I PSF 202122

PGBRK IPSF|997|231325|00997000000000002313||W||
All the proofs have to be uploaded using the scan image option using the link "Upload IPSF Proof Images". No hard copy proofs will
be accepted. Please ensure to consolidate all the images of your investment proofs and self declarations; create a ZIP file & upload.
Adobe Systems India Pvt. Limited IPSF ID : 00997000000000002313
Investment Proofs Submission Form for the Year 2021-2022
Employee ID* 231325 Gender* F Date of Joining 03/07/2018
Name* PACHIPULUSU N PREETHI No.of Children Going to School 0
PAN* BAZPP2025G No.of Children Going to Hostel 0
Regime Type Old Regime
Section A - Rent Paid for claiming HRA exemption (Only Rent Receipts will be considered)
From Date To Date Address Rent Paid Per Rent Paid Per Property ID
Month Annual
01/04/2021 31/03/2022 Flat no. S9 ,sowparnika 8150.00 97800.00 1
apartments ,basapura main road
,near hosa road junction
,bangalore,BANGALORE,KARN
ATAKA
As Per Last Declaration Section B - Chapter VI A - Deductions from Total Income Value of Proof Attached
0 Medical Insurance - Self / Spouse / Children (<60 yrs) - With Insurance 0.00
0 Medical Insurance - Self / Spouse / Children (>=60 yrs) - With Insurance 0.00
0 Medical Insurance - Self / Spouse / Children (>=60 yrs) - Without Insurance 0.00
0 Medical Insurance for Parents (<60yrs) - With Insurance 0.00
0 Medical Insurance for Parents (>=60yrs) - With Insurance 0.00
0 Medical Insurance for Parents (>=60yrs) - Without Insurance 0.00
0 Medical Treatment/Handicapped Dependent (U/s 80DD) < 80% 0.00
0 Medical Treatment/Handicapped Dependent (U/s 80DD) > 80% 0.00
0 Interest on Educational Loan (U/s 80E) 0.00
0 Permanent Physical Disability (80U) < 80% 0.00
0 Permanent Physical Disability Severe Disabilitty (80U) > 80% 0.00
0 Medical Treatment of Specified Diseases (80DDB) 0.00
0 Additional Housing Loan Interest Benefit (U/s 80EE) 0.00
0 Medical Treatment of senior citizen (80DDB) 0.00
0 Medical Treatment of very senior citizen (80DDB) 0.00
0 Atal Pension Yojana (U/s 80CCD1B) 0.00
0 Additional NPS Employee Contribution (U/s 80CCD1B) 0.00
0 Electric Vehicle Loan Interest Benefit (U/s 80EEB) 0.00
0 Additional Housing Loan Interest Benefit (U/s 80EEA) 0.00
0 Deduction for Interest on Deposits in Savings Account (U/s 80TTA) 0.00
0 Deduction for Interest on Deposits in case of Senior Citizens (U/s 80TTB) 0.00
Section C - Chapter VIA - Section 80C
0 Contribution to Pension Fund ( 80CCC ) 0.00
37878 Life Insurance Premium (Jeevan Dhara, Jeevan Akshay) etc 37878.00
0 Public Provident Fund (PPF) 0.00
0 National Savings Certificate (NSC) 0.00
0 Infrastructure Bonds 0.00
0 Children Education Tuition fees 0.00
0 Equity Linked Savings Scheme (ELSS) 0.00
120000 Mutual Funds 80000.00
0 Unit Linked Insurance Plan 0.00
0 5 Year Deposit under Senior Citizen Saving Scheme 0.00
0 Cumulative Term Deposits 0.00
0 Sukanya Samriddhi Scheme 0.00
0 NPS Employee Contribution (U/s 80CCD) 0.00
0 5 Year Time Deposit in Post Office 0.00
0 Atal Pension Yojana (U/s 80CCD) 0.00
0 Fixed Deposit Scheme (Block Period of 5 yrs) 0.00
0 NSC Interest (Will also be considered as Other Income) 0.00
Section G -Other Income
0 Bank Interest (excluding interest on savings account) 0.00
0 Interest Income to Senior Citizen(Considered as deduction u/s 80TTB upto Rs.50000) 0.00
0 Interest on Deposits in Savings Account (Considered as deduction u/s 80TTA upto Rs.10000) 0.00
0 Pension 0.00
0 Others 0.00
0 NSC Interest (Other Income) 0.00
0 Interest on PF Account 0.00
Payroll Deduction
Particulars Amount
Provident Fund 82320.00
Payroll Deduction - Total 82320.00
Dependent Details:
Dependent Name Relationship Age
PACHIPULUSU N PREETHI Self 25
P R Nataraja Father 61
P N Manjula Mother 57
Note:-
I, hereby, declare that I have read and understood the IPSF guidelines provided by the Firm and that all information/documents provided by me are true and correct to the best of
my knowledge. If any of the information is found to be false or misleading, the Firm holds the right to take a disciplinary action against me.
I also understand that Firm reserves the right to scrutinize the information and investment proof submitted by me and disallow tax benefit without providing any explanation. I
understand that if disallowed by the Firm. I can claim that benefit while filing my income tax return. I also recognize that if needed the Firm could ask for further documents or
original documents to verify and validate the investments tax saving proofs submitted by me.
I, hereby, declare that the investment proofs submitted by me for the current financial year have not been claimed by my relations in my current organization or any other
organization for the same financial year.
I further undertake to indemnify the company for any loss/liability that may arise, in the event of any incorrect information/documents
Date: 09-01-2022
Place: Bangalore
Signature of Employee *_________________________________

* Indicates mandatory fields as per our database. Please verify the same and if blank, please fill and submit the form.
HRA Land Lord Details

Property Id Landlord Name Landlord Pan Landlord Address Annual Rent
1 AdiLakshmi Flat no. S9 ,sowparnika 97800
apartments ,basapura main road
,near hosa road junction
,bangalore
HRA FUTURE RENT DECLARATION
Adobe Systems India Pvt. Limited
EMP ID 231325
EMP NAME PACHIPULUSU N PREETHI
RENT AMOUNT PER MONTH 8150
FOR THE PERIOD 01-01-2022 TO 31-03-2022
LANDLOARD NAME AdiLakshmi
LANDLOARD PAN
The proofs/original rent receipts would be submitted on request along with the copy of the Self declaration.
Employee Declaration
Date 09-01-2022
Place Bangalore
Signature of Employee * ____________________________

I hereby declare that the information provided above is true and correct and will be solely responsible for any situation arising out of non-payment of the above rent.
FORM NO. 12BB
(See rule 26C)
Statement showing particulars of claims by an employee for deduction of tax under section 192
1. Name and address of the employee : PACHIPULUSU N PREETHI
2. Permanent Account Number of the employee : BAZPP2025G
3. Financial year : 2021-2022
Details of claims and evidence thereof
Sl. No. Nature of claim Amount(Rs.) Evidence/Particulars
(1) (2) (3) (4)
House Rent Allowance:
(i) Rent paid to the landlord : Rs.97800
(i) Property No :1
(ii) Name of the landlord :AdiLakshmi
1. Rs.97800 House Rent Receipts
(iii) Address of the landlord :Flat no. S9 ,sowparnika apartments ,basapura main road ,near
hosa road junction ,bangalore
(iv) Permanent Account Number of the Landlord :
(v) Annual Rent :97800
2. Leave Travel Concessions or Assistance Rs.0 Travel Receipts/Tickets

Deduction of Interest on Borrowing:
(i) Interest Payable/Paid to the Lender
Self Occupied Interest - Property 1 :

Self Occupied Interest - Property 2 :
Self Occupied Interest :
Let-OutInterest :
(ii) Name of the Lender
Self Occupied - Property 1 :
Let-Out :
(iii) Address of the Lender Provisional Certificate from
3. Rs.0.0 Bank/Financial Institution/Lender
Self Occupied :
- Property 1
Self Occupied :
- Property 2
Let-Out :
(iv) Permanent Account Number of the Lender
Let-Out :
(a) Financial Institutions
(b) Employer
(c) Others
Deduction under Chapter VI-A
(A) Section 80C,80CCC and 80CCD

(i) Section 80C
(a) Provident Fund : Rs.82320
(b) Mutual Funds : Rs.80000
(c) Life Insurance Premium (Jeevan Dhara, Jeevan : Rs.37878

4. Photocopy of the investment
Rs. 200198.0
Akshay) etc proofs
(ii) Section 80CCC :
(iii) Section 80CCD
(B) Other sections (e.g. 80E, 80G, 80TTA, etc.) under Chapter VI-A.
:
Verification
I, PACHIPULUSU N PREETHI, Son/Daughter of P R Nataraja. do hereby certify that the information given above is complete and correct.
Place : Bangalore
Date: 09-01-2022
(Signature of the Employee)

Designation : Member of Technical Staff 1 Full Name: PACHIPULUSU N PREETHI
Note: The information/details above, as required for deduction of tax u/s 192 of the Income Tax Act, has been entered by the employee through an authorized login on
the portal.
09/01/2022, 12:40 Rent Receipt Generator Online - House Rent Receipt
RENT RECEIPT April 2021 Receipt No: 1

Generated on ClearTax Date: May 01 2021
Received sum of INR Rs.8150 from Pachipulusu N Preethi towards the rent of
property located at Flat No. s9, Sowparnika Apartments, Basapura Main Road,
near Hosa Road junction, Bangalore-560100 for the period from Apr 01 2021 to
Apr 30 2021
AdiLakhsmi (Landlord)
RENT RECEIPT May 2021 Receipt No: 2
Generated on ClearTax Date: Jun 01 2021
near Hosa Road junction, Bangalore-560100 for the period from May 01 2021 to
May 31 2021
RENT RECEIPT June 2021 Receipt No: 3

Generated on ClearTax Date: Jul 01 2021
near Hosa Road junction, Bangalore-560100 for the period from Jun 01 2021 to
Jun 30 2021
https://cleartax.in/save/rent#results 1/4
RENT RECEIPT July 2021 Receipt No: 4

Generated on ClearTax Date: Aug 01 2021
near Hosa Road junction, Bangalore-560100 for the period from Jul 01 2021 to
Jul 31 2021
RENT RECEIPT August 2021 Receipt No: 5

Generated on ClearTax Date: Sep 01 2021
near Hosa Road junction, Bangalore-560100 for the period from Aug 01 2021 to
Aug 31 2021
RENT RECEIPT September 2021 Receipt No: 6

Generated on ClearTax Date: Oct 01 2021
near Hosa Road junction, Bangalore-560100 for the period from Sep 01 2021 to
Sep 30 2021
RENT RECEIPT October 2021 Receipt No: 7

Generated on ClearTax Date: Nov 01 2021
near Hosa Road junction, Bangalore-560100 for the period from Oct 01 2021 to
Oct 31 2021
RENT RECEIPT November 2021 Receipt No: 8

Generated on ClearTax Date: Dec 01 2021
near Hosa Road junction, Bangalore-560100 for the period from Nov 01 2021 to
Nov 30 2021
RENT RECEIPT December 2021 Receipt No: 9

Generated on ClearTax Date: Jan 01 2022
near Hosa Road junction, Bangalore-560100 for the period from Dec 01 2021 to
Dec 31 2021
Provisional
RENT RECEIPT February 2022 Receipt No: 10
Generated on ClearTax Date: Jan 09 2022
near Hosa Road junction, Bangalore-560100 for the period from Jan 01 2022 to
Feb 01 2022
PREMIUM CERTIFICATE
Date : 08-01-2022
Name : P N PREETHI
Address : D/O P.R.NATARAJA SOWPARNIKA APARTMENT 51
2ND FLOOR BASAPURA ROAD NEAR GRAND SUPER
MARKET
BANGALORE, - 560100
KARNATAKA
Mobile number : 8867071065
Email ID : PREETHIPACHIPULUSU09@GMAIL.COM
Policy Details
Tata AIA Life Insurance Sampoorna
Policy Number : C290344796 Plan Name :
Raksha(110N129V03)
Payment Mode : Annual Date of Issuance : 28-06-2019
Next Due Date : 28-06-2022 Next Due Premium : 32100.00
Premium Paid Details

