Employee Name

KiruthikaSelvakumar

PAN Number :

CDYPK7237G

Employee ID

250605

Program

India Other GEOs

Velachery

Designation :

Location

ITEMS

REFERENCE

Sr Specialist-Coder

LANDLORD PAN
NO

AMOUNT

A.Interest on Housing Loan (Interest

Propotion only)

Total :
B.Loss on House Property (If Property Let
Out)

Total :
Home Loan Repayment (Principal Protion
only)

Total :
House Rent Allowance

APR-15

Pan Number Not

Required

8300

AUG-15

Pan Number Not

Required

8300

DEC-15

Pan Number Not

Required

8300

FEB-16

Pan Number Not

Required

8300

JAN-16

Pan Number Not

Required

8300

JUL-15

Pan Number Not

Required

8300

JUN-15

Pan Number Not

Required

8300

MAR-16

Pan Number Not

Required

8300

MAY-15

Pan Number Not

Required

8300

NOV-15

Pan Number Not

Required

8300

OCT-15

Pan Number Not

Required

8300

SEP-15

Pan Number Not

Required

8300

Total :

99600

Insurance Premium on Pension Plan

Total :
Life Insurance Premium
(LIC/ICICI/BAJAJI/etc.,)

Total :
Medical Reimbursement (INR 1250 per
month/ Max of INR 15000 per Yr)

303

3095

567

2134

Medical Reimbursement (INR 1250 per

month/ Max of INR 15000 per Yr)

636

2176

658

2029

715

3008

991

3144

Total :

15586

Mutual Funds

Total :
National Pension Scheme Contribution
NPS

Total :
National Saving Certificate (NSC)

Total :
Public Provident Fund (PPF)

70024

2000

Total :

2000

Sec 80D - Medical Insurance Premium

Total :
Sec 80DD/80DDU - Medical
Treatment/Insurance of Handicapped
dependent

Total :
Sec 80E - Interest on Education Loan (for
Self)

Total :
Term Deposit for Fixed Period of not less
then 5 yrs with a Scheduled Bank

Total :
Tution Fees for Children (Max 2 Children)

Total :
ULIP of UTI/LIC

Total :
I hereby state that the above information / documents submitted are true and correct.

Place

Date

(Signature of the Employee )