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“Provisional Investment” Form for Salary Income Tax - F.Y.2010-2011.

You are requested to read carefully & adhere to the following procedures/rules : 1. 2. 3. 4. Submission of Final Declaration Form should reach the HR/Payroll Department before 15/06/2010 For New Joinees or Late submissions or Revisions in declaration, the Forms recd before 15th of Every month will be considered for Tax calculations. All required details should be neatly/correctly filled in the form, else the same will not be considered. Proofs/attachments are not required to be attached with Form, except the “Provisional Certificate/Statment” for Interest & Principal paid/payable in F.Y. 2010-11 for Housing Loan and “Medical / Institute Certificates” for the specified deductions U/s 80DD,80DDB,80U,80E Permanent Account No. (PAN) must be quoted on the Form. Please Note that Forms without PAN, will not be considered for Tax calculations. Tax once deducted cannot be refunded by Payroll Department/Employer , refund if any, has to be claimed by the employee from the Income Tax Department at the time of filing the Income tax return. Both HRA exemption and Housing Loan Interest repayment exemption cannot be availed simultaneously except in following cases………. A) If it is first year of construction completion & you have not yet occupied the said property for your residence. In such case both can’t be claimed simultaneously but only for the part of the year. B) Loan is taken to acquire the house property and the employee could not occupy it due to employment at any other place & employee has to reside at rented premises. C) Only one person either Husband/Wife can avail for housing benefit subject to submission of undertaking. Section 80DD : Provides for deduction in respect of maintenance including medical treatment of handicapped dependent.(Quantum of deduction is Rs.50,000/- in respect of a dependent being a person with disability. In respect of dependent being a person with severe disability(80 % or multiple disability) quantum of deduction is Rs.1,00,000/- as against Rs.50,000/-. The employee is required to furnish a copy of the certificate issued by the medical authority in the prescribed form. Section 80DDB : Provides for deduction of Rs.40,000/-( Rs.60,000/- for Senior Citizen) in respect of medical treatment of specified disease or ailment incurred by individual for himself or a dependent .You are required to furnish a certificate in prescribed Form No.10 –I from doctor prescribed in rule 11DD(2) Section 80U : Provides for deduction to Employee, certified as disable (handicap) by medical authority(as per rule), deduction of Rs.50,000/- (in case of sever disability Rs.1,00,000/- instead of Rs.50,000/-.) Section 80E : Provides for deduction of total amount of interest paid on “Loan taken for Higher Education” for self,relative or dependent from notified Financial Institutions.

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000/-) (4) Payment for the purchase or construction of a residential house property. 1.e.00.000/-) (6) Contribution to Pension Plan (Max. Income Category Tax Rate Income Category Tax Rate 0 to 1.000/-) (3) National Saving Certificate (Max Rs. Amount invested in excess of these limits are not eligible for deduction .000 to 8. hence if any changes/corrections found. full Time tuition fees paid at the time of admission or thereafter.000 20 % 8.000 & Above 30% 8.1.000 20 % 5.90.13(1) to 13(8) is up to Rs.1.90.000 Nil ( No Tax ) 0 to 1.000 to 8.00.000/-) (8) Unit link Insurance plan ( Max Rs.000 to 5.00.1.00.000/-) (7) Fixed Deposit scheme with schedule banks with not less than Five Years Account opened in current year.(Max Rs. the rules/statements in Budget/Act will/should be referred.000) (1) Life Insurance premium paid by an individual on his/her life or on life of his/her spouse or on life of any child of such individual.000 Nil ( No Tax ) 1.or transportation facility ( Max Rs. Rates Of Income Tax ( i.000 10 % 1.00. Slab of Income for tax calculations) For Males below 65 Yrs. If any difference found he need to highlight the same to HR & Payroll Dept immediately. The maximum amount of deduction for item no.1. to any university.(Max) Deduction From Salary Income Under Section 80CCE (Maximum up to Rs. college or school. the wife or husband and any child of such individual.00.000 & Above 30% Notes : 1) Additional Surcharges as applicable 2) Income category is the Net Taxable Income after allowed Deductions. Rs 100. For Females below 65 Yrs. 16.60. excluding any payments towards any development fees or donation.60.000/-) (2) Contribution to Public Provident Fund in an account standing in the name of individual.00.00.00.000 to 5. 1.000/-. (Max Rs.12. .000 10 % 5.e. The above instructions are only for Employees of CMS Info Systems Pvt Ltd & the information mentioned above is extracted from the Budget 2010-11 & IT Act. Section 80CCF : Provides for deduction in respect of investments in Long Term Infrastructure Bond notified by Central Government.000/. to avoid any dispute.000/-) 14.00.1. 15.1.00.00.70. Its fully Employees’s responsibility to check the details in Tax Computation Sheet (in the next month of submission of Form) for the correctness of the information he submitted to HR/Payroll & updates in his Tax computation. 17. Up to Rs.000/-) (5) Children Education Expenses i. (Max Rs.00. 13.(Max Rs.00.00.00. 20.