Premiums paid in the financial year
Premium paid in Advance
1st April 2021 to 31st March 2022
37878.00 0.00
Tax Benefit Details

Sec 80 C Sec 80 CCC Sec 80 D
Includes Life Plans, Riders and Includes Pension Plans Includes Health Plans & Health Riders
Immediate Annuity products
37878.00 0.00 0.00
This document can be used for claiming tax deduction as per the prevailing tax laws.
Please note :
• Payments which have been made through modes other than cash are subject to clearance including through electronic mode
payments.
• Applicable govt taxes, surcharge, cess including GST would be charged in accordance to applicable Laws and Company will have
the right to recover the same from policyholder.
• Income Tax benefits would be available as per the prevailing income tax laws, subject to fulfilment of conditions stipulated therein
and are subject to change from time to time. Tata AIA Life Insurance Company Ltd. does not assume responsibility on tax
implication mentioned anywhere in this document. Please consult your own tax consultant to know the tax benefits available to you.
• Please refer to the policy document for detailed terms and conditions and our website for FAQs on tax related laws.
L&C/Misc/2021/May/0242
Account Statement
Page 1 of 2
NON-TRANSFERABLE
Mode of Holding : Single
P N Preethi : Individual
Status
Sowparnika Apartment S1 Nominee 1 : P R NATARAJA
2Nd Floor Basapura Road Naer Grand Nominee 2 : N/A
Super Market Electronics City
Nominee 3 : N/A
Bangalore - 560100
Second Holder : N/A
Karnataka
Third Holder : N/A
Email : preethipachipulusu09@gmail.com
Guardian Name : N/A
Mobile: +918867071065 Phone Res : N/A Your Branch : NSE Upload
Folio Number : 1038152529 Statement Date: 09-Jan-2022

PAN KYC FATCA
1st Holder BAZPP2025G OK Ok
2nd Holder N/A N/A N/A
3rd Holder N/A N/A N/A
Guardian N/A N/A N/A
PORTFOLIO SUMMARY
Scheme Unit Balance NAV as on NAV Current Value Cost of Dividend

Investment Earned
ABSL Tax Relief '96 Fund-ELSS - Growth 5,460.063 07-Jan-2022 42.30 230,960.66 180,000.00 0.00
Total: 230,960.66 180,000.00 0.00
ABSL Tax Relief '96 Fund-ELSS - Growth - INF209K01108 NAV as on 07-Jan-2022 : 42.30
Value Transaction Type Amount Price NAV Number of Units Balance Units
Date
Opening Balance 4,477.419
13/04/2021 Purchase-SIP-NSE - 4,999.75 37.81 37.81 132.234 4,609.653

11/05/2021 Purchase-SIP-NSE - 4,999.75 38.12 38.12 131.158 4,740.811
11/06/2021 Purchase-SIP-NSE - 4,999.75 40.27 40.27 124.156 4,864.967
13/07/2021 Purchase-SIP-NSE - 4,999.75 40.38 40.38 123.817 4,988.784
11/08/2021 Purchase-SIP-NSE - 4,999.75 40.51 40.51 123.420 5,112.204
13/09/2021 Purchase-SIP-NSE - 4,999.75 42.55 42.55 117.503 5,229.707
12/10/2021 Purchase-SIP-NSE - 4,999.75 43.19 43.19 115.762 5,345.469
11/11/2021 Purchase-SIP-NSE - 4,999.75 43.63 43.63 114.594 5,460.063
Live Systematic Registration as on 09-Jan-2022 SIP/STP/SWP

Type Scheme Amount Date From To Top up Amount Registration ARN CODE
Frequency
(INR) Date Date Frequency Date SUB-ARN
SIP Aditya Birla Sun Life Tax 5,000.00 10 Monthly 12/10/2099 12:00:00AM
1/10/2019 12:00:00AM 11/13/2018 12:00:00AM
Relief'96 Fund- (ELSS
U/S 80C of IT ACT) -
Growth-Regular Plan
SIP Aditya Birla Sun Life Tax 5,000.00 10 Monthly 12/10/2099 12:00:00AM
6/13/2019 12:00:00AM 6/13/2019 12:00:00AM
Relief'96 Fund- (ELSS
U/S 80C of IT ACT) -
Growth-Regular Plan
(**)if appearing above denotes SI is getting over soon.Contact your financial advisor or call us on 1800-270-7000 to renew in time.
Your registration or cancellation requests submitted recently may be under process and may not appear immediately.
Account Statement
FOLIO NUMBER : 91048437853 CAN : Statement Date : 09 Jan 2022 For the period 01 Apr 2021 to 31 Mar 2022
P N PREETHI First Holder Second Holder Third Holder Guardian/POA

