3

All lndia lnstitute of Medical Sciences Rishikesh

srfrn-s arre*rr srrgffiara ztzqra xMer
No. 204lAIIMS/Accts/21-22/55 Dated:05.10.2021

Sub.: Declaration of savings for Income Tax rebate/deductions for F.Y

2O2L-22 under Income Tax Act, L962.

In order to claim deductions under different sections of Income Tax Act from
tax deducted at source from salary, all officers/faculty/SRs/lRs/staff falls under tax

deduction category are requisted to submit requisite declaration with proof in

i

enclosed form to the undersigned on or before lOth November, 2O2L. fn case,

any officer/facutty/Sn/Jh /staft does not submit dectaration, he/she wil!
not be allowed any deduction while calculating Income Tax to be deducted
from the salary and shall be responsibte himsetf/hersetf for over or under
,I

deduction of income tax at source. Final adjustment of Income Tax shall

automatically be done from the salary for the month of December 2O21 to
February 2022 in cage. of non-submission of details of savings as
requested. r

G,-kik,")
Accounts Officer

Copy to:- I

1. PA to Director.
2. Dean/MS/FAlSE.
3. All HODs/Registrar & Administrative Head-for wider/publicity among all
Officer/ Fa cu lties/Staff .

4. All notice boards. l

5. Concerned file.
 ALL INDIA ITTT$T|TUTT OF MEDICAL SCIENCES, RISHIKESH

Employee's Tax Declaration Form for the Financial Year 2021-22

PAN NO.
Name & Address
Gender

D.O.B.
Designation
Mobile no.
Contact No.
Adhar No
Email.lD
Amount
S.No, Particulai
A. ii
Particulars of lncome from sources otheit hansalarvt@
il
B.
ncome from House Property (Separate'ih
d'
lnterest paid on housing loan for the }'yi
)hr1-))
i

lnterest paid for Pre-Cq$MIien Perio{

Total lncome from House ProPerty
j
C.
ri^n paN of landloard as oer lncome tax rule)
House Rent Paid Per Month (Please mer'l
D. lnvestment U/S 8OC,8OCCC,8!9!Pjap! rd at Rs.1.50 Lakh
Public Provident Fund (PPF)

Contribution to Certain Pension FundS

lplrahle in F Y. 2019-20)
Repayment of Housing Loan principal
lnsurance Premium
Term Deoosit with Scheduled Bank
- t . --.i - - . ^l ^^ ^ l a ^r+lfi. )t d

Mutual Fund
Lnlloren EoucdLlull tr^PErr)c)/ I urLrvrr I

Others (Pls. specifY if anY)

.l

it
E - l

1i

Medical lnsurance Premium -80D

I

FXOenOlIUlt] (JIl lvlEUlLor I I soLr rrLr rv i

r! fn cnorifiod dicease- 80DDB
lt
Rtrnavment of lnterest on Education I-ban- 80E

Rent paid but not received Ht4-!9G( -t

anent PhvqicAl Disabilitv (Normarilns:so,Oo0/- and Severe Rs'1,00,000/-)

Others (Pls. sPecrIY rI any, i

I
by L5'1'2'2021''
above are correct and the proof will be submitted
l, do hereby declare that investrnent(s) declared for all cost and
r wiI inform the lnstitute' I shall indemnify
the lnstitute
Further, in case of any change in above declaration,
consequences, if any, it the information ls found
to be incorrect'

Signature of the EmPloYee

Date: