YEARS Basic Pay + PP D.P.

SP DA HRA CCA OA TOTAL

1998-1999 10929 2667 2019 1010 16625

1999-2000 13250 4706 2200 1200 21356

2000-2001 14700 5960 1300 1000 22960

2001-2002 13850 6142 1200 21192

2002-2003 14150 6607 1400 22157

2003-2004 14450 7406 2200 24056

2004-2005 15042 8728 1447 25217

2005-2006 15688 1595 9333 3000 29616

2006-2007 18650 9332 8256 4439 40677

TOTAL 130709 10927 0 59805 19205 3210 0 223856

IT Paid

IT Paid

0
 INCOME
INCOMETAX
TAXSTATEMENT
STATEMENTFOR
FORTHE
THEFINANCIAL
FINANCIALYEAR
YEAR1998-1999
1998-1999

NAME : D.V.GAJENDRAN

DESIGNATION : P.A. TO MINISTER FOR FOOD [A.S.O.]

PUBLIC DEPARTMENT
( in Rupees )
Year EARNINGS DEDUCTIONS
and PAY+ OA/
Month DA HRA CCA Total GPF FBF/SPF SPF PT/GF HBA HBSBF LIC TOTAL
PP MA

1998 March 5500 #VALUE! ### ### 0 #VALUE! 300 0 0 - 0 0 0 0 300

1998 April 5500 #VALUE! ### ### 0 #VALUE! 1500 0 0 - 0 0 0 0 1500
1998 May 5500 #VALUE! ### ### 0 #VALUE! 1500 0 0 - 0 0 0 0 1500
1998 June 5500 #VALUE! ### ### 0 #VALUE! 1500 0 0 - 0 0 0 0 1500
1998 July 5500 #VALUE! ### ### 0 #VALUE! 1500 0 0 - 0 0 0 0 1500
1998 Aug. 5500 #VALUE! ### ### 0 #VALUE! 1500 0 0 ### 0 0 0 0 ###
1998 Sept. 5500 #VALUE! ### ### 0 #VALUE! 1500 0 0 - 0 0 0 0 1500
1998 Oct. 5500 #VALUE! ### ### 0 #VALUE! 1500 0 0 - 0 0 0 0 1500

1998 Nov. 5500 #VALUE! ### ### 0 #VALUE! 1500 0 0 - 0 0 0 0 1500

1998 Dec. 5500 #VALUE! ### ### 0 #VALUE! 1500 0 0 - 0 0 0 0 1500

1999 Jan. 5675 #VALUE! ### ### 0 #VALUE! 1500 0 0 ### 0 0 0 0 ###
1999 Feb. 5675 #VALUE! ### ### 0 #VALUE! 1500 0 0 0 0 0 0 1500

- 0 - - 0 0 - - - - - - 0
BONUS 825 825 0 - - - - - - 0
SL-15 days 0 0 0 0 0 0 0 - - - - - - 0

Pay Fix
Arrears
10929 2667 2019 1010 0 16625 0 - 0 0 - - - - 0

TOTAL = 77,279 #VALUE! ### ### 825 #VALUE! 16,800 0 0 ### 0 ... 0 0 ###

ABSTRACT
PAY : 77,279 GPF : 16,800
DA : #VALUE! FBF + SPF :
HRA : #VALUE! PT : #VALUE!
CCA : #VALUE! Health Fund :
O.A. + Bonus : 825 HBA : ,
HBASBF :
LIC : ,
Total Earnings : #VALUE! Total Deductions : #VALUE!
P.T.O.

3
 INCOME
INCOMETAX
TAXSTATEMENT
STATEMENTFOR
FORTHE
THEFINANCIAL
FINANCIALYEAR
YEAR1998-1999
1998-1999
Rs.
GROSS TOTAL EARNINGS : #VALUE!

LESS : HRA exempt u/s 10(13A) :

(a) Actual amount of HRA received #VALUE!

(b) Expenditure of rent in excess of 10% of salary (including DA

as presumed that DA is taken for retirement benefit)
(c) 50% of Salary (+Basic) #VALUE!
#VALUE!
LESS : #VALUE!
STANDARD DEDUCTIONS
(upto 100000 = 33 1/3% or 25,000
1,00,000 to 5,00,000 = 20,0000 and above 5,00,000 = NIL)

Professional Tax #VALUE!

HBA Interest [u/s 24] -

Medical Expenses [u/s 80DDB] -

TOTAL - Standard Deductions #VALUE!
TOTAL TAXABLE INCOME #VALUE!
[Rounded Off To Next Ten Rupees] #VALUE!

INCOME TAX: On theFirst Rs.50,000/- Nil

On the Next Rs.50,001/- to Rs.60,000/- (10%) #VALUE! #VALUE!
On the Next Rs.60,001/- to Rs.1,50,000/- (20%) #VALUE! #VALUE!
Exceeding Rs.1,50,000/- (30%) #VALUE! #VALUE!
GROSS INCOME TAX #VALUE!
LESS : Rebate u/s 88C (Being women) 0

#VALUE!
DEDUCTIONS u/s 88
Provident Fund (GPF) 16,800
FBF + SPF -
HBA Loan Repaid (maximum Rs.10,000) -
LIC -
N.S.C. -
AMOUNT ELIGIBLE FOR TAX REBATE (Limited to Rs.60,000/-) 16,800

LESS : 20% Tax Rebate on the Total of Deductions u/s 88 3,360

#VALUE!
NET TAX PAYABLE #VALUE!

TOTAL TAX PAYBLE #VALUE!

LESS : TAX DEDUCTION SO FAR MADE (Tax Paid) 0
BALANCE TAX PAYABLE #VALUE!

D.V.GAJENDRAN
P.A. TO MINISTER FOR FOOD [A.S.O.]

