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DCM SHRIRAM LIMITED : NEW DELHIFENESTA BUILDING SYSTEMS
EMP. SAP NO. PAN NO.
Name:Abhijit Purkayastha 39235 BGWPP5640N
DEDUCTIONS U/S 80CCC MOBILE NO. 9804254321
EMAIL ID
1. Pension FundPolicy Type Policy No. Favouring Dt of Deposit/Due on Amount/Rs. (PA)
Jeevan Suraksha/Any otherTotal
2. Any other prescribed Tax Saving Schemes e.g. New Jeevan Dhara, New Jeevan Dhara-I, New Jeevan Akshay, New Jeevan Akahay-I & II, etc.
Investment under the head Receipt No. Date of Deposit Amount (Rs.)
Total Amount
DEDUCTIONS U/S 80C
3. Insurance ( LIC & ULIP)Policy Type Policy No. Favouring Dt of Deposit/Due on Amount/Rs. (PA)
LIC - DIRECT (LIC THROUGH PAY ROLL 428502428 Abhijit Purkayastha 28-Feb 5461NOT TO BE MENTIONED) 428502427 Abhijit Purkayastha 28-Feb 12010
Total 17471ULIP
Total
4. N S C
Certificate No. Date of Purchase NSC VIII OR IX Amount(Rs.)
Total
NSC Certificate No Amount of NSC The year for which interest accrues
Intt. On NSCs
First year
Second year
Third year
Fourth year
Fifth year
Sixth year
Total :
Note: The above interest amount except 5th year for NSC IX and 6th year intt. For NSC VIII Issue respectively would
be treated as re-investment while the entire amount including 5th/6th year intt. would be considered as interest
income reported by the employee.
- For calculation of interest, please refer the annexed file on the subject.
5. Public Provident Fund/ ELSS Nature of Investment Account / Receipt No Date of Deposit Amount (Rs.)
PPFTotal
Total
6. Repayment of House Loan ( Principle Amount only) ; -
Period Amount Paid (Rs.)
From To
Declaration for calculation/deduction of Income Tax for the Financial Year : 2014-2015
(a) New NSC : I propose to purchase National Saving Certificates, details of which are as under :-
(b) Interest Accured on NSC : I am holding following NSCs on which interest accured is as under
Equity Linked Savings Scheme
Name of Institution/Company
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Total
annexed file on the subject.
Note : For Claiming deduction on payment of Interest on H.Bldg. Loan, pls. submit the required documents as mentioned in the
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7. Tuition Fees (Max. of 2 children)
I have spent/will spend the following amount towards Tuition Fees as per details given below :
Month First Child
Amount (Rs.)
Second Child
Amount (Rs.)Name of School/ Name of School/
College & Class College & Class
AprilMayJuneJuly
AugustSeptember
OctoberNovemberDecember
JanuaryFebruary
March Total : Total :
8. Term Deposits/Post Office Time Deposit for 5 years.
Nature of Investment Receipt No. Favouring Date of Deposit Amount (Rs.)
Note: - Total amount (Point No. 1 to 8) qualifies upto a max.of Rs. 1.5 Lac including PF & Addl. PF from salary.
Deductions under various section Amount/Rs. Interest under Equity Savings - 80CCG
Mediclaim (80D)-For self/Spouse & Children
Mediclaim (80D)-For Parents < 60 yrs. of age
Mediclaim (80D)-For Parents => 60 yrs. of age
Medical Treatment for handicapped dependents (80DD)
Medical Treatment for specified chronic disease (80DDB)
Repayment of Intt. on Higher Education Loan (80E)
Disability U/s 80U
Interest on Saving Bank A/c. (other than Time Deposits - Max. Rs. 10K - U/s 80 TTA
Any other Deduction (Pls. Specify)
Total
EXEMPTIONS
Details of Children Education (To be filled only by those who are in receipt of Children Ed. All.)
I hereby declare that my child/children is/are getting education & exemption may pl. be considered on this account, as under :
Pl. mark _/
For 1 child Rs.100/- p.m.
For 2 Children Rs.200/- p.m.
Besides above, Addl. Exemption of Rs.300/- p.m. per child, subject to a max. 2 children, is available for Hostel
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Details of Rented Accommodation I write to inform you that I am residing in the rented/Co. leased accommodation, as per details given below, and any change in this regard would be reported by me immediately :
Particulars of Landlord/Landlady Period Amount(1.4.2014 to 31.3.2015) (Rs./P.M.)
April 7000
Name : May 7000
June 7000
PAN No. : July 7000
(If rented amount exceeds Rs.1.0 lac in a year) August 7000
September 7000
Address of rented house : October 7000
November 7000
December 7000
January 7000
February 7000
March 7000
Please enclose the original rent receipt for the month of April'14 & February, 2015. Pl. note that any change in
the house rent should be reported immediately. Change with retro effect is not possible.
Any other income reported by an employee
Head Amount (Rs.)
Any other income
Total :
Any other information, which has not been covered above but may help in calculation of yourincome tax, pl. attach the details in
the separate sheet.
I, __________________________ (Name of the employee) Solemnly declare that to the best of myknowledge and belief, the information given above are correct, complete and truly stated and inaccordance with the provision of Income Tax Act, 1961.
Date : SIGNATURE OF EMPLOYEE
Interest Income (other than NSC Intt. as shown under Col. 3 (b)