted or collected at source (attach proof)42
43 Advance tax paid (attach proof)
44 Adjustment of tax refund [mention assessment year(s) of refund]
45 Amount paid with return (attach proof)
46 Total amount paid and adjusted (42+43+44+45)
47 Deficit or excess (refundable) (41-46)
Tax exempted income48
5 5 1 1 2 2 1 0 5 9 0 1
1,300,000
256,350
12,000
150,000
1,718,350
228,670
59,051
169,620
169,620
140,500
15,000
14,120
The following schedules shall be the integral part of this return and
must be annexed to return in the following cases:
Schedule 24A if you have income from Salaries
Schedule 24B if you have income from house property
Schedule 24C if you have income from business or profession
Schedule 24D if you have investment and claim tax rebate
IT-11GA2016
RETURN OF INCOMEFor an Individual Assesse
photo
-
PART IBasic information
03 Name of the Assessee: Md. Sakir Hossain 04 Gender M √ F
05 Twelve-digit TIN: 551142105908 06 Old TIN
07 Circle: 306 (Salary) 08 Zone-14
09 Resident Status (tick one) Resident √ Non-resident
10 Tick on the box(es) below if you are:
10AA gazetted war-woun-ded freedom fighter 10B A person with disability
10C Aged 65 years or more 10DA parent of a person withdisability
11 Date of birth (DDMMYYYY) 12 Income Year
2015 to 2016
13 If employed, employer’s name: Golden Bangladesh
Spouse Name: Mrs. Rebeka khatun 14 15 Spouse TIN (if any): 55142104102
16 Father’s Name: Md. Moshiur Rahman Mother’s Name: Nurjahan Begum17
18 Present Address: House-6, Road-1, Sector-4, Uttara , Dhaka-1230
19 Permanent Address: Vill. SantosaPost. Stall, Thana. Chowhali , Dist. Sirajganj
20 Contact Telephone: 8951233 21
23
Business Identification Numbers22 National Identification Number:2619351961095
01 Assessment Year 02 Return submitted under
2 0 1 6 1 7 section82BB? (tick one)
Yes √ No
0 1 0 3 1 9 6 8
bZzb dig-IT-GHA-2016
ACKNOWLEDGEMENT RECEIPT OFRETURN OF INCOME
Individual
Assessment Year Return under section 82BB? (tick one)
2 0 1 6 1 7-Yes No
Name of the Assessee: Md. Shakir Hossain
Twelve-digit TIN: 551142105908 Old TIN
Circle: 306 (Salary) Taxes Zone: 14
Total income shown (serial 34): 1,718,350
$
Amount payable (serial 41): 172,500 $
Amount paid and adjusted (serial 46):172,500
$
Amount of net wealth shown in IT10B15,661,000 $
Amount of net wealth surcharge paid$
Date of Submission (DD– MM –YYYY) Tax Office Entry Number
Signature and seal of the official receiving the return
Date of Signature Contact Number of Tax Office
2 0
√
49
50
51
52
53
54
PART IIIInstruction, Enclosures and Verification
TIN
Instructions1. Statement of assets, liabilities and expenses (IT-10B) and statement of life style expense (IT-10BB) must be furnished with the return unlessyou are exemptedfrom furnishing such statement(s) under section 80.2. Proof of payments of tax, including advance tax and withholding taxand the proof of investment for tax rebate must be provided along with return.3. Attach account statements and other documents where applicable
If you are a parent of a person with disability, has your spouseavailed the extended tax exemption threshold? (tick one)
Schedules annexed(tick all that are applicable)
24A 24B 24C 24D √
Statements annexed(tick all that are applicable)
IT-10B2016 IT-10BB2016
Other statements, documents, etc. attached (list all)
Are you required to submiit a statement of assets, liabilities and expenses (IT-10B2016) under section 80(1)? (tick one)
Verification and signature
VerificationI solemnly declare that to the best of my knowledge and belief the information given in this return and statements and documents annexed or attached herewith are correct and complete.
Name Signature
Date of Signature (DDMMYY) Place of Signature
2 0
2 0
For official use onlyReturn Submission Information
Date of Submission (DD– MM –YYYY) Tax Office Entry Number
5 5 1 1 2 2 1 0 5 9 0 1
Yes No
Yes No
√ √
√
√
SCHEDULE 24BParticulars of income from house property
Annex this Schedule to the return of income if you have income from house property
01 02Assessment Year: 2016-17 TIN:551142105908
For each house property
03 Description of the house property
03A Address of the property 03B Total area
03C Share of the asessee (%)
Income from house property Amount
Annual Value04
$
05 Deductions (aggregate of 05A to 05G)
05A Repair, Collection, etc.
