Maharashtra State Power Generation Company Ltd.

Investment Declaration for the Year 2017 2018

(Pay Bill No. 10 )
NAME
DESIGNATION & CPF No.
LOCATION
BIRTH DATE
DATE OF JOINING
ADDRESS (for the purpose of HRA)
PAN No. (enclose zerox copy of PAN)
I undertake to make the following investment qualifying u/s 80 CCE of the
Income Tax Act 1961 during the financial year 2017 2018 & submit the proof thereof along
with proof under chapter VI-A and Rent receipts (if applicable)
Sr. AMOUNT
DESCRIPTION
No. (Rs.)
A INVESTMENTS U/S 80 C
1 Voluntary Provident Fund (VPF)
Public Provident Fund
2
(PPF)
Insurance Premium
3 Paid excluding through
salary
4 National Saving Certificate (NSC)
5 Accrued interest on NSC
6 ULIP
7 Education Expenses
8 Housing Loan Principal payment
9 Others (with specific section of I.T. Act)
10 Infrastructure Bonds
Total Investment U/S 80 C
B DEDUCTIONS UNDER CHAPTER VI-A
1 80 CCC LIC Pension Fund
2 80 D Medical Insurance Premium (upto Rs. 15,000/-)
80 DD Expenses on Medical Treatment of Dependent Suffering
3
from Permanent Disability (upto Rs. 50,000/-)
4 80 G Specified Donations
5 80 U Permanent Physically Disability (Rs. 75,000/-)
6 Others (with specific section of I.T. Act)
C Interest Payment for Loan on Self-Occupied House (upto Rs.1.5 Lacs)
D Rent paid per Month
VERIFICATION
I do hereby declare that whatever stated above is true to the best of my
knowledge and belief. Further, in case of any change in rent and / or occupation of the above
premises I would revise the declaration and inform immediately.

Date - Employees Signature _____________________