4
 INCOME
INCOMETAX
TAXSTATEMENT
STATEMENTFOR
FORTHE
THEFINANCIAL
FINANCIALYEAR
YEAR1999-2000
1999-2000

NAME : D.V.GAJENDRAN

DESIGNATION : P.A. TO MINISTER FOR FOOD [A.S.O.]

PUBLIC DEPARTMENT
( in Rupees )
Year EARNINGS DEDUCTIONS
and PAY +
Month DA HRA CCA SA Total GPF FBF/SPF SPF PT/GF HBA HBSBF LIC TOTAL
PP

1999 March 5675 #VALUE! ### ### 0 #VALUE! 1500 0 0 - 0 0 0 0 1500

1999 April 5675 #VALUE! ### ### 0 #VALUE! 1500 0 0 - 0 0 0 0 1500
1999 May 5675 #VALUE! ### ### 0 #VALUE! 1500 0 0 - 0 0 0 0 1500
1999 June 5675 #VALUE! ### ### 0 #VALUE! 1500 0 0 - 0 0 0 0 1500
1999 July 5675 #VALUE! ### ### 0 #VALUE! 1500 0 0 - 0 0 0 0 1500
1999 Aug. 5675 #VALUE! ### ### 0 #VALUE! 1500 0 0 ### 0 0 0 0 ###
1999 Sept. 5675 #VALUE! ### ### 0 #VALUE! 1500 0 0 - 0 0 0 0 1500

1999 Oct. 5675 #VALUE! ### ### 0 #VALUE! 1500 0 0 - 0 0 0 0 1500

1999 Nov. 5675 #VALUE! ### ### 0 #VALUE! 4000 0 0 - 0 0 0 0 4000

1999 Dec. 5675 #VALUE! ### ### 0 #VALUE! 4000 0 0 - 0 0 0 0 4000
2000 Jan. 5850 #VALUE! ### ### 0 #VALUE! 4000 0 0 ### 0 0 0 0 ###
2000 Feb. 5850 #VALUE! ### ### 0 #VALUE! 4000 0 0 - 0 0 0 0 4000

- - - - 0 - - - - - - 0

- - - - 0 0 - - - - - - 0
0 0 0
SL-15 days 0 0 0 0 0 0 0 - - - - - - 0
BONUS 825 825 0 - - - - - - 0
Pay Fix
Arrears
13250 4706 2200 1200 0 21356

TOTAL = 81,700 #VALUE! ### ### 825 #VALUE! 28,000 0 0 ### 0 , 0 0 ###

ABSTRACT
PAY : 81,700 GPF : 28,000
DA : #VALUE! FBF + SPF :
HRA : #VALUE! PT : #VALUE!
CCA : #VALUE! Health Fund :
O.A. + Bonus : 825 HBA : ,
HBASBF :
LIC : ,
Total Earnings : #VALUE! Total Deductions : #VALUE!
P.T.O.

5
 INCOME
INCOMETAX
TAXSTATEMENT
STATEMENTFOR
FORTHE
THEFINANCIAL
FINANCIALYEAR
YEAR1999-2000
1999-2000
Rs.
GROSS TOTAL EARNINGS : #VALUE!

LESS : HRA exempt u/s 10(13A) :

(a) Actual amount of HRA received #VALUE!

(b) Expenditure of rent in excess of 10% of salary (including DA

as presumed that DA is taken for retirement benefit)
(c) 50% of Salary (+Basic) #VALUE!
#VALUE!
LESS : #VALUE!
STANDARD DEDUCTIONS
(upto 100000 = 33 1/3% or 25,000
1,00,000 to 5,00,000 = 20,0000 and above 5,00,000 = NIL)

Professional Tax #VALUE!

HBA Interest [u/s 24] -

Medical Expenses [u/s 80DDB] -

TOTAL - Standard Deductions #VALUE!
TOTAL TAXABLE INCOME #VALUE!
[Rounded Off To Next Ten Rupees] #VALUE!

INCOME TAX: On theFirst Rs.50,000/- Nil

On the Next Rs.50,001/- to Rs.60,000/- (10%) #VALUE! #VALUE!
On the Next Rs.60,001/- to Rs.1,50,000/- (20%) #VALUE! #VALUE!
Exceeding Rs.1,50,000/- (30%) #VALUE! #VALUE!
GROSS INCOME TAX #VALUE!
LESS : Rebate u/s 88C (Being women) 0

#VALUE!
DEDUCTIONS u/s 88
Provident Fund (GPF) 28,000
FBF + SPF -
HBA Loan Repaid (maximum Rs.10,000) -
LIC -
N.S.C. -

AMOUNT ELIGIBLE FOR TAX REBATE (Limited to Rs.60,000/-) 28,000

LESS : 20% Tax Rebate on the Total of Deductions u/s 88 5,600

LESS : 20% Tax Rebate on Investment in ICICI Bond/UTI/MF (upto 10000) 0 -
#VALUE!
NET TAX PAYABLE #VALUE!
ADD : 10% SURCHARGE ON INCOME TAX #VALUE!
TOTAL TAX PAYBLE #VALUE!
LESS : TAX DEDUCTION SO FAR MADE (Tax Paid) 0
BALANCE TAX PAYABLE #VALUE!

D.V.GAJENDRAN
P.A. TO MINISTER FOR FOOD [A.S.O.]

6
 INCOME
INCOMETAX
TAXSTATEMENT
STATEMENTFOR
FORTHE
THEFINANCIAL
FINANCIALYEAR
YEAR2000-2001
2000-2001

NAME : D.V.GAJENDRAN

DESIGNATION : P.A. TO MINISTER FOR FOOD [A.S.O.]

