Declaration for claiming both HRA exemption &

Loss on House Property (Self Occupied)

House Property in the name of:

Date of Possession of House:

Address of the Property for which loan taken:

Note: Proof to be attached, copy of Property tax receipt or EB card or Water/Sewage

receipt.

I hereby declare that the above information is provided for the purpose of claiming Loss
on House Property.

I also declare, that I am staying in the following address _________________________

__________________________________________________________ for which I have

claimed HRA exemption.

Employee No.:
Employee Name:

Date: Signature