To : All Employees 4th July 2015

Subject:- Income-Tax Deduction From Salaries for the Financial Year 2015-16

We invite your attention to some of the changes made by the Finance Act, 2015.

1. Conveyance Allowance Exemption has been increased from Rs.800/- p.m. to Rs.1600/- p.m.

2. Subscription to SUKANYA SAMRIDDHI ACCOUNT in respect of a Girl Child.

3. Revised Tax Relief in respect of Health Insurance (popularly known as MEDICLAIM) will be as under

� The Actual Premium paid by an Employee for obtaining Health Insurance for Self, Spouse & Dependant

Children (Family) shall now qualify for tax benefit up to Rs.25000/- p.a.

� In addition, the Actual Premium paid by an Employee for obtaining Health Insurance for Employee’s Parents

shall now qualify for tax benefit up to Rs.25000/- p.a.

� In case the Employee, Family Member or Parent covered under a Health Insurance Policy is above the age of

60 years then the actual premium paid shall now qualify for tax benefit up to Rs.30000/- p.a.

� In case the Employee, any Family Member or Parent is a Very Senior Citizen i.e. Above the Age of 80 years

AND is NOT covered under a Health Insurance Policy, then the actual medical expenditure incurred by the

employee on the health of such person shall now qualify for tax benefit up to Rs.30000/- p.a.

� The Maximum Deduction in respect of Health Insurance, Preventive Checkup Fees & Medical Expenditure for

Self & Family shall not exceed Rs.30000/-. Similarly, the Maximum Deduction for Health Insurance,

Preventive Checkup Fees & Medical Expenditure for Parents shall not exceed Rs.30000/-.

4. Income-tax Relief U/s 80DD in respect of Maintenance, Medical Treatment, Training, Nursing and Rehabilitation of

Handicapped Dependant has been increased to Rs.75000/- and in case of Severe Disability the Income-tax Relief has

been increased to Rs. 125000/-

5. Income-tax Relief U/s 80DDB in respect of Medical Treatment of Specified Diseases of Critical Nature such as AIDS,

Cancer etc. has been increased to Rs.80000/- if Dependant Family Member is a Very Senior Citizen above 80 years.

6. The Surcharge on Income-tax has been increased from 10% to 12% if Total Income exceeds Rs.1 crore

7. There is no change in the Income Tax Slabs. The Base Exemption limit for all Assessees is Rs.2.50 Lacs, and for Senior

Citizens aged above 60, it is Rs. 3,00,000/- and for Very Senior Citizens aged above 80 years, it continues to be Rs.5

Lacs. (The Income Tax Slabs & the Tax Rates are published on the last page of this Circular.)

Employees joining after 01/04/2015 should provide Authenticated Details of Taxable Salary Received / Receivable from their

Previous Employer during the Current Year. i.e. from April 2015 till Date of Joining

You will be getting the credit, for the tax deducted (TDS) from your salary on the basis of Income Tax Permanent

Account Number (PAN). Therefore, please ensure that your I.Tax PAN on record is correct.

Declaration Form ’A’ to be returned to us by 14th

July, 2015, duly filled in, with the information of the estimate of investments

and other eligible payments proposed by you for tax planning purposes and, Declaration Form ‘B’ to be furnished along with

photocopies of supporting proof documents, by 14th

January, 2016 of such investments and eligible payments for verification.

A gist of the relevant tax provisions is also annexed herewith for your ready reference, to enable you to plan your investments

and savings. Duly signed Declaration Forms are to be sent to Mr. P. G. Shastri (A.G.M.-Taxation) at Corporate Office at

142-AB, Kandivali Industrial Estate, Charkop, Kandivali (West), Mumbai 400067. You can also get in touch with Mr.

Shastri at prasad.shastri@ipca.com or on 022-66474514.

Best wishes,

S. K. Beli

General Manager – Taxation

GIST OF THE RELEVANT PROVISIONS OF THE INCOME TAX ACT,1961.

1. HOUSE RENT ALLOWANCE EXEMPTION

The H.R.A. exemption is available to those employees who actually pay rent to occupy residential house. This is subject to the following conditions, and the LEAST of the following amounts shall be exempt:

(a) 50% of BASIC Salary, where the residential place is situated at Delhi, Kolkotta, Chennai, Mumbai. OR 40% of BASIC Salary, where the residential place is situated at other than the above places

(b) Actual HRA received by the employee in respect of the period during which rental accommodation is occupied by the employee during the previous year.

(c) The Rent paid in excess of 10% of Salary.

Note: "Salary" for above purpose shall be Basic Salary Plus Dearness Allowance. Electricity / Water charges recovered by landlord are not to be considered as rent.

