Name of the institution ;

INCOMETAX 2010-11

ANNERE -1

1 .Name and designation of the govt .servant and

Detailed residential address

Permanent account No ;

2 .Weather Living in own house or rented house ,ifrented

House ,actual rent paid per annum ( Adeclaration

Regarading payment of house rent shall be recoverd )

3 .pay and allowances including HRA paid or payble

Including value of rent free accommodation for the year

2010-2011 (salaries 0f march 2010 to feb 2011 )om other s

Including income frources and including other arrears

Shall be included ) RS

4 .H.R.A. exemption u/s 10 ( 13 A ) RS

A ) actual amount of HRA .received during 2010-11 Rs

B ) exess of rent paid over and above 10% of basic pay ie ; RS

1 ) Actual rent paid per annum ; Rs

2 ) 10 % of the basic pay for annum RS .

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Deduct ( A ) or B whichever is less than HRA Exemtion RS

5 Gross salary income 2010-11 ( Col 3—4 ) RS

6 . less Professional Tax paid RS

7 . loss on self occupaid house property

Interest on housing loan where the house isself occupied

And HRA is not claimed RS

8 . income chargeable under the head salaries /COL ( 6+7 ) Rs

9 .Add any other income received by the employee.specify details

Interest on previous NSScs

Bank Depoists if any

Income from house property

10 . GOSS TOTAL INCOME COL (8 +9 ) RS

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11 .deductions under chapter –v1-A

A ) U/SECTION 80-D RS

B .) U/SECTION 80-DD RS

C .) U/S ECTION80-G (50 % of donations recognized by

The I. T Departement subject to minimum of Rs 250/- )

( Donations to CM relief Fund 100 %ecemtion if any RS.

D . )U /s section 80 –U RS .

E .) U/ S section 80- DDB RS .

F .) U/S 80 C ( AS furnished at COL 15 page 2 ) RS .

12 .Aggregate of deductable amount under chapter V!- A ; RS

13 .NET TAXABLE INCOME ; RS .

14 INCOME TAX ON TOTAL AT COL NO 13 . ; RS .

N.B RATES OF TAXES ;

RS 1,60,000 /- OR BELLOW TAX NIL .

RS 1,90,000 /- OR BELLOW TAX NIL FOR WOMEN ASSESSES BELLOW 65 YEARS .

RS 2,40,000 /- OR BELLOW TAX NIL FOR SENIO CITIZENS .

RS 1.60,000 /- TO 3,00,000 /-10% OF THE AMOUNT BY WHICH THE TOTAL INCOME EXCEEDS RS 3,00,000

RS 3,00,000 /- 5,00,000 RS 1500 + 20 % OF THE AMOUNT BY WHICH THE TOTAL INCOME EXCEEDS RS 3,00,000

RS 5,00,000 TO 10,00,000 55,000 . + 30 % OF THE AMOUNT BY WHICH THE TOTAL INCOME EXCEEDS RS 5,00,000 .

15 .AGREGATE SAVING OF SAVINGS UNDER 80-C

1) G.P.F RS/-

2) A.P.G.L.I RS /-

3) P.L.I RS/-

4) L.I.C RS/-

5) LIC JEEVAN SURAKHA etc U/S 80-CC RS/-

6) G.IS RS/-

7) U.L.I.P

8) P.P.F

9) N.S.CS

10) INCTEREST PREVIOUS NSCS

11) TUTION FEE OF CHILDREN ACTUAL FEE –LIMITED TO

TWO CHILDREN

12)REPAYMENT OF HOUSE OF BUILDING LOAN

13)EQUITY LINKED SAVING SCHEME RS/-

14 )ICIC SAVING BONDS RS/-

IDBI FLEXI BONDS

ANY OTHER DEDUCTIONS AS SPECIFIED BY IT DEPOT RS/-

( TOTAL DEDUCTION AMOUNT SUBJECT TO A MAXIMUM RS ONE LACK ONLY )

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16 .) INCOME TAX TO BE ACTUALLY PAID ( COL .14 ) RS/-

17 )ADD EDUCATION CESS @3%ON INCOME TAX AT COL .16 RS/-

18. )TOTAL INCOME TAX PAYBLE FOR THE YEAR 2010-11 RS/-

19 )AMOUNT OF TAX ALREADY PAID IF ANY UPTO NOV 2010 RS/-

TAX TO BE DEDUCTED FROM SALARY FOR THE MONTH OF DECEMBER 2010 ; RS/-

JANUARY 2011 ; RS/-

FEBRUARY 2011 ; RS/-

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TOTAL ---------------------------------------------

RENT DECLARATION

I ……………………………………………………………………………………………………………. ……………………….. do here by

Declare that I am paying a monthly rent of of Rs /- ……………………. Rupees ………………………………………

Towards my residential accommodation bearing DNO ………………………………………………………………………….

Certified that the particulars furnished in this Annexure are true and correct

Station:

Date : Signature&Designation

DETAILS OF INCOME DURING THE YEAR 2010-201

NAME : __________________________________________________________________

DESIGNATION :_____________________________________________________________

Month	Pay+PP	D.A	H.R.A	I.R	Total	Deductions towards				Profession tax	Income Tax Deduction
				C.C.A		G.P.F	L.I.C	A.P.G.L.I /P.L.I	G.I.S
	Rs	Rs	Rs	Rs	Rs	Rs	Rs	Rs	Rs	Rs	Rs
March 2010
April 2010
May 2010
June 2010
July 2010
Aug 2010
Sep 2010
Oct 2010
Nov 2010
Dec 2010
Jan 2011
Feb 2011
Total(I)
DA Arrears
UGS Arrears
Others
Total

DETAILS OF THE PAY & ALLOWENCES FROM 1^ST APRIL,2010 TO 31^ST MARCH 2011

1) Total Grass salary Including HRA During the year 2010-2011

(as per the statement shown above) Rs.

2) Amount if received from other sources (Other than Salary)

Such as Examination remuneration, Paper valuation etc., during the year Rs.

_______________________

Total Rs.

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SIGNATURE OF THE GOVT.EMPLOYEE