Sheet1
10 E Annex-I
Form 10 E
ACKNOWLEDGEMENT
ITR-IPage 2
ITR-I Page 1
AUTO FORM 16
Pay Statement
Auto Salary Statement
Pay sheet
BIODATA FOR ITR-1
PIN CODE:
80U
DATE OF BIRTH
Post Office:
Area/Locality:
District:
State:
GENDER- MALE
STATUS- Govt/PSU/Others
FORM
INDIAN INCOME TAX RETURN
Assessment Year
-
PERSONAL INFORMATION
First name
Middle name
Last name
Flat /Door/Block No.
Name Of Premises/Building/Village
Road/Street/Post Office
Area/Locality
Employer Category (Tick)
√
Govt.
PSU
Others
Town/City/District
State
Pin code
Email Addrs.
(STD Code) - Phone Number
FILING STATUS
Designation of Assessing Officer (Ward/Circle)
Return Filed Under Section-
[Please see instruction number-9(i)]
Whether original or Revised return? (Tick)
Original
Revised
If revised, enter Receipt No and Date of filing original return (DD/MM/YYYY)
ORIGINAL
Residential Status (Tick)
Resident
Non-Resident
Resident but not ordinarily Resident
INCOME & DEDUCTIONS
Income chargeable under the Head 'Salaries',Pension
a
b
c
Deductions under chapter VIA (Section
80C
e
80DD
I
80GG
80CCC
f
80DDB
j
80GGA
80CCD
g
80E
k
80GGC
d
80D
h
80G
l
Aggregate Income' (5+6)
TAX COMPUTATION
Rebate in respect of Net Agricultural income
Tax Payable on total Income (8a - 8b)
9a
Surcharge on 9a
9b
Relief under Section 89
Relief under Section 90/91
Total Interest Payable
13d
(13a+13b+13c)
Total Tax and Interest Payable
14
(12+13d)
Seal and signature of receiving official
Receipt No.
Date
TAXES PAID
Taxes Paid
Advance Tax (from item 23)
15a
TDS (column 7 of item21+column 7 of item 22)
15b
Self Assessment Tax (from item 23)
15c
Total Taxes paid (15a+15b+15c)
15d
REFUND
Enter your bank account number (mandatory in case of refund)
Do you want your refund by
Cheque, or
)
In case of direct deposit to your bank account give additional details
MICR Code
Savings
Current
Details of Tax Deducted at Source from Salary [As per Form 16 issued by Employer(s)]
TDS ON SALARY
Sl No
Tax Deduction Account Number(TAN) of the Employer
Namee and address of the Employer
Income chargeable under the head salaries
Deduction under Chapter VI-A
Tax payable (incl. surch. And edn. Cess)
Total tax deposited
Tax payable/ refundable
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
Details of Tax Deducted at Source on Interest [As per Form 16 A issued by Deductor(s)]
TDS ON INTEREST
Tax Deduction Account Number(TAN) of the Deductor
Namee and address of the Deductor
Amount paid/ credited
Date of Payment /Credit
Amount out of (6) claim for this year
NOTE
Enter the total of column (7) of 22 in Sl.No.15b of TAXES PAID
Details of Advance Tax and Self Assessment Tax Payments
TAX PAYMENTS
Name of Bank & Branch
BSR Code
Date of Deposit (DD/MM/YYYY)
Serial Number of Challan
Amount (Rs.)
(i)
(iii)
Enter the total of Advance tax and Self Assessmen tax in Sl.No.15a and 15c of TAXES PAID
Sl.
