JIPMER, PUDUCHERRY- 6 PROFORMA FOR DETERMINATION OF INCOME TAX DEDUCTIBLE FROM SALARY FOR THE YEAR

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1 1 JIPMER, PUDUCHERRY- 6 PROFORMA FOR DETERMINATION OF INCOME TAX DEDUCTIBLE FROM SALARY FOR THE YEAR (Please read the form thoroughly and fill up without omission and correction) 1 (i) Name & Employee No. : (iii) Date of Birth : (iv) Sex : (v) Designation & Section : (vi) PAN Number : (vii) Bill No/Contact No.(Mobile/Office No.): 2 Pay Band, Level, and Date of next increment : 3 Residential address and period from : which residing 4 House owned or rented Rent paid (Rent receipt to be produced if HRA received per month exceeds : Rs. 3,000/- and above) Computation of Income for Amount chargeable under the Head Salaries from March 2018 to February ) Gross Pay 2) Arrears, if any 3) D.A. Arrears (Jan 18 to Mar 18) 4) Expected D.A. Arrears (July 18 to Sep 18) 5) Honorarium, O.T. etc. 6) Children Education Allowance 7) Bonus 8) Leave Encashment (LTC) 9) Govt. Contribution to New Pension Scheme 10) Others TOTAL Standard Deductions: (i) A Standard deduction of Rs. 40,000 or the amount of Salary, whichever is less. (ii) Professional Tax Paid TOTAL TOTAL SALARY INCOME LESS: Amount of HRA Exempted (Least of the following) i) Actual HRA received ii) Actual Expenditure incurred on rent in excess of 10% of Salary iii) 40% of Salary Income from Salary

2 2 DETAILS OF HOUSE PRPOERTY 1 Location of the Property/Properties : 2 Date of acquisition/completion of Construction of the house : 3 Sources of funds Own/HBA/Outside loan : 4 If finance is through outside loan a) Name of the Financial Institution : b) Amount of loan obtained : c) Date of borrowal of loan : d) Repayment of Principal from to : e) Interest paid (or) accrued towards loan from to : (Enclose certificate from the Institution) 5 Whether self occupied OR let out/kept vacant /occupied by dependents : In case of joint property, certificate from the employer of the spouse must be produced COMPUTATION OF INCOME FROM HOUSE PROPERTY Annual Rent Received (A) Less: Municipal Taxes Paid (B) Net Annual Value (A-B) (C) Deductions: Sec. 23 (a) (30% of C) for maintenance (D) Sec. 24(i) Interest paid (or) accrued on borrowed capital (D) Income from house property (E)(II) (C-D) Note: In the case of self occupied property, the Net Annual Value (C) above is taken as zero. The interest paid (or) accrued on repayment loan can be taken as loss from House property. Place:

3 3 Calculation of Total Income (I) Income from Salaries (Page 1) (II) (III) Income from House Property /HBA interest (Col. E in Page 2) Income from Dividends/Interest/Other Income (As per Form 12C (5) TOTAL (1) DEDUCTIONS (i) Deduction under section 80C a) G.P.F. Subscription b) C.G.E.G.I.S c) Postal Life Insurance d) Salary Saving Scheme e) House Building Advance (Principal) (i) Recovery through office (ii) Through financial institutions (Certificate showing the amount of Principal repaid during the year should be enclosed Attach Form 12C) f) Contribution towards PPF (Enclose copy of passbook) g) Tuition fees paid (limited to two children) (Enclose payment receipt) Note: Only tuition fees paid to any college, School or university is eligible h) FD (Tax savings scheme) i) NSC purchased during the year (Enclose Xerox copy of certificate) j) Contribution/Subscription towards ULIP/ Mutual funds/deposit Schemes k) Life insurance Policy No.& Premium Paid M/Q/H/Y Total (Enclose Xerox copy of premium receipt) Sum Assured i) Life insurance premium payment, limited to 10% of the Sum assured ii) Contribution of Jeevan Suraksha/Pension plan (See 80 CCC) iii) Contribution of New Pension Scheme limited to 10% of salary (Sec. 80 CCD) (i) Aggregate amount of deduction of Sec 80c, Sec 80CCC and Sec 80CCD limited to Rs. 1, 50,000/-

