INCOME TAX DECLARATION FORM CUM TAX CALCULATOR FOR THE YEAR 1.4.2008 TO 31.3.

2009
COMPANY NAME
BRANCH
NAME VPF % 0%
EMPLOYEE ID (IMP) City metro
DATE OF JOINING (IMP) Gender Male
PAN NO. -
INCOME 2008-09 PM PA INVESTMENTS 2008-09 31-Mar-09 DEDUCTIONS & INCOME TAX
39330.00 PF ON LEAVE ENCASHMENT 0
BASIC SALARY 25000 300000 PROVIDENT FUND GROSS INCOME 1200000
DA 15000 VPF 0
HRA 7500 LIFE INSURANCE PREMIUM DEDUCTIONS 80 C
CONVEYANCE 800 PPF 0 OTHER EXEMPTIONS 0
TA 0 0 ELSS 0 HRA EXEMPTIONS 0
BME 0 0 PENSION FUND (80CCC) 0 CONVEYANCE
SPECIAL ALL. 0 0 ULIP 0 LTA EXEMPTIONS 0
LEAVE ENCASHMENT 0 MUTUAL FUND (TAX SAVER) 0 MEDICAL EXEMPTIONS 0
PLVI / CASH AWARD 0 NSC 0
MISC. ALL / OTHERS 0 NSC INTEREST 0 TAXABLE INCOME 1200000
BONUS 2007-08 0 FIXED DEPOSIT IN SCHEDULED BANK 0 INCOME TAX 265000
LTA 0 EDUCATION EXPENDITURE(CHILDREN) 0 SURCHARGE 26500
MEDICAL 0 INFRASTRUCTURE BONDS 0 EDU CESS 8745
PRINCIPLE AMOUNT OF HSG LOAN 0 TOTAL TAX 300245
TOTAL INCOME 300000 Total (1,00,000 MAX) 0 TAX PER MONTH 25020
HRA CALCULATION 0 INTEREST ON HOUSING LOAN (1,50,000 MAX) 0 INCOME TAX
HRA RECEIVED (A) 0 Mediclaim Premium u/s 80D (SELF Rs 15,000/-) 0 150000 TO 300000 10 % 15000
10 % 0F BASIC 30000 Mediclaim u/s 80D (PARENTS Rs 15,000/-) 0 300001 TO 500000 20 % 40000
50% BASIC (40% non metro) 150000 Disability Dependent u/s 80G (50 OR 75 K) 0 500001 AND ABOVE 30 % 210000
Rent Paid over 10% of Basic Salary (C) -30000 Profession Tax 0 IF "WOMEN" 0
HRA exempt 0 0 TOTAL EXEMPTIONS 0 TOTAL TAX 265000
HRA Taxable 0 HOUSE RENT 0

I am giving details of salaries & perquisites received by me during the year April 2008 to March 2009 from my previous employer (s) in the prescribed
format( applicable to employees joined from April 2008 onwards) I further undertake to abide by the declaration given above and take the
responsibility of informing the Personnel Departmenet of any change latest by January 15, 2009 I also understand that in my personal tax assessment
, I can be required by the assessing I.T.O. to substantiate the contents of the above declarations. I hereby solemnly declare that to the best of my
knoweledge and belief, the information given above is correct and complete.
Date : Signature of Employee

Pleace :

09/19/2009-09:56:10-PA/CNK/HO