Code
001
004
007
002
005
i
008
003
006
Tax-exempt interest income (for reporting purposes only)
VERIFICATION
I,
son/ daughter of
solemnly
declare that to the best of my knwledge and belief, the information given in the return thereto is correct and complete and that the amount of total income and other particulars shown therein are truly stated and in accordance with the provisions of the I
Place
Sign here
If the return has been prepared by a Tax Return Preparer (TRP) give further details as below :
Identification No. of TRP
Name of TRP
Counter Signature of TRP
Date of Birth (DD/MM/YYYY)
Sex (Tick)
Net Agricultural Income (Enter only if greater than Rs.5,000)
Tax payable(14-15d)(enter if 14 is greater than 15d, else leave blank)
Refund (15d-14) (enter if 15d is greater than 14, also give Bank account details below)
deposited directly into your bank account? (tick as applicable
Type of Account (tick as applicable)
Other Information (Transactions reported through Annual Information Return) (Please see instruction number-9(ii) for code)
If TRP is entitled for any reimbursement from the Government, amount thereof (to be filled by TRP)
Received with thanks form:
Name
Flat/Door/Block No:
Name of Premises/Building/Village:
Road/Street/Post Office:
Area/Locality:
Town/City/District:
State:
COMPUTATION OF INCOME & TAX THEREON
Gross total income
Deduction under Chapter-VI-A
Total Income
Net tax payable
Interest payable
Total tax and interest payable
Taxes paid
Advance Tax
7a
TDS
7b
TCS
7c
Self Assessment Tax
7d
Total Taxes paid (7a+7b+7c+7d)
7e
Tax payable (6-7e)
Refund (7e-6)
Computation of Income & Fringe Benefits & Tax Thereon
Value of Fringe Benefits
NA
Total fringe benefit tax liability
Total interest payable
14a
14b
Total Taxes paid (14a+14b)
14c
Tax payable (13-14c)
Refund (14c-13)
Receipt No.
Seal and Signature of receiving official:
Date:
Status(fill the code)
Tax Payable on 'Aggregate Income'
ANNEXURE-I
[See item 2 of Form No.10E]
Arrears or advance salary
Sl No.
Particulars
Total income (excluding salary received in arrears or advance)
Salary received in arrears or advance
Total income (as increased by salary received in arrears or advance) [Add item 1 and item 2]
Tax on total income [as per item 3]
Tax on total income [as per item 1]
Tax on salary received in arrears or advance [Difference of item 4 and item 5]
Tax computed in accordance with Table "A" [Brought from column 7 of Table A]
Relief under Section 89(1) [Indicate difference between the amounts mentioned against item 6 and item 7]
TABLE "A"
[See item 7 of Annexure 1]
Previous year
Salary received in arrears or advance relating to the relevent previous year as mentioned in column (1) (Rs.)
Total income (as increased by salary received in arrears or advance) of the relevent previous year mentioned in column (1) [add colmn 2 & 3] (Rs.)
Tax on total income [as per column (2)-After Rebate and including Edn Cess and Surcharge] (Rs.)
Tax on total income[as per column (4) After Rebate and including Edn Cess and Surcharge] (Rs.)
Difference in tax [Amount under column (6) minus amount under column (5)] (Rs.)
Signature:
Place:
Name:
Date:
Designation:
Dept:
FORM NO.10 E
[See rule 21AA]
Name and address of the employee
Permanent account number
Residential status
1 (a)
Salary received in arrears or in advance in accordance with the provisions of sub-rule (2) of rule 21A.
(b)
Payment in the nature of gratuity in respect of past services, extending over a period of not less than 5 years in accordance with the provisions of sub-rule (3) of rule 21A.
Not Applicable
(c)
Payment in the nature of compensation from the employer or former employer at or in connection with termination of employment after continuous service of not less than 3 years or where the unexpired portion of term of employment is also not less than 3 ye
(d)
Payment in commutation of pension in accordance with the provisions of sub-rule (5) of rule 21A
Detailed particulars of payments referred to above may be given in Annexure I,II,IIA,III, or IV as the case may be.
ANNEX-I
…………………………………………..
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 today, the
Day of
Place: …………………….
………………………………………
Date:……………………
Signature of the employee
PERMANENT RESIDENT
Arrear Received if any
a return of income &/return
Designation of Assessing Officer
Original/Revised
Government of India
INCOME TAX DEPARTMENT
ACKNOWLEDGEMENT
PARTICULARS OF SALARY
Relief under Section 89(1)
Office Address
[For Individual having Income from Salary/Pension/income from One House Property(Excluding loss brought forward from previous years)/Income from Other Sources (Excluding Winning from Lottery and income from Race Horses)]
(Please see Rule 12 of the Income-tax Rules, 1962)(Also see attached instuctions)
Original return(DD/MM/YYYY)
Income chargeable under the Head 'House Property'(enter-ve sign in case of loss, if any)
Gross Total Income (1+2+3)
Deductions (Total of 5a to5i)
Total Income (4-6)
Education Cess on (on 8)
Total Tax, Surcharge and Education cess payable (8+9)
Total interest payable u/s 234A/234B/234C
Total Tax and Interest payable (12+13)
Do not write or stamp in this areas for office use only
16a
16b
16c
Tax payable(15-17)(enter if 15 is greater than 17, else leave blank)
cheque
or
Give additional details of your bank account
Advance Tax (from item 25)
TDS (column 7 of item23+column 7 of item 24)
Details of Tax Deducted at Source other than salary
Enter the total of column (7) of 23and column (7) of 17 of TAXES PAID
Exempt income only for reporting purposes(from Dividend, Capital gains etc)
Balance Tax Payable (10-11-12)
declare that to the best of my knwledge and belief, the information given in the return thereto is correct and complete and that the amount of total income and other particulars shown therein are truly stated and in accordance with the provisions of the Income -tax Act, 1961, in respect of income chargeable to income-tax for the previous year relevant to the Assessment Year 2010-11
Date of Birth
Date of Submit this RETURN
Original
Name and address of the Employer
Employer Category
a)
G.P.F.