PAN/PEKRN BAZPP2025G
Sowparnika Apartment S1
KIN
2Nd Floor Basapura Road Naer Grand
Super Market Electronics City KYC Status Verified
Bangalore 560100 FATCA/CRS Status Compliant
Karnataka
India UBO
Mobile : 8867071065 First Nominee Second Nominee Third Nominee
Email ID :
Nominee Name P R NATARAJA
PREETHIPACHIPULUSU09@GMAIL.COM
Nominee Relationship Father
Name Of Guardian
Joint Holder 1 :
POA Registration N
Joint Holder 2 :
Tax Status INDIVIDUAL IFSC HDFC0003636
DP/CLID :
Mode of Holding SINGLE Bank A/c No. XXXXXXXXXX8634
Form 15G/H : No HDFC Bank Ltd
Intermediary/RIA/PMRN SIP FUND PRIVATE LIMITED / Bank Name
Intermediary/RIA/PMRN Code ARN-102683 / NA Account Type Savings

Sub ARN / Sub Broker Code NA / NA Payout Mode Electronic
EUIN Multiple EUIN Multiple Bank Reg No
ACCOUNT SUMMARY
Scheme Name NAV Units Investment Paid (Rs) IDCW Market Value (`)
Value(`) Paid (`) Re-invested (`)
Axis Long Term Equity Fund - Regular Growth (TSGPG) - : ISIN :
76.3075 1,503.843 75,000.00 1,14,754.50
INF846K01131
Total 75,000.00 0.00 0.00 1,14,754.50
SIP Registration Summary

Scheme Name Start Date End Date Frequency Amount Transaction Top Up Top Up Status
(`) Type Amount Frequency
Axis Long Term Equity Fund - Regular Growth ( TS-GP ) 10/01/2019 31/12/2099 Monthly 2000.00 SIP Terminated
Axis Long Term Equity Fund - Regular Growth ( TS-GP ) 10/07/2019 31/12/2099 Monthly 2000.00 SIP Terminated
SIP Termination/Cancellation Summary

Scheme Name Start Date End Date Frequency Amount Transaction Status SIP Termination / Cancellation
(`) Type Summary
Axis Long Term Equity Fund - Regular Growth ( TS-GP ) 10/01/2019 31/12/2099 Monthly 2000.00 SIP Terminated Investor Request
Axis Long Term Equity Fund - Regular Growth ( TS-GP ) 10/07/2019 31/12/2099 Monthly 2000.00 SIP Terminated Investor Request
Axis Long
Axis Regular Growth(
Term Equity Fund - RegularTS-GP)
Growth( TS-GP) ISIN : INF846K01131 NAV as on 07 Jan 2022 (`) 76.3075
Transaction Type Date NAV Stamp Duty STT Amount in Price in Units Balance
(`) (`) (`) Units
Opening Balance 12/03/2021 1,270.945
Gross Systematic Investment-NSE 13/04/2021 2,000.00
Stamp Duty 0.10
Net Systematic Investment-NSE (23/Perpetual)(NAV 13/04/2021 60.0532 1,999.90 60.0532 33.302 1,304.247
Dt.13/04/2021)
Existing Folio with SIP

Stamp Duty 0.10
Dt.11/05/2021)

Stamp Duty 0.10
Page 1 OF 3
Folio NO. : 91048437853
Name : P N PREETHI Statement Date : 09 Jan 2022
Axis Long
Axis Regular Growth(
Term Equity Fund - RegularTS-GP)
Growth( TS-GP) ISIN : INF846K01131 NAV as on 07 Jan 2022 (`) 76.3075
Transaction Type Date NAV Stamp Duty STT Amount in Price in Units Balance
(`) (`) (`) Units
Dt.11/06/2021)

