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Income Tax Financial Year 2015-16

Income Tax Assessment Year 2016-17

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Anex-1 Anex-1 Back


(A4) Form-16 (A4)
(A4)

Data Sheet

Anex-1 Anex-1 Back Form-16


(Legal) (Legal) (Legal)
e Only

ow

Form-16 (Back)
6 (A4) Form-10-I
(A4)

Rent Receipt

-16 Form-16 (Back) Form-10-lA


gal) (Legal)
Select for PAY BILL Salary
INCOME TAX 2015-16 Old PRC Month Upto Select

Employee Sri. K S S PRASAD OLD PAY as on January-2015


27000 Increment in OLD PRC Select
Only
Designation SGT Increment Month Select D.A Upto
School/OfficeName M P P S, GANESH PURAM Promotion Increment Select Upto Select
Working Place DUGGIRALA Select
AAS Increment (6,12,18 Years) Upto Select
Mandal DUGGIRALA Half Pay Leave (No of days)
Select Select
District GUNTUR Surrender leave Select
PAN No. P.Pay + F.P.Pay Basic Pays
Emp Tr.ID No T.S Incriment 27000 Jan-2015
Pensionable / C.P.S Pensionable House Rent Allowence 12 27000 Feb-2015
If HRA Change Select 27000 Mar-2015
Vacation / NonVacation
Vacation Post G.P.F/Z.P.P.F Monthly No:- 56870 Apr-2015
Rented / Own HouseRented House If GPF Change 56870 May-2015
C.C.Allowence Select A.P.G.L.I.Monthly No:- 56870 Jun-2015
S.C.Allowence Select If APGLI Change 56870 Jul-2015
P.H.C. Allowence Select Group Insurance sche 56870 Aug-2015
Additional HRA Select If G.I.S Change 56870 Sep-2015
Reader Allowence Select LIC Salary Paid monthl 56870 Oct-2015
Child Fee Concessio Select If LIC Change 56870 Nov-2015
DDO Name Sri. E.W.F & S.W.F 20 50 56870 Dec-2015
Designation Select State Andhra Pradesh 56870 Jan-2016
School/OfficeName Health Insurance 56870 Feb-2016
Working Place H.M. & Other Allowences
D.D.O. TAN Income from Other Sou
D.D.O. PAN Income from Capital Ga

For Your Salary


Monthly Rent Paid by 12,600 Tax on Income Rs.73993/- details Click Down

Without Undertaking YOUR ONLINE SALARY

ADVANCE TAX Amount SAVINGS Amount


Deduct OR Raise
Mar-15 Salary Paid in Apr-15 Tuition Fee for Children Minus 10% Salary
Monthly House Rent
Apr-15 Salary
in 100 Multiple Paid in May-15 Principle Amount of Home Loan installments Rs 78267/-
May-15 Salary Paid in Jun-15 LIC Policies premium - Yearly
Jun-15 Salary Paid in Jul-15 Sukanya Samruddhi Yojana
Jul-15 Salary Paid in Aug-15 Infrastructure Bonds
Aug-15 Salary Paid in Sep-15 Any Other enter here Total Savings
Sep-15 Salary Paid in Oct-15 DEDUCTIONS Amount Rs.150000./-
Oct-15 Salary Paid in Nov-15 Interest of Educational Loan
Nov-15 Salary Paid in Dec-15 Medical treatment of dependent (above 80% disablity)
Dec-15 Salary Paid in Jan-16 Interest of Housing Loan
Jan-16 Salary Paid in Feb-16 Any Other enter here Total Deductions
Income or Loss from House Property
Feb-16 Salary Paid in Mar-16 NO 70
U/s 24
Total Advance Tax Amount 0 YES SELECT for loss / Income from House Property

Annual Rent Received from House Property


Enter Your
Enter Muncipal Tax Paid on House Property Housing Loan
As Rebate (30% of Income as Maintenance) Get Interest in
Interest Paid on (Housing Loan) House Property DEDUCTIONS
Income from House Property Under Section 24