b)
Tuition Fees
e)
Deposit in Pension Fund (Maximum Rs. 1,00,000/-
New Pension Scheme (Maximum 10% or Salary)
Donation in Charitable Fund Maximum 100% of donation)
Premium in health insurance of self,spouse,children,dependent,Maximum Rs 15000/-
Medical treatment for self or dependent as Handicapped
Medical Treatment for self or dependent for sever desease
Permanent disability including blindnes as handicapped(Max Rs.75000/-)
80G
80E
80DD
TOTAL DEDUCTION CHAPTER VI-A Rs.
80CC
MIDDLE NAME
LAST NAME
EMPLOYEE'S RESIDENTIAL ADDRESS
Flat/Door/Block No.
Village
Income chargeable under the Head 'Other Sources' (enter-ve sign in case of loss, if any)
Name & Address of the Employer
A
Name & Designation of the Assesses
Double Click on the Yellow cell and Put the Password "pranab" and Edit the yellow Cell
B
Residential Address
Pin No.
Male
Female
C
GIR NO
Office permanent A/C No.
D.A.
H.R.A.
M.A.
Bonus
TOTAL
Total Earn
G.I.S.
H.B.Int Paid
TUTION FEES
TOTAL EARN FOR THIS YEAR
A.
B.
C.
a) Salary income with allowance excluding H.R.A.:-……………………………
Rs.
b) House Rent Allowance :-……………………………………………………………
c) Bonus :-…………………………………………………………………………………
d) Arrear,if any :-…………………………………………………………………………..
Any other income as stated by the Assesses :-
a) Income from N.S.C./Bank interest etc:-………………………………………….
b) Income from House Property:-…………………………………………………….
Gross Income(Col.1 + 2 ) :-………………………………………………………………
Interest paid as H.B.Loan (1.5 Lacks maximum) U/S 24(B):-……………………….
Professional Tax U/S 16(iii) :-…………………………………………………………
Exemption U/S 10(13A) :-
c) Expenditure on rent in excess of
University/College/School for maximum of two
3% Educational cess on tax :-……………………………………………………
Designation
Basic +Grade Pay
P.Tax
Income from Bank Interest/N.S.C/Others Source
Income from House Property
M
SARAL-II (ITR-I)
FORM NO.16
Name and designation of the employee
PAN NO.of Deductor
TAN No.of the Deductor
PAN NO. of the Employee
Period
Quarter
From
To
Gross Salary
IN RUPEES
(a)
Salary as per provisions contained in section 17(1)
(b)
Value of perquisites under section 17(2)(as per Form No. 12BA,wherever applicable)
(c)
Profits in lieu of salary under section 17(3)(as per Form No. 12BA, wherever applicable)
(d)
Less: Allowance to the extent exempt u/s 10
Allowance
Balance(1-2)
Deductions :
H.B.Loan Int.(Max-1,50,000/-) u/s 24(B)
Tax on employment
Aggregate of 4(a) to (b)
Income chargeable under the head 'salaries' (3-5)
Add: Any other income reported by the employee
a)Income form N.S.C./Bank int.etc.
Gross total income (6+7)
Deductions under Chapter VIA
Gross Amount
Deductible Amount Rs.
(a)(i)Sec.80C-G.P.F.
(ii) G.I.S.
Other sections e.g.,80E,80G,etc under chapter VI
Qulfy amount
(a)
Section
80 E
80 G
©
(e)
f)
Tax payable
G)
Refundable
Aggregate of deductible amount under Chap. VIA
Total Income (8-10)
Tax on total income
Surcharge on col.12
Education & cess @3% on col.no.12
Tax payable (12+13+14)
Relief U/s 89(1)
Tax payable/refundable (15-16)
Less (a) Tax deducted at source
do hereby certify that a sum of Rs
[See rule 31(1)(a)]
Name & Address of the Deductor
B.S.R.Code No of the Branch shich deposited the TDS
Date on which Tax deposited(dd/mm/yy)
DESIGNATION
Name of the Bank Branch which deposited the TDS
For refund enter 9 (nine) Digit MICR Code
Employee's Bank Account No.
