PAY ACCOUNTS OFFICE (GREF), DIGHI CAMP, PUNE-15 Income Tax planning Declaration form (ITPD FORM) (Concerning

Income Tax related Savings/Rebates Declaration by the assesses) FOR OFFICE USE ONLY BATCH NO SERIAL NO DECLARATION BY GREF OFFICER/PERSONNEL REGARDING INCOME TAX FOR THE F.Y ____________ NAME UNIT GRADE GS/GO No PROJECT

DECLARATION/ INPUT FOR PROOF OF SAVINGS (*SCORE WHICH EVER IS NOT APPLICABLE) I hereby declare that I intend to claim rebate during the current F.Y under I.T act under sections as indicated below. I enclose requisite certified Xerox copies of documents through which I intend to claim rebate. I am also aware that dates of reaching to PAO GREF of the declaration form/INPUT and submission of proof of savings are 31 JUL____ and 31 JAN______ respectively which I will adhere to. Srl No Name of Savings Certifi Section cate of IT act No. DD/M M/ YY 88 88 Abbreviat Amount ion Code (As per Annx1) Office use accepted/ rejected

1 2

3 4 5 6 7

NSS, NSC, Int on NSC, LIC, premium ULIP, PLI, PPF House building Loan from Bank, LIC Repayment of Principal amount only Infrastructure bonds Pension Scheme investments Medical claim Policy F.D/Expenditure for handicapped dependent Donation to charitable Trust 100% deduction

88 80 CCC (1) 80 DD 80 DDA

8 9 Srl No. 1 2 3 4

Donation to charitable Trust 50% deduction MUTUAL FUND/ELSS DETAILS OF HBA/LOAN AMOUNT OF LOAN FOR HBA LOAN TAKEN IN YEAR (WRITE DATE DD/MM/YY LOAN TAKEN FROM PRIVATE SOURCE FROM GOVT. DATE OF COMPLETION CERTIFICATE OF HOUSE AND DATE OF POSSESSION OF HOUSE AMOUNT OF NOTIONAL INTEREST ACCRUE IN FY ANY OTHER/HOUSE PROPERTY INCOME LOSS FROM HOUSE PROPERTY

80 G

DETAILS OF TRANSACTION

ABBREVIATION CODE (AS PER ANNEXURE-I)

OFFICE USE AUDITED

5 6 7

SIGNATURE OF OFFICER SEE FOLLOWING DETAILS DIRECTIVE BEFORE YOU FILL UP THIS FORM DOS AND DO NOT s WHILE FILLING UP THIS FORM DOS
FILL UP ONLY AMOUNT INVESTED/PROPOSED DURING CURRENT FINANCIAL YEAR COMMENCING FROM 01 APR____ IN AMOUNT COLUMN LAST DATE OF REACHING DECLARATION FORM TO PAO GREF IS 31 JUL ___ AND LAST DATED REACHING PROOF OF SAVINGS (ENCLOSING XEROX COPIES IN SUPPORT OF IT REBATE) IS 31 JAN___. SEND THESE DOCUMENTS CATEGORICALLY BEFORE THESE DATES OR ELSE REBATE CANNOT BE GIVEN BUT SAVINGS INTIMATED WILL BE REFLECTED IN FORM 16. PLEASE KEEP A XEROX COPY OF THE BLANK FORM FOR SUBMISSION OF PROOF OF SAVINGS. UNDER COMPUTERISED SYSTEM, THE QUARTERLY CALCULATIONS OF IT IS BASED ON PAY DETAILS HELD IN PAO GREF AS ON COMMENCEMENT OF FINANCIAL YEAR____ .

YOU ARE PERSONALLY RESPONSIBLE FOR FILING OF IT RETURN AND PAY IT CORRECTLY TO IT AUTHORITIES UNDER IT ACT. DONOTS INCLUDE GPF CONTRIBUTION, CGEIS, PLI, MESS & BAND AMOUNTS IN THIS DECLARATION.

Annexure I
Donations Qualified for deduction from Taxable Income (50% amount of donations to be deducted from the taxable income) Sl. No 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. Description National Defence Fund Jawaharlal Nehru Memorial Fund Prime Ministers Draught Relief Fund Nationals Childrens Fund Indira Gandhi Memorial Trust Rajiv Gandhi Foundation (100% amount of donation to be deducted from the taxable income) Prime Ministers National Relief Fund Prime Ministers Armenia Earthquake Relief Fund Africa (Public contribution India) Fund National Foundation for Communal Harmony University or Educational Institution of National eminence as may be approved by the prescribed authority in this behalf. Zilla Parishad Samiti constituted in district under the chairmanship of Collector for the purpose of improvement of primary education in villages and towns and for literacy and post literacy activities. Abbreviation NADEFD JANEMF PMDRFD NACHFD INGAMT RAGAFN PMNRFD PMAERF AFRICA NAFCHY EDINST ZPSPDV

13. 14. 15.

National Blood Transfusion Council of any State Blood Transfusion NABDTC Council Any fund setup by State Govt to provide medical relief to the poor. Army Central Welfare Fund or Indian Naval Benevolent Fund or AIR Force Central Welfare Fund established by the Armed forces of the Union Andhra Pradesh Chief Ministers Cyclone Relief Fund, 1996 The National illness Assistance Fund Chief Ministers/ Lat. Governors Relief Fund of any State/Union Territory. National Sports Fund set up by the Central Govt. MEDFND ACWFIF

16. 17. 18. 19.

APCYCL NAIAFD CMRFUT NSFDCG

20. 21. 22. 23. 24. 25. 26. 27. 28. 29. 30.

Interest on Home Loan Contribution to the new Pension Fund of LIC Section 80 CCC Medical Insurance Handicapped dependent Deduction of deposit made for maintenance of handicapped dependent Deduction in respect of medical treatment Deduction in the case of assessee who are partially/totally blind or physically handicapped residents personnel Transportation Allowance Deduction allowed on expenditure incurred on purchase or maintenance of uniform/washing Allowns. Entertainment Allowance (Mess Fund in r/o Officers) Interest on NSC

INTHBA CNPFLIC MEDINS HANDDP DDMDEP DEMEDT PTBLND TPTALL UNIWAL ENTALL INTNSC

Savings for rebate:

1. 2. 3. 4. 5. 6. 7. 8. 9. Insurance Premium (Self / Family). Provident Fund Contributions. Unit Linked Insurance. Post Office Saving Bank (CTD), 1959. 10 year / 15 year account. National Saving Certificates VIII issue Units of any Mutual Fund notified under Clause 23-D of Unit Trust of India upto Rs. 10,000. LFINCN PRFDCN UTLDIN POSCTD NSC8TH MUTUAL

Pension Fund Set up by Mutual Fund notified under 23-D of section PENFND 10 by Govt. of India. Shares/Debentures approved by CBDT Home Loan Availed in HDFC/LIC SHARES HLHDLI