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    Income Tax Declaration Form for the Financial Year 2006-07

    Name: Karthikeya Location: ChennaiEmp No: 1056 PAN No:

    DOJ: 37658 Gender: Male

    Exemptions under Sec Employee' Value of Proof / Bills Produced

    House Rent Paid (Sec 12000

    Medical Bills Exemptio 15000

    Children's Education Allowance Exemption (Sec 10 (14))

    LTA Exemption (Sec 10(5))

    Vehicle Maintenance (Petrol / Maint. Bills) (Sec 10 (14))

    Total 27000 0

    Other Income

    House / Property Income or Loss (Enter Loss as Negative)

    Interest on Housing Loan (for Tax Exemption)

    Other Income (Interest, etc.)

    Deductions under Cha 0 0

    Medical Insurance Premium (Sec 80D)

    Medical for Handicapped Dependents (Sec 80DD)

    Medical for Specified Diseases (Sec 80DDB)

    Higher Education Loan Interest Repayment (Sec 80E)Donation to Approved Fund and Charities (Sec 80G)

    Rent Deduction (Sec 80GG) only if HRA Not Received

    Deduction for Permanent Disability (80U)

    Any Other Deductions

    Total 0 0

    Deductions under Chapter VI (Sec 80C)

    Deduction under Pension Scheme (Sec 80C)

    NSC (Sec 80C)

    Public Provident Fund (Sec 80C)

    Employees Provident Fund & Voluntary PF (Sec 80C)

    Children's Education (Sec 80C)

    Housing Loan Principal Repayment (Sec 80C)

    Insurance Premium (S 6060

    Infrastructure Bonds & others (MF, ULIP, etc.) (Sec 80C)

    Total Investments 6060 0

    I _______________________________________________ do hereby declare that what is stated above

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    Date: Signature:

    Note:

    1. The declaration is for the Year 2006-07 (Assessment Year 2007/08)

    2. Employees are requested to fill the Column C now and send it to Finance Dept, Maples on or before

    3. Bills, Receipts etc for supporting Employee's declaration has to be enclosed and the total value of su

    4. Whenever Employee submits proof or change in the declared value, the above format need to be fill

    5. Any declaration or proof of investement without the above format will not be accepted / taken for t

    6. Declaration should have PAN Number. Those who does not have PAN are requested to apply for it i

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    is true to the best of my knowledge and belief.

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    ay 25, 2006

    portings is to be filled in Column D

    d and send to Finance Dept, Maples.

    x calculation.

    mediately and mention 'APPLIED FOR'

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    Employee's Income Tax Declaration Form for the Financial Year 2008-09

    Name: Location:

    Emp No: PAN No:

    DOJ: Gender:Address Company

    I undertake to make the following investments qualifying under the provisions of Income Tax Act, 1961

    investment proof thereof alongwith Rent Receipts (if applicable) by January 15, 2009.

    A DESCRIPTI AMOUNT Proposed Actual value of Proof Produced

    S.No INVESTMENTS U/S 80C capped at Rs 1 Lac

    1 Provident Fund (PF)

    2 Public Provident Fund (PPF)

    3 Life Insurance Premium Paid (Like LIC,ICICI Prudential, TATA AIG etc..)

    4 National Savings Certificate (NSC)

    5 Approved Superannuation Fund

    6 Interest accrued on NSC

    7 Units purchased from a recognised mutual fund

    8 Children Education Expenses / Tuition Fees

    9 Housing Loan - Principal Payment (payable 2008-09)

    10 Post Office Monthly Savings Schemes

    11 Kisan Vikas Patra

    12 NHB Scheme

    13 Investment in Mutual Funds / equity shares of Companies engaged in

    14 Infrastructure Bonds, ELSS15 Contribution to Pension Fund

    16 Others if any

    Total Investments U/S 0

    B. OTHER PERAMOUNT

    1 80D - Medical Insurance Premium

    2 80DDB - Expenditure on Medical Treatment for specified disease

    3 80E - Repayment of Interest against Educational Loan

    4 80G - Donations (Only against actual recipt and not on declaration)

    5 80U - Permanent Physical Disability

    6 Others - if any

    Total Deductions 0

    C Exemption AMOUNT

    Interest on Housing Lo 233

    - Property acquired 1220.23

    - Property acquired 145

    D RENT PAID Rent per month

    (IF the rent From: To:

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    amount an From: To:

    Rent Per Annum

    E PREVIOUS EMPLOYMENT SALARY

    If Yes, Form 16 from previous employer or Form 12 B attached

    I, _________________________ do hereby declare that what is stated above is true to the best of my k

    Signature: DateNote:

    1. The declaration is for the Year 2008-09 (Assessment Year 2009/10)

    2. Whenever Employee submits proof or change in the declared value, the above format need to be fill

    3. The date of Investments must be between 01-04-2008 to 31-03-2009

    4. For renewal of Investments like Life Insurance premium already taken, the dates on which the amou

    5. Declaration should have PAN Number. Those who do not have PAN are requested to apply for it im

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    during the financial year 2008-09 and submit the

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    nowledge and belief, the proposed investment mentioned above will be completed on or before 15th J

    d and send to Finance Department.

    t are payable are to be mentioned

    ediately and mention 'NOT FURNISHED'

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    N 2009 for final computation of Income Tax for the year 2008-2009. Further, incase of any change in r

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    nt of the above permise I would revise declaration & inform immediately.