Employee's Bank Account
Type of Bank A/C of the employee (Current/Savings)
Total Income from Salary( This Cell Auto filled)
d)
Gross Income from Salary (Salary+H.R.A.+Bonus+Arrear if any+Int.Bank/NSC+House Property)
This Cell is Auto filled (The Data comes from Pay Sheet)
This Cell is Auto filled( The Data Comes from Pay Sheet)
GROUP INSURANCE (G.I.)
L.I.C.
N.S.C.
H.B. Loan Principal
Pin Code No.
Pan No. of Deductor
Tan No. of Employer
T.V.No/Challan No. & Date which Tax Deposited
LIC
Total Taxes paid (16a+16b+16c)
Refund (18-17) (enter if 15d is greater than 14, also give Bank account details below)
Self Assessment Tax (from item 25)
Enter the total of Advance tax and Self Assessmen tax in Sl.No.17 of TAXES PAID
INCOME TAX STATEMENT FOR THE FINANCIAL YEAR 2010-2011
ASSESSMENT YEAR 2011-2012
THIS SHEET IS NOT FOR PRINT. THIS SHEET IS REQUIRED ONLY PAY CALCULATION FOR ONE YEAR
This Auto Income Tax Calculation Software only for West Bengal Govt Employees. As the D.A. is not mached with other State or Central Govt Employees.(In this Software Prepared Salary Statement+Form-16 + ITR-I + Form 10E)
FIRST NAME
Permanent A/C No.(PAN NO)
Click Next 10 E Annex-1
10 E Annex-I
of fringe benefits in Form No ITR - 1 for assessment year 20011-2012, having the following particulars:
Deduction U/S 80 C (Maximum Rs.1,20,000/- including T.Svngs Bond)
Advance Income Tax Paid
TOTAL DEDUCTION U/S 80C Max. Rs 1,00,000/- + 20,000 Infrustructure Bond, Total Rs.1,20,000/-
a) Contribution to G.P.F.:- …………………………………………….
TAX
Payble
Total Deduction U/S 80C (Max.limit 1,00,000/-) + 20,000/- New declared Infrustructure Bond
Gender ( Male or Female )
F
male
Auto Salary Statemenr
ITR PAGE 2
Click next ITR I Page 2
If Handicapped Employee Pl. put "Yes" If General put "No"
No
DEDUCTION ONLY U/S 80C, 80CC (MAXIMUM LIMIT NOT EXCCEED RS.1,20,000/- including New Tax Savings Bond(Max Rs.20000/-)
Payable
Relief U/S 89(1)[Arrears Relief from Salary]
hra Recvd
Hr Recvd
Hr Paid
Charg of H.R.A
House Rent Paid
Exemption of Conveyance Allowances U/s 10(14)(i)[Max.Rs 9600/-P.A.
Conveyance Allowances U/s 10(14)(i)
Maximum Rs. 9600 P.A.
For Rented House. Must Submit the receipt of House Rent.
House Rent Allowance (HRA) Exemption
Inputs
per month
HRA received from your Employer
Actual house rent paid by you
Do you live in a metro?
(Type Yes if you live in a metro, else No)
Calculations
Allowed HRA Exemption for Income Tax
Your basic salary +D.A
Per Year
per Year (usually capped to 50% (metros) or 40% (non-metros) of your basic salary)
BP
DA
GROSS
e) Amount exempted (Least of a,c):-
MONTH &Year
hra
> <
Conv. Allown. If any
Total Income(Col.3-4-5-6-7) :-……………………………………………………….