If Rent payable exceeds Rs. 1 Lac in the year, then PAN of Landlord is required. If Landlord does not have PAN then obtain Signed Declaration from Landlord in which the Full Name, Address, Contact Details is stated by the Landlord along with the Reason for not having PAN

2. LEAVE TRAVEL ASSISTANCE (L.T.A.) EXEMPTION

L.T.A. availed by the employee for travel to any destination in India for self, spouse and children plus dependant parents and dependant brothers and dependant sisters, qualifies for exemption in respect of two journeys, in a block of four calendar years, starting 01.01.2014. The Travel Fare qualifies for exemption as under

(1) Where the journey to the place of destination is performed by air, then the actual fare not exceeding the economy class airfare by the national carrier for that route.

(2) (a) Where the journey is performed by rail, actual ticket fare not exceeding the air conditioned first class fare by the shortest route to the place of destination, or

(b) Where the places of origin of journey and destination are connected by rail and the journey is performed by any other mode of transport, actual fare not exceeding (a) above

(c) Where the journey is performed by any other mode of transport, then actual fare not exceeding 1st

class / deluxe class fare of recognized public transport by the shortest route to the destination (d) Where the places of origin of journey and destination are not connected by rail and if a

recognized Public Transport System does not exist and if the journey is performed by any other mode of transport, then actual fare not exceeding the air conditioned first class rail fare for the distance of the journey by the shortest route to the destination.

In case of circular journeys or sightseeing tours to more than one place, then your destination shall be the farthest place visited from your point of origin. In cases of travel by any mode other than by rail, then travel agent’s bills shall have to state the distances between each of the various places of visit.

3. ALLOWANCES EXEMPT U/S 10(14)

Sr. No. Name of the allowance Exempt Amount

1. Children Education Allowance Rs.100/- per month per child (max. for 2 children.)

2. Any allowance granted to meet the hostel expenditure of his / her child

Rs.300/- per month per child (max for 2 children.)

3. Tribal Area Allowance Rs.200/- per month

4. Conveyance Allowance Rs1600/- per month

4. INTEREST ON HOUSING LOAN

� In case of Self-occupied Residential Property, purchased / constructed out of loan borrowed on or after 01/04/99, then Interest up to Rs.200000/-is allowable as a deduction against Property Income.

� In case of Self-occupied Residential Property purchased / constructed out of loan borrowed before 01/04/99,

then interest up to Rs.30000/- is allowable as a deduction against Property Income.

� Interest on Loan taken for House Repair or Renovation qualifies for deduction up to Rs.30000/-. � Tax Relief is available from the financial year in which possession of residential property is obtained.

Twenty (20) % of the Interest paid in the years prior to the year in which possession is taken is allowed to be claimed in five (5) annual installments in addition to the interest paid of the current year. This is however subject to the overall limit of Rs.200000/-.

� The employee should be owner of the house property and should be the first named borrower of the house

loan for purpose of claiming the tax relief. In case the employee’s name stands second in the loan agreement then, a declaration of no claim of tax relief by the co-applicant must be furnished.

� Self-Occupation of own residential house is a pre-condition for claiming income-tax relief from

employer in respect of interest on housing loan. However, if the employee owns only one house in his name AND is unable to occupy such residential house due to employment being in some other place, then employee can claim tax benefit in respect of housing loan interest.

� IF EMPLOYEE OWNS MORE THAN ONE PROPERTY & WANTS TO CLAIM TAX BENEFIT IN RESPECT

OF HOUSING LOAN IN RESPECT OF PROPERTY NOT OCCUPIED BY EMPLOYEE THEN EMPLOYEE SHOULD DO SO WHILE FILING RETURN OF INCOME

5. INVESTMENT/ PAYMENTS ELIGIBLE FOR DEDUCTION U/S. 80C

Under Section 80C, an individual is eligible for deduction in respect of an aggregate of Rs.150000/- in respect of the following payments made during the financial year 2015-2016 by the employee in own name, unless stated otherwise

1. Contribution by an employee to a Public Provident Fund account of Self, Spouse or Child. 2. Contribution by an employee to Sukanya Samriddhi Account of a Girl Child. 3. Contribution to UTI’s ULIP or LIC’s Dhanraksha for Self, Spouse or Child. 4. Payment of premium in respect of life insurance policies on the life of self, spouse and child, paid to LIC or

any other insurer to the extent of 10% of the Sum Assured in case of Policies issued on or after 1-4-2012 & 20% in respect of Policies issued in the earlier year.

5. In addition to Stamp Duty and Registration Fees actually paid, Loan taken and repaid to Govt. authority, Bank, LIC, Employer, Public Company and Co-operative Society for construction or purchase of residential house whose possession has been obtained and is occupied by the employee.

6. Purchase of 5 year National Savings Certificates (VIII Issue Only) in the name of SELF only. 7. Accrued interest on investment in National Savings Certificate (5 year VIII issue only) purchased by self during

earlier financial year(s) as per the rates of interest, mentioned in the calculation tables in Form A/ B. 8. Tuition Fees (under any head EXCEPT towards transportation, day boarding, hostel fees, development fund,

capitation fees and donations) paid for the full-time education of your children in a school, college, university or an educational institution in India (including Play-School or Nursery), for two children.

9. Amount deposited under the notified annuity schemes of LIC. 10. "Equity Linked Saving Schemes" (E.L.S.S.) investment in Mutual Funds having 3 year lock-in period. 11. Contribution made to the notified pension fund set up by the notified Mutual Funds. 12. Term deposit for not less than five years, with a scheduled bank, framed in accordance with the notified scheme

of the Central Government. The Deposit receipt issued by the bank should state that the said deposit qualifies for tax relief u/s 80C.

13. Five year Time (Fixed) Deposit in an account under the Post Office Time Deposit Rules 1981.

6. CONTRIBUTION TO PENSION FUND U/S 80CCC Any Deposit made in an annuity plan of LIC or any other insurer for receiving pension from such fund will qualify

for Deduction up to Rs.100000/-. However deduction u/s. 80C will not be available for this.

7. CONTRIBUTION TO NATIONAL PENSION FUND (NPS) U/S 80CCD Employee’s Contribution to NPS (National Pension Scheme) (Made directly by the Employee) qualifies for Special Deduction under the newly introduced sub-section 80CCD(1b) up to Rs. 50000/-. If an employee has made Direct NPS contributions in excess of Rs. 50000/- then such remaining excess (over & above Rs. 50000/-) will qualify for General Deduction us/ 80CCD(1) up to Rs. 1 Lac. However this General Deduction for NPS up to Rs. 1 Lac is subject to availability of balance unutilized limit u/s 80CCE for all investments including PF, Life Insurance Premiums, Education Fees, NSC, PPF, Jeevan Suraksha Premia etc which is Rs. 1.50 Lacs

U/s 80CCE, deductions u/s 80C, 80CCC & 80CCD(1) together, shall not in any case, exceed Rs. 1.5 Lac.

8. INVESTMENT IN SPECIFIED EQUITY SCHEME U/S 80CCG

U/s 80CCG, investment up to Rs.50000/- by a New Retail Investor in Listed Equity Shares / Units as may be notified by the Government (with a lock-in-period of 3 years) shall qualify for a Deduction of 50% of such investment. Employees whose Gross Total Income exceeds Rs.12 Lacs should NOT invest in this Special Equity Scheme since they are not eligible for tax benefit. This Deduction in respect of investment in the Initial year will be allowed again in the next 2 years also. This tax benefit is over & above the limit of Rs.1.50 Lac in Investments U/s 80C.

9. MEDICAL INSURANCE U/S 80D

A deduction up to Rs.25000/- will be allowable towards Actual Premium paid by the Employee for Health Insurance for Self and Family. Additional deduction of Rs.25,000/- in respect of Actual Premium paid for Health Insurance cover for Parents is allowable. If Self, Family or Parent(s) are Senior Citizen(s), aged above 60 years, then above deduction is available up to Rs.30,000/-. Within these limits, Payments up to Rs.5000/- for diagnostic tests for preventive health check-ups also qualify. If Self, family or Parent(s) are Very Senior Citizen(s) aged above 80 years and are not covered under any health insurance scheme, then Actual Amount paid by the Employee for Medical Expenditure of such person is allowable up to Rs. 30000/-. The above deductions are restricted up to Rs. 30000/- in aggregate for self and family AND separately restricted up to Rs. 30000/- in aggregate for parents.

10. MEDICAL TREATMENT OF HANDICAPPED DEPENDANTS U/S 80DD

An annual deduction of Rs.75000/- in aggregate for the expenses incurred in respect of :- (a) Medical Treatment, Nursing, Training, Rehabilitation of a dependant suffering from disability. (b) Deposits with LIC / UTI or any other insurer, for maintenance of dependant suffering from disability after the

death of the assessee.

Disability includes blindness, low vision, hearing impairment, loco-motor disability, ”leprosy-cured”, mental retardation, autism or cerebral palsy and should be certified in FORM 10-IA (At the End of This Circular) by a Neurologist or Civil Surgeon of a Government hospital / institution. If the disability is severe (more than 80%), then higher deduction of Rs.125000/- is available.