05B Municipal or Local Tax
05C Land Revenue
05D Interest on Loan/Mortgage/Capital Charge
05E Insurance Premium
05F Vacancy Allowance
05G Other, if any
06 Income from house property (04-05)
07 If case of partial ownership., the share of income
Provide information if income from more than one house property
08 Aggregate of income of all house properties (1+2+3+- - - )(provide additional papers if necessary) $
$
$
$
1 (Income from house property 1)
2 (Income from house property 2)
3 (Income from house property 3)
Name: Md. Sakir Hossain Signature & Date
612,000
153,000
45,600
450
105,600
51,000
256,350
SCHEDULE 24AParticulars of income from Salaries
Annex this Schedule to the return of income if you have income from Salaries
01 Assessment Year: 2016-17 02 TIN: 551142105908
ParticularsAmount Tax exempted Taxable
(A) (B) (C = A-B)03 Basic pay
Special pay
05 Arrear pay (if not included in taxableincome earlier)
04
06
07
Dearness allowance
House rent allowanceMedical allowance08
091011
12
13
14
15
1617
18
19
Deemed income for free furnished/unfurnished accommodation
20
2122
Name: Md. Sakir Hossain Signature & Date
All figures of amount are in taka ($)
Conveyance allowanceFestival Allowance
Allowance for support staff
Leave allowance
Honorarium/ Reward/Fee
Overtime allowance
Bonus / Ex-gratia
Other allowancesEmployer’s contribution to arecognized provident fundInterest accrued on a recognizedprovident fund
Deemed income for transport facility
TotalOther, if any (give detail)
960,000 960,000
384,000 300,000 84,000 84,000 84,000 30,000 30,000
160,000 160,000
96,000 96,000
1,714,000 414,000 1,300,000
SCHEDULE 25tobe annexed to the Statement of Assets, Liabilities and Expenses (IT-10B)
01 02Assessment Year: 2016-17 TIN: 551142105908
03 Shareholdings in limited companies as director No. of shares Value$
1
2
3
4
1
2
3
4
1
2
3
4
04 Non-agricultural property at costvalue or any advance made for
such property (description,location and size)
Value at thestart of
income year$
increased/decreasedduring the
income year$
Value at thelast date of
income year$
Value at thestart of
income year$
increased/decreasedduring the
income year$
Value at thelast date of
income year$
05 Agricultural property at cost value(description, location and size)
(Provide additional paper if necessary)
Name: Md. Sakir Hossain Signature & Date.”;
11,556,0004 Khata Land and 2 Storied Building at Dakkin Khan, Uttara, Dhaka 11556000
5 Acore Land at Sirajganj 1,050,000 1,050,000
SCHEDULE 24DPARTICULARS OF TAX CREDIT/REBATE
TO BE ANNEXED TO RETURN BY AN ASSESSEE CLAIMING INVESTMENT TAX CREDIT(ATTACH THE PROOF OF CLAIMED INVESTMENT, CONTRIBUTION, ETC.)
01 Assessment Year: 2016-17 02 TIN: 551142105908
Particulars of rebatable investment, contribution, etc. Amount
03 Life insurance premium
04 Contribution to deposit pension scheme (not exceeding allowable limit)
05 Investment in approved savings certificate
06Investment in approved debenture or debenture stock, Stock orShares
07 Contribution to provident fund to which Provident Fund Act,1925 applies
08 Self contribution and employer’s contribution to RecognizedProvident Fund
09 Contribution to Super Annuation Fund
10 Contribution to Benevolent Fund and Group Insurance Premiu
11 Contribution to Zakat Fund
12 Others, if any ( give details )
13 Total allowable investment, contribution etc.
14 Eligible amount for rebate (the lesser of 14A, 14B or 14C)
14A Total allowable investment, contribution, etc. (as in 13)25 % of the total income (excluding any income for which a tax exemption or a reduced rate is applicableunder subsection (4) of section 44 or any income fromany source or sources mentioned in clause (a) of sub-section (2) of section 82C.)
14B
14C 1.5 crore
15Amount of tax rebate calculated on eligible amount (Serial 14)under section 44(2)(b)
Name: Md. Sakir Hossain Signature & Date
15,000
60,000
200,000
192,000
467,000
467,000
429,588
59,050
429,588
IT-10B2016
STATEMENT OF ASSETS, LIABILITIES AND EXPENSESunder section 80(1) of the Income Tax Ordinance, 1984 (XXXVI of 1984)
1. Mention the amount of assets and liabilities that you have at the last date of the income year. All items shall be at cost value include legal, registration and all other related costs;2. If your spouse or minor children and dependent(s) are not assessee, you have to include their assets and liabilities in your statement;3. Schedule 25 is the integral part of this Statement if you have business capital or agriculture or non-agricultural property. Provide additional papers if necessary.
