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DECLARATION FOR INCOME TAX SAVINGS FOR THE FINANCIAL YEAR 2016-17

Following are the savings particulars/others income statement for the Financial Year 2015-16
Assessment Year 2016-17 For calculation of Income Tax on salary

Sl No.
1

Particulars
HBA Principal

Under sec
80C

Life Insurance Premium

80C

Mutual Fund/share/Debentures etc.

80C

NSC/C.govt Securities

80C

Postal Life Insurance

80C

PPF/GPF/EPF etc.

80C

Tuition Fee

80C

Annuity Pension Plan

80CCC

Notified Pension Scheme

80CCD

10

Health Insurance/Mediclaim
(self/spouse/child)
Health Insurance/Mediclaim
(Parents - SR)
Health Insurance/Mediclaim
(Parents - NONSR)
Deposit/Treatment disabled Dependent
/
Treatment for specified Disease
/
Accrued interest on Education loan

80D

80U

17

Physically handicapped resident person with


disability/severe disability
Accrued interest on Housing loan

18

Rent receipt if any(attached form 10 BA)

80GG

19

Other income (in case of savings bank interest


beyond
. if any

80TTA

11
12
13
14
15
16

NB:- Please score out


If not applicable

Amount (in Rs.)

80D
80D
80DD
80DDB
80E

24(b)

Signature of the Employee:


Name and Designation:
Contact No.:
HRMS No.:

All the information may be submitted as early as possible to the O/o AO(W&B)/CS, Calcutta Telephones, Telephone
Bhavan,1st floor,Kolkata-700001.Last date of submission 15.04.2016

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