APPLICATION FORM (For Filing of Income Tax Return)

PROVIDE THE DETAILS AS PER PAN (BLOCK LETTERS) Full Name *

JAMMALLAMMADAKA VENKATA SOMASUNDARAM

Father's Name *

JAMMALAMADAKA VENAKTA SUBRAHMANYAM

Date of Birth * Address *

0

4

/

0

7

/

1

9

8

2

A

PAN *

A

Y

P

J

1

2

3

4

P

5

0

0

0

7

0

8

0

0

8

0

0

5-7-1/599, PLOT NO 599WP, HARIHARAPURAM, VANASTHALIPURAM

HYDERABAD.

PIN Code *

State

TELANGANA

Email *

[email protected]

Mobile No. * 8

0

9

9

ANNUAL INCOME DETAILS (Please Attach form 16 Part A & B for Salaried Persons and Form 26AS / Form 16 for Non Salaried Persons with Valid TAN) AY 2014-15 o AY 2015-16  AY 2016-17 o Select Assessment Year. *



(01-04-2013 TO 31-03-2014) Late Return can be Filed Upto 31-03-2016

Select one or more Sources of Income



Income from Salary Income (As per Form 16)  House Property

Rs. 3, 60,000/-

Annual Income (INR)

(01-04-2014 TO 31-03-2015) Late Return can be filed upto 31-03-2017.



Rs.

Business or Professional

(01-04-2015 TO 31-03-2016) Select This Column Only After 30-04-2016

Income

Income from

 Capital Gains

Rs.

 Other Sources  Rs. 25,000/-

Rs.

DEDUCTIONS AND OTHER INFORMATION

Select one or more Deductions/ Exemptions



Medical / Health PF / PPF/ Life Insurance / Insurance  Term Deposits  NSC / TDR

Amount INR

Rs.

Select appropriate Head

Agricultural Income



Amount INR

Rs.25,000/-

Rs.

Housing Loan

 Principal Paid

Rs.

Children  School Fee

House Rent  Paid

Rs. 50,000/-

Rs.

Interest On Housing Donations  paid If Any

TDS or Advance Tax

 Loan

Rs.

Rs.



 Paid



Rs. 5,500/-

Rs.

AADHAAR AND BANK DETAILS Aadhaar Number Bank Account Number * Name of Bank *

3

4

5

6

7

STATE BANK OF INDIA, VANASTHALIPURAM

IFSC CODE (Verify your Checkbook or Bank Passbook for this Code) *

8

4

5

6

2

5

9

5

6

* Type of A/C



S

1

1

Savings Bank A/C.

B

I

N

0

1

1

0

0

2



Current Account 0

0

4

3

2

4

7

Note: Tax Genius calls the Applicant for collecting required information necessary for processing the Application. Income Tax Return will be filed within 15 working days subject to receipt of required full information from Applicant. Tax Genius reserves the right to reject any Application on any grounds and refund the service charges collected. E-filing Acknowledgements will be send to Applicant's email ID or they can be collected from Concerned CSC Center. ** DECLARATION: I here by declare that the details furnished above are ture and correct to the best of my knowledge. Further I hereby authorize Tax Genius LLP to Register / Aleter my Profile at www.incometaxindiaefiling.gov.in for accesing TDS particulars and filing my Tax Return on behalf of me. **

Form 16 Attached. Planning for Housing Loan. Signed. (Remarks If any) (Signature of the Applicant) * Call Centre: M/s. Tax Genius LLP, Near Govt. Area Hospital , Beside Hetero Pharmacy, TV Colony, Vanasthalipuram, Hyderabad-500070. Email: [email protected] www.taxgenius.co.in Customer Care: 08099800800

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