DECLARATION FOR THE DODUMENTS DUE FOR SUBMISSION AFTER PROOF

SUBMISSION 1 st CUT OFF DATE

Employee Code: Name: Location:

Given below are the details of documents which fall due after the proof submission 1 st cut off date,
but are payable before the financial year-end 2023-24. Please consider these as commitment to give me the tax
benefit in the current financial 2023-24.

Rent Receipts - Due

Sl. No Payment Date Amount
Month
1
2
3

Children Tuition
Attached Last Year
Sl. No Fees - Due Month (Only Name of the Child Due Date Amount
Receipt Copy (Yes/No)
Recurring Investments)
1
2
3

Mutual Fund – Due Attached Last Year

Sl. No Month (Only Recurring Folio No. Due Date Amount
Receipt Copy (Yes/No)
Investments)
1
2
3

Life insurance Attached Last

Sl. No Premium/Unit Policy No. Due Date Amount Year Receipt
Linked - Due Month Copy (Yes/No)
1
2
3
4
5

Attached Last
80D Medical
Sl. No Policy No. Due Date Amount Year Receipt
Insurance – Due Month
Copy (Yes/No)
1
2

Benefit would be extended only on submission for any existing premium falling due after the proof 1 st cut off date.

Employee Declaration

I hereby declare that the information provided above is true and correct and will be solely responsible for any
situation arising out of non-payment and submission of the above on or before March 2024 payroll.

Signature: Date: