INCOME TAX STATEMENT FOR THE YEAR 2019-2020 (ASSESSMENT YEAR 2020-2021)

(A) GENERAL INFORMATION

1 NAME OF THE OFFICE/EMPLOYEE:
2 DESIGNATION:
3 PAN NUMBER
(B)DETAILS OF SALARY DRAWN
1 BASIC SALARY
2 SPL PAY
3 GRADE PAY
4 DEARNESS ALLOWANCE
5 HOUSE RENT
6 C.C.A.
7 INCOME FROM OTHER SOURCES

STANDERD DEDUCTION

(C) LESS HRA (U/S)10(13A) (LEAST OF THE FOLLOWING)

1 HOUSE RENT ALLOWANCE RECEIVED
OR
2 HOUSE RENT PAID EXCESS OF 10% OF SALARY
OR
3 40% OF THE SALARY
(D)BALANCE (B-C)
(E) DEDUCTIONS
1 U/S 24(I) INTEREST OF HBA LOAN (UPTO Rs. 150000)
2 U/S 80(G) RELIEF FUND
3 U/S 80(DDB) (UPTO RS. 40000)
4 ANY OTHER CONTRIBUTION/MEDICLAIM

(F). GROSS SALARY (D-E)

(G). DEDUCTION U/S 80 C
1 G.P.F
2 G.I.S
3 P.P.F
4 L.I.C. PREMIUM
5 PRINCIPAL AMOUNT OF HBA
6 N.S.C. PURCHASED
7 TUTION FEE (TWO CHILDREN ONLY)
8 ULIP
9 N.S.C.INTEREST
10 MUTUAL FUNDS/ INFRASRTUCTURE BONDS
11 ANY OTHER CONTRIBUTION

(H). TAXABLE INCOME (F-G)

TAX ON TOTAL INCOME
1 UPTO RS. 250000/500000
2 RS. 250001 TO 500000 (5%)
3 RELIEF UNDER 87A (UPTO 5 LAC TAXABLE INCOME)
 4 RS.500001 TO 1000000 (20%)
5 ABOVE RS. 1000001 (30%)

(I). HEALTH AND EDUCATION CESS 4%

(J). TOTAL TAX PAYBLE
(K). TAX ALREADY PAID
(L).TAX TO BE PAID/ REFUNDABLE
VERYFIER
R 2019-2020 (ASSESSMENT YEAR 2020-2021)

SHIVKANT THAKUR
LECTURER
AHUPT9595N

RS.
RS.
RS.
RS.
RS.
RS.
RS.
TOTAL INCOME(1+7) RS.
U/S 16(ia) RS.
TOTAL -- RS.

RS.

RS.

RS.
RS.

RS.
RS.
RS.
RS.
TOTAL OF (1 TO 4) RS.
RS.

RS.
RS.
RS.
RS.
RS.
RS.
RS.
RS.
RS.
RS.
RS.
TOTAL OF (1 TO 11) RS.
RS.
RS.
NIL
RS.
RS.
 RS.
RS.
TOTAL OF (1 TO 5) RS.
RS.
RS.
RS.
RS.
COUNTER SIGNATURE