Employee Investment Declaration Form For the Financial Year 2022-2023 (AY2023-24) (April 2022 to March 2023)

Employee SLN ID *
BNG 6903
Employee Name * Chethan Narasannavar

PAN No (Attach Photocopy)* BMYPN1102K

Date of Birth* 25th December 1995

Date of Joining* 15th April 2021
Gender * Male

House Rent Address* Plot no.14 17th cross Gokul nagar mutaga belgaum Karnataka 591124

From Date To Date City Metro Yes/No PAN of Landlord Rent Paid per month

4/1/2022 3/31/2023 Belagavi No 8,000

Section B - Chapter VI A - Deductions from Total Income AMOUNT

Medical Insurance Premium (U/s 80D) - Individual, Spouse & Children (Max Limit INR 30,000 p.a)
Medical Insurance Premium (U/s 80D) - Parents not being Senior Citizens (Max Limit INR 30,000 p.a)
Medical Insurance Premium (U/s 80D) - Parents being Senior Citizens (Max Limit INR 50,000 p.a)
Interest on Educational Loan (U/s 80E)
Permanent Physical Disability (80U) < 80%
Permanent Physical Disability Severe Disability (80U) > 80%
Rajeev Gandhi Equity Savings Scheme (80CCG)
Interest on Deposit in Savings Account deduction upto Rs.10000 (80TTA)
National Pension Scheme(80CCD)
Total
Section C - Chapter VIA Sec 80C
a) Life Insurance Premium 50,000
b)
c)
d)
e)
f)
g)
h)
i)
Public Provident Fund (PPF)
National Savings Certificate (NSC)
Infrastructure Bonds
Children Education Tuition Fees
Mutual Funds / Equity Linked Saving Scheme (ELSS) 100,000
Sukanya Samriddhi Scheme
ULIP
5 Year Time Deposit in Post Office
Housing Loan - Principal Amount- Rs. Interest- Rs.
Fixed Deposit Scheme (Block Period of 5 yrs)
NSC Interest (Will be considered as Other Income)
Total (Maximum Limit INR 150,000) 150,000
Section E - Previous Employment - Refer Annexure 2a and 2b attached to the document
Income after Section 10 exemption (Joined after 01/04/2022)
Previous Employment_Provident Fund (PF)
Previous Employment_Professional Tax (PT)
Previous Employment_Tax deducted at source (TDS)
(Please attach Form 16 OR Income Tax Computation Sheet from Previous Employer for FY 2022-
23 along with 12B)Total

Declaration:
I hereby declare that the information given above is correct and true in all respects and I intend to make the investments declared above
I also undertake to indemnify the company for any loss/liability that may arise in the event of the above information being incorrect /
declared investments not made

Date: 16-Mar-22
Place: Belagavi
karnataka Chethan Narasannavar
Signature of the employee
Important Information:
For Individuals the Tax Rates as below for the FY 2020-21

Income Rs. Rate of Income Tax

Upto Rs. 2,50,000 NIL

Rs. 2,50,001 to Rs. 5,00,000 5% of Income above Rs. 2,50,000
Rs. 5,00,001 to Rs. 10,00,000 Rs. 12,500 + 20 % of Income Above Rs. 5,00,000
Rs. 10,00,001 and above Rs. 112,500 + 30 % of Income Above Rs. 10,00,000

Note:
1.Education Cess @4% as applicable
2.Tax Rebate of Rs.12,500 for total annual income up to Rs. 5lakh (As per Section 87A)

NOTE:
1.Rent Receipt
2.PAN of the Owner with address is mandatory in case the rent exceeds Rs.8,300/-Per Month
3.Copy of Rental agreent is mandatory if rent payable is more than Rs.8,300/-Per Month

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