Interest on Housing Loans Section Income from House property: (Model Calculation)
###1. Rent received Rs.10,000 pm x 12months= Rs.1,20,000
For self occupied properties, interest paid on a ###2. Less Municipal Tax paid = Rs. 20,000
housing loan up to Rs 200,000 per year is exempt
3. Balance amount (Rs.1,20,000-Rs.20,000) Rs.1,00,000
from tax. This deduction is in addition to the
deductions under sections 80C, 80CCF and 80D. 4. Less:30% deduction U/s 24 for repairs on bal Rs.1 lakh= Rs.30,000
However, this is only applicable for a residence (This deduction is allowed even if you do not spend the amount for
constructed within three financial years after the loan repairs)
is taken and also the loan if taken after April 1, 1999. 5. Balance after 30% deduction = 1,00,000-30,000=70,000
6. Less interest paid on Housing loan-----------Rs. 1,60,000
7. Balance Amt.= 70,000-160000=Rs. -90,000 (loss from house property). But the
If the house is not occupied due to employment, the interest on housing loan is allowed Max. Rs.1,50,000 only. So the loss from house
house will be considered self occupied. property will become Rs.80,000 insted of Rs.90,000. This loss Rs.80,000 can be
adjusted in other income say salary or business.
Supposing if your salary income is Rs.3,00,000 per year.
For let out properties, the entire interest paid is After this house loss your net taxable income will be *Rs.2,20,000.
deductible under section 24 of the Income Tax act.
However, the rent is to be shown as income from Further the principal paid to the bank through EMI, Say Rs.1,20,000. This principal
such properties. 30% of rent received and municipal amount paid will be treated as deduction u/s 80C. 80C deduction Max. allowed is
taxes paid are available for deduction of tax. restricted to **Rs.1,00,000 (along with other investments link LIC,PPF & NSC ect.). This
deduction of Rs.1,00,000 can be claimed by you on your total income.

The above said net taxable income *Rs.2,20,000 will be reduced by the above said 80c
deductioin **Rs.1,00,000. After adjusting the income with 80C deduction, balance
taxable is Rs.1,20,000 only.
Self Occupied Property
A self Occupied property is one which is used by the person for his own residential purpose.If a person has occupied more
than one property for his residential purpose then only one house is treated as self occupied and others are treated as
"Deemed to be let out".If a person uses his property for carrying on the business and profession then income from such
property is not chargeable to tax under House Property
How to determine annual value of self-occupied property?
In case of one self-occupied house property which has not been actually let out at any time, the annual value is taken as
nil. If, one is having more than one house property using all of them for self-occupation, he is entitled to exercise an
option in terms of which, the value of one house property as specified by him will be taken at nil. The annual value of the
other self occupied house properties will be determined on notional basis as if these had been let out.
Annual Value of one house away from work place
A person may own a house property, say in Bangalore, which he normally uses for his residence. He is transferred to
Chennai where he does not own any house property and stays in a rental accommodation. In such case, the house
property income therefore would normally have been chargeable although he derives no benefit from the property. To
save the taxpayer from hardship in such situations, it has been specifically provided that the annual value of such a
property would be taken to be nil subject to the following conditions:
The assessee must be owner of only one house property.
He is not able to occupy the house property because of his employment, business etc. being away from place where the
property is situated.
The property should not have been actually let.
He has to reside at the place of employment in a building not belonging to him.
He does not derive any other benefit from the property not occupied.

How to Compute Income from House Property? Let-Out (Rented) and Self-Occupied

Any Income from house property should be a part of your total income from other various sources such as salary, capital
gains, business/profession and other income like winning from lottery, horse race etc. Mostly such Income from house
property are in the form of rental income, even some time these incomes can be negative; for example, you have taken a
home loan and you are paying the interest on the outstanding loan principal amount. If the house property is self occupied
where obviously no rental income can be generated then these interests paid will be treated as loss (negative income)
from house property. And the best part is you can claim such losses to reduce your net tax liability, but upto certain limit.
0

Employee who is d
Please Reduce bel
(42267)

Employee who is d
Your drawing HRA

Your drawing HRA=

#REF!
Now Your drawing
It is correct Rent,
Now Your drawing

Though Your
Though Your receiv
Though Your receiv

You will Exempt Rs


#REF!

#REF!
Salary means =PAY+DA Cash

If you omit DA in HRA Exemption Calculation 0


Please Select Select 0 12
Select

D.A Change here


Jul/2014 8.908
Jan/2015 12.052
Jul/2015 8.908
1 CCA Allowences

CCA Change here


From To Hyderabad Vizag, Other
Vijayawada Municipalities

Below 16400 200 120 100


16401 28940 300 160 120
28941 37100 350 220 130
Above 37101 525 350 140

SCA Allowences

SCA Change here


From To Mandals Non Mandals Hill Area

Below 20050 325 400 475


20051 26600 400 475 550
26601 34210 475 575 625
34211 41380 575 625 700
41381 55410 625 675 775
Above 55411 675 725 850

0
0
0
0
o is drawing HRA above Rs.36000/- Annually should submit Rent Recept
ce below Monthly Rent Paid by You (Upto this Message disappear)

o is drawing HRA upto Rs.3000/- (Annually Rs.36000/-)Per month will be exempted from production of Rent Recept
HRA is more than Rs.36000/-, So you reduce your Rent Paid monthly Upto Rs.5900/-

HRA= It is more than Rs.36000/- So reduce Rent, Otherwise You should submit Rent Receipt
wing HRA below Rs.36000/------OK
ent, You need not Change Rent
wing HRA below Rs.36000/------OK

78,304 Claimed HRA= , 78,267 It is below 36000, So You need not submit Rent Receipt
received HRA=78304, Claimed HRA=78267, It is below 36000, So You need not submit Rent Receipt
received HRA=78304, Claimed HRA=78267, It is below 36000, So You need not submit Rent Receipt

mpt Rs.78267 Only,


It is below 36000, So you need not submit Rent Receipt for Your Monthly Rent=12600
Employee who is drawing HRA upto Rs.3000/- (Annually Rs.36000/-)Per month will be exempted from
production of Rent Recept

#REF!
Select
Please Reduce below Monthly Rent Paid by You (Upto this
Message disappear)
Select

Tax on Income Rs.73993/-


Nov-15

78,304 Drawing HRA Yearly

78,267 Minus 10% Salary


78,267
Rs
ANNEXURE - 1 (Financial Year 2015-16)
Statement showing Month wise Income of Sri. K S S PRASAD, SGT, M P P S, GANESH PURAM, DUGGIRALA, DUGGIRALA(M), GUNTUR(Dt)

PP+SP+ Allowe Gross GPF/ Salary SWF


Month Basic pay TS Inc D.A HRA I.R AHRA PHA CCA RA nce Total ZPPF APGLI G.I.S. P.Tax LIC
H.I
Advtax EWF
Savings Particulars if any

Mar-2015 27000 21032 3240 7290 58562 200 20


Apr-2015 56870 5066 6824 68760 200
May-2015 56870 5066 6824 68760 200
Jun-2015 56870 5066 6824 68760 200
Jul-2015 56870 5066 6824 68760 200
Aug-2015 56870 5066 6824 68760 200
Sep-2015 56870 5066 6824 68760 200
Oct-2015 56870 5066 6824 68760 200
Nov-2015 56870 5066 6824 68760 200
Dec-2015 56870 5066 6824 68760 200 50
Jan-2016 56870 5066 6824 68760 200
Feb-2016 56870 5066 6824 68760 200
DA Arrear
PRC ARREARS
Promotion Arrear

AAS Incre.Arrear

Notion Inc Arrear


Surrender Leave
Child Fee Concession
StepUp Arrears
Preponement Arrear

Grand Totals ### 76758 ### 7290 ### ### 70


0 0 ### 0

Signature of the Drawing Officer Signature of the Employee

For latest Income Tax Programme download here www.gunturbadi.com K S S PRASAD DUGGIRALA (GP)

It may change
Financial year ANNEXURE - II Assessment year
2015-2016 INCOME TAX CALCULATION 2016-2017
Name Sri. K S S PRASAD Office M P P S, GANESH PURAM, DUGGIRALA
Designation SGT Address DUGGIRALA(M) , GUNTUR
Residence Rented House Pan No Emp.Tre ID
1 Gross Salary 814,922
2 H.R.A. Exemption as per eligibility U/s. 10(13-A)
a) Actual HRA received 78,304
b) Rent paid by you minus 10% of your Salary (Rent @ 12600 /-) 78,267
c) 40% of Salary (Salary means Basic Pay+D.A) 291,731 78,267
3 Total Salary (1-2) 736,655
4 Deductions from Salary Income
a) Exemption from Conveyance Allowance U/s. 10(14) (i)
b) Profession Tax U/s 16 (3) B 2,400 2,400
5 Income From Salary (3- 734,255
6 Income From other sourc -
7 Income From Capital Gai -
8 Income from House Prop 0
9 Gross Total Income (5 734,255
10 Deductions
a) E.W.F & S.W.F & CMRF 70
b) Interest of Educational Loan -
c) Medical treatment of dependent -
d) Interest of Housing Loan -
e) Any Other enter here AND Health Insurence -
TOTAL----------- 70 70
11 Gross Total Income (9-10) 734,185
12 Savings U/s 80C (Limited to 1.50,000)
a) GPF/ZPPF
b) APGLI
c) GIS
d) Tuition Fee for Children -
e) Principle Amount of Home Loan installments -
f) LIC Policies premium - Yearly -
g) Sukanya Samruddhi Yojana -
h) Any Other enter here -
Total Savings - -
a) Infrastructure Bonds - -
b) Additional benefit under NPS U/s 80CCD(1B)
13 Net Taxable Income (11-12) (Rounded nearest 10 rupees) 734,190
14 Tax on Income
a) Up to Rs. 2,50,000 Nil
b) Rs.2,50,001 To 5,00,000. (250000 @ 10%) 25000
c) Rs.5,00,001 To 10,00,000. (234190 @ 20%) 46838
d) above Rs.10,00,001.
Tax on Income 71838
15 Tax Rebate U/s 87A (Rs.2000/-Rebate Upto Rs.5,00,000/- Taxble Income) 0
16 Education Cess @ 2% 1437
17 Secondary & Higher Education Cess @ 1% 718
18 Total Tax Payable (14+16+17-15) 73993
19 Details of Adv.Tax Deductions Adv. Tax Deductions
a) Upto Nov-2015 Rs 0
b) Dec-2015 Rs 0
c) Jan-2016 Rs 0
d) Feb-2016 Rs 0 TAX TO BE PAID NOW 73,993

For Und
Select
DATA PA
Signature of the Drawing Officer Signature of the Employee

For latest Income Tax Programme download here www.gunturbadi.com

.
It may change
FORM No. 16 ( Vide rule 31(1)(a) of Income Tax Rules, 1962 )
Certificate under section 203 of the Income-tax Act, 1961
for Tax deducted at source from income chargeable under the head "salaries"
NAME AND ADDRESS OF THE EMPLOYER NAME AND DESIGNATION OF THE EMPLOYEE
Sri. Sri. K S S PRASAD
- SGT
, M P P S, GANESH PURAM, DUGGIRALA
DUGGIRALA, GUNTUR

