IT Savings Declaration Form

1 IT Savings Declaration form Name of the Employee: Designation: PAN Number Sub: IT Deductions Declaration of Direct Savings for the financial year 2006 2007. Please find attached details of my direct Savings (actual) for the financial year 2006 2007 declared for my tax calculation. Savings ELIGIBLE FOR TAX REBATE U/S 80C AMOUNT IN Rs. 1. Life Insurance Premium 2. Unit Linked Insurance Premium 3. Public Provident Fund 4. Repayment of Housing Loan (Principal) 5. National Saving Certificate (NSC) 6. Infrastructure Bonds 7. Tuition fees for Children 8. Others (Please Specify) PAYMENT ELIGIBLE FOR DEDUCTIONS FROM GROSS TOTAL INCOME 1. Medical Insurance Premium (U/S 80D) 2. Pension Fund Scheme (annuity plan U/S 80 CCC) 3. Repayment of Housing Loan (Interest U/S 24) 4. Medical reimbursement 5. LTA HOUSE RENT (Please give a copy of the Rental Agreement) I hereby confirm that I am paying a sum of Rs.

2 _____ per month from _____ (Write date DD-MM-YY) as house rent for accommodation occupied by me at _____ _____(Address) and therefore would like to claim tax benefit under section 10 (13A). I have attached the evidence of actual payments of rent by giving details of rent paid along with name and address of the Landlord. I am aware that payments on account of above investments are eligible for rebate under the relevant sections of the Income Tax Act, only when payments are made out of my income chargeable to tax. I declare and undertake that such payments have been made and/or will be made out of my Income. I declare that to the best of my knowledge and belief, the particulars furnished by me are true and correct, in every respect. Thanking you, Name (Signature) HRA Declaration To _____ (Name of the Company) Dear Sir I hereby declare that, I am in occupation of residential premises on rental basis as hereunder: Name of the Employee : Address of rented Premises : Name & Address of Landlord : Duration of Lease / Occupation : From To Rent Paid per Month : Total Rent paid during the year : PAN of Licensor / Landlord : (Must if Rent is above Rs.)

3 10,000) I certify that above mentioned particulars are correct. Based on above kindly grant admissible exemption of House Rent Allowance under section 10 (13A) read with rule 2 A and section 10(14) of The Income Tax Act 1961. I hereby undertake to produce documentary evidence in support of above Declaration as and when required to indemnify KMG Infotech Private Ltd., for the tax liability (including interest/penalty) arising out of disallowance of HRA exemption, as imposed by the Assessing Officer. Thanking you Yours truly Signature Permanent Address Telephone Personal E-mail Id.