SALARY & OTHER DETAILS FOR INCOME TAX STATEMENT (Financial Year 2019-20)

Name of the Emp: Emp ID: Disgination: Place of Working Mandal

Present Basic Pay (Feb, Basic Pay as on Telangana Other

FPI Addl/ Spay PHA CCA HM Allow
2020) March, 2019 Increment Allow
6/12/18/24 Scale Any Other If Taken Promtn, If Surrender Leave Taken, Mention
Sanctioned Date
HRA% Any Change HRA%, Mention Date
Month, Year & Days
Arrears? Mention Dt.
Children Concession ZP/AG/CLASS IV Any GPF Amount DA Arrears (Jul,18 to
Employee PAN Number Are You CPS Yes/ No
Fee (Rs.2500/ Rs.5000) Amount Change?, Mention May,19)
TS GLI Amount GIS Change, Rented House/ Rent per
DA(Jan,19 to Oct,19) TS GLI Amount GIS
Change?, Mention Mention Own House month
5 Yr Fixed
Children Tution Fee House Loan Principal LIC PLI Sukanya Samrudhi SBI LIFE
Deposit
Any Other Savings Education Loan Handicapped Medical/ Health
Yes/No Others Name of the DDO
(mention) Interest Dependent? Insurance
DDO TAN No. (If Advance Tax Paid, Mention
DDO Design DDO Office
Available) Details (Mar,19 to Jan,20)

Name of the Emp: Emp ID: Disgination: Place of Working Mandal

Present Basic Pay (Feb, Basic Pay as on Telangana Other

FPI Addl/ Spay PHA CCA HM Allow
2020) March, 2019 Increment Allow
6/12/18/24 Scale Any Other If Taken Promtn, If Surrender Leave Taken, Mention
HRA% Any Change HRA%, Mention Date
Sanctioned Date Arrears? Mention Dt. Month, Year & Days

Children Concession ZP/AG/CLASS IV Any GPF Amount DA Arrears (Jul,18 to

Employee PAN Number Are You CPS Yes/ No
Fee (Rs.2500/ Rs.5000) Amount Change?, Mention May,19)
TS GLI Amount GIS Change, Rented House/ Rent per
DA(Jan,19 to Oct,19) TS GLI Amount GIS
Change?, Mention Mention Own House month
5 Yr Fixed
Children Tution Fee House Loan Principal LIC PLI Sukanya Samrudhi SBI LIFE
Deposit
Any Other Savings Education Loan Handicapped Medical/ Health
Yes/No Others Name of the DDO
(mention) Interest Dependent? Insurance
DDO TAN No. (If Advance Tax Paid, Mention
DDO Design DDO Office
Available) Details (Mar,19 to Jan,20)

Name of the Emp: Emp ID: Disgination: Place of Working Mandal

Present Basic Pay (Feb, Basic Pay as on Telangana Other

FPI Addl/ Spay PHA CCA HM Allow
2020) March, 2019 Increment Allow
6/12/18/24 Scale Any Other If Taken Promtn, If Surrender Leave Taken, Mention
HRA% Any Change HRA%, Mention Date
Sanctioned Date Arrears? Mention Dt. Month, Year & Days

Children Concession ZP/AG/CLASS IV Any GPF Amount DA Arrears (Jul,18 to

Employee PAN Number Are You CPS Yes/ No
Fee (Rs.2500/ Rs.5000) Amount Change?, Mention May,19)
TS GLI Amount GIS Change, Rented House/ Rent per
DA(Jan,19 to Oct,19) TS GLI Amount GIS
Change?, Mention Mention Own House month
5 Yr Fixed
Children Tution Fee House Loan Principal LIC PLI Sukanya Samrudhi SBI LIFE
Deposit
Any Other Savings Education Loan Handicapped Medical/ Health
Yes/No Others Name of the DDO
(mention) Interest Dependent? Insurance
DDO TAN No. (If Advance Tax Paid, Mention
DDO Design DDO Office
Available) Details (Mar,19 to Jan,20)

N. Suresh Babu, 9441525551