Hndcpd
New I T R -I ,For Assessment Year 2011-2012,which recent published by the MINISTRY OF FINANCE(Deptt.of Revenue)Central Board of Taxes,New Delhi. Notification Dated 23/04/2010 in the Gazette of India Extraordinary,Part-II, Section 3,(Sub Sec(ii)]
Pay Calculation Sheet for -Income Tax Calculation ,for the financial year 2010-2011, Assessment Year 2011-12 Only For West Bengal Govt Employees
Put D.A. Rate of %
Next to 10E Annex-1
10E Annex-1
Prepared by Pranab Banerjee, Kalisthanpara,Jiaganj, Murshidabad, West Bengal
HRA Exempt( U/s 10(13A)
Conv.Alw.exempt(U/s 10(14)(i)
Date(dd/mm/yy)
Total Tax Paid
Details for Refund if Excess Tax Paid - Please Fill the given below field for Refund
Bank A/C No
9(Nine) Digid MICR CODE
(ii)
(iv)
Q 1
Q 2
Q 3
Q 4
(iv) H.B.L.(Principal)
1st Quarter
2nd Quarter
3rd Quarter
4th Quarter
Note:-If any discrepency is arise about calculation of income Tax,I am not responsible for that
Vide Chln.No
April
Bank/Treasury Ch.No
May
June
Total 1st Q Amount
1. Put the Yellow Cell TDS Acknowledgement No. which Quarterly Deposited by the Employer to Tax the Deptt( Q 1)
July
August
Sept
Total 2nd Q Amount
2. Put the Yellow Cell TDS Acknowledgement No. which Quarterly Deposited by the Employer to Tax the Deptt (Q 2)
Octo
Nov
Dec
Total 3rd Q Amount
3. Put the Yellow Cell TDS Acknowledgement No. which Quarterly Deposited by the Employer to the Tax the Deptt (Q 3)
Janu
Feb
Mar
Total 4th Q Amount
4. Put the Yellow Cell TDS Acknowledgement No. which Quarterly Deposited by the Employer to the Tax Deptt(Q 4)
Date of Depst Q 1
Date of Depst Q 2
Date of Depst Q 3
Date of Depst Q 4
31/3/2011
if any discripency is arise for calculation of income tax by this software,I am not respoisible for that. pranab banerjee
Employee's Bank A/C Type, Savings or Current
ii)80G
iii)80DD
iv)80D
v)80E
H.B. Loan. Princpl
TOTAL (ExcludingBonus+ Arrears)
Arrears Received
If you live in Metro City Type Yes ,else Type No
DIN NO
PAN NO
Pan No.
<500000
>500000
>800000
Spl. Allwnc
Auto Filled Cell [the Data Comes Pay Sheet]
Auto Filled Cell [the Data Comes 10E ]
For Higher Education Loan
Salary Statement of Sri
Signature of Employee
Designation:-
Dated:-
CIT (TDS)
Address
City
Pin Code
Receipt Numbers of original statements of TDS under sub-section (3) of section 200
Amount of tax deducted in respect of the employee
Amount of tax deposited remitted in respect of the employee
PART B (Refer Note )
PRART A
Certificate under section 203 of the Income-tax Act, 1961 for Tax deducted at source from Salary
Details of Salary Paid and any other income and tax deducted
son/daughter of
working in the capacity of(designation
[Rs.
(in words)]
has been deducted and deposited to the credit of the Central Governement. I further
certifify that the information given about is true, complete and correct and is based on the books of account, documents, TDS
statement ,TDS deposited and other available records.
Place:-
Date:-
Signature of person responsible for deduction of tax
Full Name:-
Note:-
of the employers. Part B may be issued by each of the employers or the last employer at the option of the
assessee.
Government deductors to enclose Annexure-A if tax is paid without production of an income-tax
challan and Annexure-B if tax is paid accomanied by an income-tax challan.
Non-Government deducto5rs to enclose Annexure-B
The deductor shall furnish the address of the Commissioner of Income-tax(TDS) having jurisdiction
as regards TDS statements of the assesee.
This Form shall be applicable only in respect of tax deducted on or after 1st day of April, 2010.
ANNEXURE-A
DETAILS OF TAX DEDUCTED AND DEPOSITED IN THE CENT5RAL GOVERNMENT ACCOUNT THROUGH BOOK ENTRY
(The Employer to provide payment wise details of tax deducted and deposited with respect to the employee)
Sl.No
Tax Deposited in respefct on of the employee (Rs.
Book Identification Number (BIN)
DDO Sequence Number in the Book Adjustment Mini Statement
Date on which tax deposited (dd/mm/yy)
1. In the column for TDS, give total amount for TDS,Surcharge(if applicable) and education cess.
ANNEXURE-B
DETAILS OF TAX DEDUCTED AND DEPOSITED IN THE CENTRAL GOVERNMENT ACCOUNT THROUGH CHALLAN
(The Employer to provide payment wise details of tax deducted and deposited with respect to employee)
Tax Deposited in respect on of the employee (Rs.)
