Tax Computed in Accordance with

Table "A"
[Item 7 of Annexure I of Form No. 10 E]
Salary received in arrears Toatl income (as increased by salary
Tax on total Tax on total Difference in tax
Total income of or advance relating to received in arrears or advance) of
income [as income[as per [Amount under column
Previous the relevant relevant prevous year as the relevant previous year mentioned per column column (4)] (6) minus amount under
year previous year mentioned Column (1) in column 1 [Add column (2) and
(2)] Column (5)]
(3)]
(Rs) (Rs) (Rs) (Rs) (Rs) (Rs)
(1) (2) (3) (4) (5) (6) (7)
2005-06 98360 8948 107308 0 746 746
2006-07 84310 50498 134808 0 3551 3551
2007-08 107380 51056 158436 0 5859 5859
2008-09 202930 -31647 171283 5452 2193 -3259
Total 492980 78855 571835 5452 12349 6897
 FORM NO. 10E
[SEE RULE 21 AA]
Form for furnishing particulars of income under section 192 (2A) for the year ending 31st
March'2010 for claiming relief under section 89 (1) by a Government servant or an employee in a
Company, CO-operative Society, Local Authority, University, Institution, Association or Body.

1 Name and address of the Employee

2 Permanent Account Number

3 Resindential Address

Particulars of income referred to in rule 21 A of the Income-tax rules, 1962, during the previous year
relevant to assessment year 2010-2011
1 (a) Salary received in arrears or in
advance in accordance with the provisions 78847
of sub-rule (2) of rule 21 A
(b) Payment in the nature of Gratuity in
respcet of Past services, extbeding over a
period of not less than 5 years in -
accordance with the provisions of sub-rule
(3) of rule 21 A

(c ) Payment in the nature of

compemsation from the employer of
former employer at or in accordance with
terminatioin of employment after
continous service of not less than 3 years -
or where the unexpired portion of term of
empolyment is also not less than 3 years in
accordance with the provisions of sub-rule
(4) of rule 21 A

Detailed Particulars of payments referred

2 to above may be given in annexure I, II, -
IIA, III or IV as the case may be

Signature of the Employee

Verification
I do hereby declare that what is stated above is true to the best of my knowledge and belief.

Verified today, the 18th day of Nov'2009

Place
Date
Signature of the Employee
 Annexure-I
(See item-2 of Form No. 10E)
Arrears or Advanced Salary
Total income (excluding salary received in
1 313223
arrears or advance)
2 Salary received in arrears or advance 78847

Total income (as increased by salary

received in arrears or advance) of the
3 392070
relevant previous year mentioned in
column 1 [Add column (1) and (2)]

Tax on total income [as per item no 3]

