for tax computation 2012 ver 1.1 please log on to and purchase at nominal price of $1.00

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Please read the instructions1. Please enter the data in the Unprotected areas in the number format where ever it is allowed to enter the data 2

2

2

2

Assessement Year 4

This spreadsheet Calculated tax every month on cumulative basis hence it is helpful for TDS aspect under section 192 of IT Act 1961

Suggestions and Advices are invited: Please write your advices and revert me back

Type of errors in the previous Versions: Rectification statusHRA Monthly exemption system introduced due to RULE 2A Modified calculation

Rent free or concessional accommodation calculation was erroneous Rectified

Amendmends to the Car perk and other vehicles perk Introduced

Features Introduced

New Form 16 Introduced

Please make the following configurations in your MS Excel programme Tools>Options>Calculations>Iteration Check>O

Tools>Options>Security>Macro security>low>Ok

2. Please specify the Assessment Year for which you are calculating the tax Below In the Assessement Year Drop Down Menubecause there are certain provisions which are applicable for 2009 - 10 Assessement year onwards

It is Suggested to Enable the macro by seting the macro security level to Medium or Very low it is required togenerate Form 16

In the sheets the data are interlinked with each other there are some hidden files also hence this workbook is entirely protected forthe data and function security purpose. You will get the Taxable Components of Salary in the Taxable sheet.

To Generate The Form 16 Please Go to the "Details" sheet Fill up the particulars and then Click the Buttons (GENERATE

OLD FORM 16 OR GENERATE NEW FORM 16)relating to different format as per your requirement

Or Click the Buttons located in the "Details" Sheet i.e. Generate New Form 16 or Generate OldForm 16 Buttons This Spreadsheet Programme has been designed to Enable the employers to make TDS from the Salary every month on actualbasis and not on presumption or imaginary basis.

Also Please provide details like the age of the assessee and the gender as well as the status of inability in the sheet'Details' employee details which takes into consideration the various exemption limit for taxation purpose

Fill the Yellow and Sky Coloured Cells in the Sheets Additional Details, 12BA, New Form 16 Export.

Name of the author: Jiten Kumar Sahu [B.Com, M.Com, CA (Inter)]

Place of Origin: Bhubaneswar (Orissa)

Email: [email protected]

Please log on to www.jitenkumarsahu.blogspot.com for revised and updated version

Due to some Errors in the previous version Improvementsand revisons made in this version.

Further Improvements are needed to be identified by the users.

DISCLAIMER: The author is not Responsible or Liable For any damage caused due to this program to any client or organisation due to errors and ommissions in the Program. Though extensive coverage of theIncome Tax Act 1961, Section 192 has been taken care of. It is requested to the users to identify such

mistakes for further correction in the programme.

þÿ2011-12



E m p

l o y e r d

e t a i l s

m p l o y e e D e t a

i l s



a x D e t a i l

CITDetails

Receipt numbpertaining tostatements pstatement at

Receipt numbProvisional re



Place :

Date :

Quarter

June 2010

September 2010

December 2010

March 2011

Address

City

Pin code

What is the Age of the Employee as permatriculation certificate? (in Years)

er to be quoted in Form 16/16A will be generated by TIN. ReceiptY 2010-11 and onwards uploaded to TIN. Receipt number gener rtaining to FY 2010-11 and onwards. Eight digit receipt number cnder Quarterly Statement Status feature available at TIN website

er provided by TIN is in addition to the provisional receipt number eipt number will be referred as Token no for the statements perta



2010 - 11 Assessment Year 2011

No

No

Male



3

Receipt no. of Original statemen

number will be generated for the quarterly TDS/TCS stateted will be of eight digits (alphabets) and will be applicabln be obtained by viewing the status of the quarterly TDS/(www.tin-nsdl.com).

provided on acceptance/upload of quarterly TDS/TCS staining to FY 2010-11 and onwards.



- 12

, Son of, MaleErr:502 Female

Err:502

2

1

Fill up the Yellow

highlightedAreas only



FORM NO.16[See rule 31 (1) (a)]

PART A

Certificate under section 203 of the Income-tax Act, 1961 for Tax deducted at

Name and address of the employer Name

0

00

0

0

PAN No. of the Deductor TAN No. of the Deductor PAN of the Employe

0 0CIT (TDS) Assessment

Address 02011 - 1

City 0 Pin code 0

Summary of tax deducted at source

Quarter

June 2010 0

September 2010 0

December 2010 0

March 2011 0

Total 0.00

PART B (Refer Note 1)DETAILS OF SALARY PAID AND ANY OTHER INCOME AND TAX

1. Gross Salary *

( a ) Salary as per provisions contained in section 17 (1)

( b ) Value of perquisites under section 17 (2)

(as per Form No. 12 BA, wherever applicable)

( c ) Profits in lieu of Salary under section 17 (3)

(as per Form No. 12 BA, wherever applicable)

( d ) Total

2. Less : Allowance to the extent exempt under section 10

Exemption u/s 10 (13A) House Rent Allowance

Exempt U/s 10 (10B) Retrenchment Compensation

Exempt U/s 10 (10) Gratuity Exempt U/s 10 (10AA) Leave Encashment

Exempt U/s 10 (10CC) Tax on Non monetary Perquisites

Exempt U/s 10 (11), 10 (12) Provident Fund

Exempt U/s 10 (14) Special Allowances

3. Balance (1-2)

4. Deductions :

(a) Entertainment allowance Rs.

(b) Tax on Employment Rs.

5. Aggregate of 4 (a & b)

6. Income chargeable under the Head ‘Salaries’(3-5)

Receipt Numbers of original statements of TDS under sub-section (3) of section 200

Amount of tax din respect of the



(m) Notified units of Mutual Fund Rs.

(n) Notified pension fund Rs.

(o) Home Loan Account Scheme Rs.

(p) Subscription to Housing Scheme Rs.

(q) Tution Fees Rs. (r) Cost of purch./constn of a residential property Rs.

(s) Approved debentures and equity shares Rs.

(t) Fixed deposit for 5 years with Scheduled Banks Rs.

(u) 5 Yr Post Office Time Deposit Account Rs.

(v) Senior Citizen Savings Scheme Investment Rs.

(w) notified bonds issued by NABARD Rs.

(b) section 80CCC Rs.

(c) section 80CCD Rs.

Section 80CCE Total

(e) section 80CCF Investment in Infrastructure Bonds. Rs.

(B) other sections (e.g., 80E, 80G etc.) Gross Qu

Under Chapter VIA

(a) section 80 D Mediclaim Insurance policy Rs. -

(b) section 80 DD Rs. -

(c) section 80 E Interest on Educational Loan Rs. - (d) section 80 G Deductions for Donations Rs. -

(e) section 81 GG Deductions for Rent paid Rs. -

(f) section 80 U Deductions for handicaped assessee Rs. -

10. Aggregate of deductible amount under chapter VI-A

11. Total Income (8-10 )

12. Tax on total Income

13.Education Cess @ 3% on (on tax computed at S. No. 12)

14. Tax Payable on total income (12+13)

15. Relief under section 89 (attach details)

16. Tax payable (14-15)

VERIFICATION

#VALUE!

Signature of the person responsible

for deduction of tax

Place : - Full Name : -

Date : Decem er 30, 1899 Designation : -

ANNEXURE B

DETAILS OF TAX DEDUCTED AND DEPOSITED IN THE CENTRAL GOVERNMENT ACCOUNT(The Employer to provide payment wise details of tax deducted and deposited with re

Sr. No.