Challan Identification Number ( C I N )
BSR Code of the Bank Branch
Date on which tax deposited (dd/mm/yy)
Challan Serial Number
Total
b) Group Insurance Savings Scheme :-…………..
d)Purchase of N.S.C. :-…………………………………………..
e) Amount paid as excluisively tuition fees to any
f) Payment of H.B.Loan (Principal) :-
g) Equity linked savings scheme/tax savings bond etc.{Max-20000/-)
h) Others, if any as notified :-
Address of C I T ( T D S )
Address of C I T :-
City :-
Pin Code No.:-
Pan Card No.
hra alw
Total Amount Deducted (a to h) :-………………………………………..
80U
Taxable Income (8-10) :-[Rouned to the next 10]………………..
Total Tax :-………………………………………………………………………
b) Contribution to P.P.F……………………………………………………
P.P.F
(ii)P.P.F.
Designation of Assessing Officer ( Ward/Circle)
c)
g)New Flexible Tax Savings Bond ( Maximum Rs. 20,000/-)
h)Equity linked savings scheme/tax savings bond etc.
i)
Income Tax Preparation(Quarterly/Annualy) FOR Financial YEAR 2010-11 This Calculation sheet Only for West Bengal Govt. Employees Prepared by Pranab Banerjee,Kalisthanpara, Jiaganj,Murshidabad,W.B., pranab.banerjee83@gmail.com or 9474316768, 8906279547,
ADVTX
i) Upto Rs.1,60,000/- Tax Nil, (ii)Rs.1,60,001/-to 5,00,000/-Tax 10%(iii) 500000 -80000
20%, iv)Rs.8,00,001/-to Onwards Tax 30%, For Female Up to 190000/- Tax NIL
…………………………………..
Balance Tax Payable/Refundable………………..
2008-09
15/9/10
15/12/10
15/3/11
15/6/10
50% of B.Pay
10% of B.Pay …………………………………………………
In Metropol City ors 40%.............................
a) H.R.A.Received :-…………………………………………
b) House Rent paid :-……………………………………………………
In the Column for TDS, give total amount for TDS, Surcharge(if applicable) and education cess
TDS IS DEDUCTED AS MONTHLY BASIS AND ADVANCE TAX IS PAID ON QUARTERLY BASIS
Tax Paid from Salary Anually or Monthwise………………………………………………
First Fill the Pay Sheet
Deduction under chapter VI-A (LIC,PF,Tuition Fees,H.B.Principal):80C (Maximum Deposit Rs.1,00,000)+20,000/- Flixible Bond
U/s 80C (Aggregate amount Max.Rs.1,20,000/-)
Total income of the relevent previous year (Rs.)
Total income of financial year 2008-09 (Col-11) of Form No. 16 ( For Financial Year 2008-2009) + One Instlmnt which already received previous year As Arrears. For Calculating Form 10E,
For Calculation of Arrears Relief U/s 89(1). Put your Total Income of 2008-2009 +One Instlmnt. Which received as ROPA-Arrears.
Date of Deposited TDS
Deposited as monthly TDS
Put HRA Rate of %
Net Tax Payable ( 15-16)
Tax Payable including educational cess(Col.13+14) :-…………………..
Pranab Banerjee,Jiaganj,Msd
Figure #1. HRA received from your Employer
Figure #2. Actual house rent paid by you less 10% of your basic salary
Figure #3. 50% (or 40%) of your basic salary if you live in a metro (or non-metro)
If an assessee is employed under more than one employer during the year, each of the employers shall issue Part
of the certificate in Form No. 16 pertaining to the period for which such assessee was employed with each
Children( 2 )Maximum Rs.1,00,000/-)…………………………………
ULIP
c) L.I.C./Premium paid(including Notified Pension Scheme
ULIP…………………………………………………………………….
(iii) U L I P
(iv) Tution Fees
g) New Flexible Bond Max Rs. 20,000/-)…………………………………
(v) New Flexible Bond Max Rs 20,000/-)
(vi) N.S.C.
lic
nsc
tution fee
Bond
(vii) L I C Premium
Net Tax col.No. 17-18)
Receipt Numbers of Form No 24G
Total Earning for this Year excluding Bonus & Arrear
Total Earning for this Year Including Bonus & Arrear
Total Deduction Excluding TDS
Total Deduction Including TDS
You can Copy and Paste anywhere or any Sheet the above 4(four) Cell
Form for furnishing particulars of income under section 192(2A) for the year ending 31 st March, 2011 for claiming relief under section 89(1) by a Government servant or an employee in a 2[company,co-operative society,local authority ,university, instituty
Particulars of income referred to in rule 21A of the Income-tax Rules, 1962,during the previous year relevant to assessment year 2011-12
Total Arrears Received from March 10 to Feb 2011
Bonus Received From March 2010 to Feb 2011
Salary Statement for the Year 2010-2011(From March 10 to Feb 2011)
Arr. P. Tax
Arr. GPF
Other Allownc
Name of Bank & BSR CODE if TDS Deposited through the Bank
Treasury Name & No which TDS Deposited if the TDS Deposited through the Treasury
0.00
0000.00
0.00
0.00
0.00
Male
0.00
000000.00
0.00
0
000000.00
0.00
000000.00
0.00
00.00
0.00
0
000000.00
0.00
0
000000.00
0.00
000000.00
0.00
00.00
0.00
0
male
female
0
0.00
0.00
0.00
0.00
0.00
male
female
0.00
0.00
0.00
0.00
male
female
0.00
0
0.00
male
female
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
Male
0.00
male
female
0.00
male
female
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
$0.00
0.00
$0.00
$0.00
$0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
00.00
00.00
00.00
00.00
00.00
00.00
00.00
00.00
00.00
00.00
00.00
00.00
00.00
2
2
2
00.00
0.00
00.00
00.00
00.00
00.00
0.00
00.00
00.00
00.00
0.00
00.00
00.00
0.00
Savings
00.00
0.00
Payble
Refundable
$0.00
00.00
0.00
$0.00
$0.00
00.00
00.00
00.00
00.00
00.00
00.00
00.00
Fill this Cell as Manually. This Cell is Unlocked.
Fill this Cell as Manually. This Cell is Unlocked.
1
1
1
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
$0.00
0.00
12:00:00 AM
0.00
0.00
0.00
0.00
$0.00
male
0.00
0.00
0.00
$0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
000000.00
0.00
0
000000.00
0
000000.00
0.00
000000.00
00.00
0.00
0
000000.00
000000.00
0
000000.00
000000.00
000000.00
00.00
0.00
0
000000.00
00000.00
0.00
0.00
00.00
00.00
00.00
00.00
0.00
00.00
00.00
0.00
00.00
00.00
00.00
00.00
0.00
00.00
00.00
0.00
0.00
$0.00
$0.00
$0.00
0.00
0.00
$0.00
0.00
$0.00
$0.00
0000.00
0000.00
1/4/2010
$0.00
$0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
00.00
00.00
00.00
000000.00
0.00
0
000000.00
0
000000.00
0.00
000000.00
00.00
0.00
0
000000.00
000000.00
0
000000.00
000000.00
000000.00
00.00
0.00
0
0000000.00
000000.00
00.00
0.00
00.00
00.00
00.00
0.00
00.00
00.00
$0.00
00.00
Refundable
Tax payable
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
00.00
0.00
00.00
0.00
00.00
0.00
$0.00
Fill this Cell as manually.This Cell is Unlocked.
Fill this Cell as Manually.This Cell is Unlocked
Fill this Cell as Manually.This Cell is Unlocked
Fill this Cell as Manually.This Cell is Unlocked
Fill this Cell as Manually.This Cell is Unlocked
Fill this Cell as Manually.This Cell is Unlocked
Fill this Cell as Manually.This Cell is Unlocked
Fill this Cell as Manually.This Cell is Unlocked
Fill this Cell as Manually.This Cell is Unlocked
Fill this Cell as Manually.This Cell is Unlocked
Fill this Cell as Manually.This Cell is Unlocked
Fill this Cell as manually.This Cell is Unlocked.
Fill this Cell as manually.This Cell is Unlocked.
Fill this Cell as manually.This Cell is Unlocked.
Fill this Cell as manually.This Cell is Unlocked.
Fill this Cell as Manually.This Cell is Unlocked.
Fill the Cell as Manually.This Cell is Unlocked.
Fill this Cell as Manually.This Cell is Unlocked.
Fill this Cell as Manually.This Cell is Unlocked.
Fill this Cell as Manually,This Cell is Unprotected
Fill this Cell as Manually.This Cell is Unlocked
Fill this Cell as Manually.This Cell is Unlocked
Fill this Cell as Manually. This Cell is Unlocked.