01 Assessment Year 02 Statement as on (DDMMYYYY)
03 Name of the Assessee: Md. Sakir Hossain 04 TIN: 551142105908
Particulars Amount
05 Business capital (05A+05B)
05B Director’s shareholdings in limited companies (as in Schedule 25)
05A Business capital other than 05B
06 06A Non-agricultural property (as in Schedule 25)
06B Advance made for non-agricultural property (as in Schedule 25)
2 0 1 6 - 1 7
07 Agricultural property (as in Schedule 25)
08 Financial assets value (08A+08B+08C+08D+08E)
08A Share, debentures etc.
08B Savings certificate, bonds and other government securities
08C Fixed deposit, Term deposits and DPS
08D Loans given to others (mention name and TIN)
08E Other financial assets (give details)
11,556,000
1,050,000
500,000 500,000
500,000
3 0 0 6 2 0 1 6
Verification and signature
Verification I solemnly declare that to the best of my knowledge and belief the information given in this statement and the schedule annexed herewith are correct and complete.
Name Signature and date
09 Motor car (s) (use additional papers if more than two cars)
Sl Brand name Engine (CC) Registration No.
1
2
10 Gold, diamond, gems and other items (mention quantity) 40 Tolla
11 Furniture, equipment and electronic items
12 Other assets of significant value
13 Cash and fund outside business (13A+13B+13C+13D)
3A Notes and currencies
13B Banks, cards and other electronic cash
13C Provident fund and other fund
13D Other deposits, balance and advance (other than 08)
14 Gross wealth (aggregate of 05 to 13)
15 Liabilities outside business (15A+15B+15C)
15A Borrowings from banks and other financial institutions
15B Unsecured loan (mention name and TIN)
15C Other loans or overdrafts
16 Net wealth (14-15)
17 Net wealth at the last date of the previous income year
18 Change in net wealth (16-17)
19 Other fund outflow during the income year (19A+19B+19C)
19A Annual living expenditure and tax payments (as IT-10BB)
19B Loss, deductions, expenses, etc. not mentioned in IT-10BB
19C Gift, donation and contribution (mention name of recipient)
20 Total fund outflow in the income year (18+19)
21 Sources of fund (21A+21B+21C)
21A Income shown in the return
21B Tax exempted income and allowance
21C Other receipts and sources
22 Shortage of fund, if any (21-20)
2,600,000
40,000
420,000
560,000
1,091,000 1,091,000
41,600
689,400
360,000
17,817,000
2,156,000
2,156,000
2,156,000
15,661,000
14,088,650
1,572,350
560,000
560,000
560,000
2,132,350
2,132,350 2,132,350
1,718,350
414,000
IT-10BB2016
STATEMENT OF EXPENSES RELATING TO LIFESTYLEunder section 80(2) of the Income Tax Ordinance, 1984 (XXXVI of 1984)
01 Assessment Year 02 Statement as on (DDMMYYYY)
03 Name of the Assessee: Md. Sakir Hossain 04 TIN: 551142105908
Particulars Amount Commen
05 Expenses for food, clothing and other essentials06 Housing expense07 Auto and transportation expenses (07A+07B)
07A Driver’s salary, fuel and maintenance
07B Other transportation08 Household and utility expenses (08A+08B+08C+08D)
08A Electricity08B Gas, water, sewer and garbage08C Phone, internet, TV channels subscription08D Home-support staff and other expenses
09 Children`s education expencess
10 Special expenses (10A+10B+10C+10D)
10A Festival, party, events and gifts
10B Domestic and overseas tour, holiday, etc.
10C Donation, philanthropy, etc.
10D Other special expenses
11 Any other expenses12 Total expense relating to lifestyle (05+06+07+08+09+10+11)13 Payment of tax, charges, etc. (13A+13B)
13A Payment of tax at source
13B Payment of tax, surcharge or other amount
14 Total amount of expense and tax (12+13)
Verification and signature
Verification I solemnly declare that to the best of my knowledge and belief the information given in this statement and the schedule annexed herewith are correct and complete.
Name Signature and date
2 0 1 6 - 1 7 3 0 0 6 2 0 1 6
180,000
120,000
120,000
27,500
9,850 10,000
7,650
30,000
30,000
47,000
404,500
155,500
140,500 15,000
560,000