4 9352
Tax on total income [as per item no 1]
5 1232

Tax on Salary received in arrears or

6 8120
advance (Difference of item-4 & Item-5)
Tax Computed in accordance with "Table"
7 "A" (brought from Column-7 of Table 6897
"A")
Relief under Sectuion 89 (1) [indicate the
8 difference between the amounts 1223
mentioned against item-6 & 7
 5th CPC Pay Structure 06th CPC Pay Structure
Month Arr Gross PF
B Pay DP % DA DA B Pay GP DA
DA Pay subs
Jan-06 6025 3013 21% 1898 10936 753 11210 4200
Feb-06 6025 3013 21% 1898 10936 753 11210 4200
Sub total 05-06 12050 6026 3796 0 21872 1506 22420 8400
Mar-06 6025 3013 21% 1898 10936 753 11210 4200
Apr-06 6025 3013 24% 2169 813 12020 753 11210 4200
May-06 6200 3100 24% 2232 11532 775 11210 4200
Jun-06 6200 3100 24% 2232 11532 775 11210 4200
Jul-06 6200 3100 24% 2232 11532 775 11680 4200 318
Aug-06 6200 3100 24% 2232 11532 775 11680 4200 318
Sep-06 6200 3100 29% 2697 930 12927 775 11680 4200 318
Oct-06 6200 3100 29% 2697 11997 775 11680 4200 318
Nov-06 6200 3100 29% 2697 11997 775 11680 4200 318
Dec-06 6200 3100 29% 2697 11997 775 11680 4200 318
Jan-07 6200 3100 29% 2697 11997 775 11680 4200 953
Feb-07 6200 3100 29% 2697 11997 775 11680 4200 953
Sub total 06-07 74050 37026 29177 1743 141996 9256 138280 50400 3814
Mar-07 6200 3100 29% 2697 1674 13671 775 11680 4200 953
Apr-07 6200 3100 35% 3255 12555 775 11680 4200 953
May-07 6375 3188 35% 3348 12911 797 11680 4200 953
Jun-07 6375 3188 35% 3348 12911 797 11680 4200 953
Jul-07 6375 3188 35% 3348 12911 797 12160 4200 1472
Aug-07 6375 3188 35% 3348 12911 797 12160 4200 1472
Sep-07 6375 3188 41% 3920 1146 14629 797 12160 4200 1472
Oct-07 6375 3188 41% 3920 13483 797 12160 4200 1472
Nov-07 6375 3188 41% 3920 13483 797 12160 4200 1472
Dec-07 6375 3188 41% 3920 13483 797 12160 4200 1472
Jan-08 6375 3188 41% 3920 13483 797 12160 4200 1963
Feb-08 6375 3188 41% 3920 13483 797 12160 4200 1963
Sub total 07-08 76150 38080 42864 2820 159914 9520 144000 50400 16570
Mar-08 6375 3188 41% 3920 13483 797 12160 4200 1963
Apr-08 6375 3188 47% 4495 1719 15777 797 12160 4200 1963
May-08 6550 3275 47% 4618 14443 819 12160 4200 1963
Jun-08 6550 3275 47% 4618 14443 819 12160 4200 1963
Jul-08 6550 3275 47% 4618 14443 819 12650 4200 2696
Aug-08 6550 3275 47% 4617 14442 819 12650 4200 2696
Sub total 08-09 38950 19476 26886 1719 87031 4870 73940 25200 13244
G.Total 201200 100608 102723 6282 410813 25152 378640 134400 33628

Gross arr amt 135855 57000

40% Gross Arr paid Actaul arr to be paid
SRPF to be ded 17592 40% PF deducted 6969 Net PF to be deducted
Net arr amt 118263 40% net paid 50031 Net amount to be paid
06th CPC Pay Structure
PF
% DA Total
Subs
0% 15410 1284
0% 15410 1284
30820 2568 8948
0% 15410 1284
0% 15410 1284
0% 15410 1284
0% 15410 1284
2% 16198 1323
2% 16198 1323
2% 16198 1323
2% 16198 1323
2% 16198 1323
2% 16198 1323
6% 16833 1323
6% 16833 1323
192494 15720 50498
6% 16833 1323
6% 16833 1323
6% 16833 1323
6% 16833 1323
9% 17832 1363
9% 17832 1363
9% 17832 1363
9% 17832 1363
9% 17832 1363
9% 17832 1363
12% 18323 1363
12% 18323 1363
210970 16196 51056
12% 18323 1363
12% 18323 1363
12% 18323 1363
12% 18323 1363
16% 19546 1404
16% 19546 1404
112384 8260 25353 57000 -31647
546668 42744

aul arr to be paid 78855

PF to be deducted 10623
amount to be paid 68232
PF NO: CALCULATION OF INCOME TAX 09-10
Name Design : Stn. Patna
Sex M HRA B CCA B TAN No: PAN No:
Month Pay GP DA PP HRA CCA ARR Gross PF VPF GIS HBA TAX
Mar-09 12660 4200 3709 3372 0 2024 25965 1405 0 30 0 0
Apr-09 12660 4200 3709 3372 0 96 24037 1405 0 30 0 0
May-09 12660 4200 3709 3372 0 23941 1405 0 30 0 0
Jun-09 12660 4200 3709 3372 0 23941 1405 30 0 0
Jul-09 13170 4200 3821 3474 0 24665 1448 30 0 0
Aug-09 13170 4200 3821 3474 0 1818 26483 1448 30 0 0
Sep-09 13170 4200 4690 3474 0 78847 104381 12071 30 0 0
Oct-09 13160 4200 4687 3472 0 8630 34149 1447 30 0 0
Nov-09 13160 4200 4687 3472 0 25519 1447 10000 30 0 2000
Dec-09 13160 4200 4687 3472 0 25519 1447 30 0 2000
Jan-10 13160 4200 4687 3472 0 25519 1447 30 0 2000
Feb-10 13160 4200 4687 3472 0 25519 1447 30 0 0
TOTAL 155950 50400 50603 0 41270 0 91415 389638 27822 10000 360 0 6000

