FROM

FIN YEAR

4/1/2015

TO
3/31/2016

PAN NO.

ASST. YEAR 2016-2017

NAME
DESIGNATION
Allottee of Govt. Qrts.

Yes
No

HRA
Rent paid p.m.
Pay in the Pay Band as on 01st March 2015
Grade Pay
Personal Pay per month

Whether DA is
taken as Salary for
claiming HRA
exemption

Qualification pay Per month

Total HRA recd

Transport Allowance Per month (excl DA)

Spl. Pay per month

Bonus for the yr.
Honororium for yr.
Tution fee reimbs. received during the yr.
O.T.A. for the year
Any other arrears/LTC EL encashment

DEDUCTIONS :
i) Prof. Tax for the year

Total HRA
exempted

Loss from House Property (Interest on HBA)

ANNUAL SAVINGS U/S 80 C

(a) Contribution to GPF
(b) CGEGIS
(c) Life Insurance Premium
(d) NSC VI & VIII
(e) Interest accrued on NSC VI/VIII
(f) Deposits in 10/15 year A/c in P.O.
(g) Tution fees paid(limited to 2 children)
(h) Payment towards PLI Premium
(i) Repayment of HBA
(j)Other savings covered u/s 80 C (PPF etc)
k) (ICICI Bonds etc)

ANNUAL SAVINGS U/S 80 CCC

Pension fund (max 10000)

ANNUAL SAVINGS U/S 80 CCD

New Pension Scheme

Emp.cont.(max 10% of
salary
Govt.cont.(max 10% of
salary

Deductions U/s.80 CCF (infrastructure bond)

Deductions U/s.80D/80DD/80DDB/80E (includes
CGHS contribution)

DONATIONS DURING THE YEAR U/S 80 G etc

I) P.M.'S RELIEF ETC

MAX LIMIT : 80 D - Rs.20,000/80 DD - Rs.50,000 or Rs.75,000/80-DDB - Rs.60,000/-

ADVANCE TAX PAID:

Amount of Advance tax paid / Tax deducted at
source

yes

T : 80 D - Rs.20,000/Rs.50,000 or Rs.75,000/Rs.60,000/-

yes
no

NAME

0 DESIG.

FIN YEAR

4/1/2015

to

3/31/2016

MONTH

BASIC

GRADE PAY

DA

DA & DA ON TA
Arrears

TA

HRA

PP

QP

MARCH

APRIL

MAY

JUNE

JULY

AUG

DA & DA ON TA
Arrears

SEPT

OCT

NOV

DEC

JAN

FEB

TOTAL

Any other arrears / LTC EL encashment

HONORARIUM
REIMBURSEMENT OF TUTION FEES
OTA
BONUS
TOTAL
LESS

HRA EXEMPTED U/S-10(13A)

RENT PAID

TRANSPORT ALLOWANCE

GROSS SALARY
LESS

PROFESSIONAL TAX

NET SALARY INCOME

NET SALARY INCOME
Less : INTEREST ON HBA
GROSS TOTAL INCOME

SAVINGS U/S.80-C

0 (a) Contribution to GPF

0 (b) CGEGIS

Less : SAVINGS UNDER SEC. 80-C TO 80 CCD

0 (c) Life Insurance Premium

Less : INFRASTRUCTURE BOND (SEC 80 CCF)

0 (d) NSC VI & VIII

Less : DEDUCTIONS U/S.80D/80DD/80DDB/80E

0 (e) Interest accrued on NSC VI/VI

Less : DEDUCTIONS U/S.80G ETC.

0 (f) Deposits in 10/15 year A/c in

TAXABLE INCOME (rounded off to nearest ten)

0 (g) Tution fees paid(limited to 2 c

TAX ON NET INCOME

0 (h) Payment towards PLI Premi

ADD : EDUCATION CESS @ 2% OF I.T

0 (i) Repayment of HBA

ADD : SECONDARY & HIGHER EDU. CESS @ 1%

0 (j)Other savings covered u/s 80

NET TAX PAYABLE

0 k) (ICICI Bonds etc)

LESS : Advance Tax paid

BALANCE TAX TO BE PAID

0
0

TOTAL SAVINGS
80 CCC- PENSION FUND
80 CCD-NEW PENSION SCH.

SP

GROSS

0
0

0
0

0
0
0
0
0
0
0

0
0
0
0
0
0

Y INCOME

SAVINGS U/S.80-C

ion to GPF

ance Premium

accrued on NSC VI/VI

0
0
0
0
0

n 10/15 year A/c in

es paid(limited to 2 c

towards PLI Premi

nt of HBA

ngs covered u/s 80

0
0

TOTAL SAVINGS

C- PENSION FUND

W PENSION SCH.

1 APRIL

MAY
JUNE
JULY
AUG

X-30%
Y-20%
Z-10%

0
0

BASIC
PAY
D.P.
BASIC
PAY+D.P.
DUE

DRAWN

Jan

Feb

Mar

0 Err:509
Err:509
0
0 Err:509
0
0
0
0
Err:509
Err:509
0
0
Err:509
0
0
0
0
Err:509
Err:509
0
0
Err:509
0
0
0
0
Err:509
Err:509
0
0
Err:509
0
0
0
0
Err:509
Err:509
0
0
Err:509
0
0
0
0

Err:509

Err:509