11. MEDICAL TREATMENT OF SPECIFIED CRITICAL ILLNESSES U/S 80DDB

Actual Payments actually made up to Rs.40000/- on the medical treatment of self or dependant relative in respect of Neurological diseases, Cancer, AIDS, Chronic Renal failure, Hemophilia, Thalassaemia, or other ailments as specified in the Rules and so certified in FORM 10-I (At the End of This Circular) by a neurologist, an oncolo-gist, a urologist, a hematologist, an immunologist working in a Government Hospital. In case the patient is a senior citizen (60 years & above) then the deduction of actual expenditure can be availed up-to Rs.60000/-. In case the patient is a Very Senior Citizen (80 years & above) then the deduction of actual expenditure can be availed up-to Rs.80000/-

12. INTEREST ON EDUCATION LOAN U/S 80E

The interest paid by employee on the Education Loan taken from Specified Financial Institution for purpose of pursuing higher education by Self, Spouse or Children or Legal Ward.

13 TAX RATES

TOTAL INCOME INCOME TAX

Up to Rs.2,50,000/- NIL

Rs.2,50,001 to Rs.5,00,000/- 10% of the amount exceeding Rs.2,50,000/-

Rs.5,00,001 to Rs.10,00,000/- Rs.25,000/- + 20% of amount exceeding Rs.5,00,000/-

Exceeding Rs.10,00,000/- Rs.1,25,000/- + 30% of amount exceeding Rs.10,00,000/-

Basic Education Cess @ 2% and Higher Education Cess @1% on income-tax to continue. Surcharge of 12% is applicable where

the taxable income is above Rs. One Crore.

GUIDELINES Declaration Forms A & B are herein below ACPIv49yb2r517081 Due Date for submission of Initial Declaration in Form A is 14th July 2015.

Due Date for submission of Proof Documents with Form B is 14th January 2016.

• Photocopies of Proof Documents are to be submitted.

• Please do NOT submit Original Documents.

• PLEASE DO NOT SEND SCANNED COPIES BY EMAIL.

• Field Employees should NOT attach Income Tax Documents with Expense Statements but send it in separate cover.

You should ensure that all your core investments such as PPF, Tax-Saver Fixed Bank Deposits, NSCs (VIII Series for 5 Years), NPS, new ELSS etc are made well in advance so that you are in position to submit proof by 14/01/2016. New Mutual Funds, PPF Deposits, NSCs, Tax Saver Fixed Deposits and New Insurance Policies proposed, purchased or made after 14-Jan-2016, shall NOT be considered by us for granting tax relief. House Rent

• House Rent paid to your wife / husband does NOT qualify for tax relief.

• Electricity, Water, Other charges recovered by your Landlord does NOT qualify.

• You should furnish Copies of House Rent Receipts for Rent paid by you from April till December, 2015 along with Form B by 14/01/2016.

• PAN of Landlord must be informed if Rent exceeds Rs.100000/- p.a.

• Rent Agreement copy must be given if Rent exceeds Rs.120000/- p.a. Housing Loan Repayment.

• Provisional Certificate of Repayment of Principal and Interest in the Current Year from Bank / Lending Institution is COMPULSORY to claim tax benefit of Housing Loan Interest.

• If you have taken Housing Loan from your EMPLOYER, then also, you should obtain Certificate of Loan Repayment from Payroll Department.

• Do NOT submit PASS-BOOK or LOAN ACCOUNT STATEMENT or EMI SCHEDULE or LOAN SANCTION OR DISBURSEMENT LETTER as supporting document.

• Tax Benefit of Housing Loan in respect of UNDER-CONSTRUCTION property can be claimed only if construction of property is completed and is ready to occupy and possession obtained by you during the financial year. In such cases, copy of possession letter must be furnished by 14th February, 2016.

• If you own more than one house, then, as your employers, we shall be able to grant you income tax relief for housing loan repayment in respect of ONLY ONE SELF-OCCUPIED property.

• In respect of your OTHER residential properties, whether vacant, rented or occupied by your parents or otherwise, you shall have to claim income tax relief at the time of filing your Income Tax Return.

• Provisional Certificate of Home Loan Repayment and Interest for F.Y.2015-2016 should be obtained and submitted to us for verification by 14/01/2016.

Tuition Fees ACPIv49yb2r517081

• Copies of School / College Fee Receipts for April to December 2015 are to be given by 14/01/2016 for claiming Deduction of Tuition Fees. Balance fee Amount due and payable from January till March 2016 for which receipts are not available in December should be stated separately.

