Name of the Employee Dr./Mr./Sh./Smt. Designation. PAN No. (attach copy of PAN card), Date of Birth (for Scientist staff only)

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ICAR - INDIAN INSTITUTE OF SOIL SCIENCE : BHOPAL Final Income Tax Statement of Income U/s 192(2B) of the Income Tax Act 1961 Year ending 31.3.2019 Financial Year 2018-19 Assessment Year 2019-20 Name of the Employee Dr./Mr./Sh./Smt. Designation PAN No. (attach copy of PAN card), Date of Birth (for Scientist staff only) AADHAR NO Details of Total emoluments paid & Tax deducted at Source 1. Annual Salary Income each total (a) Gross Salary (Basic Pay+GP+DA+TA+DA on TA) (b) Leave encashment (c) Tuition fee reimbursement (Maximum 02 children (d) Honorarium/ Intellectual fee/ Remuneration (e) Bonus (f)other perquisite, if any Less-Standard deduction under Sec 16(ia) 40,000/- 2 Less : HRA Rebate qualifying for exemption if any U/s 19(13A) enclose House rent receipt with owner s PAN No. (admissible amt. - whichever is less out of a, b and c mentioned below) (a) HRA Received Rs. (b) Rent paid on excess of 10% of (salary +GP) Rs (c) 40% of salary Rs.. (d) Professional Tax Total of S.No. 2 Page 1 of 4

3 Income chargeable U/head Salary (1-2) 4 Income from other source: Bank Interest, P.O. deposit, NSC,FD interest etc. 5 Gross Total Income (3+4) 6 Income from House Property: (a) Interest accrued on HBA deductions u/s24(i)(iv) before 31.3.99 max 30000/- After 31.3.99 maximum 2,00,000 for self occupied house 7 Deduction under chapter VI-A Gross Qualifying Amt. Amt. (a) Donation 80G(100 or 50%) (b) Med.Insur.80D( 25000) (C) H/Capped persons 80U ( 75000-1.25lakh.) (d) Repayment of Edu.loan no limit of Interest (e) Any other 8 Total deductions (6+7) 9 Net Income (5-8) 10 Contribution of saving : U/s 80CCC Pension Plan LIC GPF Contribution Employee contribution to NPS (80-ccd (1)) LIC Premium ICAR GSLIS Tuition Fee limited to two children 10 or 15 Yrs. a/c under the PO Saving(CTD)/PPF Page 2 of 4

NSC Purchase Re-investment of interest on NSC ULIP/Mutual fund, PLI Repayment of House Building loan Bonds A Total saving u/s 80 cc (S.No.10) subject to maximum Rs.1,50,000/- B NPS contribution under section 80 CCD (1-B)- Additional (maximum Rs. 50000/-) C Government s contribution to NPS under section 80 CCD(2) 11 *Taxable Income (9-10) 12 Amount of Tax 13 Rebate Under section 87 A (An assessee whose total income does not exceed Rs. 3.5 lakh, shall be entitled to a deduction of an amounts equal to 100% of income tax or Rs. 2500/- whichever is less) 14 Net Tax (12-13) 15 4% Education Cess will be payable on the net tax (including surcharge)payable for all accesses 16 Total Tax (14+15) 17 Relief U/s 89 (Arrears difference of tax) 18 Tax payable (16-17) 19 Less: Income Tax deducted for 2018-19 (up to November 2018) 20 Balance Tax to be deducted 21. a. b. Balance Tax to be deducted in equal proportion from the salary for m/o Dec 18 Jan 19 c. Total of 21 a to c Feb 19 Page 3 of 4

