To whomsoever it may concern

Dear Sir,

Sub: Declaration for claiming 100% benefit on Housing Loan Principal/Interest for the
financial year ending 2011 - 12

PAN

Name of the Employee with Employee Code Name:

Employee Code:
S/o, D/o, W/o, H/o
Name of the Employer and Address of the
Employer
Names of the Co – borrowers 1.
2.
3.
Housing Loan availed from
(Name of the Institution)
Loan amount Rs.
Date of Final disbursement
Amount repaid towards Principal Rs.
Amount accrued towards Interest. Rs.
Date of completion of construction of the
Property/handing over.
Property situated at with full address including
district and state.
Details of Co borrowers share in the property 1.
2.
3.
Whether the property is Self occupied or let out.

Whether the co borrower is claiming deduction 1.

for Principal repayment and Interest, if so 2.
provide the details of each co borrower’s claim 3.

I hereby confirm the above information’s are true and correct.

Signature of the Co-Borrowers Signature of the Employee
x x

Place:
Date:
(Note: All columns should be compulsorily filled in)