Income Tax Return Forms are proposed to be changed. Draft Forms are placed here for public comments.

RETURN OF TOTAL INCOME/STATEMENT OF FINAL TAXATION IT-2 (Page 1 of 2) UNDER THE INCOME TAX ORDINANCE, 2001 (FOR INDIVIDUAL / AOP) N° Taxpayer's Name NTN CNIC (for Individual) Gender Male Female Business Name Year Ending Business Address Tax Year 2012 Res. Address Person IND AOP E-Mail Address Phone Res. Status Non-Res. Resident Registration Principal Activity Code Birth Date Employer NTN Name Filing Section Representative NTN Name RTO/LTU Authorized Rep. NTN Name Is authorized Rep. applicable? Yes No NTN Proprietor/Member/Partners' Name % in Capital Capital Amount Ownership Others Total 100% Items Code Total & 1 Net Sales (excluding Sales Tax/ Federal Excise Duty & Net of Commission/ Brokerage) [to be reconciled with Annex-C] 3103 2 Cost of Sales [3 + 4 + 5 - 6] [to be reconciled with Annex-C] 3116Profit Final/Fixed 3 Opening Stock 3117 4 Net Purchases (excluding Sales Tax/ Federal Excise Duty & Net of Commission/ Brokerage) 3106 5 Other Manufacturing/ Trading Expenses [ Transfer from Sr-7 of Annex-G] 3111Trading, including ( 6 Closing Stock 3118 7 Gross Profit/ (Loss) [1-2] [ to be reconciled with Annex-C ] 3119 8 Other Revenues/ Fee/ Charges for Professional and Other Services/ Commission 3131 AccountManufacturing/ 9 Profit & Loss Expenses Transfer from Sr-24 of Annex-G] 3189 Loss 10 Net Profit/ (Loss) [(7 + 8) - 9] 3190 11 Inadmissible Deductions [Transfer from Sr-22 of Annex-E] 3191 12 Admissible Deductions (excluding tax depreciation/ including proportionate FTR income [to be reconciled with Annex-?] 3192 13 Unadjusted Loss from business for previous year(s) [Transfer from Sr. 27 of Annex-A] 3902 Adjustments 14 Un-absorbed Tax Depreciation for previous/ current year(s) 3988 15 Total Income [Sum of 16 to 21] 9099 16 Salary Income 1999 17 Business Income/ (Loss) [ (10 + 11) - 12 - 13 - 14 ] 3999 18 Share from AOP [Income/(Loss)] 312021 19 Capital Gains/(Loss) u/s 37 4999 20 Other Sources Income/ (Loss) 5999 21 Foreign Income/ (Loss) 6399 22 Deductible Allowances [23 + 24 + 25] 9139 Computation 23 Zakat 9121 24 Workers Welfare Fund (WWF) 9122 Income 25 Workers Profit Participation Fund (WPPF) 9123 26 Charitable donations admissible as straight deduction 9124 27 Taxable Income/ (Loss) [15 - 22] 9199 Taxable 28 Exempt Income/ (Loss) [Sum of 29 to 34] 6199 / 29 Salary Income 6101 30 Property Income 6102 Total 31 Business Income/ (Loss) 6103 32 Capital Gains/(Loss) 6104 33 Agriculture Income 6106 34 Other Sources Income/ (Loss) 6105 35 Tax chargeable on Taxable Income @ 9201 36 Tax Reductions/Credits/Averaging (including rebate on Bahbood Certificates, etc.) (from Annex xxx) 9249 37 Difference of minimum Tax Chargeable on business transactions [37(e)(v) minus 37(e)(iii)] (i) (ii) (iii) (iv) (v) Import Value/Services Proportionate receipts subject to Proportionate Chargeable collection or tax* Rate Minimum tax Higheror (iv)of (iii) income deduction of tax at source 9303 (a) Import of Edible Oil U/S 148(8) 3% (b) Import of Packing Material U/S 148(8) 5% (c) Transport Services U/S 153(1)(b) 2% (d) Other Services U/S 153(1)(b) 6% (e) Total Computation * [(35 minus 36) divided by 27 multiply by 37(a)(ii) or 37(b)(ii) or 37(c)(ii) or 37(d)(ii), as the case may be] Tax 38 Minimum tax on electrcity consumption under section 235(4) 9304 Amount of tax collected alongwith electrcity bill where the monthly bill amount is upto Rs. 30,000 39 Balance tax chargeable [ (34 minus 35 plus 36) or 37, whichever is higher 9305 40 Difference of minimum Tax Chargeable U/S 113 [39(iv) minus 38, if greater than zero, else zero] (i) Total Turnover (iii) Reduction @ - 9306 (ii) Minimum tax @ 1% - (iv) Net Minimum tax - 41 Net tax chargeable [38 + 39 + 85] 9307 42 Total Tax Payments (Transfer from Sr. 28 of Annex-B) 9499 43 Tax Payable/ Refundable [40 - 41 + WWF Payable from Sr. 29 of Annex-B] 9999 44 Refund Adjustments (not exceeding current year's tax payable) 9998 45 Annual personal expenses for individual only (transfer from Sr. 12 of Annex-D) 6109 Net Tax Refundable, may be credited to my bank account as under: Refund A/C No. Bank Branch Name & Code Signature