Challan identification number

BSR Code of the Bank Date on which tax deposited

Branch (dd/mm/yyyy)

1 0 0000000 12/30/18992 0 0000000 12/30/18993 0 0000000 12/30/18994 0 0000000 12/30/18995 0 0000000 12/30/18996 0 0000000 12/30/18997 0 0000000 12/30/18998 0 0000000 12/30/18999 0 0000000 12/30/1899

10 0 0000000 12/30/189911 0 0000000 12/30/1899

12 0 0000000 12/30/1899T t l 0

Tax Deposited inrespect of theemployee (Rs.)



FORM NO. 12 BA

[See rule 26A(2)(b)]

Statement showing particulars of perquisites, other fringe benefi

amenities and profits in lieu of salary with value thereof

1. Name and address of employer :

, , , ,

2. TAN 0

3. TDS Assessment Range of the Employer : 0

4. Name and designation and PAN of employee : ,

0

5. Is the employee a director or a person withsubstantial interest in the company No

(where the employer is a company)

6. Income under the head "Salaries" of the employee : #VALUE!

7. Financial Year : 2010 - 11

8. Valuation of Perquisities :

S. Nature of Perquisite Value of Amount,if any

No. (see rule 3) perquisite as paid by

per rules employee

(Rs.) (Rs.)

1 Accommodation -

2 Cars -

3 Sweeper, gardener, watchman or personal attendant -

4 Employee owns any automotive conveyance other than car - 5 Gas, electricity, water -

6 Interest free or concessional loans -

7 Holiday expenses -

8 Free or concessional travel -

9 Free meals -

10 Free Education -

11 Gifts, vouchers, etc. -

12 Credit card expenses -

13 Club expenses -

14 Use of movable assets by employees -

15 Transfer of assets to employees -

16 Value of any other benefit/amenity/service/ previlege -

17 Stock options (non-qualified options) -

18 Medical Expenses Reimbursement -

19 Tax paid by employer - 20 Total value of perquisites -

21 Total value of profits in lieu of salary as per section 17(3) -

-

9. Details of tax,-

(a) Tax deducted from salary of the employee under section 192(1)

(b) Tax paid by employer on behalf of the employee under section 192(1A)

(c) Total tax paid

(d) Date of payment into Government Treasury

DECLARATION BY EMPLOYER

I, , Son of, working as do hereby declare on behalf of that the information given above is based on the books of accounavailable with us and the details of value of each such perquisite are in accordance with section 17 and rules framed ther



Form 16 (Annexure)

Assessment Year 2011 - 12

Employer : 0

Employee : 0

Particulars

Gross Salary

(a) Salary as per Provisions contained in Section 17(1)

Salary and other Salary Components

Employer's Contribution to Provident Fund

Bonus

Gratuity

Leave Encashment

Retrenchment Compensation

House Rent Allowance

Employer's Contribution to Superannuation Fund

Other Allowances

Special Allowance

(c) Profits in lieu of salary under section 17(3) (as per

Form No. 12BA, wherever applicable)

Gross Salary

Particulars Rupees

Allowance to the extent exempt under section 10


Exemption u/s 10 (13A) read with Rule 2A

Since Salary/Rent paid/HRA Received during the previous year

is varying and not constant through out the relevant period -

calculation of exemption has been made on monthly exemption -

basis The gross exemption amount due to above reason


Exempt U/s 10 (10) Gratuity

Exempt U/s 10 (10AA) Leave Encashment




Total amount claimed to be exempt

0

(b) Value of perquisites under section 17(2) (as per FormNo. 12BA, wherever applicable)



t records or informationn is true and correct



ncial Year 2010 - 11

Rupees

-

-

-

-

Rupees

#VALUE!



Certificate under section 203 of the Income-tax Act, 1961 for Tax deducted at source on Salary

Financial year 2010 - 11

Whether Original / Duplicate / Amended

TAN of Deductor - -

PAN of Deductee - -

TDS/TCS

Gross amount of TDS / TCS -

Total TDS amount where PAN was found valid by Income Tax Department*

Details of Salary paid and any other income and tax deducted

1. Gross Salary

(a) Salary as per provisions contained in sec.17(1) Rs.0

(b) Rs.0

(c) Rs.0

(d) Total Rs.0

2. Less: Allowance to the extent exempt u/s 10

House Rent Allowance 10 (13A) Rs.0

Retrenchment Compensation 10 (10B) Rs.0

Gratuity 10 (10) Rs.0

Leave Encashment 10 (10AA) Rs.0

Special Allowances 10 (14) Rs.0

Provident Fund 10(11) or 10(12) Rs.0

Rs.0Rs.0 Rs.0

3. Balance(1-2) Rs.0

4. Deductions :

(a) Standard deduction Rs -

(b) Entertainment allowance Rs -

(c) Tax on employment Rs -

5. Aggregate of 4(a) to (c) Rs.0

6. Income chargeable under the head 'salaries' (3-5)

7. Add: Any other income reported by the employee

Income From the House Property Rs.0

Rs.0

Rs.0

Rs.08. Gross total income (6+7)

FORM NO.16[See rule 31(1)(a)]

TDSCertificatenumber#

If Amended give Previous TDSCertificate number

Name of Deductor

Name of Deductee

TDS Unique Transaction Number (UTN) as provided byIncome Tax Department

Whether PAN uploadedwas validated by Income

Tax Department? (Y/N)

Gross AmountPaid/ Collected

Value of perquisites u/s 17(2) (as per Form No.12BB, whereverapplicable)

Profits in lieu of salary under section 17(3)(as per FormNo.12BB, wherever applicable)



9. Deductions under Chapter VIA

Gross Amount

(a) Deductions u/s 80C Rs.0 Rs.0

(b) Deductions u/s 80CCC Rs.0 Rs.0

(c) Deductions u/s 80CCD Rs.0 Rs.0

(d) Deductions u/s 80CCE Rs.0 Rs.0 Rs.0

(e) Deductions u/s 80D Rs.0 Rs.0 Rs.0

(f) Deductions u/s 80DD Rs.0 Rs.0 Rs.0(g) Deductions u/s 80E Rs.0 Rs.0 Rs.0

(h) Deductions u/s 80G Rs.0 Rs.0 Rs.0

(i) Deductions u/s 80GG Rs.0 Rs.0 Rs.0

(j) Deductions u/s 80U Rs.0 Rs.0 Rs.0

(k)

(l)

10. Aggregate of deductible amount under Chapter VIA Rs.

11. Total Income (8-10) Rs.

12. Tax on total income Rs.

13. Rebate and relief under Chapter VIII

I. Under section 88 (please specify)

Gross Amount(a) Rs.0 Rs.0 Rs.0

(b) Rs.0 Rs.0 Rs.0

(c) Rs.0 Rs.0 Rs.0

(d) Rs.0 Rs.0 Rs.0

(e) Rs.0 Rs.0 Rs.0

(f) Total [(a) to (e)] Rs.

II. (a) Under section 88B Rs.0 Rs.0

(b) Under section 88C Rs.0 Rs.0

III. Under section 89 (attach details) Rs

14. Aggregate of tax rebates and relief at 13 above [I(f) + II(a)+ II(b) + III]

15. Tax payable (12-14) and surcharge thereon Rs

16. Less: Tax deducted at source Rs

17. Tax payable/refundable (15-16) Rs

#VALUE!

