You are on page 1of 2

Employee Investment Details for Income Tax Purposes

To be filled by the Employee To be filled by the Accounts Department

Sign if
Date of Joining : 25th Sep 2015 Required Verification verified &
Testimonials Procedure
found ok
Tax Exemption
Sno. Description of Allowances Eligibility Actual Spent Amount Passed
Rental Receipts &
As per IT slab House Owner PAN
1 House Rent 1.00 No. (if requried)

2 Conveyance Nil Nil Nil

3 Medical 12.00 Medical Bills Medical Bills

4 Uniform ( As per Salary ) Nil Nil Nil

5 Child Education (INR 1200/Child) School Fee Rcpts No. of Children /


ages / Receipts
5 Hostel ( INR 3600/Child) Hostel Fee Rcpts
Leave Travel ( Block 2014-17) 1) leave on travel
All Tickets & dates? 2) Tckt &
6 Dates of Travel ( To be filled ) xx / xx / xxxx to xx /xx /xxxx Boarding Passes Boarding Pass 3)
Dependants
Last LTA availed ( Calendar Year )
Investment Under Section 80C
7a
b Total of INR Employee PF
of Premium Contribution
150000 for a) +
c Home Loan 12.00 2.00 ReceiptsPaid Verify for gap
between 1.5 L and
d Principal/ PF / PF contribution
LIC / PPF / NSC
e etc
Bank Interest Joint Name ? / Full
8 Housing loan interest ( Sec 24 ) 200,000 2.00 2.00 Statement Claim or shared
9 Contribution to NPS 50,000 -
10 Others (Please specify if any) Pension Statetment
Date Signature of Accounts Exec : Date
Signature of the employee :
1/29/2019 Signature of Accounts HOD : xx/xx/xxxx