RETURN OF TOTAL INCOME/STATEMENT OF FINAL TAXATION IT-2 (Page 2 of 2) UNDER THE INCOME TAX ORDINANCE, 2001 (FOR INDIVIDUAL / AOP) N° Taxpayer's Name NTN CNIC (for Individual) Tax Year 2012 Business Name RTO/LTU Source Code Receipts/Value Rate(%) Code Tax Chargeable 46 Imports 64013 5 92013 47 64011 2 92011 48 64012 1 92012 49 64015 3 92015 50 Dividend 64032 10 92032 51 64033 7.5 92033 52 Profit on Debt 64041 10 92041 53 Royalties/Fees (Non-Resident) 640511 15 920511 54 640512 920512 55 Contracts (Non-Resident) 640521 6 920521 56 Insurance Premium (Non-Resident) 640524 5 920524 57 Advertisement Services (Non-Resident) 640525 10 920525 Tax 58 Supply of Goods 640611 3.5 920611 Final 5960 640612640613 1.5 920612920613 61 Payments to Ginners 640614 1 920614 62 Contracts (Resident) 640631 6 920631 63 Exports/related Commission/Service 640641 0.5 920641 64 64072 1 92072 65 Foreign Indenting Commission 64075 5 92075 66 Prizes/Winnings of cross word puzzles 64091 10 92091 67 Winnings - Others 64092 20 92092 68 Petroleum Commission 64101 10 92101 69 Brokerage/Commission 64121 10 92121 70 Advertising Commission 64122 5 92122 71 Services to Zero rated taxpayers U/S 153(1)(b) 64123 1 92123 72 Goods Transport Vehicles 92141 73 Gas consumption by CNG Station 64142 4 92142 74 Distribution of cigaratte and pharmaceutical products 64143 1 92143 75 Retail Turnover upto 5 million 310102 1 920202 76 Retail Turnover above 5 million 310103 920203 77 Property Income 210101 920235 78 Capital gains on Securities held for < 6 months 610401 10 961041 Tax 79 Capital gains on Securities held for >= 6 months and < 12 months 610402 8.00 961042 80 Capital gains on Securities held for >= 12 months 610403 0 961043 81 Purchase of locally produced edible oil 310431 2 920208Fixed 82 Flying Allowance 112001 2.5 920234 Services rendered / contracts executed 83 63311 1 920236 outside Pakistan 84 Employment Termination Benefits 118301 920211 85 Final/Fixed Tax Chargeable (46 to 84) 9202 I, holder of CNIC No. , in my capacity as Self/ Partner or Member of Association of Persons/ Representative (as defined in section 172 of the Income Tax Ordinance, 2001) of Taxpayer named above, do solemnly declare that to the best of my knowledge and belief the information given in this Return/Statement u/s 115(4) and the attached Annex(es), Statement(s), Document(s) or Detail(s) is/are correct and complete in accordance with the provisions of theVerification Income Tax Ordinance, 2001 and Income Tax Rules, 2002 (The alternative in the verification, which is not applicable, should be scored out). Acknowledgement Signatures & Stamp Date : Signatures: of Receiving Officer with Date

