INDIAN INCOME TAX RETURN ACKNOWLEDGEMENT Assessment Year

[Where the data of the Return of Income in Form ITR-1 (SAHAJ), ITR-2, ITR-3, 2018-19
ITR-4 , ITR-5, ITR-6,ITR-7 transmitted and verified electronically]

Name PAN
PREM LAL TODA AQSPT2132Q
PERSONAL INFORMATION AND THE

Flat/Door/Block No Name Of Premises/Building/Village Form No. which

WARD NO.15 has been
DATE OF ELECTRONIC

electronically ITR-4
transmitted
TRANSMISSION

Road/Street/Post Office Area/Locality

JHUMARPALI PARA BHATGAON Jhumarpali
Status Individual
Town/City/District State Pin/ZipCode Aadhaar Number/Enrollment ID
RAIPUR CHHATTISGARH
493222 XXXX XXXX 3887

Designation of AO(Ward/Circle) WARD 1(1) BILASPUR Original or Revised ORIGINAL

E-filing Acknowledgement Number 443861810280319 Date(DD/MM/YYYY) 28-03-2019

1 Gross total income 1 248175
2 Deductions under Chapter-VI-A 2 0
3 Total Income 3 248180
COMPUTATION OF INCOME

3a Current Year loss, if any 3a 0

4 0
AND TAX THEREON

4 Net tax payable

5 Interest and Fee Payable 5 0
6 Total tax, interest and Fee payable 6 0
a Advance Tax 7a 0
7 Taxes Paid
b TDS 7b 0
c TCS 7c 0
d Self Assessment Tax 7d 0
e Total Taxes Paid (7a+7b+7c +7d) 7e 0
8 Tax Payable (6-7e) 8 0
9 Refund (7e-6) 9 0
Agriculture 10
10 Exempt Income 0
Others 0

The return has been electronically uploaded on 28-03-2019 09:39:51 from IP address 157.34.65.56 and has been electronically

verified by PREM LAL TODA in the capacity of Self having PAN AQSPT2132Q

on 29-03-2019 19:56:15 from IP address 157.34.65.56 at JHUMARPALI using

Electronic Verification Code PI9TS39PNI generated through Aadhaar OTP mode.

DO NOT SEND THIS ACKNOWLEDGEMENT TO CPC, BENGALURU