National Institute of Wind Energy

Chennai-600100

Provision Savings Declaration for the year 2020-21

I request you to consider the following for computation of Income tax for the year
2020-21:

I. House Rent:
I am paying a sum of Rs. –NA- p.m. as rent for the house hired at
___________________________________________________________

II. House Building Advance:

Amount of HBA Interest for 2020-21 : Rs. _/-
Amount of HBA Principle for 2017-2018 : Rs. _19,641/-
Copy of Provisional certificate for EMI issued by the bank enclosed.
III. Any other income: - NA-

Sl. No Details of Income Amt.

IV. Savings qualifying for deduction under Chapter VI-A (LIC, NSC, PLI, PPF,
etc.) and Medical Insurance

Sl.
Details of Savings Amt. (Rs.)
No.
1 GSLI 1,440/-
EPF no. 65067/52
2. 92,688/-
(Individual Subscription)
3. LIC policy (Quarterly- Aug, Nov and Feb) 36,444/-

1. Copy of latest receipts for __ EMI and LIC policy__are enclosed.

2. I will provide receipts for ______________________ on or before 15th February,

2021.

Signature
V. Any other item not covered above:

Sl.
Details Amt. (Rs.)
No.
1. HDFC Resident Principle component 1,112/-
Insurance Interest Component 4,774/-

I hereby declare that the information given above are true to the best of my
knowledge. Income tax may be worked out and deducted based on above particulars. I
undertake to pay / reimburse the interest, penalty and other expenses, if any charged by
Income Tax department on NIWE / Drawing and Disbursing officer of NIWE in the event of
any default in my commitment undertaken in this letter,

Place: Signature:

Date: Name & Designation:

Documents needs to be compulsorily attached with this declaration:

1) Latest Rent receipt.

2) Provisional housing loan (EMI) statement issued by Bank
3) Latest receipts for savings under chapter IV-A

Signature