PAN No. of Deductor TAN No. of Deductor PAN OF Employee Emp. Treasusy Id

Acknowledgement Nos.of allquarterly statements of TDS under sub-section 200 as provided by TIN facilitation center or NSDL web-site
Acknowledgeme Amoun
Quarter Period Assessment
nt No t
Quarter - 1 - From To Year
Quarter - 2 -
Quarter - 3 - Mar/2015 Feb/2016 2016-2017
Quarter - 4 -
DETAILS OF SALARY PAID AND ANY OTHER INCOME AND TAX DEDUCTED
1 Gross Salary 814,922
a) Salary as per provisions cotained in section 17 (1) -
b) Value of percuisites under section 17(2) -
(As Per Form No. 12BA, Wherever applicable)
c) Profits in lieu of salary under section 17(3) -
(as per Form No. 12BA, Wherver applicable)
d) Total 814,922 814,922
2 Less: Allowance to the extent exempted U/s 10
a) House Rent Allowence 78,267
b) Other Allowance 78,267
3 Balance (1-2) 736,655
4 Deductions
a) Entertainment Allowence -
b) Tax on Employment 2,400
5 Aggreate of 4 (a)&(b) 2,400
6 INCOME UNDER THE HEAD SALARIES (3-5) 734,255
7 Any other income reported by the empl -
Income of Capital Gains -
Income from House Property 0
8 Gross Total Income (6+7) 734,255
9 Deductions Under Chapter VI-A
A) UnderSections 80C,80CCC,80CCD,80CCF Gross Amount Qualify Amount
a) 80C GPF/ZPPF 150,000
b) 80C A.P.G.L.I - -
c) 80C G.I.S - -
d) 80CC Tuition Fee for Children - -
e) 80CC Principle Amount of Home Loan installments - -
f) 80CC LIC Policies premium - Yearly - -
g) 80CC Sukanya Samruddhi Yojana - -
h) Any Other enter here - -
### 0 150,000 -
Total Income Under 80C Section
a) 80CCF Infrastructure Bonds 0 0 0
b) Additional benefit under NPS U/s 80CCD(1B)
B) Other Sections Under Chapter VI A
a) 80G E.W.F & S.W.F & CMR 70 70
b) 80E Interest of Educational Loan - -
c) 80DD Medical treatment of dependent - -
d) 24B Interest of Housing Loan - -
e) 80d Any Other enter here AND Health Insurence - -
70 70 70
Aggregate of Deductible Amounts U/Chapter VIA (A+B)----------------------------- 70
Note: 1.aggregate amount deductible under section 80c shall not exceed one lakh rupees.
2.aggregate amount deductible under section 80C,80CCC,80CCD, shall not exceed one lakh rupees.
For latest Income Tax Programme download here www.gunturbadi.com K S S PRASAD DUGGIRALA (GP)
10 TOTAL INCOME (8-9) Rs 734,190
11 TAX ON TOTAL INCOME Rs. Rs -
12 Tax Rebate U/s 87A (Rs.2000/-Rebate Upto Rs.5,00,000/- Taxble Income) -
13 Education Cess @ 2% (On Tax at S.No.11 ) Rs 1,437
14 Secondary and Higher Education Cess @ 1% (On Tax at S.No.11 ) Rs 718
15 TAX PAYABLE (11+13+14-12) Rs 73,993
16 Less: Relief under section 89 (attach details) Rs -
17 TAX PAYABLE (15-16) Rs 73,993
18 (a) Tax deducted at source U/s 192(1) Rs -
(b)Tax paid by the employer on behalf of the employee U/s 192 (1A) on perquisited U/s 17 (2) Rs -
19 TAX PAYABLE Rs 73,993

DETAILS OF TAX DEDUCTED AND DEPOSITED INTO CENTRAL GOVERNMENT ACCOUNT


(The employer is to provide tranction - wise details of tax deducted and deposited)

Sl. TDS Surcharge Education Total Tax Cheque/DD BSR Code Date on Transfer
No. Rs. Rs. Cess Deposited No. (if any) of Bank Which Tax vocher/chalana
Rs. Rs. Branch DepositedIdentification No
1
2
3
4
5
6
7
8
9
10
11
12

I working in
the capacity of - do hereby certify that the sum of Rs 73993/-
Rupees in words.. Seventy three Thousand Nine Hundred and Ninety three rupees Only

has been deducted at source and paid to the credit of the central Government. I further certify that
the Informtion given above is true, complete and correct based on the books of account, documents and
other available records.

Sign--

Place: - Signature of the person responsible for deduction of tax


Date: 17-Apr-2017 Full Name-- -
Designation- , ,

You may
Delate / Change
this Date
You may
Delate / Change
this Date

For latest Income Tax Click here www.gunturbadi.com


ANNEXURE - 1 (Financial Year 2015-16)
Statement showing Month wise Income of Sri. K S S PRASAD, SGT, M P P S, GANESH PURAM, DUGGIRALA, DUGGIRALA(M), GUNTUR(Dt)
PP,SP,T Allowe Gross GPF/ Salary SWF Deductio Net
Month Basic Pay S.Inc D.A HRA IR AHRA PHA CCA RA nce Total ZPPF APGLI G.I.S. P.Tax LIC
H.I
Advtax EWF ns Amount
Savings Particulars if any