Rate Extent Description Code WDV (BF) Additions Deletions (%) Initial Allowance Rate (%) (%) Depreciation WDV (CF) 2012 12 BuildingMachinery(allandtypes)plant (not otherwise specified) 3203013202 50%50% 10%15%Annex-A 3 Computer hardware (including allied items) 320302 50% 30% 4 Furniture (including fittings) 320303 0% 15% 5 Technical and professional books 320304 50% 15% Year 6 Below ground installations of mineral oil concerns 320306 50% 100% 7 Off shore installations of mineral oil concerns 320307 50% 20% Tax 8 Machinery and equipment used in manufacture of IT pr 320308 50% 30% 9 Motor vehicles (not plying for hire) 32041 0% 15% Assets 10 Motor vehicles (plying for hire) 32042 50% 15% 11 Ships 32043 50% 15% 12 Air crafts and aero engines 32044 50% 30% Depreciable Machinery and equipment Qualifying for 1st year 320309 90% 15% 13 Allowance Computer hardware including printer, monitor and allied items, 320312 0% 50% 14 that have been used previously in Pakistan Any plant or machinery that has been used previously 320310 0% 15% 15 in Pakistan 16 Any plant or machinery in relation to which a Amortization deduction has been allowed under another section for 320311 0% 15% and the entire cost of the asset in the tax year in which the asset is acquired. No. Total Useful Extent Description Code Acquisition Date Original Cost . Amortization Life(Years) (%) Allowance Initial Reg/Inc/CNIC 1718 IntangiblesExpenditure providing long term advantage/benefit 32053207 Intangibles 19 Total Original Description Code Expenditure . Rate (%) Amortization 20 Pre commencement expenditure 3206 20% Depreciation, Description Code Amount Tax Year Description Code Amount Tax Year Unadjusted Business loss for previous year adjusted Unabsorbed Amortization of intangibles / expenditure 3902 2006 against Business income for current year providing long term advantage/benefit for previous 21 year(s) adjusted against Total Income for current year 3987 upto 2011 Unadjusted Business loss for previous year adjusted Amortization of intangibles / expenditure providing long 3902 2007 against Business income for current year term advantage/benefit for current year adjusted against 22 Total Income for current year 3987 2012 Unabsorbed tax depreciation/initial allowance of fixed Adjustments Unadjusted Business loss for previous year adjusted 3902 2008 assets for previous year(s) adjusted against Total against Business income for current year 23 Income for current year 3988 upto 2011 Unadjusted Business loss for previous year adjusted Forward 3902 2009 Depreciation/initial allowance of fixed assets for current against Business income for current year 24 year adjusted against Total Income for current year 3988 2012 Unadjusted Business loss for previous year adjusted 3902 2010 Brought 25 against Business income for current year Unadjusted Business loss for previous year adjusted 3902 2011 26 against Business income for current year Total (Not exceeding the amount of Business Income available Total (Not exceeding the amount of Total Income available for NTN 27 for adjustment) (transfer to Sr. 13 of Main Return) adjustment) (transfer to Sr. 14 of Main Return)

