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National Board of Revenue
www.nbr.gov.bd
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For office useReturn of Income
For Individual & Other Assessee (Without Company)
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Serial no. in return registerIT-11GA 2023
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Volumn no. in return register
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Date of return submission
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1Name of the Assessee:Mr. XYZ
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2National Identification Number/Passport Number (If no NID):111111111111
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3TIN424224224442
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4(a) Circle:0111(b) Tax Zone:0111, Dhaka
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5Asssessment Year:2023-246Resident StatusResident√Non-Resident
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7Assessee Status Tick (√) as Applicable): Individual√FirmHindu Undivided FamilyOthers
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8Tick (√) on the box below for getting special benefit:
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A gazetted war-wounded freedom fighter Female3rd GenderDisabled Person
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Aged 65 years or moreA parent or legal guardian of a person with disability
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9Date of Birth
(dd-mm-yy))		15-03-197310Name of Spouse:XYZ Akter
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Spouse of TIN:XXXXXXX
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11Present Address:XYZ House, Village- xxxxxx, Post- xxxxxx
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P.S.- xxxxxx, Dist- xxxxxxxxxx.
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Telephone:1200000000
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Mobile:1000000000E-maillearningmaterils.blogspot.com
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12If employed, employer’s name (Latest employer's name in case of multiple employment)::
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Government of the People's Republic of Bangladesh
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13(a)Name of Business:Not Applicable
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(b)
Business Identification Number (BIN):Not Applicable
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14Name & TIN of Partners/Members in case of Frim/Association of person (If needed, please use separate sheet):
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