SDG SOFTWARE INDIA PVT LTD

EMPLOYEE DECLARATION FORM FOR DETERMINING TAX LIABILITY

For the Financial Year 2014-2015
PERSONAL INFORMATION
(ALL FIELDS ARE MANDATORY)
EMPLOYEE CODE SDG-2923

NAME
Rahul Bahal
FATHER's NAME (For married women
also) Raj Kamal Bahal
DATE OF BIRTH (DD/MM/YYYY)
8/1/1985
GENDER
Male
LOCATION (Sect 2/ NSEZ/ HYD)
Sect 2
PAN
BKYPB4916P
Contact no.
8447464430
email
Rahul.Bahal1@sdgc.com
Date of Joining
23/06/2014

SECTION-I
PROOF OF RENT PAID FOR THE PURPOSE OF CLAIMING BENEFIT OF HRA U/S 10(13A) OF THE ITAX ACT, 1961
In Respect of House Rent Paid RENT P.M.
55000
Kamal & Usha Rani

NAME &
ADDRESS OF
LANDLORD
PAN NO.OF LANDLORD for rent of & above Rs.1,00,000 p.a.
RENT P.A.
FULL ADDRESS 660,000
OF RENTED
PROPERTY Pan No.BEWPB5071F, 659 Mukherjee Nagar Delhi 110009

SECTION-II
(DECLARATION OF SAVING ALLOWED U/S 80 OF THE IT ACT, 1961)

In respect of Saving allowed under Chapter VI

S.No Description AMOUNT (Rs.)

Section 80D- Medical Insurance Premium( Rs.15,000 for self & family.Additional 30,000
deduction of upto Rs.15000 to cover dependent parents; Rs.20,000if parents
are senior citizens) (Rs.15000 includes max.of Rs.5000 paid for preventive
1 Health check-ups)
Section 80DD- Medical treatment for Handicap (Limited to Rs.50,000,if severe
2 disability deduction up to Rs.1Lac)
Section 80U- Permanent Physical disability (Limited to Rs.50,000,if severe disability
3 deduction up to Rs.75,000)
Rajiv Gandhi Equity Savings Scheme (Maximum amount eligible Rs.50,000, but Tax
Benefit is available on 50% of the amount invested. The benefit is in addition
4 to deduction available u/s Sec 80C )

5 Section 80E- Payment of interest on loan taken for Higher Education in FY 2014-15

-Whether loan taken for full time or part time education

-Date on which loan taken

-Course for which loan taken

-Name of institution from which loan taken

SECTION-III
PROOF OF SAVING U/S 80C OF THE IT ACT, 1961

Investment under this Sec can be made upto Rs. 1 Lac in any of the below
S.No Description AMOUNT

1 Accrued Interest on NSC

Public Provident Fund (PPF)

2

3 LIFE INSURANCE (LIC)

National Savings Certificate Purchased (NSC)

4
Housing Loan repayment of Principal up to a maximum of Rs.1 Lac P.A (Including Stamp
Duty, Registration Fees & Other Expenses incurred for the purpose of Transfer of
5 Property to the Assessee.) 1,50,000

Unit Linked Insurance Plan (ULIP)

6

Confidential Page 1
Declaration
 Mutual Funds notified u/s 10(23D)
7

Investment u/s.80CCC (Pension Policy)

8

Children Tuition Fee

9
Term Deposits (made during April14-March15) for a fixed period of not less than 5 years
10 with a Scheduled Bank

Purchase of NSS under National Savings Scheme 1992

11

Contribution by an employee to approved superannuation fund. (Contribution of

employer shall not qualify for benefit. Besides fund must be approved one i.e. approved
12 by commissioner or assistant commissioner of income tax)

ELSS (Equity Linked Saving's Scheme)

13

Notified pension fund (UTI-Retirement Benefit pension fund is the notified one)
14

5 year Post Office deposits & Senior Citizen Scheme

15

SECTION-IV
PROOF OF DEDUCTION U/S 24 OF THE IT ACT, 1961 INTEREST ON HOUSING LOAN

With respect of the amount of any interest payable on borrowed capital for acquiring, constructing , renewal, repairing or re-
constructing property.

1. Address of the Property against which Loan taken : ___E 504, Capital Gateway sector 111 Chauma, gurgaon -122001

______________________________________________________________________________________

2. Self - Occupied / Rented : _______Self Occupied________________________________________________________

3. Date of loan availed : __April 2013_______________________________________________________________

4. Purpose of the Loan (construction / Acquiring property) _Acquiring Property________________________________________

5. Construction of Property will be completed on or before (date)______N/A______________________________

6. Date on which Construction is/will be Completed : ______N/A_________________________________________

7. Date of Possession of Property : ________April 2013_______________________________________

(Please mention month & Year if Date cannot be known)

8. Total amount of interest paid (post construction/possession) during the financial year (April 250,000
2014 to March 2015)

9. Specify amount of interest paid for pre-construction/possession period. {Pre-Construction Possession Period: 250,000
Period (i.e. for the period starting from the date of taking loan till 31st March 2014). Pre-
Construction Period :- If construction of property is started in one financial year and it ends in
another financial year then the period starting from the day assessee has taken loan till the end
of financial year immediately preceding the year in which construction ends is called pre-
construction period. The same is true for purchase of house property. Such interest is allowed in
five equal installments starting from the year in which construction/acquisition is completed.}

10. Ownership ( Joint or Sole) Joint

11. If Joint Ownership Name and Relationship with Owner(s) Raj Kamal Bahal, Father

Share of Joint Owner(s) in Property N/A

Whether any sum Contributed by Joint Owner in Acquiring Property No

Name(s) of Joint Owner(s) (Apart from the Employee) Who are Repaying Aforesaid Housing Loan N/A

Whether Joint Owner(s) is/are claiming Deduction Under Income Tax Act , 1961 On Account of Housing Loan No
Taken for Aforesaid Property

SECTION-V
I, ___________________________, do hereby declare that the aforesaid information is true and correct to the best of

my information and belief and I shall indemnify the company against all costs and consequences if any information is

later on found to be incorrect.

Signature of Employee :______________________

Date :______________________

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Declaration
Place :______________________

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Declaration