Annex-B 2012 Tax Already Paid B NTN CNIC (for individual) Amount of Tax Particulars Code deducted (Rs.) 1 On import of goods (other than tax deduction treated as final tax) 94019 2 From salary 94029 3 On dividend Income (other than tax deduction treated as final tax) 94039 4 On Government securities 94043 5 On profit on debt (other than tax deduction treated as final tax) 94049 Certificate/Account No. etc. Bank Branch Share% 6 On payments received by non-resident (other than tax deduction treated as final tax) 940539 7 On payments for goods (other than tax deduction treated as final tax) 940619 only) 89 OnOn paymentspayments forfor servicesexecution(otherof contractsthan tax(otherdeductionthan taxtreateddeductionas finaltreatedtax) as final tax) 940629940639 Tax 10 On property income 940640 11 On withdrawal from pension fund 94028 12 On cash withdrawal from bank 94119 Certificate/Account No. etc. Bank Branch Share% (Adjustable 13 On certain transactions in bank 94120 14 With Motor Vehicle Registration Fee 94179Source Registration No. Engine / Seating Capacity Owner's Name Manufacturer Particulars at 15 On sale/purchase of shares through a Member of Stock Exchange 94131 16 On trading of shares through a Member of Stock Exchange 94138 17 On financing of carry over trade 94139 18 With motor vehicle token tax (Other than goods transport vehicles) 94149 Registration No. Engine / Seating Capacity Owner's Name Share%Collected/Deducted Tax 19 With bill for electricity consumption 94159 Consumer No. Subscriber's CNIC Subscriber's Name Share% 20 With telephone bills, mobile phone and pre-paid cards 94169 Number Subscriber's CNIC Subscriber's Name Share% 21 On Sale by Auction 94180 22 On purchase of domestic air travel ticket 94121 23 Total Tax Deductions at source (Adjustable Tax) [Sum of 1 to 22] 94599 24 Total Tax Deductions at source (Final Tax) 94591 25 Advance Tax U/S 147(1) [ a + b + c + d] 9461 a. First installment CPR No. b. Second installment CPR No. c. Third installment CPR No. d. Fourth installment CPR No. 26 Advance Tax U/S 147(5B) [ a + b + c + d] 9461Payments a. First installment CPR No. Tax b. Second installment CPR No. c. Third installment CPR No. d. Fourth installment CPR No. 27 Admitted Tax Paid U/S 137(1) CPR No. 9471 28 Total Tax Payments [23 + 24 + 25 + 26+27] (Transfer to Sr. 43 of Main Return) WWF Payable with Return (WWF payable will be 29 adjusted against the excess payments made during 9308 the current year) Note-1 : Grey blank fields are for official use

Annex C 2012 Breakup of Sales in case of Multiple Businesses C Taxpayer Name NTN 0 CNIC/Reg.No. Tax Year 2012 Business Name RTO/LTU 0 Business Name & Business Activity Sales Cost of Sales Gross Profit/Loss Sr. (1) (2) (3) (4) = (2) - (3) Business Name 1 Business Acitivity Business Name SALES 2 OF Business Acitivity Business Name 3 Business Acitivity BREAKUP Business Name 4 WISE Business Acitivity Business Name 5 Business Acitivity BUSINESS Total (to be reconciled with Sr. 1, 2 & 7 of Main Return) Signature: Note : Grey blank fields are for official use

Annex - D 2012 Details of Personal Expenses (for individual) D Taxpayer Name NTN CNIC (for individual) Sr Description Expenses 1 Residence electricity bills 2 Residence telephone/mobile/internet bills 3 Residence gas bills 4 Residence rent/ground rent/property tax/fire insurance/security services/water bills 5 Education of children/ spouse/ self (Optional, it can be included in Sr-9)EXPENSES 6 Travelling (foreign and local) (Optional, it can be included in Sr-9) 7 Running and maintenance expenses of Motor vehicle(s)PERSONAL 8 Club membership fees/bills 9 Other personal and household expenses 10 Total personal expenses (Sum of 1 to 9) 11 (Less) Contribution by family members 12 Net Personal Expenses (10 - 11) transfer to Sr-44 of Main Return Adults Minor 13 Number of family members/dependenets 1 3 Signature: _____________________

Annex - E 2012 Deductions (Admissible & Inadmissible) E Taxpayer Name NTN CNIC (for individual) Sr. Particulars Code Amount (Rs.) 1 Tax Amortization 319287 2 Tax Depreciation 319288 Deductions 3 Income/(Loss) relating to Final and Fixed tax [Transfer from Annex-F] 319289 4 Other Admissible Deductions 319298 Admissible 5 Total [Add 1 to 4] to be transferred to Sr-11 of main return 3192 1 Cess, rate or tax that is levied on the profits or gains or assessed as a percentage or otherwise on the basis of profits or gains 319101 Salary, rent, brokerage or commission, profit on debt, payment to non-resident, payment for services or fee from which the 2 company was liable to deduct tax at source unless the company has deducted and paid the tax as required by the Income Tax 319102 Ordinance 2001 3 Entertainment expenditure in excess of prescribed limits 319104 4 Contribution to an un-recognized provident fund, pension fund, superannuation fund or gratuity fund 319105 319106 5 Contributionbeen made totodeducta providenttax atfundsourceor otherin respectfund establishedof which theforrecipientthe benefitis chargeableof the employees,to tax underunlessthe effectivehead "salary"arrangements have 6 Fine or penalty for the violation of any law, rule or regulation 319107 7 Personal expenditure 319108 8 Provisions or amounts carried to reserves or funds etc. or capitalised in any way 319109 Profit on debt, brokerage, commission, salary or other remuneration paid by an AOP to its members 319110 inadmissible 9 319110/ 10 Anyrequiredsalary,to berent,deductedbrokerageandorpaidcommission,but was notprofitdeductedondebt,andpaymentpaid to non-resident or payment for services or fee on which tax was Expenditure under a single account head which, in aggregate, exceeds Rs. 50,000 paid otherwise than by a crossed bank cheque 11 or crossed bank draft (excluding expenditures not exceeding Rs. 10,000 or on account of freight charges, travel fare, postage, 319112 utilities or payment of taxes duties fees fines or any other statutory obligation) 319113 12 Salarybank accountexceeding Rs. 10,000 per month paid otherwise than by a crossed cheque or direct transfer of the funds to the employee's allowed not 13 Capital expenditure 319114 14 Provisions for bad debts, obsolete stocks, etc. 319115 319116 15 Apportionmentactivities of expenditure including profit on debt, financial cost and lease payments relatable or attributable to non-business 16 Mark-up on lease financing 319118 17 Accounting pre-commencement expenditure written off 319120 Deductions 18 Accounting loss on disposal of depreciable assets / intangibles 319121 19 Accounting amortization 319123 20 Accounting depreciation 319124 21 Any other (please specify) 319125 22 Total [Add 1 to 21] to be transferred to Sr-11 of main return 3191 - Signature _______________________

Annex - F 2012 Bifurcation of Income/(Loss) from business attributable to F Sales/Receipts Etc. subject to Final Taxation Taxpayer Name NTN CNIC (for individual) Subject to Final Subject to Normal Total Taxation Taxation Particulars Code Code Amount (Rs.) Amount (Rs.) Amount (Rs.) 1. Sales (net of brokerage, commission and discount) 3010 3010F (a) Local sales/supplies - Out of imports (Trading) 30101 30101F - (b) Local sales/supplies - Others 30102 30102F - (c) Execution of contracts 30103 30103F - (d) Export sales 30104 30104F - (e) Others 30105 - 30105F - (f) Sub-total [ Add 1(a) to 1(e)] 30106 - 30106F - - (g) Selling expenses (Freight outward, etc.) 30107 30107F - (h) Net ex-factory or F.O.B. sales [ 1(f) minus 1(h)] 30108 - 30108F - - 2. Cost of sales 3011 3011F (a) Apportioned on the basis of: (i) Actual / identifiable (ii) Average / proportionate to sales  (b) As per income statement 30111 - 30111F - - (c) Adjustment of inadmissible costs etc. 30112 30112F (i) Accounting depreciation 301121 301121F - - (ii) Accounting amortization 301122 301122F - - (iii) Others 301123 301123F - - (iv) 301124 301124F - - (d) Sub-total [Add c(i) to c(iv)] 30113 - 30113F - - (e) Revised cost of sales [2(b) minus 2(d)] 30114 - 30114F - - 3. Gross profit/(loss) / other business revenues/receipts 3012 3012F (a) Gross profit [ 1(h) minus 2(e)] 30121 - 30121F - - (b) Other business revenues/receipts 30122 30122F (i) Brokerage and commission 301221 301221F - (ii) Transport services 301222 301222F - (iii) Royalty & fee for technical services (non-residents) 301223 301223F - (iv) Others 301224 - 301224F - (v) Other inclusions/exclusions in income 301225 - 301225F - (c) Total gross income [ Add 3(a) to 3(b)(v)] 30123 - 30123F - - 4. Administrative, selling, financial expenses etc. 3013 3013F (a) Apportioned on the basis of: (i) Actual / identifiable (ii) Average / proportionate to gross income  (b) As per income statement 30131 - 30131F - - (c) Adjustment of inadmissible expenditures etc. 30132 30132F (i) Accounting depreciation 301321 301321F - - (ii) Accounting amortization 301322 301322F - - (iii) Markup lease financing 301323 - 301323F - - (iv) Selling expenses (Freight outward, etc.) 301324 - 301324F - - (v) Other inadmissible deductions 301325 - 301325F - - (vi) Others 301326 301326F - - (d) Sub-total [Add c(i) to c(vi)] 30133 - 30133F - - (e) Adjustment of admissible expenditures etc. 30134 30134F (i) Tax depreciation (Total) 301341 - 301341F - - (ii) Tax amortization (Total) 301342 - 301342F - - (iii) Lease rentals 301343 - 301343F - - (iv) Other admissible deductions 301344 - 301344F - - (v) Others 301345 - 301345F - - (f) Sub-total [Add e(i) to e(v)] 30135 - 30135F - - (g) Net expenditure [ 4(b) minus to 4(d) plus 4(f)] 30136 - 30136F - - 5. Net profit/loss from business [3(c) minus 4(g)] 3014 - 3014F - - Signature _______________________

