INDIAN INCOME TAX RETURN VERIFICATION FORM. Assessment Year PRLV| (Wired oft e o nwt in Frm TH SAAR, 3, : ITR-4S (SUGAM), ITR-4, ITR-S, FTR-7 transmitted electronically without digital signature] - 2014 15 ta fit ee a meee SOD Rg eee — rare tavDooeBock No Name OFPremiseuiling Vilage ‘Form No. which | SHREEPATHPURAM BALAJLPURAM HOUSE NO 147 es rea HRA — transmitted UStrcet/Post Office ‘reall ocality POST \URANGABAD PIN28100-— 6 | 7 nvidia MATHURA Designation of $0 (Ward / Cire) de Revised | ORIGIN IGINAL |] F filing Acknowledgement Number 4 1) Gross Total Tacome 205000 2) Deductions une 4500 Tota Fncome 200800 a Curren 0 4 Neus Pa @ a | Advance Tax » Tos cite ae Self Assessment Tay ¢_ Total Faxes Paid (Ta+ Tbe 7e +7) 0 NTs Payable 6-76) : ay “9 Refund Hes) ra aan VERIFICATION MINOp KUMAR __ son/daughter of GOPAL a J.SINGH holding Permanent Acsount Nbr sins declare ta the hes oF my Knowledge and belie the information given in he er and the schedules there hich hae ban Wasted ‘conical hy mie vse acknowledgement aumber mentioned above i correct and complete an! thatthe mount offre income and oer pris shown threw are tly stated and are in accordance with the provisions ofthe Income-tax Act, 1961. ia vespect ot income chargeable the pees ots yer relevant to thé assessment ear 2014415, [further declare that am making this et in my capacity os and Tan also competent to make tis return and verity i 1H ihe rote has been prepared by a Tax Return Preparer (TRP) give further details x below idee " Gousier Signatare of TRF FeO ON cine aie Cl) » IS SPMT ignatare of oficial ‘copra. ctesrszenasto wstzsenoFFeanoness?seabRs 08017 « fie dly signed Form ITR-V to come Tax Department - CPC, Post Bag No 1, Electronic City Post Office, Bengaturw - 60100, ‘armataha by ORDINARY POST OR SPEED POST ONLY, within 120 dys from date of eansmitting the data eleconically Form ITR-Y sh hot he ceived in any othe five of the Income-tax Department orin any thee marie, The confirmation of receipt ofthis Fonn ITR-V at TD-CPC willbe sem to the email adress qundusarkars gmail.com m8