• Deduction shall NOT be allowed for Bus Fee, School Development Fund, Donations, Caution Money, Security Deposit, Hostel Fee

• Fees paid to private coaching classes do NOT qualify for Deduction. Health Insurance (Mediclaim)

• Deduction in respect of Mediclaim is available only in the year of ACTUAL PAYMENT (including cases of single lump-sum payment for a 2/3 year policy).

• If Mediclaim is paid by Credit Card then the Premium paid by Credit Card Agency to the Insurer qualifies for tax benefit IMMEDIATELY & NOT at the time of repayment of your credit dues in monthly installments.

• If Mediclaim of your Parents has been paid by you, but if policy is in name of your parents, do state YOUR cheque number debited to YOUR bank account.

• You should submit photocopy of Mediclaim Policy to enable us to verify the age of parents if you claim higher relief for them as Senior Citizens.

• Photocopies of Mediclaim Policy / Receipt due and paid till December MUST be submitted along with Form B by 14/01/2016. If your Mediclaim is renewable between January and March, attach photocopy of previous year’s receipt.

LIFE Insurance

• Premium paid for parents, brothers, sisters & others does NOT qualify.

• In case of Life Insurance, submit copies of premium receipts due and paid by you till December 2015 or a Premium paid statement.

• Do note that if you have not paid premiums due till December within due dates / grace period, then it will not be possible for us to grant you income tax relief by assuming that premiums due in January-March 2016 will be paid on time.

• If Annual Premiums of your Life Insurance Policies are due between January and March 2016, attach photocopy of previous year’s receipt.

• If Premium exceeds 10% of the Sum Assured than, Income Tax relief is available only up to 10% of Sum Assured for policies taken from 1-4-2012

• Do NOT submit Copies of Life Insurance Policies as proof. ELSS – Mutual Funds In case of Mutual Funds, invest in funds where there is a compulsory 3 year lock-in period. Submit copies of NAV statement issued by the Mutual Fund in which your SIP purchases of Current Year up to December 2015 are reflected. Such Statement SHOULD STATE that Investment in that Fund qualifies U/s 80C and that there is a lock-in period of 3 years. Employees whose Gross Total Income exceeds Rs.12 Lacs should NOT invest in Specified Special Equity Scheme since they are not eligible for tax benefit.

FOR OFFICE USE ONLY Date of Receipt _________ ; Received by _________ ACPIv49yb2r517081

FORM - A ESTIMATE OF INVESTMENTS FOR THE FINANCIAL YEAR 2015-16 Submit by 14-07-2015

Name ________________________________ P.A.N.:_______________ OLD Emp No. :____________ Present Residential Address: ----------- OWNERSHIP / RENTED _________ _____________________________________________________________ NEW Emp No.:____________ _____________________________________________________________ Co:_______ Locn:__________ Dept:__________ Tel-Extn:________ Email Id:______________________ 1 House Rent paid to Landlord (p.m. Rs._______) :P.A Rs.___________ 821

If Rent is more than Rs1,00,000/- p.a. PAN of Landlord ___________

If Landlord does not have PAN then, take a Signed Declaration from

Landlord on Plain Paper stating the reason for not having PAN with

Full name, address & contact details of Landlord and submit to us

2. Housing Loan Repayment Possession Date : ___/___/___

Address of house purchased by taking loan : ___________________

_________________________________________________________

Above property owned by Self / Jointly with ____________________

Status of above property Self-occupied / Vacant / Given on Rent

Do you own another house? YES / NO

Housing Loan Interest payable to Banks & Others Rs. ________ p.a.

Housing Loan Interest payable to Employer Rs. ________ p.a.

(FOR OFFICE USE ONLY) Rs.___________

Loss from House Property (FOR OFFICE USE ONLY) Rs.___________ 815

Housing Loan (Principal) repaid to Banks & Others Rs._________ p.a.

