Statement to be submitted by persons for determination of Income Tax to be deducted from Salary upto 31st March 2015 FINANCIAL YEAR :- 2014-2015 ASSESSMENT YEAR :- 2015-2016 FULL NAME (START WITH FIRST NAME) :- MAHENDRA PRAKASHCHAND RAKHECHA FATHERS FULL NAME :- PRAKASHCHAND ZUMBARLAL RAKHECHA COMPLETE RESIDENTIAL ADDRESS :- MARWADI LANE, SHIRPUR TAL- SHIRPUR DIST - DHULE PIN NO. :- 425405 BIRTH DATE :- 12/08/1980 PAN.NO. :- DESIGNATION :- APPOINTMENT DATE :- BANK NAME FULL ( NATIONALIZE ) :- BANK OF MAHARASHTRA SHIRPUR BANK A/C.NO. ( FULL ) :- IFSC CODE :- MAHB0000349 MICR CODE :- 000014000 MOBILE NO :- 9881262378 Email ID :- [email protected] SR.NO. PARTICULARS AMOUNT RS. 1 GROSS SALARY 2 H.R.A. 20,982.00 3 VEHICLE ALLOWANCE 13,200.00 4 PROFESSIONAL TAX 5 SAVING A/C INTEREST ( ALL A/C) 6 HOUSE LOAN INTEREST 7 L.I.C.PENSION PLAN 8 534,921.00 2,500.00 - 80G DONATION RECEIPT - NO.OF RECEIPTS & INSTITUTION NAME 9 SUNAMI FUND / C.M. / P.M./ FUND 10 HANDICAPPED EXPENTURE INVESTMENTS 1 L.I.C. FROM SALARY 2 L.I.C. 3 P.F. 4 P.P.F. 5 CHILDREN'S TUTION FEES 6 HOUSE LOAN PRINCIPAL REPAY 7 TAX SAVING FD ( 5 YEARS & ABOVE ) 8 80 D ( MEDICAL INSURANCE ) 9 80 E ( EDUCATION LOAN INTEREST ) 10 EARLIER YEAR N.S.C. DETAILS 11 (DATE OF N.S.C. & AMOUNT ) 12 HOUSE RENT 9,360.00 13 14 I certify that the information is Correct & True as per my knowledge. Also I hav, attached all the proofs of above Investment. TDS DEDUCTED AS ON :DATE :- SIGNATURE OF THE ASSESSEE
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