THE AGA KHAN UNIVERSITY / THE AGA KHAN HOSPITAL AND MEDICAL COLLEGE

FOUNDATION
Finance Division – Payroll Section
Income Tax Credit / Exemption Claim Form: Income Tax Year: 2019
(This form is applicable to income tax assesses only)

Name Employee #

CNIC # NTN #

Sr Details Amount
1 Zakat (Section 60) Rs.
Amount of Zakat paid by a person in a tax year under the Zakat and Ushr Ordinance 1980, and
deposited in Government treasury. Zakat deducted under the head “Income from Other sources”
shall not be allowed
2 Profit On Debt (Section 60C) Rs.
Any profit (or share in rent or share in appreciation for the value of house) paid on loan by a
scheduled bank or non-banking finance institution regulated by SECP or advanced by Govt. or
local authority or a statutory body or a public listed company, if the loan is used for construction
of new house or acquisition of a house. [Limit is lower of A) Interest or Rent paid to lender B)
50% of taxable income C) Rs. 2,000,000
3 Charitable Donations (Clause 61 Part I Second Schedule, limit up to Rs.
30% of total income)
Amount of Donation paid by a crossed cheque to Govt. run hospital / educational institutions,
relief fund established by the Government, non-profit organizations approved by the
Commissioner or to institutions approved as per clause (61) of Part I of the Second Schedule of
the Income Tax Ordinance, 2001

4 Charitable Donation (Section 61, limit up to 30% of taxable income Rs.

after deducting Donation as per Clause 61 & Zakat as per Section 60,
as mentioned on Sr. # 1 & 2)
Amount of Donation paid by a crossed cheque to Govt. run hospital / educational institutions,
relief fund established by the Government, non-profit organizations approved by the
Commissioner
5 Investment in Shares or Sukuks or Insurance (Section 62) Rs.
Either cost of acquiring new shares of a listed company or shares offered by the privatization
Commission of Pakistan or sukuks and / or premium paid on a policy to a life insurance company
registered by the SECP under the Insurance Ordinance 2000. [Limit is lower of A) Cost &
Premium paid. B) 20% of taxable income C) Rs. 2,000,000.
Note: Minimum holding period of investment is 24 Month. If disposed before required holding
period, original tax credit allowed will be clawed back in the disposal tax year.]
6 Investment in Health Insurance (Section 62A) Rs.
Amount of premium paid or contribution paid in respect of health insurance to any insurance
company registered with SECP under Insurance Ordinance 2000. [Limit is lower of A)
Contribution or Premium paid. B) 5% of taxable income C) Rs. 150,000. Note: Provided the
person being a filer.
7 Contribution to an Approved Pension Fund (Section 63) Rs.
Amount of premium paid in an approved pension fund under the Voluntary Pension System Rules,
2005[Limit is lower of A) Premium paid B) 20% of taxable income (with some additional limits
for persons having age of 41 years or above)]

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THE AGA KHAN UNIVERSITY / THE AGA KHAN HOSPITAL AND MEDICAL COLLEGE
FOUNDATION
Finance Division – Payroll Section
Income Tax Credit / Exemption Claim Form: Income Tax Year: 2019
(This form is applicable to income tax assesses only)

Sr Details Amount
8 Cash Withdrawal & Transaction in Bank (Section 231A & 231AA) Rs.
Withholding Tax deducted by bank on cash withdrawals exceeding Rs. 50,000 in a day or on
transfer of funds (Please do not include withholding tax deducted on profit credited by bank)
9 Advance Tax on Private Motor Vehicle (Section 231B) Rs.
Withholding tax paid at the time of registration of motor vehicle in the name of the employee.
10 Advance Tax on Private Motor Vehicle (Section 234) Rs.
Withholding tax paid at the time of payment of motor of vehicle tax in the name of the employee.
11 Advance Tax on Domestic Electricity Consumption (Section 235) Rs.
12 Advance Tax Under Section 236:
Purchase of Air Tickets Rs.
Sale or Transfer of immovable property, except that acquired and Rs.
disposed off within same tax year.
Function and Gatherings Rs.
Purchase or Transfer of immovable property Rs.
Telephone & Internet bills or prepaid mobile & internet cards Rs.
Banking transaction other than cash Rs.
Educational Institutes Rs.
Education related expenses remitted abroad Rs.
Insurance premium in general and life Rs.
Remitting (utilization) amounts abroad through credit or debit or prepaid Rs.
cards
13 Any other credit for tax paid to FBR during the financial year which Rs.
claimable and is adjustable under Income Tax Ordinance, 2001

Kindly attach copies of receipts and other documents in support of your claims:

I solemnly declare that:

a. I have no other employer;
b. I have no income from gain on disposal of shares subject to restriction of transfer or a right or option
to acquire shares acquired under the employee share scheme;
c. I do/do not opt for separate taxation in respect of payments to termination etc. or arrears of salary;
d. I have no income chargeable to tax under the head Business (including share from association of
persons), Property, Capital Gains and other Sources (like royalty, profit on debt, yield, interest, sub-
lease of land or building, etc.);
e. My agricultural income does not exceed Rs. 80,000;
f. To the best of my knowledge and belief the information given in this form and is/are correct,
complete and in accordance with the provisions of the income Tax Ordinance 2001 and Income Tax
Rules, 2002.

Signature of Employee Contact Number Date

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