ANNEX-G 2012 Breakup of Expenses (Separate form should be filled for each business) G Taxpayer Name NTN CNIC Tax Year 2012 Business Name RTO/LTU Registry Business Address Business City Sr. Description Code Amount & 1 Salaries,Wages 311101 2 Electricity 311102 3 Gas 311103 Expenses 4 Stores/Spares 311106 5 Repair & Maintenance 311108Manufacturing 6 Other Expenses 311118 Trading 7 Total [ Add 1 to 6] [Transfer to Sr. 5 of main Return] 31100 8 Rent/ Rates/ Taxes 3141 9 Salaries & Wages 3144 10 Travelling/ Conveyance 3145 11 Electricity/ Water/ Gas 3148 12 Communication Charges 3154 13 Repairs & Maintenance 3153 Expenses 14 Stationery/ Office Supplies 3155 15 Advertisement/ Publicity/ Promotion 3157 16 Insurance 3159 Account 17 Professional Charges 3160 18 Profit on Debt (Markup/Interest) 3161 Loss & 19 Donations 3163 Profit 2021 BadObsoleteDebtsStocks/Stores/SparesWritten Off Written Off 3182131822 22 Selling expenses(Freight outwards etc.) 31080 23 Others 31090 24 Total [ Add 8 to 23] [Transfer to Sr. 9 of main Return] 3170 Signature _______________________ "

"Part - II D WEALTH STATEMENT UNDER SECTION 116 WS 1/2 OF THE INCOME TAX ORDINANCE, 2001 N° Taxpayer's Name NTN CNIC Tax Year 2012 Address RTO/LTU Particulars/Description of assets and liabilities (Please read WS Notes for guidance) Code 1. Business Capital (indicate name of business) 821311 - Sr. Name of Business Code Amount (Rs.) 1 82131101 - 2 82131102 - 3 82131103 - 4 82131104 - 5 82131105 - 6 82131106 - 7 82131107 - 8 82131108 - 9 82131109 - 10 82131110 - 2. Non-Agricultural Property (indicate location, Size/Area & identification) 711111 - Sr. Location and Identification Code Amount (Rs.) 1 71111101 - 2 71111102 - 3 71111103 - 4 71111104 - 5 71111105 - 6 71111106 - 7 71111107 - 8 71111108 - 9 71111109 - 10 71111110 - 3. Agricultural Property (indicate location, Size/Area & identification 711211 - Sr. Location and Identification Code Amount (Rs.) 1 71121101 - 2 71121102 - 3 71121103 - 4 71121104 - 5 71121105 - 6 71121106 - 7 71121107 - 8 71121108 - 9 71121109 - 10 71121110 - 712111 - 4. AgriculturalHarvester, Thrasher,Property Driller(Tractor,& otherTrolley,AgriculturalLoader, Tubewell,EquipmentsTurbine,etc. &Sprinkler,Live Stock)Planter, Sr. Property Name Code Amount (Rs.) 1 71211101 - 2 71211102 - 3 71211103 - 4 71211104 - 5 71211105 - 6 71211106 - 7 71211107 - 8 71211108 - 9 71211109 - 10 71211110 -