Mar-2015 27,000 21,032 3,240 7,290 58,562 200 20 220 58,342


Apr-2015 56,870 5,066 6,824 68,760 200 200 68,560
May-2015 56,870 5,066 6,824 68,760 200 200 68,560
Jun-2015 56,870 5,066 6,824 68,760 200 200 68,560
Jul-2015 56,870 5,066 6,824 68,760 200 200 68,560
Aug-2015 56,870 5,066 6,824 68,760 200 200 68,560
Sep-2015 56,870 5,066 6,824 68,760 200 200 68,560
Oct-2015 56,870 5,066 6,824 68,760 200 200 68,560
Nov-2015 56,870 5,066 6,824 68,760 200 200 68,560
Dec-2015 56,870 5,066 6,824 68,760 200 50 250 68,510
Jan-2016 56,870 5,066 6,824 68,760 200 200 68,560
Feb-2016 56,870 5,066 6,824 68,760 200 200 68,560
DA Arrear
PRC ARREARS 0 0 0
Promotion
Arrear
AAS
Incre.Arrear

Notional Increments
Surrender Leav
Child Fee Concession
StepUp Arrears
Preponement Arrear

Grand Totals 652,570 76,758 78,304 7,290 814,922 2,400 70 2,470 812,452
0 0 ### 0

Signature of the Drawing Officer Signature of the Employee

For latest Income Tax Click here www.gunturbadi.com


Financial year ANNEXURE - II Assessment year
2015-2016 INCOME TAX CALCULATION 2016-2017
Name Sri.K S S PRASAD Office M P P S, GANESH PURAM, DUGGIRALA

Designation SGT Address DUGGIRALA(M) , GUNTUR

Residence -- Rented House Pan No Emp.Tre ID


1 Gross Salary 814,922
2 H.R.A. Exemption as per eligibility U/s. 10(13-A)
a) Actual HRA received Rs 78,304
b) Rent paid by you minus 10% of your Salary (Rent @ 12600 /- Rs 78,267
c) 40% of Salary (Salary means Basic Pay+D.A) Rs 291,731 78,267
3 Total Salary (1-2) Rs 736,655
4 Deductions from Salary Income Rs
a) Exemption from Conveyance Allowance U/s. 10(14) (i) Rs
b) Profession Tax U/s 16 (3) B Rs 2,400 2,400
5 Income From Salary (3-4) 0 734,255
6 Income From other sources 0 -
7 Income From Capital Gains 0 -
8 Income from House Property 0 0
9 Gross Total Income (5+6+7+8) 0 734,255
10 Deductions
a) E.W.F & S.W.F & CMRF Rs 70
b) Interest of Educational Loan Rs -
c) Medical treatment of dependent Rs -
d) Interest of Housing Loan Rs -
e) Any Other enter here AND Health Insurence Rs -
TOTAL----------- Rs 70 70
11 Gross Total Income (9-10) Rs 734,185
12 Savings U/s 80C (Limited to 1,50,000)
a) GPF/ZPPF Rs -
b) APGLI Rs
c) GIS Rs
d) Tuition Fee for Children Rs -
e) Principle Amount of Home Loan installments Rs -
f) LIC Policies premium - Yearly Rs -
g) Sukanya Samruddhi Yojana Rs -
h) Any Other enter here Rs -
i) Infrastructure Bonds Rs -
Total Savings Rs - -
13 Net Taxable Income (11-12) Rs 734,190
14 Tax on Income Rs
a) Up to Rs. 2,50,000 Rs Nil
b) Rs.2,50,001 To 5,00,000. (250000 @ 10%) 25000
c) Rs.5,00,001 To 10,00,000. (234190 @ 20%) 46838
d) above Rs.10,00,001. Rs
Tax on Income Rs 71838
15 Tax Rebate U/s 87 (Rs.2000/-Rebate Upto Rs.5,00,000/- Taxble Income) Rs 0
16 Education Cess @ 2% Rs 1437
17 Secondary & Higher Education Cess @ 1% Rs 718
18 Total Tax Payable (14+16+17-15) Rs 73,993
19 Details of Adv.Tax Deductions Adv. Tax Deductions
a) Upto Nov-2015 Rs 0
b) Dec-15 Rs 0
c) Jan-16 Rs 0
d) Feb-16 Rs 0 TO BE PAID NOW 73,993

For Und
Select
DATA PA
Signature of the Drawing Officer Signature of the Employee

.
For latest Income Tax Click here www.gunturbadi.com

.
FORM No. 16 ( Vide rule 31(1)(a) of Income Tax Rules, 1962 )
Certificate under section 203 of the Income-tax Act, 1961
for Tax deducted at source from income chargeable under the head "salaries"
NAME AND ADDRESS OF THE EMPLOYER NAME AND DESIGNATION OF THE EMPLOYEE

Sri. Sri. K S S PRASAD


- SGT
, M P P S, GANESH PURAM, DUGGIRALA
DUGGIRALA, GUNTUR

PAN No. of Deductor TAN No. of Deductor PAN OF Employee Emp. Treasusy Id

Acknowledgement Nos.of allquarterly statements of TDS under sub-section 200 as provided by TIN facilitation center or NSDL web-site
Acknowledgement
Quarter Amount Period Assessment
No
Quarter - 1 - From To Year
Quarter - 2 -
Quarter - 3 - Mar/2015 Feb/2016 2016-2017
Quarter - 4 -
DETAILS OF SALARY PAID AND ANY OTHER INCOME AND TAX DEDUCTED
1 Gross Salary Rs 814,922
a) Salary as per provisions cotained in section 17 (1) Rs -
b) Value of percuisites under section 17(2) Rs -
(As Per Form No. 12BA, Wherever applicable)
c) Profits in lieu of salary under section 17(3) Rs -
(as per Form No. 12BA, Wherver applicable)
d) Total Rs 814,922 Rs 814,922
2 Less: Allowance to the extent exempted U/s 10
a) House Rent Allowence Rs 78,267
b) Other Allowance Rs Rs 78,267
3 Balance (1-2) Rs 736,655
4 Deductions
a) Entertainment Allowence Rs -
b) Tax on Employment Rs 2,400
5 Aggreate of 4 (a)&(b) Rs 2,400
6 INCOME CHARGEABLE THE HEAD SALARIES (3-5) Rs 734,255
7 Any other income reported by the employee Rs -
Income of Capital Gains Rs -
Income from House Property Rs 0
8 Gross Total Income (6+7) Rs 734,255
9 Deductions Under Chapter VI-A
A) UnderSections 80C,80CCC,80CCD,80C Gross Amount Qualify Amount
a) 80C GPF/ZPPF Rs - Rs 150,000
b) 80C A.P.G.L.I Rs Rs -
c) 80C G.I.S Rs Rs -
d) 80CC Tuition Fee for Children Rs - Rs -
e) 80CC Principle Amount of Home Loan installments Rs - Rs -
f) 80CC LIC Policies premium - Yearly Rs - Rs -
g) 80CC Sukanya Samruddhi Yojana Rs - Rs -
h) Any Other enter here Rs - Rs -
i) 80CCF Infrastructure Bonds Rs - Rs -
## Rs 0 Rs 150,000 Rs 150,000
B) Other Sections Under Chapter VI A
a) 80G E.W.F & S.W.F & CMRF Rs 70 Rs 70
b) 80E Interest of Educational Loan Rs - Rs -
c) 80DD Medical treatment of dependent Rs - Rs -
d) 24B Interest of Housing Loan Rs - Rs -
e) 80d Any Other enter here AND Health Insurence Rs - Rs -
Rs 70 Rs 70 Rs 70
Aggregate of Deductible Amounts U/Chapter VIA (A+B)------------------------------- Rs 150,070
Note: 1.aggregate amount deductible under section 80c shall not exceed one lakh rupees.
2.aggregate amount deductible under section 80C,80CCC,80CCD, shall not exceed one lakh rupees.
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10 TOTAL INCOME (8-9) Rs 734,190

11 TAX ON TOTAL INCOME Rs. Rs -

12 Tax Rebate U/s 87A (Rs.2000/-Rebate Upto Rs.5,00,000/- Taxble Income) -

13 Education Cess @ 2% (On Tax at S.No.11 ) Rs 1,437

14 Secondary and Higher Education Cess @ 1% (On Tax at S.No.11 ) Rs 718

15 TAX PAYABLE (11+13+14-12) Rs 73,993

16 Less: Relief under section 89 (attach details) Rs -

17 TAX PAYABLE (15-16) Rs 73,993

18 (a) Tax deducted at source U/s 192(1) Rs -


(b)Tax paid by the employer on behalf of the employee U/s 192 (1A) on perquisited U/s 17 (2) Rs -

19 TAX PAYABLE Rs 73,993

DETAILS OF TAX DEDUCTED AND DEPOSITED INTO CENTRAL GOVERNMENT ACCOUNT


(The employer is to provide tranction - wise details of tax deducted and deposited)

Sl. TDS Surcharge Education Total Tax Cheque/DD BSR Code Date on Transfer
No. Rs. Rs. Cess Deposited No. (if any) of Bank Which Tax vocher/chalana
Rs. Rs. Branch Deposited Identification No
1
2
3
4
5
6
7
8
9
10
11
12

I working in
the capacity of - do hereby certify that the sum of Rs 73993/-
Rupees in words.. Seventy three Thousand Nine Hundred and Ninety three rupees Only
has been deducted at source and paid to the credit of the central Government. I further certify that the
Informtion given above is true, complete and correct based on the books of account, documents and other
available records.

Sign--

Place: - Signature of the person responsible for deduction of tax


Date: 17-Apr-2017 Full Name-- -
Designation- , ,

You may
Delate / Change
this Date

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RECEIPT OF HOUSE RENT
(Under Section 1 (13-A) of Income Tax Act )

Received a sum of (House Rent Annual Amount)


from Sri. K S S PRASAD (Tenant) Rs 151,200
Amount in words One Lakh Fifty one Thousand Two Hundred rupees Only
towards the rent @ 12,600 Per Month from Apr/2015 to Mar/2016
in respect of

House Address (Affix Revenue Stamp of Rs.1/-)

Signature of the Tenant Signature of the House Owner


FORM NO. 10-I
[See rule 11DD]
Certificate of prescribed authority for the purposes of section 80DDB

1. Name of the Patient


2. Address
3. Fathers name
4. Name and address of the person on whom the patient is dependent
and his relationship with the patient.

5. Name of the disease or ailment


(please see rule 11DD)
6. For diseases or ailments mentioned in item (i) of clause (a) of
sub-rule (1), whether the disability is 40% or more (Please specify the extent)
7. Name, address, registration number and qualification of the
specialist issuing the certificate, along with the name and address
of the Government hospital [see rule 11DD(2)] Verification

VERIFICATION

This is to verify that I, Dr.________________________________________________ s/o (w/o)

Shri_____________________, in the case of the patient Shri/Smt./Ms.________________________,

after considering the entire history of illness, careful examination and appropriate investigations,

am of the opinion that the patient is suffering from______________________________disease/ailment

during the previous year ending on 31st March,_______________________

I also certify (only in case of neurological disease) that the extent of disability is more than 40%)
(Strike off, if not applicable).
I certify that the information furnished above is true to the best of my knowledge.

Date _______________ Signature


Place _______________
(Name and Address)

To be countersigned by the Head of the Government hospital, where the prescribed authority is a
specialist with post-graduate degree in General or Internal Medicine.

Date ______________ Signature


Place ______________
(Name and Address)
FORM NO. 10-IA
[See sub-rule (2) of rule 11A]
Certificate of the medical authority for certifying person with disability, severe disability',
autsm', cerebral palsy and multiple disability for purposes of section 80 DD and section 80U

Certificate No.
Date :

This is to certify that Shri/Smt./Ms.________________________________ son/daughter of


Shri____________________________________, age________ years___________male/female*
residing at______________________________________, Registration No._______________is a
person with disability/severe disability* suffering from autism/cerebral palsy/multiple disability.

2. This condition is progressive/non-progressive/likely to improve/not likely to improve*.

3. Reassessment is recommended/not recommended after a period of _____months/years

Sd/-
(Neurologist/Pediatric Neurologist/Civil Surgeon/
Chief Medical Officer*)
Name :___________________
Address of Institution/Government hospital :
____________________________________
____________________________________

Qualification/designation of specialist :____________________


SEAL
Signature/Thumb impression* of the patient
Note : *Strike out whichever is not applicable.