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FORM OF INFORMATION SHOWING INCOME TAX RATES AND MAXIMUM OF PROPOSED SAVING
INVESTMENT MADE/TO BE MADE DURING CURRENT F/Y 01/04/2013 TO 31/03/2014
Emp. No:
Date of Birth:
Date of joining:
Designation:
Sex: Male/Female
Residential Address:
(in BLOCK LETTERS)
PAN
SLAB
MALE
FEMALE
SENIOR CITIZEN
(Age 60 79 years )
TAX
RATES
Rs.2,00,001/- to
Rs.2,00,001/- to
Rs.2,50,001/- to
Nil
10%
Rs.5,00,000/Rs.5,00,000/Rs.5,00,000/Rs.5,00,001/- to
Rs.5,00,001/- to
Rs.5,00,001/- to
Rs.5,00,001/- to
20%
Rs.10,00,000/Rs.10,00,000/Rs.10,00,000/Rs.10,00,000/30%
Above Rs.10,00,000/Above Rs.10,00,000/Above Rs.10,00,000/Above Rs.10,00,000/Note: 1. Tax rebate of Rs.2000/- is given if the taxable income is less than or equal to 5 lac, or those
under the tax bracket of 10%
2. Surcharge @10% is applicable on tax for those incomes above Rs.1 crore
Instructions:
(1) Completed Form should reach us on or before
/ /2013 positively.
(2) ALL PROOFS OF INVESTMENT MUST BE SUBMITTED EXPEDITIOUSLY BUT NOT LATER THAN
_____________
(3) GIVE DETAILS ON SEPARATE SHEET, IF SPACE PROVIDED IS NOT SUFFICIENT.
(4) Please dont mention As per last year, since the declaration has to be given every year by the assessee.
(5) New joiners to give their previous income details with out fail. Failing which investments will be taken on prorata basis for the current employment.
(6) PAN is compulsory (If there is no PAN, tax @ 20% or higher will be levied on entire earnings, no
exemption is permissible-Refers sec 206AA of Finance Act, 2010 effective 01 Apr 2010 )
Sr.
No.
Under
Sec
10
2
3
4
5
6
7
8
9
10
11
Nature of Investment/Eligible
Expenditure
House Rent Paid
(50% - Metro (Delhi, Mumbai,
Chennai & Kolkotta)
40% - Non-Metro)
Address of Landlord:
Children Education Allowance
80C
Limit
Actual/Proposed
Amount (ANNUAL)
Children 1
Children 2
Hostel
Hostel
Day Scholar
Day Scholar
Rs.
INVESTMENTS
01/04/2012 to 31/03/2013
National Saving Certificates
Purchased during the period
PPF(Max 70000 up to Nov 2011)
Unit linked-Insurance Plan (ULIP)
Insurance payable (give annual value
for each existing policies of self,
spouse and children)(This does not
include SSS if any)
(Max 10% of sum assured for the
policy issued on or after 01 Apr 12)
(Policy for parents cannot be
considered)
Total :
Senior Citizens Saving Scheme 2004
Post Office 5 year Term Deposit
Scheme
Home loan Principal for acquisition
or construction of a house
(ANNUAL)
Stamp duty paid
Registration fees Paid
Jeevan Dhara / Jeevan Akshay Policy
premium
Rs.
Rs.
Rs.
Rs.
Rs.
Rs.
Rs.
Rs.
Rs.
Rs.
Rs.
Rs.
Maximum of 1 lac (includes
80C + 80CCC + 80CCD)
Rs.
Rs.
Rs.
Rs.
Rs.
Rs.
Rs.
Rs.
22
23
80G
24
80TTA
25
26
27
Maximum 1 lac
i) Housing loan taken on or after
01 Apr 13.
ii) The loan sanctioned is less
than or equal to 25 lac.
iii) The registered value of the
property should be less than or
equal to 40 lac.
iv) The assesse is having only
one house property.
NDF, PMs National relief fund
etc 100%
1. To Individual employee
2. Max Rs.10,000/-(Interest
should be shown on other
income)
Fixed Rs.50,000/- or 1 lac for
severe disability of 80% &
above.
No deduction should be
allowed by the DDO from the
salary income in respect of
any donations made for
charitable purposes. Circular
No. 5/2011, dated 16/8/2011
Rs.
Rs.
Rs.
Rs.
Rs.
Rs.
Rs.
VERIFICATION
I do herby solemnly declare that the details given by me is true and correct. I hereby confirm that
the above investments will be made out of my chargeable income and the proofs will be submitted
in due course.
Date: