A CMM LEVEL 5 & ISO 9001 CERTIFIED COMPANY C-40, SECTOR-59, NOIDA-201 307, DISTT. Ghaziabad, U.P. (INDIA) PHONES 0120-2587424-29, 2588234-35 FAX: 0120-2587123 EMAIL: rsystems.india@rsystems.com, URL:www.rsystems.com

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Name of the employee Date of Joining
Permanent Account No. (PAN)
Srl No. 1 Metro- Y/N Particulars Address of the rented property Rz-285E Block-F, Street no-9, Raj Nagar part-II, (Near DDA Park), Palam Colony, New Delhi-11045

Dinesh Chander Joshi Employee code 24-01-2007 Name of Dept. AHHPJ1196J Emp Extn No./Cell No
Details Name of the Landlord Address of the Landlord Rz-285E Block-F, Street no-9, Raj Nagar part-II, (Near DDA Park), Palam Colony, New Delhi-11045

2200 BPO (Infra QA) 2463
Amount (Rs.) Rent Per month Rent per annum

PAYMENT OF HOUSE RENT << Employees who have opted for company leased accomodation need not fill this information >>


Heera Devi


(in case of any revision in the rent please indicate the effective month) 2 (i) DEDUCTION U/S 80C OF INCOME TAX ACT Life insurance premium paid during the year 1-04-07 to 31-03-08 Policy no. 330588525 331676079 331377788 Sum Insured 40,000 100,000 200,000 For - self / wife / children Self Self Self

56,400 0 0 0 56,400

Total insurance premium (ii) Unit linked insurance premium paid to UTI Policy No. For - self / wife / children

Amount of Insurance premium premium paid qualifiying amount as per individual (20% of the sum receipt attached insured) 2608 2,608 6126 6,126 12742 12,742 0 0 0 0 0 0 0 0 0 0 0 0 21476 21,476 Premium paid 60,000 0 0 60,000 0 Amount 30,000 0 0 0 0 0 30,000 0

Total (iii) (iv) Contribution to Public Provident fund (Maximum Rs 70,000/-) Purchase of National Savings Certificates (NSC) VIII issue, during the year 1-04-07 to 31-03-08 Date of purchase Certificate no.

Total (v) (vi) Purchase of infrastructure bond/Fixed Deposit (Maximum Rs 1,00,000/-) Tuition Fee (Maximum upto 2 children) Name of Children Child 1

Name of School/College

Quarterly Period

Fee Amount 0 0 0 0 0 0 0 0 0 0 0

Total Child 1 Child 2

Total Child 2 Total

(vii) (viii) (iX)

Equity linked saving scheme of mutual fund (Subject to maximum of Rs. 1,00,000) Contribution in Pension Plan - U/s 80CCC Mediclaim insurance premium paid - U/s 80D Medical treatment of Handicapped Dependents-U/s 80DD Interest on Housing Loan Date of Commencement of Loan Date of Possession Interest Loss during the FY 07-08 Principal Amount during the FY 07-08 Pre-EMI Interest(If any) Joint Holder's Name (If any) Declaration in case of Joint name in the loan Loss on house property and rent can't be given together. Upto maxmum Rs. 50,000/-

9,500 0 0 0

(X) 3

Upto maxmum Rs. 1,50,000/-

I confirm that the above statements are true to the best of my knowledge and I am responsible for any tax calculation / tax deducted on the basis of the above statement. I also confirm that I shall furnish adequate supporting to the company failing which company is authorised to disregard the above as a basis for any tax calculation done.

Signature of the employee

Name of the Employee

Dinesh Chander Joshi

Date :


SUMMARY EMP NAME EMP CODE House Rent Metro or Non Metro LIC - premium Public provident fund Infrastructure bonds Equity + UTI Tuition Fee Contribution in Pension Plan - U/s 80CCC Mediclaim insurance premium -U/s 80D
Interest Loss during the FY 05-06 Principal Amount during the FY 05-06

<FOR OFFICE USE ONLY> Dinesh Chander Joshi 2,200 56,400 Y 21,476 30,000 69,500 Checked by

Input by Audited by

Medical treatment of Handicapped Dependents-U/s 80DD


< Please read instructions on the next sheet> < Any information you wish to communicate which has not been covered in the form above may be given separately >

ease Tick (P) as applicable

Instructions for submitting Proof of Investments
1 2 Hard copy of Investment declaration should reach us on or before 25th April, 2007 Tax benefit U/s 80C, 80CCC, 80D, is available only if any amount to this effect has been paid during the financial year starting 1st April 2007 to 31st March 2008 Employees joined on or after 01/04/2007 should declare their earning with former employer(s) for the financial year 2007-08 in a specified Form within seven days of joining. In the absence previous earning details, TDS will be made at the highest rate which is presently 30% + Surcharge (if applicable) + Educational Cess. Also please make a note that any benefit U/S 24, 80C, 80D, 88CCC can not be allowed if no salary certificate or Form 16 is attached with the tax declaration. Any investment made on or after joining RSIL may be allowed subject to providing proofs of Investment.