Stamp Duty 0.10
Dt.13/07/2021)

Stamp Duty 0.10
Dt.11/08/2021)

Stamp Duty 0.10
Dt.13/09/2021)

Stamp Duty 0.10
Dt.12/10/2021)

Stamp Duty 0.10
Dt.11/11/2021)
Investment Cost ( `) : 75,000.00 Market Value( `) : 114,754.50

Locked Units : 1266.572 Lien Units : 0.000 Free Units : 237.271
Intermediary/RIA/PMRN : SIP FUND PRIVATE LIMITED / NA EUIN No. : E187371
EXIT LOAD ##
Axis Long Term Equity Fund - Regular Growth( TS-GP)
Entry Load - NIL, Exit Load - NIL. Investment in Axis Long Term Equity Fund is eligible for availing tax benefit under section 80C of Income Tax ACT 1961 read with circular no. - 9/2005 dated 30 Nov`05 issued by
Ministry Of Finance, subject to the limitsconditions specified under section 80C.
Investment will be locked-in for 3 years from the date of allotment. Units cannot be redeemed during this period.
Page 2 OF 3
Account Statement
Current Financial Year (2021-2022)
Page 1 of 3
First Holder Second Holder Third Holder

PAN No. XXXXX2025G
Off : N.A
PAN Validity Yes
Res : N.A
Mobile : +918867071065
KYC Status Verified
*G$2518222$ACT$090122* Mode Of Holding Single

Tax Status Resident Individual
P N Preethi
Sowparnika Apartment S1 Nominee P R NATARAJA
2Nd Floor Basapura Road Naer Grand
Super Market Electronics City CAN
Bangalore - 560100 FATCA Available
Karnataka - India
Additional KYC Available
UBO Not applicable

Email : preethipachipulusu09@gmail.com
Folio Number:- 2518222/82 Statement Date : 09-Jan-2022
Account Summary
Scheme Mode Last Nav Date NAV Unit Balance Cost Value(INR) Current Value(INR)
IDFC Tax Advantage

(ELSS) Fund-Growth- Lump sum 07/01/2022 99.52 203.674 11,000.00 20,269.64
(Regular Plan)
IDFC Tax Advantage
(ELSS) Fund-Growth- Systematic Transactions 07/01/2022 99.52 779.253 46,500.00 77,551.26
(Regular Plan)
Total:- 57,500.00 97,820.90
IDFC Tax Advantage (ELSS) Fund-Growth-(Regular Plan) SCHEME CODE:- 223
ISIN NO: INF194K01292 NAV as on 07/01/2022 : 99.52
Amount in Price in INR Number of Units

Date Transaction Type Balance Units
INR
Opening Balance as on 13/04/2021 845.919
SIP Purchase U/s 80C of IT Act,1961-NSE -

13/04/2021 1,499.93 75.05 19.986 865.905
Physical - EUIN - E187371

11/05/2021 1,499.93 79.51 18.865 884.770

11/06/2021 1,499.93 85.68 17.506 902.276

13/07/2021 1,499.93 87.35 17.171 919.447
MFONLINE-09/01/2022

11/08/2021 1,499.93 88.39 16.969 936.416

13/09/2021 1,499.93 92.51 16.214 952.630

12/10/2021 1,499.93 98.48 15.231 967.861

11/11/2021 1,499.93 99.56 15.066 982.927
....continued on next page

(01-APR-2021 to 09-JAN-2022)
Folio Number : 5007841 / 31 Statement Date : 09-Jan-2022 Page 1 of 3
Mode Of Holding : Single
P N Preethi Tax Status : Individual
2nd Unit Holder : None
Sowparnika Apartment S1 3rd Unit Holder : None
2Nd Floor Basapura Road Naer Grand Nominee 1 / Percentage : XXXXXXXXRAJA - 100%
Super Market Electronics City
Nominee 2 / Percentage : Alert: Please Nominate
Bangalore - 560100
Karnataka , India Nominee 3 / Percentage : Alert: Please Nominate
Guardian Name :
Phone :(O): Please Provide (R) : Please Provide (M) : +918867071065 Statement Preference : By Email
Email : XXXXXXXXXXXXXXXXsu09@gmail.com
CAN : <Please Provide>
1st Holder 2nd Holder 3rd Holder KYC Status : Verified
FATCA Registered Holder PAN PAN Verified KYC Status
1st Unit Holder XXXXXX025G Yes KYC Registered
UBO Not applicable
2nd Unit Holder
3rd Unit Holder
Guardian
EISC-CAMSWEB-15.10.3-090122121114(I)-A15701--10020
NAV as on 07/01/2022 : INR 83.466