__________ 3.__________ Rs._________ Rs._________ Rs.__________ Rs. Contribution to Pension Fund 2. Deduction under section 80 CCE 1.__________ Rs.__________ Rs. Other ( Pls Specify _______________ ) Allowable Deduction Max Rs.000/- . Public Provident Fund 4.__________ Rs.: ________________ Gender : ________________ I. Repayment of Housing Loan Principal 7.Y. Children’s Education Expenses (Restricted to Two children) 9.__________ Rs.1. ________ b. VIII Issue of NSC 6.000/-) II.__________ Rs. Fixed Deposit more than 5 Yr’s 8. Deduction under section 80 CCF Name of Infrastructure Bond Amount Invested Rs. __________ TOTAL (1 TO 9 ) Allowable Deduction u/s 80CCE (Max to Rs. ULIP 5.Provisional Investments Declaration Form for the year F.________ c.Code : ______________ Dt.of Join_______________ PAN No.Y 2010-11 out of my Taxable Income with a request to consider the same while computing tax to be deducted from my salary for the period Apr10-Mar11._________ Rs.2010-2011 I hereby submit my Provisional declaration of investments Form during the F.________ _______________ _______________ ________________ Rs.20._________ Total Premium Paid / Payable Rs.00.__________ Rs.__________ Rs. Name of Employee Job Location Present Residential Address :_______________________ :______________________ :_______________________ _______________________ _______________________ Emp.__________ Total Premium Paid (a+b+c)Rs. For (Relationship) Policy Amount a.__________ Rs. Life Insurance Premium details as under: Policy No.

___________ ___________ Rs.a.80U & 80E U/S Description 80DD Maintenance of handicapped dependent 80DDB Medical Exp for Specified Disease 80U Handicapped Employee 80E Int of Loan for Higher Education Note : Copy of Certification is compulsory required for above deductions.Y. ________ _______________ Rs. Interest paid on Housing Loan from approved Financial Institution. Tax Dept. Address of Property Amount of Loan Date of Loan Interest ___________________ Rs. And I SHALL INDEMNIFY the Income Tax Liability if any asked by I.__________ Total IV._________ Rs.20.a.80DDB. related to my Investment Proofs/Declaration. For (Relationship) Policy Amount Total Premium Paid / Payable a.000/-p._________ Rs.p. Place : Date : ________________________________ Signature of the HR Representative(CISPL) Name : . Deduction U/s 80DD. HOUSE RENT ALLOWANCE EXEMPTION u/s 10(13A) Rent Payable/Paid Per Mth From Month To Month Owner’s Name Address of Rented Premises Rs. 2010-2011 from respective Financial Inst) UNDERTAKING BY EMPLOYEE I hereby declare that above information is correct and I shall be solely responsible for any queries that may be raised by Income Tax dept. Policy No._________ (Pls attach latest copy of the Provisional certificate for the F.__________(Total premium pd p. Deduction under Section 80 D – Mediclaim Premium (excluding paid through CMS) Note : Deduction restricted to Rs.) Amt Paid Eligible Amt for Dedcuction VI.000/.15.________ _______________ Rs. Place : Date : ___________________________ Signature of the Employee(CISPL) VERIFICATION BY HR REPRESENTATIVE I hereby declare that I have verified the above form & they are properly filled in.III. & Premium Paids includes Senior Citizens premisible deduction is Rs. V.a.__________ b.