Exemption for House Rent - Employee availing benefit U/s 10(13A) read with rule 2A, should declare the actual rent paid /full name and the address of the landlord, full name of the tenant, address of the rented property, period for which rent is paid (i.e. month or quarter), mode of payment - cash or cheque. Receipt should be signed on revenue stamp. Rent amount should be in figures and in words. For the purpose of calculating exemption for House rent payment, any payment made to landlord by the employee towards electricity, water, maintenance charges and hire charges for furniture & fittings will not be considered as part of rent. Copy of any one month’s rent receipt for each quarter is required to be submitted. If Rent amount is =>Rs 8,000/- pls submit the PAN of your Land lord. Incase of cheque payment, Cheque no and date should be mentioned on the receipts. Also for rent exceeding Rs. 12,000 PM, we would require a lease apreement apart from Rent receipt. If there is any changes in your Rent during the Financial Year, you will have to provide the lease aggreeement to that effect. We'll not accept any change in Rent request withouth that.

5 6 7

Life Insurance premium receipt should be attached in the same order of details provided in declaration form. Please mention sum assured on the face of premium receipt. A late payment fee for payment of Insurance Premium is not allowable. For investment made in PPF, employees are requested to submit a copy of passbook or deposit challan. No other proof is acceptable. National saving Certificates VIII Issue purchased during the financial year should be mentioned and copies be attached. Accrued Interest on NSC(s) purchased in the previous year(s) may be claimed showing interest calculation as mentioned in form. However such interest will be taxable under the head Income from other sources. Copies of NSC Certificates should be attached serially, by month & year. . Income tax deduction U/S 80C on tuition fees paid for childrens is available subject to following conditions: >> tuition fee is paid for full time education and does not include development fees or donations >> tuition fee is paid to a university, college, school and other educational institution situated in India >> the qualifying amount is Rs.100,000/- per child for a maximum of 2 children Please attach copies of receipt of Tuition Fee paid. Name of month or quarter as he case may be, should be appearing therein. For Pension Plans with riders, premium paid for the rider may not always be eligible u/s 80CCC. Premium paid for certain types of riders may be eligible u/s 80D. Please indicate your PAN in the Form. Those who do not have PAN should apply and submit the acknowledgement copy for record. On receipt of PAN no., the same should be furnished at the earliest. Submission of PAN is mandatory. In case where tax has been deducted and deposited due to non-submission of tax declaration along with Investments proof, excess income tax deduction to this effect (if any) may be adjusted against future income tax liability for the same financial year after receiving income tax declaration with investment proof not later than 20th January 2008. If the excess tax deduction leads to refund situation, the amount will not be refunded to employee and the employee will have to claim it from the Income Tax Department. This will also apply in cases where the initial income tax declaration has been amended at a later date and such declaration may result in income tax refund. Employees may avail Income tax benefit for payment of Interest & principal repayment U/s 24 & 80 C respectively. Employees who have been availing tax benefit on housing loan should submit Banker’s Interest and Principal Repayment Certificate along with following: >>Copy of Title Deed / Sale Deed/ Conveyance Deed >>Copy of loan disbursement certificate with date of disbursement >>Copy of the Banker Certificate for Interest & Principal repayment for the current financial year >>Copy of Banker Certificate for Pre EMI / Pre Possession Interest payment >>Possession Letter where house or flat has been bought / Completion Certificate where house property has been constructed >>Incase the loan is in joint name, pls submit a declaration on Rs 10/- stamp paper duly notarised that the co- applicant is not taking any benefit u/s 24 against this particular loan.


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Rent Recipts Sl.No Emp Code 2200 Name Dinesh Chander Joshi Per Month Location 4,700 Y

House Loan Total Rent Intrest Loss 56,400


Savings Home Loan Principal 80 CCC 80 D LIC/Others 21,476 NSC 30,000


Child Ed. -

Infra Bond -

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