Housing Loan (Principal) repaid to Employer Rs._________ p.a

Stamp Duty / Registration fees paid in 2015-16 Rs.___________ Rs.___________ 810

3 Number of school & college going children ____________ 814

4 Number of children studying and staying in Hostel ____________ 813

5 Tuition Fees payable to school / college for any 2 children only Rs.___________ 896

6 Contribution to Pension Plan (S.80CCC Only) eg. Jeevan Suraksha Rs.___________ 816

7 Mediclaim Premium for Self, Spouse & Dependant Children Rs_______

Preventive Health Checkup paid for above persons Rs_______

Mediclaim Premium payable for Parents Rs_______

Preventive Health Checkup payments for Parents Rs_______

Medical Expenses for VERY Senior Citizen above 80 years Rs_______ Rs.___________ 853

8 Public Provident Fund Deposits Rs.___________ 804

9 Life Insurance Premiums other than thru Salary (Give details overleaf) Rs.___________ 805

10 Special Tax Saver 5 Year Fixed Deposit with Banks made in 2015-16 Rs.___________ 903

11 Investment in Sukanya Samruddhi Account for Girl-Child (SSA) Rs.___________ 913

12 National Savings Certificates – VIII Issue (NSC) only in self name Rs.___________ 808

13 Accrued Interest on NSCs (Give details overleaf) Rs.___________ 809

14 Investment in Mutual Funds (ELSS - Lock-in-period of 3 years) Rs.___________ 854

15 DIRECT Contribution in NPS (National Pension Plan) by employee Rs.___________ 918

16 Interest repayable on Educational Loan in 2015-2016 Rs.___________ 820

17 Particulars of Salary received in 2015-16 from your Ex-employer

Ex-employer’s salary received in 2015-16 Rs.___________ 851

Ex-employer’s profession tax deducted in 2015-16 Rs.___________ 803

Ex-employer’s Provident Fund (P.F.) deduction in 2015-16 Rs.___________ 802

Ex-employer’s Income-Tax deduction in 2015-16 Rs.___________ 827 18 Any other Taxable Income received during 2015-16 (Other Than Salary) Rs.___________ 852

19 Any other investments /payments (Specify) ______________________ Rs.___________

A. DETAILS OF LIFE INSURANCE PREMIUM PAID DURING THE YEAR 2015-2016 ACPIv49yb2r517081

Sr. No.

Policy No. Date of Policy

Sum Assured (Rs.)

Policy Holder’s Name and Relationship

Premium Installment Amount (Rs.)

No. of Installments

Total Premium Amount (Rs.)

1. 1.

2.

2.

3. 3.

4.

4.

5. 5.

6. 6.

7. 7.

8. 8.

9. 9.

10.

TOTAL PREMIUM - For Policies issued on or after 1-4-2012, Premium up to Only 10% of the Policy Amount (Sum Assured) qualifies for income tax benefit

B. STATEMENT OF INTEREST ACCRUING DURING 2015-2016 ON VIII ISSUE of NSC.

Sr. No.

NSCs purchased during the period from

No. of years as on 31/03/2016

Total Value of NSCs purchased

Interest per Ten thousand (Rs.)

Accrued Interest (Rs.)

Certificate Holder’s Name and relationship with you

1. 01-04-2010 to 31-03-2011 FIVE 1117 2. 01-04-2011 to 30-11-2011 FOUR 1033 3. 01-12-2011 to 31-03-2012 FOUR 1098 4. 01-04-2012 to 31-03-2013 THREE 1040 5. 01-04-2013 to 31-03-2014 TWO 943 6. 01-04-2014 to 31-03-2015 ONE 868 TOTAL ACCRUED INTEREST ON NSCs

DECLARATION

I confirm that the particulars / information given hereinabove are true and correct to the best of my knowledge. I further undertake to produce evidence in support of the above declaration by 14/01/2016. I confirm that all above payments shall be made by me out of my income and also confirm that my spouse or any other person shall not claim the tax relief being claimed by me in respect of the aforementioned payments and investments.

Date :_____________ Place : ______________ Signature : __________________

NOTES :

1. NSCs purchased in 2009-2010 are due to mature in the current year. The interest of the final year (Rs.1208/- per Rs.Ten Thousand) is not reinvested and therefore does not qualify for Deduction u/s 80C.

2. Employees joining on or after 01.04.2015 are required to give details of taxable salary received from their ex-employer in

the current year, if any, & such details have to be supported by Final Tax Computation / Salary Certificate / Form 16. 3. Please attach separate statement, if required. ORIGINAL Documents NOT to be submitted. Photocopies to be submitted.

4. Permanent Account Number (P.A.N.) is compulsory for all employees drawing taxable salary in excess of Rs.2.50 Lac

5. Provisional Certificate from Bank / Lending Institution is COMPULSORY to claim tax benefit of Housing Loan Interest. DO NOT SUBMIT PASS-BOOK / LOAN ACCOUNT STATEMENT / EMI SCHEDULE as supporting document.

6. Investments and Payments made after 14/01/2016 shall not be considered EXCEPT Life Insurance & Mediclaim Premium of Existing Policies purchased in Previous Years which are due in 4

th Quarter.

