MVJ College of Engineering

DECLARATION FOR COMPUTING TAXABLE INCOME FOR F.Y. 2020-21

NOTE: Please read the NOTES carefully before filling up this form. Date:
NAME: Employee ID: Sl.NO:
Dept: DOJ:
DOB:
My Permanent Account Number (PAN):

PAN Example A A A A A 1 1 1 1A

Old tax regime of New tax regime of

the FY 2019-20 FY the 2020-21

In case you choose for the old tax regime, then only it is necessary to furnish the other details as mentioned below in the tax declaration
format. Other wise, for opting for the new scheme below details of this form not required.

Note: As per the Income-tax Act, it is mandatory to furnish PAN allotted by the Income-tax dept. to the Company. Further, it must be noted that as per the Income-tax Act, the
Company has to file a statement of tax deducted at source in respect of each employee to the Income-tax dept. (or to the person authorised by Income-tax dept.). Such
statement requires PAN of each employee. Hence, all employees are requested to furnish their PAN.

In accordance with Section 206AA of the Income-tax Act and as per CBDT Circular issued in this respect where the employee has not furnished PAN / furnished an invalid
PAN, tax will be deducted at an average rate of tax as per Finance Act, 2013 or at 20% on taxable salary, whichever is higher. In other words, if such average rate of tax is
below 20%, then tax will be deducted at 20% on taxable salary. Hence to avoid higher tax deduction, those employees who have not obtained PAN are requested to obtain it
and furnish the correct PAN to the Company at the earliest without failure

PLEASE NOTE THAT FURNISHING OF INCORRECT PAN IS LIABLE FOR PENALTY UNDER THE INCOME-TAX ACT

I, declare that the above statement is true to the best of my knowledge and belief. Income Tax liability arising due to not making not making investment for proposed by me
and / or any wrong declaration would be my responsibility.

A. House Rent [Sec.10(13A) PAN of Landlord Month/Year Rent (Rs.) Month/Year Rent (Rs.)
I am living in a rented house [Pl. see note (c)] [Pl. see note (b)] [Pl. see
note (b)]
Yes/NO

Details of monthly rent paid/payable by me are furnished

NOTES:
(a) The employee has to provide the copy of the rental agreement which should cover the period of April 20 to Mar 21. If the employee has already made a rental
agreement and it covers part of period, then the employee can give the copy of the existing rental agreement and then when the new agreement is executed, the
employee can provide the new agreement

(a)  E.g.: if living in the house from April '20, please write 04.20; and if living in the house in subsequent months, please write the month/year as applicable.
Additional column is for subsequent change during the year, if any.

(c) If annual rent paid exceeds Rs. 1,00,000 p.a., it is mandatory for the employee to report PAN of the landlord.

(d)The rental agreements must by mandatorily signed by both the Tenant and the Landlord failing which the rental agreements will not be considered

B. Payment of medical insurance premium and Preventive health check-up (Sec.80D)

( A) for Employee, spouse and dependent Children: Name of the Spouse Amount
(I) Deduction up to Rs. 25,000 for self (employee), spouse and dependent children if none of them is aged 60 years. OR
(II) Deduction up to Rs. 50,000 for self (employee)*, spouse* and dependent children if any one of them* is of the age 60 years or more.
AND
( B) for Employee's Parent/s: Name of the parent
(I)    Deduction up to Rs. 25,000 for employee's parent/s if none of the parents is aged 60 years OR
(II)   Deduction up to Rs. 50,000 for employee's parent/s if any of them is of the age 60 years or more.
Deduction u/s 80D shall be allowed only if the payment is made by any mode other than cash.

C.   Expenditure for medical treatment or payment/deposit for maintenance of employee’s dependant with disability (Sec. 80DD) Tick if yes

- Deduction: Rs.75,000 in case of person (i.e., employee's dependant) with disability & Rs.1,25,000 in case of person
(i.e., employee's dependant) with severe disability.
- Dependant' means employee's spouse, children, parents, brothers and sisters dependant wholly or mainly on the employee and such dependant has not claimed
deduction u/s 80U.
-Certificate from a medical authority in the prescribed form to be enclosed.

D.Tax relief for employee with disability (Sec. 80U)

- Deduction: Rs.75,000 in case of employee) with disability and Rs.1,25,000 in case of person (i.e. employee) with severe disability.
- Certificate from a medical authority in the prescribed form to be enclosed.
Medical certificate enclosed
 (tick, if enclosed)

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E. Payment of interest on loan taken from Bank / notified financial institution / approved charitable institution for pursuing higher education of the
employee or employee's spouse or children or the student for whom the employee is the legal guardian (Sec. 80E)

-             Deduction : Actual interest paid during the year ( Provisional Interest certificate to be
provided)maximum for 8 years including the first year of payment of interest).
Proposed: Rs.

- "Higher Education" means any course of study pursued after passing the Senior Secondary No. of consecutive
Examination or its equivalent from any school, board or university recognised by the Central/State year f or which the
Government or local authority or by any other authority authorised by Central / State Government or deduction is
local authority to do so. claimed

-Provisional interest Certificate from Bank / notified financial institution / approved charitable institution towards interest
payment to be produced
Certificate
enclosed( tick, if
enclosed)

F.1. Payments/deposit for Annuity Plan of Life Insurance Corporation or any other Insurer for receiving Pension (Sec.8 CCC)
[if the deduction is claimed under this section, no deduction u/s 80C for this payment is allowed (See G)]

- Deduction up to Rs.1,50,000.
However, this deduction together with the deduction u/s 80C and 80CCD(1) cannot exceed Rs.1,50,000. Proposed: Rs.

2.     Deposit by employee in respect of investment in New Pension Scheme of Central Govt. (Sec.80CCD)

Deduction: Deposit not exceeding 10% of the salary.

However, this deduction together with the deduction u/s 80C and 80CCC cannot exceed Rs.1,50,000. Proposed: Rs.

3. 80CCD(1B) => NPS , Deduction: Deposit not exceeding 10% of the salary (up to the limit of Rs. 50,000 over and above Rs.
150000/-)
Proposed: Rs.

G. Deduction under chapter VI-A (Sec.80C). [Deduction u/s 80C is limited to Rs. 1,50,000 including deduction u/s 80CCC and 80 CCD(1)] (Other
than deduction under employee's contribution to PF )
Particulars Proposed (Rs.)
1. Public Provident Fund in the name of employee, spouse or any child
Name of Spouse or Child :
2. NSC (VIII Issue) Rs. ………. (Accrued interest on NSC VIII Issue) Rs. ……….
3.      Life Insurance Premium in the name of employee, spouse or any child
Name of Spouse
Name of Child

4.      Unit Linked Insurance Premium UTI/LIC Mutual Fund ( in the name of employee, spouse or any child)
5.      Subscription to specified schemes of notified Mutual Funds / UTI.
6.      Notified Annuity plans of LIC or other insurers
7.      Contribution to any pension fund setup by any notified mutual fund or established by UTI
8. Repayment of Principal towards Housing Loan.
( Please provide provisional certificate from the Bank)
9. Term Deposit for a period not less than 5 years with scheduled banks
(Bank Term Deposit Scheme, 2006)

10. Other eligible investments (Please specify )

a)
b)
c)
d)
10. Tuition fees*
[* Includes fee paid to any university, college, school or other educational institution situated within India for the purpose of
full time education of any two children of the employee. Excludes development fees or donation or payment of similar nature.]

Name of the First Child :

Tuition fee

Name of the Second Child :

Tuition fee

11. Sukanya Samriddhi Account

Total

Signature of the Employee

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