Place:

Date: 30-Dec-1899 Signature of person responsible for deduction of tax

Designation: Full Name:

# TDS certificate number is an internal reference number to be given by the Deductor (optional)

QualifyingAmount

DeductibleAmount

Qualifying

Amount

Tax rebate/

relief



0

0

0

0

0

0

0

0

-

-



FORM NO. 12 BA


Statement showing particulars of perquisites, other fringe benefits or


1. Name and address of employer :

, , , ,

2. TAN -

3. TDS Assessment Range of the Employer : -

4. Name and designation and PAN of employee :, ,

5. Is the employee a director or a person with

substantial interest in the company No


6. Income under the head "Salaries" of the employee : -



S. Nature of Perquisite Value of Amount,if any

No. (see rule 3) perquisite as paid by

per rules employee

(Rs.) (Rs.)

1 Accommodation - -

2 Cars - -

3 Sweeper, gardener, watchman or personal attendant - -

4 Employee owns any automotive conveyance other than car - -

5 Gas, electricity, water - -

6 Interest free or concessional loans - -

7 Holiday expenses - -

8 Free or concessional travel - -9 Free meals - -

10 Free Education - -

11 Gifts, vouchers, etc. - -

12 Credit card expenses - -

13 Club expenses - -

14 Use of movable assets by employees - -

15 Transfer of assets to employees - -

16 Value of any other benefit/amenity/service/ previlege - -

17 Stock options (non-qualified options) - -

18 Medical Expenses Reimbursement - -

19 Total value of perquisites - -

20 Total value of profits in lieu of salary as per section 17(3) - -

Page 1 of 2 [FORM NO. 12 BA]



Form 16 (Annexure)

Assessment Year 2011 - 12 Financi

Employer :

Employee :

Particulars Rupees Rupees

Gross Salary


Salary and other Salary Components -

Employer's Contribution to Provident Fund -

Bonus -

Gratuity -

Leave Encashment -

Retrenchment Compensation -

House Rent Allowance -

Other Allowances -

Special Allowance -

(b) Value of perquisites under section 17(2) (as per Form

No. 12BA, wherever applicable)



Gross Salary

-

Place:

December 30, 1899

-



Amount of

taxable

perquisite

(Rs.)

-

-

-

-

-

-

-

--

-

-

-

-

-

-

-

-

-

-

-



l Year 2010 - 11

Rupees

-

-

-

-



9. Details of tax,-

(a) Tax deducted from salary of the employee under section 192(1) Rs.0

(b) Tax paid by employer on behalf of the employee under section 192(1A) Rs.0

(c) Total tax paid Rs.0





Place: Full Name :

Date: December 30, 1899 Designation :

Page 2 of 2 [FORM NO. 12 BA]

I, , Son of, working as do hereby declare on behalf of that the information given above is based on the books of account, docrelevant records or information available with us and the details of value of each such perquisite are in accordance with secframed thereunder and that such information is true and correct.



ments and other ion 17 and rules



FORM NO.16[See rule 31 (1) (a)]

Certificate under section 203 of the Income Tax Act, 1961 for tax d

at source from income chargeable under the head “ Salaries

Name and address of the employer Name a

0

00

0

0

PAN No. of the Deductor TAN No. of the Deductor PAN No. of the Emp

0 0PERIOD

FROM

Quarter Acknowledgement No.

30-Dec-99 30

June 2010 0

September 2010 0

December 2010 0

March 2011 0

DETAILS OF SALARY PAID AND ANY OTHER INCOME AND TAX

1. Gross Salary *

( a ) Salary as per provisions contained in section 17 (1) Rs.


(as per Form No. 12 BA, wherever applicable) Rs.


(as per Form No. 12 BA, wherever applicable) Rs.( d ) Total

2. Less : Allowance to the extent exempt under section 10 Rs.

3. Balance (1-2)

4. Deductions :

(A) Standard Deduction Rs. -

(B) Entertainment allowance Rs. -

(C) Tax on Employment Rs. -

5. Aggregate of 4 (a to c)


7. Add. : Any other income reported by the employee

Capital Gain

Income From House Properties

8. Gross total income (6+7)

9. Deductions Under Chapter VI-A

(A) sections 80C, 80CCC and 80CCD

(a) section 80C

(a) Accrued Interest on NSC Rs. -

(b) Life insurance premium Rs. -

(c) Non-commutable deferred annuity Rs. -

(d) Deferred annuity Rs. -

( ) S id f d d R P id f d R

Acknowledgement Nos. of all quarterly statements of TDS under sub-section (3) of section 200 as provided by TIN Facilitation Centre or NSDL web-site

Gro



(d) section 80CCF Investment in Infrastructure Bonds. Rs. -



(B) other sections (e.g., 80E, 80G etc.)

Under Chapter VIA

(a) section 80 D Mediclaim Insurance policy Rs. -

(b) section 80 DD Rs. -

(c) section 80 E Interest on Educational Loan Rs. - (d) section 80 G Deductions for Donations Rs. -

(e) section 81 GG Deductions for Rent paid Rs. -

(f) section 80 U Deductions for handicaped assessee Rs. -




13. Surcharge (on tax computed at S. No. 12)

14.Education Cess @ 3% on (tax at S. No. 12 plus surcharge at S. No. 13)

15. Tax Payable on total income (12+13+14)



18. Less:(a) Tax deducted at source u/s 192(1)(b) Tax paid by the employer on behalf of the employee

u/s 192(1A) on perquisites u/s 17(2)

19. Tax payable / refundable (17-18)

DETAILS TAX DEDUCTED AND DEPOSITED INTO CENTRAL GOVERNMENT AC

S. No.

1 - - - - 02 - - - - 0

3 - - - - 0

4 - - - - 05 - - - - 06 - - - - 07 - - - - 08 - - - - 09 - - - - 0

10 - - - - 011 - - - - 012 - - - - 0

Total amount Paid -

#VALUE!



Place : - Full Name : -

Date : December 30, 1899 Designation : -

TDSRs.

SurchargeRs.

EducationCessRs.

Total taxdeposited

Cheque/DD No.(if any)

BSR CBank



Form 16 (Annexure)

Assessment Year 2011 - 12

Employer : 0

Employee : 0

Particulars

Gross Salary


Salary and other Salary Components

Employer's Contribution to Provident Fund

Bonus

Gratuity

Leave Encashment

Retrenchment Compensation


Employer's Contribution to Superannuation Fund

Other Allowances

Special Allowance



Gross Salary

Particulars Rupees




Since Salary/Rent paid/HRA Received during the previous year is varying and not constant through out the relevant period -

calculation of exemption has been made on monthly exemption -

basis

The gross exemption amount due to above reason


Exempt U/s 10 (10) Gratuity

Exempt U/s 10 (10AA) Leave Encashment









t records or informationi t d t



ncial Year 2010 - 11

Rupees

-

-

-

-

Rupees

#VALUE!



Name and address of the employer Name and designatio

0 00 0000

PAN No. of the Deductor TAN No. of the Deductor PAN No. of the Employee 0 0 0

PERIOD

FROM TO

Quarter Acknowledgement No.

30-Dec-99 30-Dec-99

June 2010 0

September 2010 0

December 2010 0

March 2011 0

DETAILS OF SALARY PAID AND ANY OTHER INCOME AND TAX DEDUCTED1. Gross Salary *

( a ) Salary as per provisions contained in section 17 (1) -


(as per Form No. 12 BA, wherever applicable) -


(as per Form No. 12 BA, wherever applicable) -

( d ) Total

2. Less : Allowance to the extent exempt under section 10 #VALUE!

3. Balance (1-2)

4. Deductions :

(A) Standard Deduction Rs. -

(B) Entertainment allowance Rs. -

(C) Tax on Employment Rs. -

5. Aggregate of 4 (a to c) -


7. Add. : Any other income reported by the employee

Capital Gain

Income From House Properties

8. Gross total income (6+7)

9. Deductions Under Chapter VI-A

(A) sections 80C, 80CCC and 80CCD

(a) section 80C

(a) Accrued Interest on NSC Rs. - -

(b) Life insurance premium Rs. - - (c) Non-commutable deferred annuity Rs. - -

(d) Deferred annuity Rs. - -

(e) Statutory provident fund and Recg.Provident fund Rs. - -

(f) Public provident fund Rs. - -

(g) Superannuation fund Rs. - -

(i) NSC VIIIth Issue Rs. - -

(j) ULIP (UTI) Rs. - - (k) ULIP (LIC) Rs. - -

(l) Notified annuity plan of LIC Rs. - -

(m) Notified units of Mutual Fund Rs. - -

(n) Notified pension fund Rs. - -

Acknowledgement Nos. of all quarterly statements of TDS under sub-section (3) of section 200 as provided by TIN Facilitation Centre or NSDL web-site

Gross AmountDAm



(q) Tution Fees Rs. - -

(r) Cost of purch./constn of a residential property Rs. - -

(s) Approved debentures and equity shares Rs. - -

(t) Fixed deposit for 5 years with Scheduled Banks Rs. - -

(u) 5 Yr Post Office Time Deposit Account Rs. - -

(v) Senior Citizen Savings Scheme Investment Rs. - -

(w) notified bonds issued by NABARD Rs. - -

(b) section 80CCC Rs. - -

(c) section 80CCD Rs. - -

section 80CCE Total

(d) section 80CCF Investment in Infrastructure Bonds. Rs. - -

(B) other sections (e.g., 80E, 80G etc.)

Under Chapter VIA

(a) section 80 D Mediclaim Insurance policy Rs. - -

(b) section 80 DD Rs. - -

(c) section 80 E Interest on Educational Loan Rs. - -

(d) section 80 G Deductions for Donations Rs. - -

(e) section 81 GG Deductions for Rent paid Rs. - -

(f) section 80 U Deductions for handicaped assessee Rs. - -




13. Surcharge (on tax computed at S. No. 12)14.Education Cess @ 3% on (tax at S. No. 12 plus surcharge at S. No. 13)

15. Tax Payable on total income (12+13+14)



18. Less:(a) Tax deducted at source u/s 192(1) Yes - Y

(b) Tax paid by the employer on behalf of the employee No - N N

u/s 192(1A) on perquisites u/s 17(2)

19. Tax payable / refundable (17-18)

DETAILS TAX DEDUCTED AND DEPOSITED INTO CENTRAL GOVERNMENT ACCOUNT

S. No.

1 -

2 -

3 -

4 -

5 -

6 -

7 -

8 -

9 -

10 -

11 -

12 -

Total amount Paid -

Do You want toaccept the

recommendedtax on perk? If yes then select"Y" else leave itblank the below

cell

I

refigudoa

TDSRs.

SurchargeRs.

EducationCess

Rs.

Total taxdeposited

Cheque/DD No.(if any)

BSR Code of Bank branch

Da



0.1 0

Capital gain Tax Rate inFraction i.e. +10/100



Avg. Rate #VALUE!

#VALUE!



FORM NO. 12 BA


Statement showing particulars of perquisites, other fringe benefits or


1. Name and address of employer : , , , ,

2. TAN 0

3. TDS Assessment Range of the Employer : 0

4. Name and designation and PAN of employee : , ,

0

5. Is the employee a director or a person with

substantial interest in the company No


6. Income under the head "Salaries" of the employee : #VALUE!



S. Nature of Perquisite Value of Amount,if any Amoun

No. (see rule 3) perquisite as paid by taxab

per rules employee perqu

(Rs.) (Rs.) (Rs

1 Accommodation - -

2 Cars - -

3 Sweeper, gardener, watchman or personal attendant - -

4 Employee owns any automotive conveyance other than car - -

5 Gas, electricity, water - -

6 Interest free or concessional loans - 7 Holiday expenses - -

8 Free or concessional travel - -

9 Free meals - -

10 Free Education - -

11 Gifts, vouchers, etc. -

12 Credit card expenses - -

13 Club expenses - -

14 Use of movable assets by employees - -

15 Transfer of assets to employees - -

16 Value of any other benefit/amenity/service/ previlege - -

17 Stock options (non-qualified options) - -

18 Medical Expenses Reimbursement - -

19 Tax paid by employer -

20 Total value of perquisites - - 21 Total value of profits in lieu of salary as per section 17(3)

- -

9. Details of tax,-

(a) Tax deducted from salary of the employee under section 192(1)

(b) Tax paid by employer on behalf of the employee under section 192(1A)

(c) Total tax paid



I, , Son of, working as do hereby declare on behalf of that the information given above is based on the books of account, documents and other relor information available with us and the details of value of each such perquisite are in accordance with section 17 and rules framed thereunder ainformation is true and correct.



Place : 0 Full Name : 0Date : 12/30/1899 Designation : 0



sh



Form 16 A[ANNEXURE]

Employer : 0

Employee : 0


Gross Salary


Salary and other Salary Components -

Employer's Contribution to Provident Fund -

Bonus -

Gratuity -

Leave Encashment -

Retrenchment Compensation -

House Rent Allowance -

Employer's Contribution to Superannuation Fund -Other Allowances -

Special Allowance -





Gross Salary





Since Salary/Rent paid/HRA Received during the previous year -

is varying and not constant through out the relevant period -

calculation of exemption has been made on monthly exemption - -

basis -

The gross exemption amount due to above reason -

Exempt U/s 10 (10B) Retrenchment Compensation -

Exempt U/s 10 (10) Gratuity -

Exempt U/s 10 (10AA) Leave Encashment -

Exempt U/s 10 (10CC) Tax on Non monetary Perquisites #VALUE!

Exempt U/s 10 (11), 10 (12) Provident Fund -

Exempt U/s 10 (14) Special Allowances -


For

0

0

30/Dec/1899 0



5 1

4 0

Basic Dearness Pay Dearness allowance Commission Commission Bonus PF Tax

Month

Apr 2010 0

May 2010 0

n 2010 0 0

2010 0 0

Aug 2010 0

Sep 2010 0

Oct 2010 0

Nov 2010 0

Dec 2010 0

n 2011 0 0

Feb 2011 0Mar 2011 0

TOTAL 0 0 0 0 0 0 0

Month Turnover

April -1

May -1

June -1

July -1

August -1

September -1

October -1

November -1

December -1

January -1

February -1

March -1

TOTAL

(if provided in terms of employment - Percenage that enters for

calculation of Retirement benefit please select the%)

(Based on Fixed %of turnover

achieved by anemplyee as per

terms of employment)

(CommissionNot based on

turnover)

Employer'sContribution



arrears of salary Leave encashment Leave encashment Salary in lieu of notice Fees Gratuity Grat

