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NAME : PAN :

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STATEMENT OF TOTAL INCOME FOR THE PERIOD 01-04-2006 TO 31-03-2007 INCOME FROM SALARIES

Salary Received 0 LESS : Allowance Exempt U/s 10 U/s 10(14) towards Conveyance U/s 10(13A) towards HRA 0 0 LESS : Deduction U/s 16 Professional Tax U/s 16(iii) 0 0 ADD : Any other income as reported by the employee LESS : Interest paid for Housing Loan on Self Occupied Property ( Restricted to Rs 1,50,000/= maxm.) LESS: DEDUCTION U/S ( C ) 1 2 3 4 5 6 7 8 PF - Employee's contrbn. Life Insurance Premium PPF NSC / NSS Children's Education Housing Loan Repayment Educational Exp Investment in Mutual Fund 0 LESS: DEDUCTION U/S ( CCC )- Pension Fund Total Total Deductions U/s 80 (C ), 80 (CCC) & 80 (CCD) LESS: DEDUCTION U/S ( D ) for Mediclaim LESS: DEDUCTION U/S ( G ) for Donations Sub Total 0 0 0 0 0 0 0 0

Taxable Total Income Tax Liability ADD: Educational Cess @ 2 % Total Tax Payable Less: Tax deducted if any in the previous months @ CIT Balance Tax to be deducted

0 0 0 0 0 0 0

Name: GROSS SALARY Convey Night Shift Employer's Spl. Allwn. ance Allowance PF Contrn. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Month

Basic+DA

HRA

Incentive

Total Salary

April May June July Aug Sept Oct Nov Dec Jan Feb March Total

12000 12000 12000 12000 12000 12000 12000 12000 12000 12000 12000 12000 144000

0 0 0 0 0 0 0 0 0 0 0 0 0 0

Less : Non Taxable Items Employer's PF Contribution Non Taxable Allowances Taxable income Actual Rent Paid 0 0 0

PAN : DEDUCTIONS Total Net Paid Deductions 0 0 0 0 0 0 0 0 0 0 0 0 0 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0

Prof. Tax

P F Contbn. Income Tax

Others

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0 0 0 0 0