Scribd
Upload
316 views

IT Declaration Format

This document is an employee's income tax declaration form for the 2011-2012 financial year. It includes sections for the employee to declare proposed investments qualifying for tax deductions under section 80C of the Income Tax Act, amounts and details of other permitted tax deductions, exemptions under section 24 for housing loans, rental payments received and deductions claimed under section 10(13A) for house rent allowance (HRA), and details of any previous employment income. The employee declares that the information provided is true to the best of their knowledge and they will submit proof of investments by January 10, 2012.

Uploaded by

Kamal Verma
Copyright
© Attribution Non-Commercial (BY-NC)
Available Formats
Download as PDF, TXT or read online on Scribd
316 views

IT Declaration Format

This document is an employee's income tax declaration form for the 2011-2012 financial year. It includes sections for the employee to declare proposed investments qualifying for tax deductions under section 80C of the Income Tax Act, amounts and details of other permitted tax deductions, exemptions under section 24 for housing loans, rental payments received and deductions claimed under section 10(13A) for house rent allowance (HRA), and details of any previous employment income. The employee declares that the information provided is true to the best of their knowledge and they will submit proof of investments by January 10, 2012.

Uploaded by

Kamal Verma
Copyright
© Attribution Non-Commercial (BY-NC)
Available Formats
Download as PDF, TXT or read online on Scribd
You are on page 1/ 2

Employee's Income Tax Declaration Form for the Financial Year 2011-12

Name: Designation Location: Function: DOJ: Work Permit No. Address I undertake to make the following investments qualifying under the provisions of The Income Tax Act, 1961 during the financial year 201112 and submit the investment proof thereof alongwith Rent Receipts (if applicable) by January 10, 2012. Actual value of Proof Produced (for office use) PAN No: Gender: DOB DO Marriage Blood Group Email Contact No.

S. No.

DESCRIPTION

AMOUNT

Proposed Date of Investment or submission

A 1 2 3 B 1 2 3 4 5 6 7 8 9 10 11 12 13 14 C 1 2 3 4 5 6 7 8

Particulars of Income from sources other than salary from the NIT Raipur (optional) Dividends Interest Other Incomes (specify) Total Earnings INVESTMENTS U/S 80C, 80CCC, 80CCD capped at Rs 1 Lac Provident Fund (PF) Contribution to Certain Pension Funds Contribution to Notified Pension Scheme Deposit in Housing Board / Bank Housing Loan Repayment Principal (payable in F.Y. 2011-12) Insurance Premium (Details in Annexure A) National Saving Scheme / Certificate Other Eligible Investment Other Mutual Fund Pension Fund / Scheme Public Provident Fund Term Deposit with Schedule Bank Children Education Expenses / Tuition Fees Others, (Please specify if any) Total Investments U/S 80C - limited to Rs 1,00,000/- only OTHER PERMITTED DEDUCTIONS 80CCF - Notified Long Term Infrastructure Bond (Maxmimum Rs.20000/- Inserted
by Finance Bill 2010)

0 AMOUNT

80D - Medical Insurance Premium Maximum Rs. 15,000


(Rs. 20,000 in case of premium on the health of Dependents above 65 years old)

80DDB - Expenditure on Medical Treatment for specified disease


(Certificate from Prescribed Authority Required)

80E - Repayment of Interest against Educational Loan 80G - Donations (Only against actual recipt and not on declaration) 80GG - Rent Paid but not in Receipt of HRA 80U - Permanent Physical Disability
(Certificate from Prescribed Authority Required)

Others - (Please specify if any) Total Deductions

Date:

Page 1 of 2

Name with Signature of Employee

D 1 2 3 4 5 6 7 8 9 10

11

Exemptions under Section 24 Address of Property Purchased / Contructed Status of Property (Self Occupied / Letout / Vacant) Housing Loan Taken From Aforesaid Housing Laon Amount Account of Housing Loan Taken for Aforesaid Property Date on Which Loan Taken Purpose of Loan (Construction / Purchase / Repairs) Date on Which Contruction is / will be Completed Date of Possession of Property Ownership (Joint or Sole) If Joint Ownership Name of Joint Owner(s) Relationship with Joint Owner(s) Share of Joint Owner(s) in Property Interest on Housing Loan

AMOUNT

12

(for Tax Exemption - Self Occupied Property acquired /constructed before 01-04-1999 - Rs.30,000 elgible & Self Occupied Property acquired /constructed after 01-04-1999 - Rs.150,000 eligble)

Amount of Interest for the F.Y. 2011-12 Amount of Interest for Pre-Contruction Period (as per Income Tax Rule) Total Deductions E HRA: RENT PAID PER MONTH ( Please mention the starting and ending month) (IF the rent amount changes during the financial year please specify the amount and the period separately)
(Submission of copies of rent receipts, L&L Agreement etc are essential for considering the exemption).

0 Rent per month


From: From: To: To:

Rent Per Annum F 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 knowledge and belief, the proposed investment mentioned above will be completed on or before declared dates for final computation of Income Tax for the year 201112. Further, incase of any change in above declaration, I would revise it and inform immediately. I shall indemnify the institute for all cost and consequences if any information is found to be incorrect. Signature: Date

Notes: 1. The declaration is for the Year 2011-12 (Assessment Year 2012-13) 2. Whenever Employee submits proof or change in the declared value, the above format need to be filled and send to Main Office 3. The date of Investments must be between 01-04-2011-31.03.2012. 4. For renewal of Investments like Life Insurance premium already taken, the dates on which the amount are payable are to be mentioned 5. Deduction u/s 10(13A) for HRA is available only where employees have actually paid the rent. Original rent receipts may be retained at your end while xerox copies can be provided to Main Office. Deduction wef April will be considered against declaration only if copy of lease agreement / land lord's ownership declaration is attached. 6. Declaration should have PAN Number. Those who do not have PAN are requested to apply for it immediately and mention 'NOT FURNISHED' 7. Income Tax Slabs for the Year 2011-12 (Assessment Year 2012-13) Slab Rs. Nil to 1.80 Lacs (For Woman below 65 years limit is 1.90 Lacs I. For Senior Citizens limit is 2.40 Lacs) II. Above 1.80 Lacs to Rs. 5.00 Lacs III. Above 5.00 Lacs to 8.00 Lacs IV. Above 8.00 Lacs Rate Nil 10% 20% 30%

Date:

Page 2 of 2

Name with Signature of Employee

You might also like