4 iii) (a)*** 50,000 Additional benefit for NPS Employee Under Sec 80CCD (1B) iv) Govt. Contribution to New Pension Scheme limited to 10% of salary (sec 80 CCD) (2) v) Equity shares (50% of investment or Rs /- whichever is less (Sec 80 CCG)) If invested in the FY (vi) Medical insurance premium/cghs contribution (Maximum Rs. 50,000/- for Senior Citizens Others Rs. 25,000) Sec 80D vii) *Medical treatment for Handicapped Dependants (Sec 80 DD) 4 (viii) Interest paid for Education loan (Loan taken for self, dependants for) Higher secondary education (+1 & +2) onwards (Section 80 E) ix) Interest on loan taken for residential house property (80EE) x) * Physically handicapped assesses (Sec 80 U) xi) Interest on deposits in Saving Account with a Banking Co., (Section 80TT (A) exempted upto Rs. 10,000/-) Total Taxable Income (1 2) (Rounded off to nearest tens) Total Deductions (2) INCOME TAX CALCULATION: Upto Rs. 2,50,000 Nil ** From Rs. 2,50,001/- to Rs. 5,00,000/- 5% From Rs. 5,00,001/- to Rs.10,00,000/- 20% Above Rs.10,00,001/- and above 30% INCOME TAX REBATE: (I) Total income does not exceed Rs.3 lakhs, shall be entitled to a deduction of an amount equal to 100% of income tax or Rs.2,500 whichever is less. (II)Sec 87A is applicable if Total income less than 3,50,000 only. NET TAX Add: Health and Educational Cess 4% on Income Tax TOTAL INCOME TAX PLUS CESS PAYABLE Tax already recovered The balance tax may be deducted from my salary from the month of at the rate of Rs. per month. * Deduction under Sec. 80U and Sec. 80DD will be allowed only for those officials who have produced the medical certificate issued by the medical board in the new format. (Rs. 75,000 normally and Rs. 1,25,000/- severe disability) ** Income Tax exemption upto Rs. 3,00,000 for Senior citizens (60 years and above but less than 80 years). *** For NPS employees who s employee contribution exceeds 1,50,000 and individual who contribute in NPS.

5 5 RECEIPT OF HOUSE RENT (Under Section 1 (13-A) of Income Tax Act) Received a sum of Rs. (Rupees ) from towards the rent for the Month of in respect of House No. Situated at (Affix Revenue Stamp of Rs.1/-) Signature of the House Owner House Owner Name: Address: PAN No: (If yearly Rent exceeds Rs.1, 00,000/- and above) Note:- Monthly House Rent Receipt (If applicable) for the period from March 2018 to February 2019 is to be submitted along with savings particulars.

6 6 FORM No. 12C FORM FOR SENDING PARTICULARS OF INCOME UNDER SECTION 192(2B) FOR THE YEAR ENDING OF 31 ST MARCH Name & Address of the Employee : 2 Permanent Account Number (PAN) : 3 Residential Status : 4 Particulars of Income under any head of income other than Salaries (not beings a loss under any such head other than the loss under the head Income from house property received in financial year Income from House Property (i) (Col. E in page 2) (as per computation) (ii) Profits and gains of business or profession (iii) Capital gains (iv) Dividends/Interest/Other incomes Interest (Section 80 TTA) i) FD ii) RD iii) SB 5 Aggregate of sub-items (i) to (iv) of item 4 6 Tax deducted at source (Enclose certificate issued under section 203) Place: Note: 1) For item (ii) to (iv) only plus income to be included 2) Tax will be deducted at source but proof should be produced to the Department along with return VERIFICATION I, do hereby declare that what is stated above is true to the best of my knowledge and belief. Verified today, the day of. Place:

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