Government of India

INCOME-TAX DEPARTMENT

ACKNOWLEDGEMENT

Received with thanks from MAHAROGI SEWA SAMITI, WARORA a return of income and/or
Return of
fringe benefits in
Name:
Form No. ITR- 7MAHAROGI
for SEWA SAMITI, WARORA PAN: - AAATM 2248 N
assessment year
2010-11, having the
Flat/Door/Block No Name Of
following
Premises/Building/Village
particulars.
Road/Street/Post Office Area/Locality:- MAHARASHTRA

Town/City/District:- WARORA 442914 State:- MAHARASHTRA

1 Gross total income 1

2 Deductions under Chapter-VI-A 2
3 Total Income 3
4 Net tax payable 4
5 Interest payable 5
6 Total tax and intere st payable 6
7 Taxes Paid NIL
A. Advance Tax NIL
B. TDS NIL
C. TCS7a NIL
D. Self Assessment
7b
NIL Tax NIL
E. Total 51192.00
Taxes
7d Paid (7a+7b+7c
NIL +7d)
8 Tax Payable (6-7d) 7e NIL
8
9 Refund (7e-6) 7c 51192.00 9
10 Value of Fringe B enefits 10
11 Total fringe benefit tax liability 11
NILpayable
12 Total interest 12
13 Total tax and interest payable 13
51192.00
14 Taxes Paid
a Advance Tax NIL
b Self Assessment14aTax
c Total Taxes Paid
14b(14a+14b) N. A.
14c
15 Tax Payable (13-14c) 15
16 Refund (14c – 13) 16

Receipt No. Seal & Signature of receiving official

Date