L&T Tax Advantage Fund - Growth - INF677K01064
Date Particulars Amount NAV Price Units Unit Balance
(INR) (INR) (INR)
Opening Balance 861.805
13/04/2021 Systematic Purchase-NSE - 1,499.93 67.070 67.070 22.364 884.169
Gross Amount: Rs.1500/-; Stamp Duty charges Levied 0.07
... continued on next page
Your nearest Investor Service Centre is at CAMS, Rajabahdur Compd, Gr Flr Opp Allah. Bk, Behind ICICI Bk 30, M S Marg, Fort Mumbai-400023 Maharashtra Toll Free:1800 2000 400 /1800 4190 200
Folio No. : 5007841 / 31 Folio KYC Status : Verified PAN KYC Status
P N Preethi XXXXXX025G KYC Registered
Mode of Holding : Single Last transaction done through : ARN-102683 / SIP FUND PRIVATE LIMITED
CAN: <Please Provide> Sub Broker ARN : EUIN :
I/We would like to submit following transaction in the scheme :

Amount Rs. : Cheque/DD No.: Date :
Additional
A/c. type: Saving/Current/NRE/NRO
purchase
Bank Name : Branch :
Redemption Amount Rs. : or Units :
Amount Rs. : or Units :

Switch To Scheme : Plan : Option:
Sub. Option:
Signatures of
Account holder(s): 1. 2. 3.
Folio Number : 5007841 / 31 Statement Date : 09-Jan-2022 Page 2 of 3
First Holder : P N Preethi
NAV as on 07/01/2022 : INR 83.466

L&T Tax Advantage Fund - Growth - INF677K01064
Date Particulars Amount NAV Price Units Unit Balance
(INR) (INR) (INR)

12/10/2021 Systematic Purchase-NSE - 1,499.93 81.582 81.582 18.386 1,003.751
11/11/2021 Systematic Purchase-NSE - 1,499.93 81.210 81.210 18.470 1,022.221
Unit Balance : 1,022.221 Current Cost : INR 57,500.00 Current Value : INR 85,320.70
Bank Details : SB XXXXXXXXXX8634 / HDFC Bank Ltd / BANGALORE / BANGALORE Payout Mode : ELECTRONIC PAYMENT
IFSC Code : HDFC0003636 MICR Code : 000000000
Distributor : SIP FUND PRIVATE LIMITED; EUIN : E187371
Free Units Available For Redemption (with applicable exit load, if any) : 85.388 Units Under Lien : 0.000
An Open-ended Equity Linked Savings Scheme with a lock-in period of 3 years. Investments in this scheme qualify for deduction u/s 80C of the Income-tax Act, 1961 subject
to the terms and conditions specified therein and read with Section 80CCE of the Act. Current Entry Load - NIL; Exit Load - NIL(If redeemed on completion of 3 years from the
date of allotment). STT during the exit window (15-10-2012 to 15-11-2012) was paid by the AMC."Exit load is inclusive of GST@18% (wherever applicable)".
EISC-CAMSWEB-15.10.3-090122121114(I)-A15701--10020
... continued on next page
Your nearest Investor Service Centre is at CAMS, Rajabahdur Compd, Gr Flr Opp Allah. Bk, Behind ICICI Bk 30, M S Marg, Fort Mumbai-400023 Maharashtra Toll Free:1800 2000 400 /1800 4190 200
Folio No. : 5007841 / 31 Folio KYC Status : Verified PAN KYC Status
P N Preethi XXXXXX025G KYC Registered
Mode of Holding : Single Last transaction done through : ARN-102683 / SIP FUND PRIVATE LIMITED
CAN: <Please Provide> Sub Broker ARN : EUIN :
I/We would like to submit following transaction in the scheme :

Amount Rs. : Cheque/DD No.: Date :
Additional
A/c. type: Saving/Current/NRE/NRO
purchase
Bank Name : Branch :
Redemption Amount Rs. : or Units :
Amount Rs. : or Units :

Switch To Scheme : Plan : Option:
Sub. Option:
Signatures of
Account holder(s): 1. 2. 3.