7. Photocopies of Insurance Premium Receipts required. Photocopies of Insurance POLICIES are NOT to be submitted.

FOR OFFICE USE ONLY Date of Receipt _________ ; Received by _________ ACPIv49yb2r517081

FORM - B ESTIMATE OF INVESTMENTS FOR THE FINANCIAL YEAR 2015-16 Submit by 14-01-2016

Name ________________________________ P.A.N.:_______________ OLD Emp No. :____________ Present Residential Address: ----------- OWNERSHIP / RENTED _________ _____________________________________________________________ NEW Emp No.:____________ _____________________________________________________________ Co:_______ Locn:__________ Dept:__________ Tel-Extn:________ Email Id:______________________ 1 House Rent paid to Landlord (p.m. Rs._______) :P.A Rs.___________ 821

If Rent is more than Rs1,00,000/- p.a. PAN of Landlord ___________

If Landlord does not have PAN then, take a Signed Declaration from

Landlord on Plain Paper stating the reason for not having PAN with

Full name, address & contact details of Landlord and submit to us

2. Housing Loan Repayment Possession Date : ___/___/___

Address of house purchased by taking loan : ___________________

_________________________________________________________

Above property owned by Self / Jointly with ____________________

Status of above property Self-occupied / Vacant / Given on Rent

Do you own another house? YES / NO

Housing Loan Interest payable to Banks & Others Rs. ________ p.a.

Housing Loan Interest payable to Employer Rs. ________ p.a.

(FOR OFFICE USE ONLY) Rs.___________

Loss from House Property (FOR OFFICE USE ONLY) Rs.___________ 815

Housing Loan (Principal) repaid to Banks & Others Rs._________ p.a.

Housing Loan (Principal) repaid to Employer Rs._________ p.a

Stamp Duty / Registration fees paid in 2015-16 Rs.___________ Rs.___________ 810

3 Number of school & college going children ____________ 814

4 Number of children studying and staying in Hostel ____________ 813

5 Tuition Fees payable to school / college for any 2 children only Rs.___________ 896

6 Contribution to Pension Plan (S.80CCC Only) eg. Jeevan Suraksha Rs.___________ 816

7 Mediclaim Premium for Self, Spouse & Dependant Children Rs_______

Preventive Health Checkup paid for above persons Rs_______

Mediclaim Premium payable for Parents Rs_______

Preventive Health Checkup payments for Parents Rs_______

Medical Expenses for VERY Senior Citizen above 80 years Rs_______ Rs.___________ 853

8 Public Provident Fund Deposits Rs.___________ 804

9 Life Insurance Premiums other than thru Salary (Give details overleaf) Rs.___________ 805

10 Special Tax Saver 5 Year Fixed Deposit with Banks made in 2015-16 Rs.___________ 903

11 Investment in Sukanya Samruddhi Account for Girl-Child (SSA) Rs.___________ 913

12 National Savings Certificates – VIII Issue (NSC) only in self name Rs.___________ 808

13 Accrued Interest on NSCs (Give details overleaf) Rs.___________ 809

14 Investment in Mutual Funds (ELSS - Lock-in-period of 3 years) Rs.___________ 854

15 DIRECT Contribution in NPS (National Pension Plan) by employee Rs.___________ 918

16 Interest repayable on Educational Loan in 2015-2016 Rs.___________ 820

17 Particulars of Salary received in 2015-16 from your Ex-employer

Ex-employer’s salary received in 2015-16 Rs.___________ 851

Ex-employer’s profession tax deducted in 2015-16 Rs.___________ 803

Ex-employer’s Provident Fund (P.F.) deduction in 2015-16 Rs.___________ 802

Ex-employer’s Income-Tax deduction in 2015-16 Rs.___________ 827 18 Any other Taxable Income received during 2015-16 (Other Than Salary) Rs.___________ 852

19 Any other investments /payments (Specify) ______________________ Rs.___________

A. DETAILS OF LIFE INSURANCE PREMIUM PAID DURING THE YEAR 2015-2016 ACPIv49yb2r517081

Sr. No.

Policy No. Date of Policy

Sum Assured (Rs.)

Policy Holder’s Name and Relationship

Premium Installment Amount (Rs.)

No. of Installments

Total Premium Amount (Rs.)

1. 1.

2.

2.

3. 3.

4.

4.

5. 5.

6. 6.

7. 7.

8. 8.

9. 9.

10.

TOTAL PREMIUM - For Policies issued on or after 1-4-2012, Premium up to Only 10% of the Policy Amount (Sum Assured) qualifies for income tax benefit

B. STATEMENT OF INTEREST ACCRUING DURING 2015-2016 ON NSCs’ VIII ISSUE.

Sr. No.