Present/Corresponding Address: Signature of the Employee ------------------------------------------ Mobile No.& Intercom No. ------------------------------------------ PIN CODE- ICAR e-mail given by ICAR ---------------------------------------- Alternate e-mail address---------------------------------------------- Permanent Address: PIN CODE- (A) NORMAL RATES OF TAX Taxable Income Others Up to 2,50,000 Nil 2,50,001 to 5,00,000 5% of the amount by which the total income exceeds 2,50,000/- 5,00,001 to 10,00,000 12500/- plus 20% of Income exceeding 5,00,000/- Where the total income exceeds 10,00,001 above 112500/- plus 30% of Income exceeding 10,00,000/- ( B ) Rates of tax for a Senior Citizens 60 years and above but less than 80 years 3,00,000 Nil 3,00,001-5,00,000 5% of the amount by which the total income exceeds 3,00,000/- 5,00,001-10,00,000 10000+20% on Income exceeding 5,00,000/- 10,00,001 and above 110000+30% on Income exceeding 10,00,000/- Note: Income Tax Assess claiming the above deduction/rebate under different Sections of IT Act are required to provide documentary proof documentary proof regarding the claim, failing which no deduction/rebate will be allowed. Page 4 of 4

Annexure-I Those who are paying rent for his/her residential purpose and seeking rebate on Income Tax, the following details of the landlord be furnished. 1. Name of the Landlord : 2. Address : 3. PAN No. (Landlord) 4. In case there is no PAN No. of the : Landlord, Declaration to this effect from the Landlord be attached along with copy of property tax paid. 5. Whether the person to whom rent being paid is declared to be dependent to the employee and the declaration to this effect is submitted to the concern Establishment section or not. 6. Whether the employee or his/her spouse owns residential accommodation or not. If so, the details and status be furnished. 7. Whether the spouse of the employee is availing Income Tax rebate on account of rent being paid from his/her employee. Signature: -------------------------------------- Name: ------------------------------------------- Designation:------------------------------------- Page 1 of 4

Annexure-II COMPUTATION OF HOUSE PROPERTY 1. Location of property : 2. Status (Self Occupied/let out) : 3. Annual value amount for which the : Property might reasonably be let out or Annual Municipal valuation or actual rent received or receivable whichever is highest. 4. Less: Municipal tax paid : 5. Net adjust annual value : 6. Less-deduction under section 24(1) : 30% of net adjusted annual value 7. Less-Interest on borrowed capital 8. Net Income from House property : Signature: -------------------------------------- Name: ------------------------------------------- Designation:------------------------------------- Page 2 of 4

ANNEXURE-III INCOME TAX RULES, 1962 FORM No.12C (See Rule 26B) Form for sending particulars of Income under section 192 (2B) for the year Ending 31st March, 2019. 1.Name and address of the employee 2.Permanent Account Number 3.Residential Status : : : 4. Particulars of income (not being less) under any head other than Salaries received in the financial year: (i) Interest on securities (ii) Income from house property (iii) Profits and gains of business or profession (iv) Capital gains (v) Income from other sources Rs. : Rs. : Rs. : Rs. : a) Dividends Rs. : b) Interests Rs. : c) Other Income (Specify) Rs. : Total Rs. : 5. Aggregate of sub items(i) to (v) of item 4. 6. Tax deducted at source (enclosed certificate(s) issued under Section203.) Place Dated (Signature of the employee) Verification I, do hereby declare that what is stated above is true to the best of my knowledge and belief. Verified to-day, the day of 2018 Place Dated (Signature of the employee) Page 3 of 4

Form No.19BA (See Rule 11B) DECLARATION TO VE FILLED BY THE ASSESSEE CLAIMING DEDUCTION U/S 80CC ANNEXURE-IV I/We (Name of the assessee with Permanent Account Number) Do hereby certify that during the previous year I/We had occupied the premises (full address of the premises) for the purpose of my/our residence for a period of months and have paid Rs. in cash/through crossed cheque, bank draft towards payment of rent to Shri/Ms/Mrs (name and complete address of the landlord). It is further certified that no other residential accommodation is owned by (a) Me/my spouse/my minor child/our family (in case the assessee is HIF), at Where I/we ordinarily reside / perform duties of Office or employment or carry on business of profession, or (b) Me/us at any other place, being accommodation in my occupation, the value of which is to be determined u/s 23(2)(1) or u/s 23(2)(b). (c) The information as per enclosed Performa is also required on Annexure-1. Name Designation Divn./Section Page 4 of 4