I PSF 202122

Uploaded by

Document Information

Original Description:

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

I PSF 202122

Uploaded by

Copyright:

Available Formats

PGBRK IPSF|997|231325|00997000000000002313||W||

Signature of Employee *_________________________________

HRA Land Lord Details

Adobe Systems India Pvt. Limited

Signature of Employee * ____________________________

2. Leave Travel Concessions or Assistance Rs.0 Travel Receipts/Tickets

(i) Interest Payable/Paid to the Lender

Self Occupied Interest - Property 1 :

(A) Section 80C,80CCC and 80CCD

(a) Provident Fund : Rs.82320

(b) Mutual Funds : Rs.80000

(c) Life Insurance Premium (Jeevan Dhara, Jeevan : Rs.37878

(ii) Section 80CCC :

(iii) Section 80CCD

(Signature of the Employee)

RENT RECEIPT April 2021 Receipt No: 1

RENT RECEIPT May 2021 Receipt No: 2

Generated on ClearTax Date: Jun 01 2021

RENT RECEIPT June 2021 Receipt No: 3

RENT RECEIPT July 2021 Receipt No: 4

RENT RECEIPT August 2021 Receipt No: 5

RENT RECEIPT September 2021 Receipt No: 6

RENT RECEIPT October 2021 Receipt No: 7

RENT RECEIPT November 2021 Receipt No: 8

RENT RECEIPT December 2021 Receipt No: 9

RENT RECEIPT February 2022 Receipt No: 10

Generated on ClearTax Date: Jan 09 2022

Premium Paid Details

Tax Benefit Details

37878.00 0.00 0.00

Folio Number : 1038152529 Statement Date: 09-Jan-2022

1st Holder BAZPP2025G OK Ok

2nd Holder N/A N/A N/A

3rd Holder N/A N/A N/A

Guardian N/A N/A N/A

Scheme Unit Balance NAV as on NAV Current Value Cost of Dividend

Total: 230,960.66 180,000.00 0.00

Opening Balance 4,477.419

13/04/2021 Purchase-SIP-NSE - 4,999.75 37.81 37.81 132.234 4,609.653

Live Systematic Registration as on 09-Jan-2022 SIP/STP/SWP

P N PREETHI First Holder Second Holder Third Holder Guardian/POA

Intermediary/RIA/PMRN Code ARN-102683 / NA Account Type Savings

SIP Registration Summary

SIP Termination/Cancellation Summary

Gross Systematic Investment-NSE 11/05/2021 2,000.00

Gross Systematic Investment-NSE 11/06/2021 2,000.00

Gross Systematic Investment-NSE 13/07/2021 2,000.00

Gross Systematic Investment-NSE 11/08/2021 2,000.00

Gross Systematic Investment-NSE 13/09/2021 2,000.00

Gross Systematic Investment-NSE 12/10/2021 2,000.00

Gross Systematic Investment-NSE 11/11/2021 2,000.00

Investment Cost ( `) : 75,000.00 Market Value( `) : 114,754.50

First Holder Second Holder Third Holder

*G$2518222$ACT$090122* Mode Of Holding Single

UBO Not applicable

Folio Number:- 2518222/82 Statement Date : 09-Jan-2022

IDFC Tax Advantage

Total:- 57,500.00 97,820.90

IDFC Tax Advantage (ELSS) Fund-Growth-(Regular Plan) SCHEME CODE:- 223

ISIN NO: INF194K01292 NAV as on 07/01/2022 : 99.52

Amount in Price in INR Number of Units

Opening Balance as on 13/04/2021 845.919

G$2518222$ACT$090122 Mode Of Holding Single