STATEMENT OF INCOME TAX FOR THE FINANCIAL YEAR 2016-2017 (A.Y 2017-2018) Name, Designation and Employee Code 1 Date of Birth Contact No.(Cell/Landline) Permanent Account Number 2 (PAN) (Section 206AA) Probable income from salary/Pension FOR OFFICE USE during 2016-2017 including all allowances ( Pay, Grade Pay, HRA, DA, Transport Allowance, Bonus, EL Rs Surrender) Employer’s contribution towards New Pension Scheme during the Financial Rs Year 2016-17 3 Honorarium or any similar income received from NITC but not income from Rs other sources Reimbursement of Medical Claim Rs received in excess of Rs.15000/- Children Education Allowance received Rs during financial year 2016-17 Rs Total FOR OFFICE USE Less: House Rent Allowance exempt U/s 10 (13A) and Rule 2A :Least of the following:- Rs Actual Amount of HRA received Expenditure on rent for 4 accommodation occupied by the Rs employee in excess of 10% of salary 40% of salary (basic pay + GP + DA) Rs Least of the above Rs 5 Balance (Col.3 minus Col.4) Rs Rs Less: a)Transport Allowance exempt 6 Rs b)Children Education Allowance
STATEMENT OF INCOME TAX FOR THE FINANCIAL YEAR 2016-2017 (A.Y 2017-2018) 1 Name, Designation and Employee Code Date of Birth Contact No.(Cell/Landline) 2 Permanent Account Number (PAN) (Section 206AA) 3 Probable income from salary/Pension during 2016-2017 including all allowances ( Pay, Grade Pay, HRA, DA, Transport Allowance, Bonus, EL Surrender) Employer’s contribution towards New Pension Scheme during the Financial Year 2016-17 Honorarium or any similar income received from NITC but not income from other sources Reimbursement of Medical Claim received in excess of Rs.15000/- Children Education Allowance received during financial year 2016-17 Total Rs Rs Rs Rs Rs Rs FOR OFFICE USE 4 Less: House Rent Allowance exempt U/s 10 (13A) and Rule 2A :Least of the following:- Actual Amount of HRA received Expenditure on rent for accommodation occupied by the employee in excess of 10% of salary 40% of salary (basic pay + GP + DA) Least of the above Rs Rs Rs FOR OFFICE USE Rs 5 Balance (Col.3 minus Col.4) Rs 6 Less: a)Transport Allowance exempt b)Children Education Allowance Rs Rs