Calculation of Income Tax for the Year 2012-13

A Salary and Other benefits (Received during financial year 2012-13) B Income exempted u/s 10 Travelling Concession/ Assistance House Rent Allowance Fixed Conveyance Allowance Total C Income from House Property D Interest paid in case of Self-occupied residential house E Income from Other Sources F Gross Total Income G Deductions u/s 80C and 80 CCF etc. General Provident Fund (GPF)/ NPS Group Insurance Scheme (GIS) Life Insurance Premia (LIC) ULIP (Unit Linked Plans) Repayment of House Loan Tuition Fee (Max. for two children) Investment in NSC Accrued Interest on NSC Any Other Any Other Total Deductions (Max. limit up to Rs. 1,00,000/-) Investment in Infrastructure bonds (Max. Rs. 20,000/-) Total Deductions admissible H Deductions u/s 80D to 80U Type the deduction here (if any) Type the deduction here (if any) I Taxable Income (Rounded off to nearest Ten rupees) J Computation of Tax Rate Upto first Rs. 2,00,000/0% Rs. 2,00,001 to Rs. 5,00,000/10% Rs. 5,00,000/- to Rs. 10,00,000/20% Exceeding Rs. 10,00,000/30% Tax Payable K Education and Higher Edu. Cess @ 3% L Total Tax Payable M Tax Deducted at Source N Balance to be paid O Refund (If any) Amount (in INR) 0

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

0 Amount 0 0 0 0 0 0 0 0 0 0

Verification: I . Do hereby declare that the data given above is true to the best of my knowledge and belief. Verified today, the . Day of , 2013. Place: Date: Head/DDO of the Office Signature of the Employee

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