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0 0 0 0 0 0

pertaining to currentyear while in service

not pertaining tocurrent year while inservice of preceedingyear

payable inrespect of service of

the currentyear

payabrespeservi

thprece

ye



CHILDREN'S HOSTEL ALLOWANCE

Conveyance

Month Tax Free Taxable MonthReceipt Utilised Receipt

April 0 0 0 1 April

May 0 0 0 1 May

June 0 0 0 1 June

July 0 0 0 1 July

August 0 0 0 1 August

September 0 0 0 1 September

October 0 0 0 1 October

November 0 0 0 1 November

December 0 0 0 1 December

January 0 0 0 1 January

February 0 0 0 1 February

March 0 0 0 1 March

TOTAL 0 0 0 TOTAL 0 0 0

Please select the city

Transport Allowance CHILDREN EDUCATION ALLOWANCE House Rent Allowances

Month Month Month

April 0 April 0 1 April

May 1 May 0 1 May

June 2 June 0 1 June

July July 0 1 July

August August 0 1 August

September September 0 1 September

October October 0 1 October

November November 0 1 November

December December 0 1 December

January January 0 1 January

February February 0 1 FebruaryMarch March 0 1 March

Travelling / Transferallowance

No.OFChildren

AmountReceived

AmountReceived No.OF

Children

AmountReceived

HRAReceived

Rent Paid byemployee



HPLoss_Income

1. Income From the head House Property 4 Fin . Year 2010-2011

House Locations >>>>>>>> Self Occupied Location 2 Location 3 Locatio

1 Municipal Rental Value (a)

2 Fair Rental Value (b)

3 Standard Rental Value (c)

4

5 Unrealised rent

6 Vacancy

7 0 0

8 Reasonable Expected Rent 0 0

9 Gross Annual Value 0 0

10 Municipal taxes Paid by assessee

Please Fill the dates in the Format of DD MM

Date of Borrowing or taking the loanHouse Acquisition or construction Completion Date

Target Date of Acquisition or Completion of constructionNot Applicable Not Applicable Not Applicable Not Ap

Please provide Pre Construction Interest from

Up Up Up

to to to

Pre Construction Interest

Sum total of Gross Annual Values -

Less, Municipal taxes Paid by the assessee -

Net Annual Value -

less, 30% of NAV u/s - 24 towards repair and maintainance -

Less, Interest Paid on Loan taken for house

Pre Construction Interest Self Occupied -Current Yr. Interest for self occupied -

Total interest on self occupied property -

Pre Construction Interest for Let out property -

Current Yr. Interest for for Let out property -

Total interest on let out property -

Allowable Interest Deduction -

Income From the House Property -

Actual Rent that could have been earned if the property islet through out the year (d1)

(d2)

(d3)

Received or receivable rent (d1-d2-d3)



As on April 1, 2009 for the AY 2010-11

Type of loan Period Others

Housing loan Up to 5 years 9.75% 10.25%

Housing loan Above 5 years but up to 15 years 10.00% 10.50%

Housing loan Above 15 years but up to 25 years 10.25%

Car loan, for new car Up to 3 years (Rs. 7.5 lakh and above) 11.50%

Car loan, for new car Up to 3 years (below Rs. 7.5 lakh) 11.75%

Car loan, for new car Above 3 years but upto 5 years 11.75%Car loan, for new car Above 5 years but upto 7 years 12.00%

Two wheeler loan 16.25%

Education loan Loan amount up to Rs. 4 lakh 11.75%

Education loan Loan amount > Rs. 4 lakh < 7.5 lakhs 13.25%

Education loan Loan amount above Rs. 7.5 lakh 12.50%

For Girl student [Concession of 0.50%] 10.25%

For Others 10.75%

Personal loan upto 3 years 16.50%

Personal loan Above 3 years but upto 6 years 14.50%

Type of loan Period

<=20Lac >20Lacs <=20LacHousing loan Up to 5 years 10.25% 10.25% 10.00%

Housing loan Above 5 years but up to 10 years 10.75% 10.75% 10.25%



Car loan, for new car Up to 3 years (Rs. 7.5 lakh and above) 11.50% 11.50% 11.50%

Car loan, for new car Up to 3 years (below Rs. 7.5 lakh) 11.75% 11.75% 11.75%

Car loan, for new car Above 3 years but upto 5 years 11.75% 11.75% 11.75%

Car loan, for new car Above 5 years but upto 7 years 12.00% 12.00% 12.00%

Two wheeler loan 14.25% 14.25% 15.50%

Upto Rs. 30Lacs

More thanRs. 30 Lacs

Education loan under SBIScholar Loan Scheme

As on April 1, 2007 forthe AY 2008-09

As on Aprilthe AY



Education loan Loan amount up to Rs. 4 lakh 11.50% 11.50% 12.25%

Education loan Loan amount > Rs. 4 lakh < 7.5 lakhs 13.25% 13.25% 13.25%

Education loan Loan amount above Rs. 7.5 lakh 13.25% 13.25% 13.25%

Personal loan upto 3 years 15.25% 15.25% 15.50%

Personal loan Above 3 years but upto 6 years 15.25% 15.25% 15.50%

As on April 1, 2010 for the AY 2011-12

Please refer Taxmann's Income tax book or ready reckoner following are only overview

1) Housing Loan - 8%2) Car Loan (for new Car) - 8%

3) Two wheeler Loan - 15.75%

5) Personal Loan - 16%

6) Loan to employees to suscribe ESOP's - 14%

4) Education loan - {other than Scholor Loan scheme where Rate was 10.25% + concession of 0.5% for Girl stude

a) Upto Rs. 4 Lacs - 11.25%

b) Above 4 Lacs - 12.75%



10.75% 11.00%

>20Lacs10.25%

10.50%

10.50%

10.75%

11.50%

11.75%

11.75%

12.00%

15.50%

Rs. 30Lacs to 75Lacs

More thanRs.75 Lacs

1, 2008 for009-10



12.25%

13.25%

13.25%

15.50%

15.50%

nt}



Perquisites Value of Loans Taken from the Company

Housing Loan Phone Loan

Original Loan Amount 0 0 0 0 0 0 0Co. interest rate

Prescribed interest rate

Differential int 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0

Maximum Outstanding Balance at the end of months

Apr 2010

May 2010

Jun 2010

Jul 2010

Aug 2010

Sep 2010

Oct 2010

Nov 2010

Dec 2010 Jan 2011

Feb 2011

Mar 2011

Total value of Perquisites for the year

“maximum outstanding monthly balance” means the aggregate outstanding balance for each loan as on the last day of each monthInstructions:

1. Enter the original loan amount, and company interest rate in rows 5, 6 respectively

2. Please enter the Interest rate on the 1st Day of month of April for the Financial Year which is fixed by the SBI

If medical Loan made for the following purposes then it is fully exempt for taxable perk calculation but for other purp

(a) cancer;

(b) tuberculosis;(c) acquired immunity deficiency syndrome;

(e) ailment or disease of the eye, ear, nose or throat, requiring surgical operation;

(f) fracture in any part of the skeletal system or dislocation of vertebrae requiring surgical operation or orthopaedic treatment;

(g) gynaecological or obstetric ailment or disease requiring surgical operation, caesarean operation or laperoscopic intervention;

(h) ailment or disease of the organs mentioned at (d), requiring medical treatment in a hospital for at least three continuous days;

(i) gynaecological or obstetric ailment or disease requiring medical treatment in a hospital for at least three continuous days;

(j) burn injuries requiring medical treatment in a hospital for at least three continuous days;

(k) mental disorder - neurotic or psychotic - requiring medical treatment in a hospital for at least three continuous days;

(l) drug addiction requiring medical treatment in a hospital for at least seven continuous days;

(m) anaphylectic shocks including insulin shocks, drug reactions and other allergic manifestations requiring medical treatment in a hosp

(a) “qualified doctor” means a person who holds a degree recognised by the Medical Council of India and is registered by the Medical

(b) “nurse” means a person who holds a certificate of a recognised Nursing Council and is registered under any law for the registration

(c) “surgical operation” includes treatment by modern methodology such as angioplasty, dialysis, lithotropsy, laser or cryo-surgery.]

Car loan, for new car

PCLoan

SoftLoan

SalaryLoan

EducationLoan

MarrL

(d) disease or ailment of the heart, blood, lymph glands, bone marrow, respiratory system, central nervous system, urinary system, liverglands or the skin, requiring surgical operation;

Explanation : For the purpose of this rule,—

Where the benefit relates to the loans made available for medical treatment referred to above, the exemption so provided shall not applyto the employee under any medical insurance scheme.



“member of household” shall include— (a) spouse(s), (bValuation of perquisite in respect of the Car

MONTH

(A) (B) (C )

April

May

June

July

August

SeptemberOctober

November

December

January

February

March

MONTH

(A) (B) (C ) (D)=(B)-(C )

April 0

May 0

June 0 July 0

August 0

September 0

October 0

November 0

December 0

January 0

February 0

March 0

0 0 0

Actual cost of the Car tothe employer if ownedby the employer

Owned/hired byemployer or

owned byemployee Please

Select\/

Cubic Capacity of Engine (CC)

Credit Card expenses for Credit Card used by the employee or anymember of his household

Exp. Incurred by theemployer in respect of Credit Card other thanofficial use

Recovery from theemployee

Value of theperquisite taxable



MONTH

(A) (B) (C ) (D)=(B)-(C )

April 0

May 0

June 0

July 0

August 0

September 0

October 0

November 0

December 0

January 0

February 0

March 0

0 0 0

MONTH

(A) (B) (C ) (D)

April

May

June

July

August

September

October

November

December

January

February

March

0 0

member of his household other than official purpose

Exp. Incurred by theemployer in respect of club facility



Food and Non-alcoholic beverages provided in office premises otransferable paid vouchers usable only in eating joints (a). excludin

hours in remote area or in an offshore installation, (b). excludingprovided in working hours

Exp. Incurred by theemployer in respect of Meals


No. of Holidays andleaves during themonth incl.Sundays(i.e. nonworking days)



) children and their spouses, (c) parents, and (d) s

(D) (E) (F)

MONTH amount exempt

(A) (B) (C )

April 0

May 0

June 0 July 0

August 0

September 0

October 0

November 0

December 0

January 0

February 0

March 0

0 0

Whether Driver

provided? selectfrom the dropdown menu

\/

Total amount of Actual

exp. Incurred byemployer TowardsRunning andmaintainance

Amount recoveredfrom the employee

towards Runnig andmaintainance(expenditure born bythe employee)

or vouc er o en n eu o w c suc g may e remployee (or by the member of his household)] on cerem

Expenditure towarsGifts, vouchers, etc.

Perquisite in respect of Travelling, touring, accomodation



MONTH

(A) (B) (C )

April

May

June

July

August

September

October

November

December

January

February

March

0 0

MONTH

(E) (A) (B)

0 April

0May

0 June

0 July

0 August

0 September

0 October

0 November

0 December

0 January

0 February

0 March

0 0

expneses paid for any holiday availed by the employee (or a

household) other than LTC or LTA (see the Note

Exp. Incurred by theemployer in respect of Holiday Expenses


through nonduring working

Tea or snacks

Value of any other benefit/N.B.:- in case of free transport facility pr

who is a transport service provider (Exceptemployer is the cost at which it

Value of theperquisite taxablein excess of Rs. 50per meal

Exp. Incurred by theemployer in respect of benefit

The value of benefit to the employee (or any member of the



(A) (B) (C )

0 0

prov e y t e emp oyer n t e orm o serv ces o weeper,watchman or personal attendant. (PLEASE SPECIFY WHETHEIS SPECIFIED OR UNSPECIFIED EMPLOYEE) No need to selec

>>>>N.B.:- Please don't include the expenditure towards the sweetc. if provided to the employee for the maintainance of garthe rent free house owned and provided by the employer to i

Employed byselect from the

drop down menu\/

Exp. Incurred by theemployer in respect of benefit




rvants and dependants;

(G)=(E)-(F) (H) (I)

0

0

0

0

0

00

0

0

0

0

0

EMPLOYEE OWNS ANY AUTOMOTIVE CON

(D)=(B)-(C ) (A) (B)

0

0

00

0

0

0

0

0

0

0

0

0 0Credit Card rel

Amount notrecovered fromemployee

Amount of Running andmaintainance exp.

Relating to official purposeas per the recordsavailable (as certified byemployer)

Purpose of use of carOFFICIAL /PRIVATE AND

OFFICIAL / PRIVATE selectfrom the drop down

menu\/

ce ve y enial occasion or

Taxable value of perquisite

Total amount of Actualexp. Incurred byemployer

Amount recoveredfrom the employee(expenditure born bythe employee)

and any other



amount of expenses including membership fees and

employee or any member of his household, which is c

add-on-card) provided by the employer, or otherwise,

(D)=(B)-(C ) employer shall be taken to be the value of perquisite

0 Club Relate

0 The value of benefit to the employee resulting from t

0 the employer of any expenditure incurred (including t

0 a club by him or by a member of his household shall

0 expenditure incurred or reimbursed by such employe

0 Travelling, touring, accomod

0

0

0

0

0

0

0

(C ) (D)=(B)-(C )

0

0

0

0

0

0

0

0

0

0

0

0

0 0


public. Where the employee is on official tour and thhis household accompanying him, the amount of ex

ame

Provided that where any official tour is extended aslimited to the expenses incurred in relation to suchdetermined shall be reduced by the amount, if any,

or am

menity/service/ previlegevided to the employees of the EmployerRailways/Airline) the cost incurred by theprovides service to the public.


Value of the perquisitetaxable

ousehold)



nnual fees incurred by the

harged to a credit card (including any

paid for or reimbursed by such

chargeable to tax

d Provisions

e payment or reimbursement by

he amount of annual or periodical fee) in

e determined to be the actual amount of

on that account.

tion and any other expnesese expenses are incurred in respect of any member of enditure so incurred shall also be a fringe benefit ornity:

a vacation, the value of such fringe benefit shall beextended period of stay or vacation. The amount soaid or recovered from the employee for such benefitenity.



le 8 & 9]

Not a Specified equity share of acompany or not listed on arecognised stock exchange

FMV = Value determined by themerchant Banker on the Specified Date

"specified date” means,—(i) the date of exercising of the option; or (ii) any date earlier than the date of the

exercising of the option, not being adate which is more than 180 days earlier

than the date of the exercising.



No

365

Month Salary

0 0 0 0 April 0

0 0 0 0 May 0

0 0 0 0 June 0

0 0 0 0 July 0

0 0 0 0 August 0

0 0 0 0 September 00 0 0 0 October 0

0 0 0 0 November 0

0 0 0 0 December 0

0 0 0 0 January 0

0 0 0 0 February 0

0 0 0 0 March 0

0 TOTAL 0

Delhi

Mumbai

Chennai

Kolkata

Others



Please Select the city from the control box

Rent free Accommodation

0 0 0 0 0

0 0 0 0 0

0 0 0 0 0

0 0 0 0 0

0 0 0 0 0

0 0 0 0 00 0 0 0 0

0 0 0 0 0

0 0 0 0 0

0 0 0 0 0

0 0 0 0 0

0 0 0 0 0

0 0 0 0

Lease rent paid

by employer (incaseAccomodationnot owned by

employer)

Rent Paid byemployee

value forthe year

Taxableupto 90

days



0

0

0

0

0

00

0

0

0

0

0

0

0

0

50% or40% of Salary



NSC Accrued Interest

Page 1

NSC Accrued Interest Calculation

Enter details of all NSCs purchased before the period 01-Apr-2011

Certificate No. Date of Purchase Amount invested

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0

0




Page 2

0

0

0

Total Accrued Interest

Instructions:

1. Enter details of all NSCs purchased before the period 01-Apr-2011

2. NSCs purchased before or after this date do not accrue interest for this financial year

3. Entry of certificate number is optional




Page 3

31-Mar-2012

Accrued Interest

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00



Sr. No.

1

2

3

4

5

6

7(i)

7(ii)

8

9

10

11

12

13

14

15



i.

ii.

iii.

iv.

v.

vi.

vii.

viii.

a.

b.

c.

d.

a.

b.

c.



Please Put the Figures by reading the instructions carefully

Particulars

Accrued interest on NSC Reinvested

Life insurance premium (including payment made by Government employees to the Central GovernmentEmployees’ insurance scheme and payment made by a person under children’s deferred endowmentassurance policy) [subject to a maximum of 20 per cent of sum assured (sum assured does not include any premium agreed to be returned or any benefit by way of bonus)][ see Note 1]

Payment in respect of non-commutable deferred annuity [ see Note 2]

Any sum deducted from salary payable to a Government employee for the purpose of securing him adeferred annuity (subject to a maximum of 20 per cent of salary) [ see Note 3]

Contribution (not being repayment of loan) towards statutory provident fund and recognized provident fund

Contribution (not being repayment of loan) towards 15 year Public Provident Fund (PPF) [ see Notes 4and 6]

Contribution towards an approved superannuation fund

Subscription to National Savings Certificates, VIII Issue [ see Note 7]

Contribution for participating in the unit-linked insurance plan (ULIP ) of Unit Trust of India [ see Note 5]

Contribution for participating in the unit-linked insurance plan (ULIP ) of LIC Mutual Fund (i.e., formerlyknown as Dhanraksha plan of LIC Mutual Fund) [ see Note 5]

Payment for notified annuity plan of LIC (i.e., New Jeevan Dhara and New Jeevan Akshay, New JeevanDhara I, New Jeevan Akshay I and New Jeevan Akshay II)

Subscription towards notified units of Mutual Fund or UTI

Contribution to notified pension fund set up by Mutual Fund or UTI (i.e., Retirement Benefit UnitScheme of UTI and Kothari Pioneer Pension Plan of Kothari Mutual Fund)

Any sum paid (including accrued interest) as subscription to Home Loan Account Scheme of the NationalHousing Bank or contribution to any notified pension fund set up by the National Housing Bank.

Any sum paid as subscription to any scheme of— a. public sector company engaged in providing long-term finance for purchase/construction of residentialhouses in India

b. housing board constituted in India for the purpose of planning, development or improvement of cities/towns

Any sum paid as tuition fees (not including any payment towards development fees/donation/payment of similar nature) whether at the time of admission or otherwise to any university/college/educationalinstitution in India for full time education



repayment of the amount borrowed by the assessee from —

the Central Government or any State Government, or

any bank, including a co-operative bank, or

the Life Insurance Corporation of India, or

the National Housing Bank, or

The following payments are not qualified for the purpose of section 80C :

any expenditure in respect of which deduction is allowable under the provisions of section 24.

9. The following payment made towards the cost of purchase/construction of a new residential house property is qualified for the purpose of section 80C :

any instalment or part payment of the amount due under any self-financing or other scheme of anydevelopment authority, housing board or other authority engaged in the construction and sale of house property on ownership basis ; or

any instalment or part payment of the amount due to any company or co-operative society of which theassessee is a shareholder or member towards the cost of the house property allotted to him (it is notapplicable if the assessee is not a shareholder or member of the company/co-operative society which provides house to the assessee); or

any public company formed and registered in India with the main object of carrying on the business of providing long-term finance for construction or purchase of houses in India for residential purposes whichis eligible for deduction under section 36(1)(viii), or

any company in which the public are substantially interested or any co-operative society, where suchcompany or co-operative society is engaged in the business of financing the construction of houses, or

the assessee’s employer where such employer is an authority or a board or a corporation or any other bodyestablished or constituted under a Central or State Act, or

the assessee’s employer where such employer is a public company or public sector company, or auniversity established by law or a college affiliated to such university or local authority or co-operativesociety ;

stamp duty, registration fee and other expenses for the purpose of transfer of such house property to theassessee.

the admission fee, cost of the share and initial deposit which a shareholder of a company or a member of aco-operative society has to pay for becoming such shareholder or member ; or

the cost of any addition or alteration to, or renovation or repair of, the house property which is carried outafter the issue of the completion certificate in respect of the house property by the authority competent toissue such certificate or after the house property (or any part thereof) has either been occupied by theassessee or any other person on his behalf or been let out ; or



For the purposes of this clause, “scheduled bank” means the State Bank of India constituted under theState Bank of India Act, 1955 (23 of 1955), or a subsidiary bank as defined in the State Bank of India(Subsidiary Banks) Act, 1959 (38 of 1959), or a corresponding new bank constituted under section 3 of theBanking Companies (Acquisition and Transfer of Undertakings) Act, 1970 (5 of 1970), or under section 3of the Banking Companies (Acquisition and Transfer of Undertakings) Act, 1980 (40 of 1980), or anyother bank, being a bank included in the Second Schedule to the Reserve Bank of India Act, 1934 (2 of 1934);]



Nov Dec Jan Feb Mar

00

0

0

0

0

0

0

0

0

00

0

0

0

0



0

0

0

0

0

0

0 0 0 0 0



Particulars April May June July

Total 0 0 0 0Such insurance shall be in accordance with a scheme framed in this behal

On the health of the taxpayer, spouse, parents or dependent children of the taxpayer.

Dependent Children Does not mean the Grandson or Grand doughter

Amount Paid For Self, Spouse or Dependent Children (Please Specify themode of Payment Also.[Cash or Other]) OR

Contribution made to the Central Government Health Scheme

Amount Paid for the Self, Spouse or Dependent Children who is a senior Citizen. (Please Specify the mode of Payment Also.[Cash or Other])

Amount paid for the benefit of the Senior

Citizen Parent who is Resident in India.(Please Specify the mode of PaymentAlso.[Cash or Other])

Amount paid for the benefit of theParents (who are Not Senior Citizen) whois Resident in India. (Please Specify themode of Payment Also.[Cash or Other])

(a) The General Insurance Corporation of India fo1972) and approved by the Central Governme

(b)Any other insurer and approved by the Insurathe Insurance Regulatory and Development A

Senior Citizen:One who is resident in India and who is at least of 65 years of age at any time during the previo

þÿOther þÿOther þÿOther þÿOther






Mar

0

2 (57 of

ection 3 of

þÿOther

þÿOther

þÿOther

þÿOther



May June July Aug Sep Oct

% DISABLE % DISABLE % DISABLE % DISABLE % DISABLE % DISABLE


0 0 0 0 0 0

a.

b.

c.

d.

For the above purpose, a “dependent being a person with disability” is a person who satisfies the following points—

in the case of an individual, dependent means the spouse,children, parents, brothers and sisters of the individual or any of them;

such person has not claimed any deduction under section80U in computing his total income for the assessment year relating to the previous year;

“disability”* shall have the meaning assigned to it in section2(i) of the Persons with Disabilities (Equal Opportunities,Protection of Rights and Full Participation) Act, 1995

Person with disability means- a person suffering from not less than 40 % of any disability as certified by medical authority.

þÿ þÿ þÿ þÿ þÿ þÿ

þÿ þÿ þÿ þÿ þÿ þÿ



Deduction in respect of interest on loanParticulars April May June July Aug Sep

Total 0 0 0 0 0 0

Following are the conditions to be satisfied

For the purposes of this section,

Amount paid during theyear by way of interest

(1) In computing the total income of an assessee, being an individual, there shall be deducted, in accord of this section, any amount paid by him in the previous year, out of his income chargeable to tax, by wayany financial institution or any approved charitable institution for the purpose of pursuing his higher ed education of his relative.

