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FORM FOR CLAIMING ADDITIONAL DEDUCTION OF RS. ONE LAC ON HOUSING LOAN I Mr. / Ms ___________________________________ Emp No.

___________ Declare that I am not owner/co-owner in any residential house property at the time of sanction of home loan.

I also undertake to reimburse to the Company, any liability arising out of dis-allowance of any of the above exemption by the Income tax authorities on account of error in claim. Place : -----------------------------------Date : (SIGNATURE OF THE EMPLOYEE)

* Attach relevant Brochure.

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