Income Tax Declaration Form for the Financial Year 2006-07

Name: Emp No: DOJ:

KarthikeyanLocation: Chennai T 1056 PAN No: 37658 Gender: Male

Exemptions under Section 10 & 17Value of Proof / Bills Produced Employee's Declaration House Rent Paid (Sec 10 (13A)) 12000

Medical Bills Exemption (Sec 17(2)) 15000 Children's Education Allowance Exemption (Sec 10 (14)) LTA Exemption (Sec 10(5)) Vehicle Maintenance (Petrol / Maint. Bills) (Sec 10 (14)) Total 27000 0 Other Income House / Property Income or Loss (Enter Loss as Negative) Interest on Housing Loan (for Tax Exemption) Other Income (Interest, etc.) Deductions under Chapter VI-A 0 0 Medical Insurance Premium (Sec 80D) Medical for Handicapped Dependents (Sec 80DD) Medical for Specified Diseases (Sec 80DDB) Higher Education Loan Interest Repayment (Sec 80E) Donation to Approved Fund and Charities (Sec 80G) Rent Deduction (Sec 80GG) only if HRA Not Received Deduction for Permanent Disability (80U) Any Other Deductions Total 0 0 Deductions under Chapter VI (Sec 80C) Deduction under Pension Scheme (Sec 80C) NSC (Sec 80C) Public Provident Fund (Sec 80C) Employees Provident Fund & Voluntary PF (Sec 80C) Children's Education (Sec 80C) Housing Loan Principal Repayment (Sec 80C) Insurance Premium (Sec 80C) 060 6 Infrastructure Bonds & others (MF, ULIP, etc.) (Sec 80C) Total Investments 6060 0

I _______________________________________________ do hereby declare that what is stated above is true to the best of

Receipts etc for supporting Employee's declaration has to be enclosed and the total value of supportings is to be fille 4. 6. Maples on or before May 25. Whenever Employee submits proof or change in the declared value. Declaration should have PAN Number. the above format need to be filled and send to Financ 5. Any declaration or proof of investement without the above format will not be accepted / taken for tax calculation. Those who does not have PAN are requested to apply for it immediately and ment . 2006 3.Date: Signature: Note: 1. Bills. Employees are requested to fill the Column C now and send it to Finance Dept. The declaration is for the Year 2006-07 (Assessment Year 2007/08) 2.

stated above is true to the best of my knowledge and belief. .

Maples. 2006 l value of supportings is to be filled in Column D eed to be filled and send to Finance Dept. / taken for tax calculation.n or before May 25. apply for it immediately and mention 'APPLIED FOR' .

limited to Rs 1.No INVESTMENTS U/S 80C capped at Rs 1 Lac 1 Provident Fund (PF) 2 Public Provident Fund (PPF) 3 Life Insurance Premium Paid (Like LIC.Employee's Income Tax Declaration Form for the Financial Year 2008-09 Name: Emp No: DOJ: Address Location: PAN No: Gender: Company I undertake to make the following investments qualifying under the provisions of Income Tax Act.Principal Payment (payable 2008-09) 10 Post Office Monthly Savings Schemes 11 Kisan Vikas Patra 12 NHB Scheme 13 Investment in Mutual Funds / equity shares of Companies engaged in 14 Infrastructure Bonds.Property acquired /constructed before 01-04-1999 .000 eligble 145 D RENT PAID PER MONTH ( Please mention the starting and ending month) Rent per month (IF the rent From: changes during the financial year please specify the amount To: .000/.Rs.) 4 National Savings Certificate (NSC) 5 Approved Superannuation Fund 6 Interest accrued on NSC 7 Units purchased from a recognised mutual fund 8 Children Education Expenses / Tuition Fees 9 Housing Loan .Permanent Physical Disability 6 Others .Property acquired /constructed after 01-04-1999 .00.Repayment of Interest against Educational Loan 4 80G .000 elgible 1220.. A DESCRIPTION AMOUNT Proposed Date of Investment or submission Actual value of Proof Produced S.only 0 B. 1961 during the financial investment proof thereof alongwith Rent Receipts (if applicable) by January 15.ICICI Prudential. 2009.30.Medical Insurance Premium 2 80DDB . OTHER PERMITTED DEDUCTIONS AMOUNT 1 80D .Donations (Only against actual recipt and not on declaration) 5 80U . ELSS 15 Contribution to Pension Fund 16 Others if any Total Investments U/S 80C .Rs. TATA AIG etc.150.if any Total Deductions 0 C ExemptionsAMOUNT under Section 24 Interest on Housing Loan (for Tax Exemption) 233 .23 .Expenditure on Medical Treatment for specified disease 3 80E .

Signature: Date Note: 1. Those who do not have PAN are requested to apply for it immediately and mentio . the dates on which the amount are payable are to 5. Whenever Employee submits proof or change in the declared value. the above format need to be filled and send to Financ 3.amount and the periodTo: From: separately) Rent Per Annum E PREVIOUS EMPLOYMENT SALARY If Yes. _________________________ do hereby declare that what is stated above is true to the best of my knowledge and belief. Declaration should have PAN Number. The declaration is for the Year 2008-09 (Assessment Year 2009/10) 2. The date of Investments must be between 01-04-2008 to 31-03-2009 4. Form 16 from previous employer or Form 12 B attached I. For renewal of Investments like Life Insurance premium already taken.

1961 during the financial year 2008-09 and submit the .Tax Act.

ch the amount are payable are to be mentioned ply for it immediately and mention 'NOT FURNISHED' .best of my knowledge and belief. the proposed investment mentioned above will be completed on or before 15th JAN 2009 for final com eed to be filled and send to Finance Department.

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Further.before 15th JAN 2009 for final computation of Income Tax for the year 2008-2009. incase of any change in rent of the above perm .

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y change in rent of the above permise I would revise declaration & inform immediately. .

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