(2) The deduction specified in sub-section (1) shall be allowed in computing the total income in respect assessment years immediately succeeding the initial assessment year or until the interest referred to in sull, whichever is earlier.

(3) “higher education” means any course of study pursued after passing the Senior Secondary Examinaboard or university recognised by the Central Government or State Government or local authority or byCentral Government or State Government or local authority to do so;]

1. The assessee is an individual.

2. He had taken a loan from any financial institution [i.e., a banking company or notified financial institu657(E) 21-6-2002)] or an approved charitable institution [i.e., an institution approved for the purpose of

3. The loan was taken for the purpose of pursuing higher education [i.e., full-time studies for any graduaengineering (including technology/architecture), medicine, management or for postgraduate course in apincluding mathematics and statistics].

4. Amount is paid by the individual during the previous year by way of repayment of such loan or intere

5. Such amount is paid out of his income chargeable to tax.

Entire payment of interest is deductible. The deduction is available for a maximum of 8 years or till thThis deduction is allowed in computing the taxable income of the initial assessment year (i.e., the asseyear in which the assessee starts paying the interest on the loan) and seven immediately succeedininterest is paid in full, whichever is earlier).



(a) approved charitable institution means an institution specified in, or, as the case may becharitable purposes and 74b[notified by the Central Government] under clause (23C) of seto in clause (a) of sub-section (2) of section 80G;

(b) financial institution means a banking company to which the Banking Regulation Act, 19any bank or banking institution referred to in section 51 of that Act); or any other financial

Government may, by notification in the Official Gazette75, specify in this behalf;

(c) higher education means any course of study pursued after passing the Senior Secondarfrom any school, board or university recognised by the Central Government or State Goverother authority authorised by the Central Government or State Government or local author

(d) initial assessment year means the assessment year relevant to the previous year, in wthe interest on the loan.]

(e) relative, in relation to an individual, means the spouse and children of that individual oindividual is the legal guardian.(wef 1-4-2010)



taken for higher educationOct Nov Dec Jan Feb Mar

0 0 0 0 0 0

nce with and subject to the provisionsof interest on loan taken by him fromcation or for the purpose of higher

f the initial assessment year and sevenb-section (1) is paid by the assessee in

tion or its equivalent from any school,any other authority authorised by the

tion HDFC Bank (Notification no.SOection 10(23C) or 80G(2)(a)].

e or post-graduate course inlied sciences or pure sciences

t on such loan.

e interest is paid, whichever is earlier.ssment year relevant to the previousassessment years (or until the above



, an institution established forction 10 or an institution referred

49 (10 of 1949) applies (includinginstitution which the Central

y Examination or its equivalentnment or local authority or by anyity to do so;(wef 1-4-2010)

ich the assessee starts paying

the student for whom the



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it as "--------Please select----------"



Total

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s been made



Particulars April May June July Aug

% DISABLE % DISABLE % DISABLE % DISABLE % DISABLE

0 0 0 0 0

TOTAL 0 0 0 0 0

united

107.32-1c PERSON WITH DISABILITY(The meaning of disability has been extended from th

i. loss of sensation in hands or feet as well as loss of sensation

ii. manifest deformity and paresis but having sufficient mobil

iii extreme physical deformity as well as advanced age which

107.32-1d CERTIFIED BY MEDICAL AUTHORITY (Form No. 10-IA if the person is suffering

“Medical authority” for this purpose means any hospital or institution specified by notification

Please specify the percentage of Disablility in the

percent dropdownmenu

107.32 Deduction in case of a person with disability [Sec. 80U] - The present section 80U has been

107.32-1 CONDITIONS - Deduction is available if the following conditions are satisfied—

107.32-1a INDIVIDUAL - The taxpayer is an individu

107.32-1b RESIDENT IN INDIA - He is resident in India (maybe ordinarily resident or not ordinaril

i. blindness;

ii. low vision;

iii. leprosy-cured;

iv. hearing impairment;

v. locomotor disability;

vi. mental retardation;

vii. mental illness.

Blindness - “Blindness” refers to a condition where a person suffers from any of the following condit

i. total absence of sight; or

ii. visual acuity not exceeding 6/60 or 20/200 (snellen) in the better eye with correcting lenses; or

iii. limitation of the field of vision subtending an angle of 20 degree or worse.

Low vision - “Person with low vision” means a person with impairment of visual functioning even af

Leprosy cured person - “Leprosy cured person” means any person who has been cured of leprosy b

Hearing impairment - “Hearing impairment” means loss of sixty decibels or more in the better ear i

Locomotor disability - “Locomotor disability” means disability of the bones, joints or muscles leadi

Mental retardation - “Mental retardation” means a condition of arrested or incomplete development

Mental illness - “Mental illness” means any mental disorder other than mental retardation.

FORM

107.32-2 AMOUNT OF DEDUCTION – If the aforesaid conditions are satisfied, then a fixed deducti

þÿ þÿþÿ þÿþÿ þÿþÿ þÿþÿ

http://opt/scribd/conversion/tmp/scratch6106/

http://opt/scribd/conversion/tmp/scratch6106/



Sep Oct Nov Dec Jan Feb


0 0 0 0 0 0

0 0 0 0 0 0

assessment year 2005-06 to include “autism”, “cerebral palsy” and “multiple disability

and paresis in the eye and eye-lid but with no manifest deformity;

ity in their hands and feet to enable them to engage in normal economic activity;

revents him from undertaking any gainful occupation.

from autism, cerebral palsy, etc. ) - The taxpayer shall have to furnish a copy of t

by the appropriate Government for the purpose of the Persons with Disabilities (Equal

ubstituted by a new section with effect from the assessment year 2004-05. The provisions of

resident). Deduction under this section is not available if he is non-resident in India for the r

ions, namely :—

ter treatment or standard refractive correction but who uses or is potentially capable of using

t is suffering from—

the conversational range of frequencies.

g to substantial restriction of the movement of the limbs or any form of cerebral palsy.

of mind of a person, which is specially characterised by subnormality of intelligence.

n of Rs. 50,000 is available. A higher deduction of Rs. 75,000 is allowed in respect of a pers

þÿþÿ þÿþÿ þÿþÿ þÿþÿ þÿþÿ þÿþÿ



eans a person suffering from not less than 40 per cent of any disability given below—

, a fresh certificate from the medical authority shall have to be obtained after the expiry o



f the period mentioned on the original certificate in order to continue to claim the deducti



n.



Form No. 10-IA

STANDARD FORMAT OF THE CERTIFICATE

Certificate No. ........................... Date........................

Certificate for the persons with disabilities

Notes:—

*Strike out whichever is not applicable.

Sd/- (Doctor) Sd/- (Doctor)

Seal Seal

Signature/Thumb impression of the patient.

Recent attested photograph showing the disability affixed here.

Name & address of the institute/hospital issuing the certificate

This is to certify that Shri/ Smt./ Kum....................................................................................... son/ wife/ daughter of Shri......................................................................old male/female, Registration No. ........................................ is a case of ........................................................................................ He/She is physically disabled/visual dhas .......................% (...................... . per cent) permanent (physical impairment/visual impairment/speech & hearing impairment) in relation to his/her ..........................

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

2. Re-assessment is not recommended/is recommended after a period of .....................................................................months/years.*

Countersigned by the MedicalSuperintendent/CMO/Head of Hospital (with seal)



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