Income Tax Declaration for the Financial Year 2009-10

Deduction u/s 80C
PF 27822 Salary 389638
VPF 10000 Less Over Pay
GIS 360 Tution fee reimbursement 0
HBA 0 Leave Encasement 0
LIC 60250 Taxable amount of Transport allowance 2432
NSC 0 Gross Salary 392070
Tuition Fees 0 Add Perquisites in respect of Medical Expenses in 0
exess of Rs.15000/- in view of Section 17(2)(v)
PPF 0 Less U/s 10(13)A 41270
Bajaj Alianz Tax on Employment 0
Other Proposed 0 Total amount 350800
(i) Income from House Property 0
Total Saving 98432 (ii) Income from Other Sourcess 0
Qualifying Amount U/S 80C 98432 Total amount 350800
Medical Reimbursement 0 Restricted to a Maximum of Rs. 100000 u/s (80C) 98432
1. I do hereby declare that I am resding Total amount 252368
in my own/ a rented house. Int.of HBA 0
2. Home Address. MR relief fund 0
Chronic disease u/s (80DDB) 0
Medi Claim (Max.15000) u/s 80D 0
Monthly Rent Paid @ RS. : 5600 Chronic disease u/s (80DD) 0
Gross Income 252370
a. Actual Rent Allowance Recived : 41270 Less non taxable income 160000
b. Rent paid per annum 67200 Net Income 92370
Total Tax on Income 9237
c. 10% of Pay+DP+DA+GP : 25704 Relief under Sectuion 89 (1) 1223
d. Actual excess rent paid (c-b) : 41496 Balance Income Tax 8014
Education Cess 0.03 240
e. Less amount of a & d : 41270 Net tax payble Amount 8254
Tax Already Deducted at Source 6000
Net Tax reqd. to be paid 2254
 05-06 06-07 07-08 08-09 09-10
Without With Without With Without With Without With Without With
arrear Arrear arrear Arrear arrear Arrear arrear Arrear arrear Arrear
Gross Salary 145215 145215 166160 166160 184960 184960 302929 302929 313223 313223
Arrear 6 CPC 0 8948 0 50498 0 51056 0 -31647 0 78847
Less U/s 10(13)A 10130 10130 16662 16662 17130 17130 0 0 41270 41270
Tax on Employment 0 0 0 0 0 0 0 0 0 0
Total amount 135085 144033 149498 199996 167830 218886 302929 271282 271953 350800
Less Saving restricted to a
Maximum of Rs. 100000 u/s 36726 36726 65188 65188 60452 60452 100000 100000 100000 100000
(80C)
Total amount 98359 107307 84310 134808 107378 158434 202929 171282 171953 250800
Int.of HBA 0 0 0 0 0 0 0 0 0
MR relief fund 0 0 0 0 0 0 0 0 0 0
Chronic disease u/s (80DDB) 0 0 0 0 0 0 0 0 0 0
Medi Claim (Max.15000) u/s
0 0 0 0 0 0 0 0 0 0
80D
Chronic disease u/s (80DD) 0 0 0 0 0 0 0 0 0 0
Gross Income 98360 107310 84310 134810 107380 158440 202930 171290 171960 250800
Less non taxable income 100000 100000 100000 100000 110000 110000 150000 150000 160000 160000
Net Income 0 7310 0 34810 0 48440 52930 21290 11960 90800
Total Tax on Income 0 731 0 3481 0 5688 5293 2129 1196 9080

@2% for the year

Education
05-06 & 06-07 and 0 15 0 70 0 171 159 64 36 272
Cess
thareafter @ 3%

Net tax payble Amount 0 746 0 3551 0 5859 5452 2193 1232 9352

Tax Already Deducted at Source 0 0 0 0 0 0 0 0 0 0

Net Tax reqd. to pay 0 746 0 3551 0 5859 5452 2193 1232 9352

Difference between Tax

on income with arrear & 746 3551 5859 -3259 8120
Without arrear