ABHIJEET GROUP

DECLARATION TO BE SUBMITTED BY EMPLOYEES

Declaration form for TDS from Salary for the Financial year 01-04-2012 to 31-03-2013 (Asst. Year 2013-2014) Please submit this form duly filled to the Corporate Taxation Department. In case the form is not submitted before the said date, it will be assumed that the Employee is not going to make any investment/expenditure for tax exemption/rebate, and the TDS will be calculated and deducted every month from the salary & deposited in the Government Treasury. There shall be no refund for tax which has been already deducted & paid to the Government. Income Tax Refund if any shall have to be claimed by the employee from the Income Tax Dept.

NAME OF EMPLOYEE (In Full) COMPANY DESIGNATION EMPLOYEE CODE DATE OF JOINING GENDER PAN NO ADDRESS
EXECUTIVE TRAINEE 11001525 18-Sep-12 Male AGSPL2569F

NILESH RAGHUNATH LAKHODE ABHIJEET PROJECTS LTD

PLOT NO: 337 KUKDE LAY OUT NAGPUR-440027

MOBILE NO
Sr. No 1 Section 80C INVESTMENT

8102920815 Particulars of the deduction available Amount (Rs.)

(Enclose Xerox copy of Receipt/s)

a) Employee Provident Fund b) Life Insurance Premium paid between 01.04.2011 To 31.03.2012 c) 15 Year Public Provident Fund - Maximum 1 lac per Person d) National Saving Certificate (VIII Issue) e) Unit Linked Insurance Plan (ULIP) f) Equity-Linked Saving Scheme of a Mutual Fund/UTI g) Repayment of Housing Loan - Only Principle Amount h) Amount paid as only Tuition Fees (For Max. 2 children) i) Fixed Deposit with Scheduled Bank for 5 YEARS & above j) Payment for non commutable deferred annuity k) Contribution towards an approved superannuation fund l) Payment for notified annity plan of LIC m) Contribution to notified pension fund of Mutual Fund or UTI n) Subscription to Home Loan Account Scheme of National Housing Bank or National Housing Bank (Tax Saving) Term Deposit Scheme, 2008 o) Subscription to public deposit scheme of HUDCO or housing board p) Investment in approved debentures / equity shares in public company engaged in infrastructure or units of mutual fund whose proceeds are utilised for developing new infrastructure facility q) Subscription to notified bonds of NABARD r) Deposit in Senior Citizens Saving Scheme s) Deposit in Five Year Time Deposit Scheme in post office 80CCC t) Deduction in respect of amount paid in any Annuity plan of Insurance Company for receiving pension from fund Total investment from a to t should not exceed Rs. 1,00,000/2 80CCF Long Term Infrastructure Bonds Max. deduction Rs.20,000/3 80CCD National Pension Scheme

80D

Deduction in respect of medical insurance premium (Mediclaim) taken on the health of the individual or his family members Max. deduction Rs.15,000/Deduction in respect of medical insurance premium (Mediclaim) taken on the health of the Parents

Deduction in respect of medical insurance premium (Mediclaim) taken on the health of the Parents Parents - Max additional 15000/Parents - Senior Citizen Additional 5000/4 80E Deduction in respect of of Interest on Loan taken for higher education Max. deduction Whole Amount of Interest (upto 8 Years) Deduction in respect of a person of disability Flat Deduction of Rs 50,000/- (Severe Disability - Rs 1,00,000/-) 6 10(13A) Exemption in respect of HRA a) Own a House / Houses b) Resident in own Flat/House? (If Yes, HRA Fully taxable) c) If Resident in let out Flat/House, provide Name and complete Address (Including Ward No) of landlord : 0

80U

Rent Per Month

PAN No. of Land Lord

7

Any other eligible deduction under section 80CCC to 80U

Sr. No 8

Section 24(b)

Particulars of the deduction available Amount borrowed for Construction, Repairs, Reconstruction or purchase of house property Address of the property (Mandatory):

Amount (Rs.)

1) Date of Commencement of housing loan 2) Date of purchase of house property from that loan 3) If the house property is constructed, then A) Date of Commencement B) Date of Completion 4) Do you have any other house property which you have claimed for own residence purpose (i.e. self occupied)? If Yes, please specify 5) Whether the property which you have claimed for deduction under section 24(b) of the Income Tax Act is self occupied? 6) If the property is let out to any other person, give the amount of the rent which you have received/receivable from the tenant for the financial year 01-04-2012 to 31-03-2013 7) Amount of Installments towards interest due for the Fin.Yr. 01-04-2012 to 31-03-2013 9 Any other Income & TDS thereon (Please Specify)

I promise to submit all the supporting for the above declaration / Investment made by me to the company latest by 15-12-2012 failing which the company will have full right to deduct the tax amount from my salary. I declare that all the facts stated above are true and correct and if on subsequent verification if the said fact is found to be false, I shall be personally liable for any tax, interest and penalty imposed on account of the same by Income tax Department. Date : Place : Signature