5. Investments (Specify stocks, shares, debentures, unit certificates, other certificates, deposits and certificates of National Saving Schemes,mortgages, 712611 loans, advances, etc.) - Sr. Description of Investments Code Amount (Rs.) 1 71261101 - 2 71261102 - 3 71261103 - 4 71261104 - 5 71261105 - 6 71261106 - 7 71261107 - 8 71261108 - 9 71261109 - 10 71261110 - 6. Loans and Advances, etc. 712641 - Sr. Creditor Name Code Amount (Rs.) 1 71264101 - 2 71264102 - 3 71264103 - 4 71264104 - 5 71264105 - 6 71264106 - 7 71264107 - 8 71264108 - 9 71264109 - 10 71264110 - 7. Motor vehicles (Indicate make, model and registration number) 712211 - Sr. Registration Make Model with Year Engine Capacity (CC) Code Amount (Rs.) 1 71221101 - 2 71221102 - 3 71221103 - 4 71221104 - 5 71221105 - 6 71221106 - 7 71221107 - 8 71221108 - 9 71221109 - 10 71221110 - 8. Jewellery (Indicate description and weight) 712411 - Sr. Description and weight with unit of measure (e.g 10 Tolas) Code Amount (Rs.) 1 71241101 - 2 71241102 - 3 71241103 - 4 71241104 - 5 71241105 - 6 71241106 - 7 71241107 - 8 71241108 - 9 71241109 - 10 71241110 - 9. Furniture and Fittings - Residence 712311 - Sr. Description Code Amount (Rs.) 1 71231101 - 2 71231102 - 3 71231103 - 4 71231104 - 5 71231105 - 6 71231106 -

7 71231107 - 8 71231108 - 9 71231109 - 10 71231110 - 10. Cash & Bank Balances 7128 - (a) Non-business cash in hand 712811 - (b) Non-business bank balances, etc. in current/ deposit/ savings accounts712711 - Sr. Account No Country Bank Name City Name Br. Code Branch Name Code Amount (Rs.) 1 71271101 - 2 71271102 - 3 71271103 - 4 71271104 - 5 71271105 - 6 71271106 - 7 71271107 - 8 71271108 - 9 71271109 - 10 71271110 - 11. Any Other Assets 7126 - Sr. Description Code Amount (Rs.) 1 71267101 - 2 71267102 3 71267103 - 4 71267104 - 5 71267105 - 6 71267106 - 7 71267107 - 8 71267108 - 9 71267109 - 10 71267110 - 12. Assets, if any, standing in the name of spouse, minor children & other dependents* 713111 - Sr. Description Code Amount (Rs.) 1 71311101 - 2 71311102 - 3 71311103 - 4 71311104 - 5 71311105 - 6 71311106 - 7 71311107 - 8 71311108 - 9 71311109 - 10 71311110 - 13. Total Assets [ Sum(1 to 12) ] 719999 - 14. Liabilities (including mortgages, loans, overdrafts, advances, 8213 borrowings, amounts due under hire purchase agreement ) - Sr. Business Name Code Amount (Rs.) 1 72111101 - 2 72111102 - 3 72111103 - 4 72111104 - 5 72111105 - 6 72111106 - 7 72111107 - 8 72111108 - 9 72111109 -

