INCOME TAX COMPUTATION STATEMENT

FOR THE FINANCIAL YEAR 2016-2017 (ASSESSMENT YEAR 2017-2018)

NAME AND DESIGNATION OF INCUMBENT :- PAN NO :-
PRESENT ADDRESS :- TAN NO :-
1 a) Gross salary from 1/03/2016 to 28/02/2017 Rs.
b) Arrear Salary of previous year(s) received during the year Rs.
c) Government contribution to New Pension Scheme Rs.
TotalRs.
2 Deduct allowance(s) to the extent exempt U/S 10(14) (Notes overleaf) Rs.
3 Deduct allowances to the extent exempt U/S(13A)
i) H.R.A received during the year Rs.
ii) H.R. Paid in excess of 10% of Salary Rs.
iii) 40% of Salary Rs.
(H.R.A. admissible (i), (ii) & (iii) whichever is least)
TotalRs.
4 a) Entertainment allowance (U/S 16(ii)) Rs.
b) Tax on Employment ( U/S16(iii)/ Professional Tax) Rs.
TotalRs.
5 Add any other Income reported by the employee Rs.
Grand Total Income Rs.
6 Deduction under Chapter VIA
A) U/S 80 C
a) GPF (Subscription only) Rs.
b) GIS (Subscription only) Rs.
c) LIC (Subscription only) Rs.
d) NSC (Purchased during the Financial Year) Rs.
e) Repayment of HBA Loan (Principal) Rs.
f) ULIP/P.P.F Rs.
g) Tution fees ( Limited two Children only) Rs.
h) CTD (ten year/fifteen year/) Infrastructure Bonds Rs.
i) Sub in Sukanya samridhi Account in the girl child name Rs.
B) U/S 80 CCD (1) Employee's contribution to NPS Rs.
C) U/S 80 CCD (1-B) Additional Rs. 50,000/- Rs.
D) U/S 80 CCC (Pension Fund of LIC) Rs.
( Limited Maximum Rs. 1,50,000/-) Total Rs.
E) U/S 80 CCD (2) Government contribution to New Pension Scheme Rs.
F) U/S-80 D : Mediclaim Maximum of Rs. 25,000/- only in case of dependent, for Rs.
Senior Citizens Rs. 30,000/-
G) U/S- 80 DD : Physicaly Handicaped for dependent Max. Of Rs 75,000/-, for Rs.
Severe disease up to Rs. 1,25,000/-
H) U/S-80 DDA Rs.
I) U/S-80 DDB : Medical treatment, Cancer/ AIDS Maximum Rs. 40,000/- Rs.
J) U/S-80 E : Educational Loan Interest of Rs. 1,00,000/- after S.S. Exam. Rs.
K) U/S-80G : Donation For Earthquke ect (50% donation receipt) Rs.
L) U/S-80U : Rs. 75,000/- in the case of assesses who is a person with
disability, and Rs. 1,25,000/- if he is a person with severe disability. Rs.
M) U/S 80 TTA Rs.
TotalRs.
7 Deduction U/S-24 (b) Interest amount of Housing Loan/H.B. Loan Rs.

8 Net Taxable Income of the Year Rs.

9 Tax on Total Income Rs.
10 Tax Rebate ( Section 87-A) Rs.
a) Tax Payable on Total Income (9-10) Rs.
11
b) Surcharge Rs.
12 Relief U/S 89 ( attach details) Rs.
13 Tax Payable on Total Income after Relief u/s 89 (11(a)-12) Rs.
14 Educational Cess and Higher Education Cess 3% Rs.
15 Tax Payable (16+17) Rs.
16 Advance Tax paid Rs.
17 Tax Deducted at Source U/S 192 (1) Rs.
18 Tax Payable (15-16-17) Rs.

Signature of Employee Signature of DDO

Department Seal