Fill this Cell as Manually.This Cell is Unlocked
MONTH &Year
Basic +Grade Pay
Conv. Allown. If any
Other Allownc
Spl. Allwnc
D.A.
H.R.A.
M.A.
G.P.F.
P.Tax
G.I.S.
H.B. Loan. Princpl
H.B.Int Paid
Deposited as monthly TDS
TOTAL
0.00
0.00
0.00
00000.00
00000.00
00000.00
0.00
0.00
0.00
0.00
0.00
yes
0.00
no
0.00
No
No
0.00
0.00
no
0.00
yes
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
Male
0.00
0.00
0.00
yes
no
0.00
0.00
00.00
00.00
No
0000.00
00.00
00.00
00.00
0.00
00.00
00.00
0.00
00.00
00.00
0.00
00.00
0.00
0.00
3/1/2010
0.00
0.00
0.00
0.00
0.00
0.00
000.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
4/1/2010
0.00
0.00
0.00
5/1/2010
0.00
0.00
0.00
6/1/2010
0.00
0.00
0.00
7/1/2010
0.00
0.00
0.00
8/1/2010
0.00
0.00
0.00
9/1/2010
0.00
0.00
0.00
10/1/2010
0.00
0.00
0.00
11/1/2010
0.00
0.00
0.00
0.00
12/1/2010
0.00
0.00
0.00
1/1/2011
0.00
0.00
0.00
2/1/2011
0.00
0.00
0.00
0.00
0.00
0.00
0.00
Auto Calculated Field
Put GPF Amount
Including GPF
Deduction
As per G.O.No.1691-F,Dtd -23/2/09, the Maximum House Rent will be fixed Rs 6000 pm or 72000/- P.A.
Conv Alwns.Max.Rs. 800 p.m. Above Rs.800/- will be chargeble for IT.Handcpt Employee are also entitled this IT Rules U/s 10(14)(i)
Edit the Month as you like
If you have availed the Govt Housing/Quarter then leave blank this HRA %
Editable.If you need the change this column head you can do the same as you like, in place of other allowances.
0.00
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0.00
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0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
00000.00
00000.00
00000.00
00.00
0.00
00.00
0.00
00.00
0.00
00.00
0.00
00.00
0.00
00.00
0.00
00.00
0.00
00.00
0.00
00.00
0.00
00.00
0.00
00.00
0.00
00.00
0.00
00.00
00.00
0.00
0.00
0.00
0.00
Pl.Fill the Pay Sheet, It is automatically filled
Pl.first you Fill Pay Sheet This Cell is locked.If you fill the pay Sheet it can fill automatically linked with.
Fill the TDS deposited Bank/Treasury Ch.Number,which detucted by the Employer monthly basis.
Fill the TDS deposited Bank/Treasury Ch.Number,which detucted by the Employer monthly basis.
Fill the TDS deposited Bank/Treasury Ch.Number,which detucted by the Employer monthly basis.
Fill the TDS deposited Bank/Treasury Ch.Number,which detucted by the Employer monthly basis.
Fill the TDS deposited Bank/Treasury Ch.Number,which detucted by the Employer monthly basis.
Fill the TDS deposited Bank/Treasury Ch.Number,which detucted by the Employer monthly basis.
Fill the TDS deposited Bank/Treasury Ch.Number,which detucted by the Employer monthly basis.
Fill the TDS deposited Bank/Treasury Ch.Number,which detucted by the Employer monthly basis.
Fill the TDS deposited Bank/Treasury Ch.Number,which detucted by the Employer monthly basis.
Fill the TDS deposited Bank/Treasury Ch.Number,which detucted by the Employer monthly basis.
Fill the TDS deposited Bank/Treasury Ch.Number,which detucted by the Employer monthly basis.
Fill the TDS deposited Bank/Treasury Ch.Number,which detucted by the Employer monthly basis.
This Cell is Auto Filled. The Data comes from Pay Sheet.First You Fill the Pay Sheet of all required Cell.
This Cell is Auto Filled
This Cell is Auto Filled. The Data Comes From Pay Sheet
This Cell is Auto Filled.The data Comes From Pay Sheet
This Cell is Auto Filled. The Data comes from Pay Sheet.
This Cell is Auto Filled.The Data comes from Pay Sheet. First you fill the Pay Sheet's All column.
This Cell is Auto filled.The Data comes from Pay Sheet.First you Fill the Pay Sheet.
Maximum Limit Rs. 40,000/-