A1728

Minu Mathew

4030

RMZ 3A

Employee ID :

Employee Name :

Entity/C.Code :

Location :

Ford Technology Services India (A Div of Ford BusinessINVESTMENT PROOF SUBMISSION FOR FINANCIAL YEAR 2014-15

Investment Type Reference Number Creation Date Investment Amount

Housing (HRA / CLA / COA) 4001024800006 23.01.2015 8,000.00

Payment towards Life Insurance Policy 4001024800007 23.01.2015 40,200.00

Date Signature