7/27/2019 TDS DECLARATIONS 13-14.xls

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Name PAN No. Date of joining

Date of Birth

As per the provisions of section 139A(5A) of the Income Tax Act it is mandatory for you to intimate your PAN to the Institution

A PARTICULARS OF INVESTMENT U/S. 80 C AMOUNT Rs.

1

2

3

4

5

6

7

8

9

10

11 5 yrs Term Deposit in a Sch.Bank

B

1 Medical Insurance Premia Up to Rs.15,000/- (u/s.80 D)

(paid by cheque for self/spouse/dependent parents and dependent children)

Upto Rs.20,000 in case any member of the family is a Senior Citizen

2 (u/s 80DD)

3 Deduction in respect interest on loans for pursuing higher studies (u/s.80E)

4 (u/s.80U)

5 Others (please specify)

C

(I) Loan taken prior to 1 April, 1999 on fully constructed accommodation only - Upto Rs.30,000

(II) Loan taken on or after 1 April, 1999

Interest on Housing Loan on fully constructed accommodation only

- Upto Rs.150,000 inclusive of (I) above

D Rent paid per month for rented accommodation (for claiming exemption U/s. 10(13A)

1. I Hereby delcare that the information given above is correct and true in all respects. I am also aware that the Managem

will be considering the above details in utmost good faith based on the details provided by me and that I am personally

liable for any consequences arising out of errors, if any, in the above information.

2. I am also aware that any person making a false statement/declaration in the above form shall be liable to be fined

and prosecution u/s 277 of the Income Tax Act, 1961,

3. The proof of payment/supporting of claim will be provided before 15.12.2013

SIGNATURE OF THE EMPLOYEE

DECLARATION OF PROPOSED INVESTMENT FOR THE YEAR 2013-2014

(APRIL 2013 TO MARCH 2014)

Residential Address:

LIC for self/spouse/children.a)Direct

Deposit in Public Provident Fund (self/spouse/children) PPF

Contribution to Unit Linked Insurance Plan of LIC/UTI (self/spouse/children) ULIP

Subscription to "Home Loan Account Scheme' of National Housing Bank

Investment in notified Equity Linked Saving Schemes

N S C purchased during the year 01.04.13 - 31.03.14

Repayment of Housing Loan: Principal amount payable (April / March)

LIC Jeevan Suraksha Plan (self only) 80 CCC

Contribution to Retirement Benefit Unit Scheme of UTI

Exemption for physically handicapped (self) Rs.50,000 or Rs.75,000 in case of

severe disability

Interest payable on housing loan

Declarations

Children Education Allownce for two children (Tuition Fees only)

PARTICULARS OF INVESTMENT / EXPNDITURE DEDUCTIBLE FROM GROSS TOTAL INCOME

Expenditure on medical treatment / Payment under specified schemes of LIC/UTI of

benefit of Handicapped dependent. Rs.50,000/- for permanent disablement 75,000/-

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