NSCs purchased during the period from

No. of years as on 31/03/2016

Total Value of NSCs purchased

Interest per Ten thousand (Rs.)

Accrued Interest (Rs.)

Certificate Holder’s Name and relationship with you

1. 01-04-2010 to 31-03-2011 FIVE 1117 2. 01-04-2011 to 30-11-2011 FOUR 1033 3. 01-12-2011 to 31-03-2012 FOUR 1098 4. 01-04-2012 to 31-03-2013 THREE 1040 5. 01-04-2013 to 31-03-2014 TWO 943 6. 01-04-2014 to 31-03-2015 ONE 868 TOTAL ACCRUED INTEREST ON NSCs

DECLARATION

I confirm that the information given hereinabove is true and correct to the best of my knowledge. I further undertake to preserve the Original Supporting Documents and produce them on demand. I confirm that all above payments are made by me out of my income and also confirm that my spouse or any other person shall not claim the tax relief being claimed by me in respect of the aforementioned payments and investments

Date :_____________ Place : ______________ Signature : __________________

NOTES :

1. NSCs purchased in 2009-2010 are due to mature in the current year. The interest of the final year (Rs.1208/- per Rs.Ten Thousand) is not reinvested and therefore does not qualify for Deduction u/s 80C.

2. Employees joining on or after 01.04.2015 are required to give details of taxable salary received from their ex-employer in

the current year, if any, & such details have to be supported by Final Tax Computation / Salary Certificate / Form 16. 3. Please attach separate statement, if required. ORIGINAL Documents NOT to be submitted. Photocopies to be submitted.

4. Permanent Account Number (P.A.N.) is compulsory for all employees drawing taxable salary in excess of Rs.2.50 Lac

5. Provisional Certificate from Bank / Lending Institution is COMPULSORY to claim tax benefit of Housing Loan Interest. DO NOT SUBMIT PASS-BOOK / LOAN ACCOUNT STATEMENT / EMI SCHEDULE as supporting document.

6. Investments and Payments made after 14/01/2016 shall not be considered EXCEPT Life Insurance & Mediclaim Premium of Existing Policies purchased in Previous Years which are due in 4

th Quarter.

7. Photocopies of Insurance Premium Receipts required. Photocopies of Insurance POLICIES are NOT to be submitted.

FORM NO. 10-IA [See sub-rule (2) of rule 11A]

Certificate of the medical authority for certifying ‘person with disability’, ‘severe

disability’, ‘autism’, ‘cerebral palsy’ and ‘multiple disability’ for purposes of section 80DD and section 80U

Certificate No.

Date :

This is to certify that Shri/Smt./Ms son/daughter of Shri , age years male/female* residing at , Registration No. is a person with disability/severe disability* suffering from autism/cerebral palsy/multiple disability*.

2. This condition is progressive/non-progressive/likely to improve/not likely to improve*.

3. Reassessment is recommended/not recommended after a period of months/years*.

Sd/-

(Neurologist/Pediatric Neurologist/Civil Surgeon/ Chief Medical Officer*)

Name :

Address of Institution/Government hospital :

Qualification/designation of specialist :

SEAL

Signature/Thumb impression* of the patient

Note : *Strike out whichever is not applicable.

Printed from www.incometaxindia.gov.in Page 1 of 1

FORM NO. 10-I [See rule 11DD]

Certificate of prescribed authority for the purposes of section 80DDB

1. Name of the Patient

2. Address

3. Father’s name

4. Name and address of the person on whom the patient is dependent and his relationship with the patient.

5. Name of the disease or ailment (please see rule 11DD)

6. For diseases or ailments mentioned in item ( i) of clause ( a) of sub-rule (1), whether the disability is 40% or more (Please specify the extent).

7. Name, address, registration number and qualification of the specialist issuing the certificate, along with the name and address of the Government hospital [ see rule 11DD(2)]

Verification

This is to verify that I, Dr. s/o (w/o) Shri , in the case of the patient Shri/Smt./Ms. , after considering the entire history of illness, careful examination and appropriate investigations, am of the opinion that the patient is suffering from disease/ailment during the previous year ending on 31st March, . I also certify (only in case of neurological disease) that the extent of disability is more than 40%) (Strike off, if not applicable). I certify that the information furnished above is true to the best of my knowledge.

Date . Signature

Place .

(Name and Address )

To be countersigned by the Head of the Government hospital, wh ere the prescribed authority is a specialist with post-graduate degree in General or Internal Medicine.

Date . Signature Place .

(Name and Address )

Printed from www.incometaxindia.gov.in Page 1 of 1