10 72111110 - 15. Total Liabilities [ sum( 14(a) to 14(b) ] 729999 - 16. Net Wealth of the current year [13 minus 15] 799999 - 17. Annual personal expenses ( To be Reconciled with Annex D) 749999 - 18. Number of family members and dependents 740000 Minors 19. Assets, if any, transferred to any person 714111 - Sr. Description Code Amount (Rs.) 1 71411101 - 2 71411102 - 3 71411103 - 4 71411104 - 5 71411105 - 6 71411106 - 7 71411107 - 8 71411108 - 9 71411109 - 10 71411110 - Verification I, , holder of CNIC No. in my capacity as Self / Representative* of Taxpayer named above, do hereby solemnly declare that to the best of my knowledge thed assetsb li f thandi liabilitiesf ti of myself,i i thimy spouset t ort spouses,f minor children and of my personal expenditure for the year and other dependentsare correctas on and complete in accordance with the provisions of the IncomeendedTax Ordinance, 2001 and Income Tax Rules 2002 (The alternative in the verification, which is not applicable, should be scored out.) * As defined in section 172 of the Income Tax Ordinance, 2001 Date (dd/mm/yyyy): Signature

WEALTH RECONCILIATION STATEMENT WS 2/2 N° Taxpayer's Name NTN CNIC Tax Year 2011 Address RTO/LTU Particulars Code Amount (Rs.) 1 Net assets as on 30-06-2012 2 Net assets as on 30-06-2011 3 Increase/Decrease [1 - 2] - 4 Income - a) Income declared for the Tax Year - 2012 b) Exempt income including agriculture income c) Others - i) ii) iii) iv) v) 5 Expenditures - a) Personal expenditures b) Other expenditures - i) ii) iii) iv) v) 6 Increase/ Decrease in wealth [4 - 5] - Date : Signature: "

RETAILER'S STATEMENT U/S 115 (4) OF THE INCOME TAX ORDINANCE, 2001 IT-4 (For retailers (Individuals) having annual turnover upto 5 million rupees (English) but not having any other taxable source of income) 1 CNIC - - Tax Year 2012 2 NTN (if available) - Gender Male Female 3 Business Name 4 Business Address Province District 5 Principal Activity REGISTRATION 6 Phone No. Electricity No. 7 Mobile No. Gas Ref. No. Description Amount 8 Opening Stock 9 Net Sales during the year 10 Closing Stock 11 Turnover Tax payable u/s 113A @ 1 % of turnover (1% of Sr-11) 12 Turnover Tax Paid COMPUTATION 13 CPR No. CPR Date 14 Agriculture IncomeOther from 15 Foreign Remittance (along with proof) 16 Dividend income Sources 17 Profit on debtIncome Description Expenses 18 Residence electricity bills 19 Residence telephone/mobile/internet bills 20 Residence gas bills 21 Residence rent/ground rent/property tax/fire insurance/security services/water bills 22 Education of children/ spouse/ self (Optional, it can be included in Sr-26) 23 Travelling (foreign and local) (Optional, it can be included in Sr-24) EXPENSES 24 Running and maintenance expenses of Motor vehicle(s) 25 Club membership fees/bills 26 Other personal and household expenses 27 Total personal expenses (Sum of 18 to 26) PESONAL 28 (Less) Contribution by family members 29 Net Personal Expenses (27 - 28) 30 Number of family members/dependenets Adults Minors I, ______________________________________ holder of CNIC No. _______________ in my capacity as Self/ Representative (as defined in section 172 of the Income Tax Ordinance, 2001) of Taxpayer named above, do solemnly declare that to the best of my knowledge and belief the information given in this Statement is correct and complete in accordance with the provisions of the Income Tax Ordinance, 2001 and Income Tax Rules, 2002 (The alternative in the verification, which is not applicable, should be scored out). Signature & Stamp VERIFICATION Date : Signature of Receiving Officer with Date ACKNOWLEDGEMEN Note-1 : Retailers having turnover of more than Rs. 5 million should file IT-2 Return instead of this Statement Note-2 : Retailers having any other source of income should file IT-2 Return instead of this Statement "