Name: |
|
PAN No: |
|
Designation: |
|
Gender: |
|
Department: |
|
DOB: |
|
DOJ: |
|
Contact No. |
|
Email: |
|
AADHAAR No |
|
Whether AADHAAR -PAN Linked? |
YES / No |
|
Option |
Whether wish to opt for Old Regime |
Yes |
|
(Tick whichever is applicable and strike out the other option) |
NO |
|
In case Old Regime is opted for, deductions as specified by Govt. of India shall be considered while computation of Income tax. If no option is exercised, tax will be computed as per new tax regime rates only. |
S. No. |
DESCRIPTION
|
Rs. |
Proof Document Required |
|
A |
Particulars of Income from sources other than salary (if applicable) |
|
|
1 |
Dividends |
|
Certificate |
2 |
Interest (Please mention saving bank account interest separately) |
|
Certificate |
3 |
Other Incomes (specify) |
|
Appropriate Certificate |
|
Total Earnings |
|
|
S No. ‘B’ to ‘E’ BELOW TO BE FILLED ONLY BY THOSE EMPLOYEES WHO WISH TO OPT FOR OLD TAX REGIME |
B |
Income from House Property |
|
|
|
Annual Value of House Property (As Per Income Tax Act) |
|
Documentary Proof |
|
Less: |
|
|
|
(I) Standard Deduction as per Section 24(1) |
|
|
|
(II) Interest on Housing Loan – as per Section 24(2) (for Tax Exemption – Self Occupied Property acquired /constructed before 01-04-1999 – Rs.30,000 eligible & Self Occupied Property acquired /constructed after 01-04-1999 – Rs.200,000 eligible) |
|
|
|
a. Amount of Interest for the F.Y 2024-25 |
|
Bank Certificate |
|
b. Amount of Interest for Pre-Construction Period (as per Income Tax Rule) |
|
Certificate |
|
Total Income from House Property |
|
|
C |
HRA: RENT PAID PER MONTH (Please mention the starting and ending month) |
Rent (p.m.) |
|
|
Period: |
|
Original Rent Receipts every month or Rent Agreement. Receipt should contain Name, Address & PAN of Landlord (if Rent for the year exceeds one Lakh). |
|
|
|
|
Total Rent Paid (per annum) |
|
D |
INVESTMENTS U/S 80C, capped at Rs 1.5 Lakh |
|
|
1 |
Employee’s share of PF contribution |
|
No proof of document required. Details will be filled by Us. |
2 |
Employees Contribution under New Pension Scheme 80CCD(1) |
|
No proof of document required. Details will be filled by Us. |
3 |
Employees Contribution (Voluntary) under New Pension Scheme 80CCD(1B) (Max Rs.50000.00 In Addition to u/s 80C) |
|
Proof of document/ remittance required |
4 |
Public Provident Fund (PPF) |
|
Receipts / Statement |
5 |
Contribution to Certain Pension Funds |
|
Certificate |
6 |
Housing Loan Repayment Principal (payable in F.Y 2024-25) |
|
As per Provisional Bank Certificate |
7 |
Insurance Premium (excluding GIS contribution) |
|
Receipts / Statement, No Proof submission required for GIS |
8 |
Allowable Term Deposit with Schedule Bank |
|
Certificate |
9 |
National Saving Scheme / Certificate |
|
Certificate |
10 |
Equity Linked Saving Scheme (ELSS) |
|
Certificate / Acknowledgement |
11 |
Children’s Tuition Fee |
|
Receipts |
12 |
Investment in Sukanya Samriddhi Account |
|
Statement / Receipt |
13 |
Contribution to notified Pension Fund set up by Mutual Fund or UTI. |
|
Statement / Receipt |
14 |
Additional contribution to NPS U/s 80CCD(1B) |
|
Statement / Receipt |
15 |
Others, (Please specify if any) |
|
Certificate / Receipts |
Total Investments U/S 80C – limited to Rs 1,50,000/- + U/S 80 CCD (1B) maximum Rs.50,000/- |
|
|
E |
OTHER PERMITTED DEDUCTIONS |
|
|
1 |
80D – Medical Insurance Premium, Medical Expenses (Senior Citizen parents) & Preventive health check-up |
For Self, Spouse and Children [Rs. 25,000 Rs. 50,000(in case of senior citizen)] |
|
Receipt / Statement |
For Parents [Rs. 25,000 Rs. 50,000(in case of senior citizen)] |
|
Receipt / Statement |
2 |
80DD – Deduction in respect of maintenance including medical treatment of a handicapped dependent who is a person with disability. (Rs.75000.00 for person with disability i.e. not less than 40 percent and Rs.125000.00 for person with severe disability i.e. 80 percent or above. |
|
Receipt / Statement/Proof of expenditure and necessary certificate from medical authority. |
3 |
80DDB – Expenditure on Medical Treatment for specified disease |
|
certificate / prescription from medical specialist + expense vouchers |
4 |
80E – Repayment of Interest against loan taken for higher Education. |
|
Bank Certificate and proof of payment, copy of sanction letter. |
5 |
80EE – Deduction (up to Rs. 50,000) in respect of interest on loan taken for residential house property, subject to certain conditions satisfied. |
|
Copy of sanction letter + Bank certificate+ Declaration regarding the only house on which such deduction is claimed. |
6 |
80EEA – Deduction for interest paid on home loan for affordable housing |
|
Copy of sanction letter + Bank certificate+ Declaration regarding the only house on which such deduction is claimed. |
7 |
80G – Deduction in respect of donations to certain funds, charitable institutions etc. |
|
Receipts/ Proof of payment. |
8 |
80U-Permanent Physical Disability (Normal Rs. 75000/- and Severe Rs.1,25,000/-) |
|
Certificate from a medical authority along with Proof of expenditure or self-declaration |
9 |
Others – (Please specify if any) |
|
Related documents |
Total Deductions |
|
|
F |
PREVIOUS EMPLOYMENT SALARY |
Gross Salary |
TDS (in Rs.) |
|
If Yes, Form 16 from previous employer or Form 12 B attached |
|
Form 12 B from previous employer |
DECLARATION:
i. I hereby declare that I shall inform immediately to the company any change in monthly rent stated above or discontinuation of house rent payments.
ii. I also declare that no residential accommodations owned by me or by my spouse or by my child or by HUF of which I am a member at the place where I reside or perform the duties of employment.
iii. I hereby declare that what is stated above is true and correct. Any Income Tax dues arising out of wrong declaration will be my sole responsibility.
Date : __________________
Signature of Employee:__________________________
|