PUBLIC DEPARTMENT
( in Rupees )
EARNINGS DEDUCTIONS
Year
and PAY+
GPF/
Month PP+ DA HRA CCA SA Total FBF/SPF SPF PT/GF HBA HBSBF LIC TOTAL
IDA
SP

2000 March 5850 ### ### ### 0 #VALUE! 4000 0 0 - 0 0 0 0 4000

2000 April 5850 ### ### ### 0 #VALUE! 4000 0 0 - 0 0 0 0 4000

2000 May 5850 ### ### ### 0 #VALUE! 4000 0 0 - 0 0 0 0 4000

2000 June 5850 ### ### ### 0 #VALUE! 4000 0 0 - 0 0 0 0 4000

2000 July 5850 ### ### ### 0 #VALUE! 4000 0 0 0 0 0 0 4000

2000 Aug. 5850 ### ### ### 0 #VALUE! 4000 0 0 ### 0 0 0 0 ###

2000 Sept. 5850 ### ### ### 0 #VALUE! 4000 0 0 - 0 0 0 0 4000

2000 Oct. 5850 ### ### ### 0 #VALUE! 4000 0 0 - 0 0 0 0 4000

2000 Nov. 5850 ### ### ### 0 #VALUE! 4000 0 0 - 0 0 0 0 4000

2000 Dec. 5850 ### ### ### 0 #VALUE! 4000 0 0 - 0 0 0 0 4000

2001 Jan. 6025 ### ### ### 0 #VALUE! 4000 0 0 ### 0 0 0 0 ###

2001 Feb. 6025 ### ### ### 0 #VALUE! 4000 0 0 0 0 0 0 0 4000

0 0 - - - - - - 0

0 0 - - - - - - 0

SL-15 days ### 0 0 0 0 #VALUE! 0 - - - - - - 0

ADHOC BONUS 0 - - - 825 825 0 - - - - - - 0

Pay Fix
Arrears
14700 5960 1300 1000 0 22960

TOTAL = #VALUE! #VALUE! ### ### 825 #VALUE! 48,000 0 0 ### 0 , 0 0 ###

ABSTRACT
PAY : #VALUE! GPF : 48,000
DA : #VALUE! FBF + SPF :
HRA : #VALUE! PT : #VALUE!
CCA : #VALUE! Health Fund :
O.A. + Bonus : 825 HBA : ,
HBASBF :
LIC : ,
Total Earnings : #VALUE! Total Deductions : #VALUE!
P.T.O.

7
 INCOME
INCOMETAX
TAXSTATEMENT
STATEMENTFOR
FORTHE
THEFINANCIAL
FINANCIALYEAR
YEAR2000-2001
2000-2001
Rs.
GROSS TOTAL EARNINGS : #VALUE!

LESS : HRA exempt u/s 10(13A) :

(a) Actual amount of HRA received #VALUE!

(b) Expenditure of rent in excess of 10% of salary (including DA

as presumed that DA is taken for retirement benefit)
(c) 50% of Salary (+Basic) #VALUE!
#VALUE!
LESS : #VALUE!
STANDARD DEDUCTIONS
(upto 100000 = 33 1/3% or 25,000
1,00,000 to 5,00,000 = 20,0000 and above 5,00,000 = NIL)

Professional Tax #VALUE!

HBA Interest [u/s 24] -

Medical Expenses [u/s 80DDB] -

TOTAL - Standard Deductions #VALUE!
TOTAL TAXABLE INCOME #VALUE!
[Rounded Off To Next Ten Rupees] #VALUE!

INCOME TAX: On theFirst Rs.50,000/- Nil

On the Next Rs.50,001/- to Rs.60,000/- (10%) #VALUE! #VALUE!
On the Next Rs.60,001/- to Rs.1,50,000/- (20%) #VALUE! #VALUE!
Exceeding Rs.1,50,000/- (30%) #VALUE! #VALUE!
GROSS INCOME TAX #VALUE!
LESS : Rebate u/s 88C (Being women) 0

#VALUE!
DEDUCTIONS u/s 88
Provident Fund (GPF) 48,000
FBF + SPF -
HBA Loan Repaid (maximum Rs.20,000) -
LIC -
N.S.C. -
AMOUNT ELIGIBLE FOR TAX REBATE (Limited to Rs.60,000/-) 48,000

LESS : 20% Tax Rebate on the Total of Deductions u/s 88 9,600

LESS : 20% Tax Rebate on Investment in ICICI Bond/UTI/MF (upto 10000) 0 -
#VALUE!
NET TAX PAYABLE #VALUE!
ADD : Upto Rs.1,50,000/- 10% Above 15% SURCHARGE ON INCOME TAX #VALUE!
TOTAL TAX PAYBLE #VALUE!
LESS : TAX DEDUCTION U/S 80c FOR WOMEN 0
LESS : TAX DEDUCTION SO FAR MADE (Tax Paid) 0
BALANCE TAX PAYABLE #VALUE!

D.V.GAJENDRAN
P.A. TO MINISTER FOR FOOD
[A.S.O.]

8
 INCOME
INCOMETAX
TAXSTATEMENT
STATEMENTFOR
FORTHE
THEFINANCIAL
FINANCIALYEAR
YEAR2001-2002
2001-2002

NAME : D.V.GAJENDRAN

DESIGNATION : P.A. TO MINISTER FOR FOOD [A.S.O.]

PUBLIC DEPARTMENT
( in Rupees )
Year EARNINGS DEDUCTIONS
and
Month PAY+PP DA HRA CCA MA/SA Total GPF FBF/SPF SPF PT/GF HBA HBSBF LIC TOTAL

2001 March 6025 ### ### ### 0 #VALUE! 4000 0 0 - 0 0 0 0 4000

2001 April 6025 ### ### ### 0 #VALUE! 4000 0 0 - 0 0 0 0 4000

2001 May 6025 ### ### ### 0 #VALUE! 4000 0 0 - 0 0 0 0 4000

2001 June 6025 ### ### ### 0 #VALUE! 4000 0 0 - 0 0 0 0 4000

2001 July 6025 ### ### ### 0 #VALUE! 4000 0 0 0 0 0 0 4000

2001 Aug. 6025 ### ### ### 0 #VALUE! 4000 0 0 ### 0 0 0 0 ###

2001 Sept. 6025 ### ### ### 0 #VALUE! 4000 0 0 - 0 0 0 0 4000

2001 Oct. 6025 ### ### ### 0 #VALUE! 4000 0 0 - 0 0 0 0 4000

2001 Nov. 6025 ### ### ### 0 #VALUE! 4000 0 0 - 0 0 0 0 4000

2001 Dec. 6025 ### ### ### 0 #VALUE! 4000 0 0 - 0 0 0 0 4000

2002 Jan. 6200 ### ### ### 0 #VALUE! 4000 0 0 ### 0 0 0 0 ###

2002 Feb. 6200 ### ### ### 0 #VALUE! 4000 0 0 0 0 0 0 4000

0 0 - - - - - - 0

0 0 - - - - - - 0

SL-15 days ### 0 0 0 0 #VALUE! 0 - - - - - - 0

ADHOC BONUS - - - - 0 0 0 - - - - - - 0

Pay Fix
Arrears
13850 6142 1200 0 0 21192

TOTAL = #VALUE! #VALUE! ### ### 0 #VALUE! 48,000 0 0 ### 0 , 0 0 ###

ABSTRACT
PAY : #VALUE! GPF : 48,000
DA : #VALUE! FBF + SPF :
HRA : #VALUE! PT : #VALUE!
CCA : #VALUE! Health Fund :
O.A. + Bonus : HBA : ,
HBASBF :
LIC : ,
Total Earnings : #VALUE! Total Deductions : #VALUE!
P.T.O.

9
 INCOME
INCOMETAX
TAXSTATEMENT
STATEMENTFOR
FORTHE
THEFINANCIAL
FINANCIALYEAR
YEAR2001-2002
2001-2002
Rs.
GROSS TOTAL EARNINGS : #VALUE!

LESS : HRA exempt u/s 10(13A) :

(a) Actual amount of HRA received #VALUE!

(b) Expenditure of rent in excess of 10% of salary (including DA

as presumed that DA is taken for retirement benefit)
(c) 50% of Salary (+Basic) #VALUE!
#VALUE!
LESS : #VALUE!
STANDARD DEDUCTIONS
(upto 150000 = 30,000 or 33 1/3 or whichever LESS
From 150001 to 300000 = 25,000
From 300001 to 500000 = 20,000
Above 500000 = Nil)
[subject to maximum of Rs.30,000 u/s 16(1)]

Professional Tax #VALUE!

HBA Interest [u/s 24] -

Medical Expenses [u/s 80DDB] -

TOTAL - Standard Deductions #VALUE!
TOTAL TAXABLE INCOME #VALUE!
[Rounded Off To Next Ten Rupees] #VALUE!

INCOME TAX: On theFirst Rs.50,000/- Nil

On the Next Rs.50,001/- to Rs.60,000/- (10%) #VALUE! #VALUE!
On the Next Rs.60,001/- to Rs.1,50,000/- (20%) #VALUE! #VALUE!
Exceeding Rs.1,50,000/- (30%) #VALUE! #VALUE!
GROSS INCOME TAX #VALUE!
LESS : Rebate u/s 88C (Being women) 0

#VALUE!
DEDUCTIONS u/s 88
Provident Fund (GPF) 48,000
FBF + SPF -
HBA Loan Repaid (maximum Rs.20,000) -
LIC -
N.S.C. -

AMOUNT ELIGIBLE FOR TAX REBATE (Limited to Rs.60,000/-) 48,000

LESS : 20% Tax Rebate on the Total of Deductions u/s 88 9,600

LESS : 20% Tax Rebate on Investment in ICICI Bond/UTI/MF (upto 10000) 0 -
9,600
#VALUE!
NET TAX PAYABLE #VALUE!
ADD : 2% SURCHARGE ON INCOME TAX #VALUE!
TOTAL TAX PAYBLE #VALUE!
LESS : TAX DEDUCTION SO FAR MADE (Tax Paid) 0
BALANCE TAX PAYABLE #VALUE!

D.V.GAJENDRAN
P.A. TO MINISTER FOR FOOD [A.S.O.]

PUBLIC DEPARTMENT

10
 INCOME
INCOMETAX
TAXSTATEMENT
STATEMENTFOR
FORTHE
THEFINANCIAL
FINANCIALYEAR
YEAR2002-2003
2002-2003

NAME : D.V.GAJENDRAN
DESIGNATION : P.A. TO MINISTER FOR FOOD [A.S.O.]

PUBLIC DEPARTMENT
( in Rupees )
Year EARNINGS DEDUCTIONS
and GPF/ SPF FBF-
Month PAY+PP DA HRA CCA SA/MA Total FBF/SPF PT/GF HBA LIC
IDA 2000 HBA

2002 March 6200 ### ### ### 0 #VALUE! 4000 0 0 - 0 0 0 0

2002 April 6200 ### ### ### 0 #VALUE! 4000 0 0 - 0 0 0 0

2002 May 6200 ### ### ### 0 #VALUE! 4000 0 0 - 0 0 0 0

2002 June 6200 ### ### ### 0 #VALUE! 4000 0 0 - 0 0 0 0

2002 July 6200 ### ### ### 0 #VALUE! 4000 0 0 0 0 0 0

2002 Aug. 6200 ### ### ### 0 #VALUE! 4000 0 0 ### 0 0 0 0

2002 Sept. 6200 ### ### ### 0 #VALUE! 4000 0 0 - 0 0 0 0

2002 Oct. 6200 ### ### ### 0 #VALUE! 4000 0 0 - 0 0 0 0

2002 Nov. 6200 ### ### ### 0 #VALUE! 4000 0 0 - 0 0 0 0

2002 Dec. 6200 ### ### ### 0 #VALUE! 4000 0 0 - 0 0 0 0

2003 Jan. 6375 ### ### ### 0 #VALUE! 4000 0 0 ### 0 0 0 0

2003 Feb. 6375 ### ### ### 0 #VALUE! 4000 0 0 0 0 0 0

0 0

Pay Fix
Arrears 14150 6607 1400 0 0 22157

TOTAL = 88,900 #VALUE! ### ### 0 #VALUE! 48,000 0 0 ### 0 0 0 0

ABSTRACT

PAY : 88,900 GPF : 48,000

DA : #VALUE! FBF + SPF :

HRA : #VALUE! PT : #VALUE!

CCA : #VALUE! Health Fund :

O.A. + Bonus : HBA FBF : ,

Total Earnings : #VALUE! Total Deductions : #VALUE!

P.T.O.
 INCOME
INCOMETAX
TAXSTATEMENT
STATEMENTFOR
FORTHE
THEFINANCIAL
FINANCIALYEAR
YEAR2002-2003
2002-2003
Rs.
I. GROSS TOTAL EARNINGS : #VALUE!
LESS : STANDARD DEDUCTIONS u/s 16 of IT Act
[Upto Rs.1,50,000/- = Rs.30,000/- #VALUE!
Rs.1,50,0001/- to Rs.3,00,000/- = Rs.25,000/-
Rs.3,00,0001/- to Rs.5,00,000/- = Rs.20,000/-]
[No Standard Deduction exceeds 5 lakhs rupees]

Professional Tax [clause (2) of Art.276 of Constitution] #VALUE!

HRA Exemption u/s 10(13A) of IT Act #VALUE!
[(a) Actual amount of HRA received (OR)
(b) Rent paid in excess of 10% of Pay+DA (OR)
(c) 50% of Pay+DA WHICHEVER IS LESS]

II. TOTAL - Standard Deductions #VALUE!

TOTAL TAXABLE INCOME #VALUE!
III. TOTAL INCOME [Rounded Off To Next Ten Rupees] #VALUE!
LESS : DEDUCTION UNDER CHAPTER VI-A of IT Act
Section Scheme Policy/Cert.No. Max. Limit
(1) 80-CCC Annuity Plan Rs.10000/- -
(2) 80-D Insurance on the Health MediClaim Rs.10000/-
(3) 80-DD Handicapped Dependent Rs.40000/- -
(4) 80-DDB Specific Ailments (Medical) Rs.40000/- -
(5) 80-E Ednl. Loan/Interest for Assessee only Rs.40000/- -
(6) 80-G Donations made for Charitable purposes- 50% (Rs.25,000/-)
(7) 80GG Deduction in respect of HRA -
(8) 80-L Interest from Banks/NSC/Bonds Rs.12000/- -
80GGA CRY
192(3.4(i)) Interest on HBA Rs.150000/- -
(for loans taken after 1-4-99)
192(3.4(ii)) Interest on HBA Rs.30000/- -
(for loans taken before 1-4-99)
IV. Aggregate of Deductible amount under Chapter VI-A 0
V. TOTAL TAXABLE INCOME #VALUE!
INCOME TAX CALCULATION
On theFirst Rs.50,000/- Nil
On the Next Rs.50,001/- to Rs.60,000/- (10%) #VALUE! #VALUE!
On the Next Rs.60,001/- to Rs.1,50,000/- (20%) #VALUE! #VALUE!
Exceeding Rs.1,50,000/- (30%) #VALUE! #VALUE!
VI. GROSS INCOME TAX DUE #VALUE!
LESS : VII. Rebate u/s 88C (Being women) 0
VIII. TOTAL INCOME TAX DUE: #VALUE!
CHAPTER-VIII TAX REBATES ALLOWED FROM GROSS INCOME TAX u/s 88
G.P.F. (Subscription + IDA) 48,000
FBF + SPF + SPF2000 + HBA SPF -
Repayment of HBA (maximum Rs.20,000) -
LIC - Salary Deduction -
LIC-Self -
AMOUNT ELIGIBLE FOR TAX REBATE (Limited to Rs.70,000/-) 48,000
LESS : Rate of REBATE u/s 88 [Upto 150000 = 20% / Above 150000 = 15%] ###
ADDITIONAL REBATES UNDER SECTION 88
Subscription in notified Insfrastructure Bonds (I.e. ICICI,IDBI) -
Others -

AMOUNT ELIGIBLE FOR TAX REBATE (Limited to Rs.20,000/-) -

LESS : 20% Additional Tax Rebate -

IX. AGGREGATE OF TAX REBATES AND RELEIF #VALUE!
#VALUE!
X. NET TAX PAYABLE #VALUE!
ADD : XI. Surchage @ 5% on Income Tax #VALUE!
XII. TOTAL TAX DUE AFTER SURCHARGE #VALUE!
LESS : TAX DEDUCTED AT SOURCE (so far Tax Paid) 0
XIII. TAX PAYABLE / REFUNDABLE #VALUE!
INCOME
INCOMETAX
TAXSTATEMENT
STATEMENTFOR
FORTHE
THEFINANCIAL
FINANCIALYEAR
YEAR2002-2003
2002-2003
( D.V.GAJENDRAN )
 TOTAL

4000

4000

4000

4000

4000

###

4000

4000

4000

4000

###

4000

#VALUE!

P.T.O.
 INCOME
INCOMETAX
TAXSTATEMENT
STATEMENTFOR
FORTHE
THEFINANCIAL
FINANCIALYEAR
YEAR2003-2004
2003-2004

NAME : D.V.GAJENDRAN
DESIGNATION : P.A. TO MINISTER FOR FOOD [A.S.O.]
PUBLIC DEPARTMENT

( in Rupees )
Year EARNINGS DEDUCTIONS
and SPF
Month PAY DA HRA CCA SA Total GPF FBF/SPF PT/GF HBA HBSBF LIC TOTAL
2000

2003 March 6375 ### ### ### 0 ### 4064 0 0 - 0 0 0 0 4064

2003 April 6375 ### ### ### 0 ### 4064 0 0 - 0 0 0 0 4064

2003 May 6375 ### ### ### 0 ### 4064 0 0 - 0 0 0 0 4064

2003 June 6375 ### ### ### 0 ### 4064 0 0 - 0 0 0 0 4064

2003 July 6375 ### ### ### 0 ### 4000 0 0 0 0 0 0 4000

2003 Aug. 6375 ### ### ### 0 ### 4000 0 0 ### 0 0 0 0 ###

2003 Sept. 6375 ### ### ### 0 ### 4000 0 0 - 0 0 0 0 4000

2003 Oct. 6375 ### ### ### 0 ### 4000 0 0 - 0 0 0 0 4000

2003 Nov. 6375 ### ### ### 0 ### 4000 0 0 - 0 0 0 0 4000

2003 Dec. 6375 ### ### ### 0 ### 4000 0 0 - 0 0 0 0 4000

2004 Jan. 6550 ### ### ### 0 ### 4000 0 0 ### 0 0 0 0 ###

2004 Feb. 6550 ### ### ### 0 ### 4000 0 0 0 0 0 0 4000

4000

Pay Fix
Arrears 14450 7406 2200 0 0 24056

TOTAL = 91,300 #VALUE! ### ### 0 ### 48,256 0 0 ### 0 , 0 0 ###

ABSTRACT

PAY : 91,300 GPF : 48,256

DA : #VALUE! FBF + SPF :

HRA : #VALUE! PT : #VALUE!

CCA : #VALUE! Health Fund :

O.A. + Bonus : HBA : ,

HBASBF :

LIC : ,
Total Earnings : #VALUE! Total Deductions : #VALUE!

P.T.O.
 INCOME
INCOMETAX
TAXSTATEMENT
STATEMENTFOR
FORTHE
THEFINANCIAL
FINANCIALYEAR
YEAR2003-2004
2003-2004
Rs.
I. GROSS TOTAL EARNINGS : #VALUE!
LESS : STANDARD DEDUCTIONS u/s 16 of IT Act
[Upto Rs.5,00,000/- = Rs.30,000/- #VALUE!
Above Rs.5,00,000/- = Rs.20,000/-]

Professional Tax [clause (2) of Art.276 of Constitution] #VALUE!

HRA Exemption u/s 10(13A) of IT Act #VALUE!
[(a) Actual amount of HRA received (OR)
(b) Rent paid in excess of 10% of Pay+DA (OR)
(c) 50% of Pay+DA WHICHEVER IS LESS]

II. TOTAL - Standard Deductions #VALUE!

TOTAL TAXABLE INCOME #VALUE!
III. TOTAL GROSS INCOME [Rounded Off To Next Ten Rupees] #VALUE!
LESS : DEDUCTION UNDER CHAPTER VI-A of IT Act
Section Scheme Policy/Cert.No. Max. Limit
(1) 80-CCC Annuity Plan Rs.10000/- -
(2) 80-D Insurance on the Health Rs.10000/- -
(3) 80-DD Handicapped Dependent Rs.40000/- -
(4) 80-DDB Specific Ailments (Medical) Rs.40000/- -
(5) 80-E Ednl. Loan/Interest for Assessee only Rs.40000/- -
(6) 80-G Donations made for Charitable purposes- 50% -
(7) 80GG Deduction in respect of HRA -
(8) 80-L Interest from Banks/NSC/Bonds Rs.12000/- -
80-U Assessee's Permanent Physical Disability Rs.40000/- -
192(3.4( Interest on HBA Rs.150000/- -
i)) (for loans taken after 1-4-99)
192(3.4( Interest on HBA Rs.30000/- -
ii)) (for loans taken after 1-4-99)
IV. Aggregate of Deductible amount under Chapter VI-A ,
V. TOTAL TAXABLE INCOME #VALUE!
INCOME TAX CALCULATION
On theFirst Rs.50,000/- Nil
On the Next Rs.50,001/- to Rs.60,000/- (10%) #VALUE! #VALUE!
On the Next Rs.60,001/- to Rs.1,50,000/- (20%) #VALUE! #VALUE!
Exceeding Rs.1,50,000/- (30%) #VALUE! #VALUE!
VI. GROSS INCOME TAX DUE #VALUE!
LESS : VII. Rebate u/s 88C (Being women) 0
VIII. TOTAL INCOME TAX DUE: #VALUE!
CHAPTER-VIII TAX REBATES ALLOWED FROM GROSS INCOME TAX u/s 88
G.P.F. (Subscription + IDA) 48,256
FBF + SPF + HF + SPF2000 + HBA SPF -
Repayment of HBA (maximum Rs.20,000) -
LIC - Salary Deduction -
Tuition Fees -
AMOUNT ELIGIBLE FOR TAX REBATE (Limited to Rs.70,000/-) 48,256
LESS : Rate of REBATE u/s 88 [Upto 150000 = 20% / Above 150000 = 15%] ###
ADDITIONAL REBATES UNDER SECTION 88
Subscription in notified Insfrastructure Bonds (I.e. ICICI,IDBI) -
Others -
AMOUNT ELIGIBLE FOR TAX REBATE (Limited to Rs.30,000/-) -
LESS : Rate of REBATE u/s 88 [Upto 150000 = 20% / Above 150000 = 15%] ###
IX. AGGREGATE OF TAX REBATES AND RELEIF #VALUE!
#VALUE!
X. NET TAX PAYABLE #VALUE!
ADD : XI. Surchage @ 5% on Income Tax #VALUE!
XII. TOTAL TAX DUE AFTER SURCHARGE #VALUE!
LESS : TAX DEDUCTED AT SOURCE (so far Tax Paid) 0
XIII. TAX PAYABLE / REFUNDABLE #VALUE!

( D.V.GAJENDRAN )
 INCOME TAX STATEMENT FOR THE FINANCIAL YEAR
2004-2005

Name : D.V.GAJENDRAN
Designation : P.A. TO MINISTER FOR FOOD [A.S.O.]

Department : PUBLIC DEPARTMENT PAN No. : A M A P G 6 8 5 4 G

EARNINGS DEDUCTIONS

Month

CMPRF
FBF IT

P.T.
B.Pay PP SP DA HRA CCA OA TOTAL GPF SPF HBA LIC TOTAL
HBAFBF paid

Mar-2004 6550 ... ... ### ### ### 0 ### 4000 20 0 0 ... 4020

Apl-2004 6550 ... ... ### ### ### 0 ### 4000 20 0 0 ... 4020

May-2004 6550 ... ... ### ### ### 0 ### 4000 20 0 0 ... 4020

June-2004 6550 ... ... ### ### ### 0 ### 4000 20 PT Diff. 0 0 ... 4020
Arr.

July-2004 6550 ... ... ### ### ### 0 ### 4000 20 0 0 0 ... 4020

Aug-2004 6550 ... ... ### ### ### 0 ### 4000 20 ### 0 0 ... ###

Sep-2004 6550 ... ... ### ### ### 0 ### 4000 20 0 0 ... 4020

Oct-2004 6550 ... ... ### ### ### 0 ### 4000 20 0 0 ... 4020

Nov-2004 6550 ... ... ### ### ### 0 ### 4000 20 0 0 ... 4020
1 Day
Dec-2004 6550 ... ... ### ### ### 0 ### 4000 20 ### 0 0 ... ###

Jan-2005 6725 ... ... ### ### ### 0 ### 4000 20 ### 0 0 ... ###

Feb-2005 6725 ... ... ### ### ### 0 ### 4000 20 0 0 0 4020

SLS ... ... ... 0 ... ... 0 0 0

[7 days]

0 0

Pay Fix
Arrears
15042 0 0 8728 1447 0 0 25217

TOTAL 93992 0 ... ### ### ### 0 ### 48000 240 ### 0 0 0 ###

ABSTRACT
EARNINGS DEDUCTIONS

Basic Pay : ,93,992 48,000 : G.P.F. Subscription

Personal Pay : ... 240 : FBF+SPF+HF+HBA FBF

Special Pay : ... #VALUE! : P.T.

Dearness Allowance : #VALUE! 0 : HBA Repayment

House Rent Allowance : #VALUE! 0 : LIC - Salary Deduction

City Compensatory Allowance : #VALUE! ... : IT Paid

Other Allowance : , #VALUE! : CMPRF

TOAL - Earnings : #VALUE! #VALUE! : TOTAL - Deductions

P.T.O.
 DETAILS OF SALARY PAID AND ANY OTHER INCOME AND TAX DEDUCTED
1. GROSS SALARY #VALUE!
2. LESS H.R.A. exempt u/s 10 (13A) [WHICHER IS LESS]
(a) Actual amount of HRA received. #VALUE!
(b) Exp. on rent in excess of 10% of Salary
(c) 50% of Salary
#VALUE!
3. Balance [1-2] #VALUE!

4. DEDUCTIONS under Section 16

(a) Standard Deduction #VALUE!
(b) Tax on Employment [PT] #VALUE!

5. Aggregate of 4 [(a)+(b)] #VALUE!

Income from House Property

Annual Value Nil
Interest payable on loan u/s 24 0
Loss from House property [Max. Rs.30,000/- before 1-4-99 After Rs.1.5 lakhs] 0
#VALUE!
6. Income chargeable under the head 'Salaries' [GROSS TOTAL INCOME] #VALUE!
7. ADD Any other income reported by the employee
(a) Income under the head 'Income from House Property
(b) Income under the head 'Income from Other Sources'
(c) Total of (a) + (b) above

8. Particulars of Bank Account [Mandatory in Refund Cases]

Name of the Bank MICR Code (9digit) Address of Branch Type of A/c Account Number ECS (Y/S)

9. Deductions under Chapter VI-A G. Amt. Q. Amt. D. Amt.

(a) 80-D Insurance on the Health 0 10,000 0
(b) 80-U Person with disability 0 75,000 0
(c) 80-CCC Annuity Plan of LIC for receiving pension 0 10,000 0
(d) 80-G Relief Fund [100%] 0 100% 0
(e) 80-GG House Rent paid for his own residence 0 0
10. Aggregate of deductible amounts under Chapter VI-A 0
11. TOTAL INCOME [8-10] (NET TAXABLE INCOME) #VALUE!

12. Tax on Total Income

(1) On the First Rs.50,000/- Nil
(2) On the Next Rs.50,001 to Rs.60,000/- [10%] #VALUE! #VALUE!
(3) On the Next Rs.60,001 to Rs.1,50,000/- [20%] #VALUE! #VALUE!
(4) Exceeding Rs.1,50,000/- [30%] #VALUE! #VALUE!
#VALUE!
13. Rebate under Chapter VIII (u/s 88)
I. Under Section 88 (Please Specify) G. Amt. Q. Amt. Tax Rebate
(a) Payment of Insurance Premium 0 0
(b) GPF-Subscription 48,000 48,000
(c) FBF + SPF + HF + SPF2000 + HBA FBF 240 240
(d) Repayment of HBA [Max. Rs.20,000/-] 20,000 20,000
(e) Tuition Fees (any two child) [Rs.12,000/- per child] 0 0
Total [(a) to (e)] resctricted to Rs.70,000/-. 68240 68,240 #VALUE!

(f) Equity Shares or Debentures 0 0

(g) Any Mutual Fund 0 0
Total [(f) to (g)] resctricted to Rs.30,000/-. 0 0 #VALUE!

II. (a) Under Section 88B [Senior Citizens] [Rs.20,000] 0

(b) Under Section 88C [Being a Woman] [Rs.5000] 0
(c) Under Section 88D [Rebate to Certain Individuals] 0
14. Aggregate of Tax Rebates at 13 above [I+II(a)+II(b)] #VALUE!
15. Tax payable on Total Income (12-14) #VALUE!
ADD : Surcharge @ 10% on Net Income Tax
[where Total Income exceeds Rs.8,50,000/-] #VALUE!
ADD : Education Cess on IT @ 2% of IT and Surcharge #VALUE!
16. LESS Relief under section 89 (attach details) 0
17. Balance Tax payable (15-16) #VALUE!
18. LESS : (a) Tax deductioned at source under section 192(1) 0
(b) Tax paid by the employer on behalf of employee 0
0
19. Tax payable / refundable (17-18) #VALUE!

D.V.GAJENDRAN
 INCOME TAX STATEMENT FOR THE FINANCIAL YEAR
2005-2006

Name : D.V.GAJENDRAN

Designation : P.A. TO MINISTER FOR FOOD [A.S.O.]

Department : PUBLIC DEPARTMENT PAN No. : A M A P G 6 8 5 4 G

EARNINGS DEDUCTIONS

Basic
LIC /

CMPRF
Month Pay FBF IT

P.T.
DP SP DA HRA CCA OA TOTAL GPF SPF HBA CTD / TOTAL
+ HBAFBF paid
PLI
PP

Mar-2005 6725 0 ### ### ### 0 ### 4000 80 0 0 0 4080

Apl-2005 6725 0 ### ### ### 0 ### 4000 80 0 0 0 4080

May-2005 6725 0 ### ### ### 0 ### 4000 80 0 0 0 4080

June-2005 6725 0 ### ### ### 0 ### 4000 80 0 0 0 4080

July-2005 6725 0 ### ### ### 0 ### 4000 80 0 0 0 4080

Aug-2005 6725 0 ### ### ### 0 ### 4000 80 ### 0 0 0 ###

Sep-2005 6725 0 ### ### ### 0 ### 4000 80 0 0 0 4080

Oct-2005 6725 0 ### ### ### 0 ### 4000 80 0 0 0 4080

Nov-2005 6725 0 ### ### ### 0 ### 4000 80

1 day
0 0 0 4080

Dec-2005 6725 0 ### ### ### 0 ### 4000 80 0 0 0 0 4080

Jan-2006 6900 3450 0 ### ### ### 0 ### 4000 80 ### 0 0 0 ###

Feb-2006 6900 3450 0 ### ### ### 0 ### 4000 80 0 0 0 4080

SLS 5175 0 0 1087 550 150 0 6962

[7 days]

Pay Fix
Arrears
15688 1595 0 9333 3000 0 0 29616

TOTAL 101913 8495 0 ### ### ### 0 ### 48000 960 ### 0 0 0 ###

ABSTRACT
EARNINGS DEDUCTIONS

Basic Pay + Dearness Pay : 101,913 48,000 : G.P.F. Subscription

Personal Pay : 8,495 960 : FBF+SPF+HF+HBA FBF

Special Pay : 0 #VALUE! : P.T.

Dearness Allowance : #VALUE! 0 : HBA Repayment

House Rent Allowance : #VALUE! 0 : LIC - Salary Deduction

City Compensatory Allowance : #VALUE! 0 : IT Paid

Other Allowance : 0 0 : CMPRF

TOAL - Earnings : #VALUE! #VALUE! : TOTAL - Deductions

P.T.O.
 DETAILS OF SALARY PAID AND ANY OTHER INCOME AND TAX DEDUCTED

1. GROSS SALARY #VALUE!

2. LESS Allowance to the extent exempt u/s 10 [WHICHER IS LESS]
(a) H.R.A. exempt u/s 10 (13A) [WHICHER IS LESS]
(a) Actual amount of HRA received 0
(b) Expenditure of rent in excess of 10% of salary (including DA)
(c) 50% of salary (including DA) [Metropolitan Cities]
(d) 50% of salary (including DA) [Other Cities]
[whichever is least among c & d]
0
3. Balance [1-2] #VALUE!

4. DEDUCTIONS under Section 16

(a) Entertainment allowance 0
(b) Tax on Employment [PT] #VALUE!

AGGREGATE OF 4(a) to (b) #VALUE!

LOSS ON HOUSE PROPERTY

Gross Annual Value Nil
Interest payable on loan u/s 24 0
Loss from House property [Max. Rs.30,000/- before 1-4-99 After Rs.1.5 lakhs] 0
#VALUE!
5. Income chargeable under the head 'Salaries' [GROSS TOTAL INCOME] #VALUE!

6. ADD Any other income reported by the employee 0

(a) Income under the head 'Income from House Property
(b) Income under the head 'Income from Other Sources'
(c) Total of (a) + (b) above

7. GROSS TOTAL INCOME [(5) + (6)] #VALUE!

8. Deductions under Chapter VI-A G. Amt. Q. Amt. D. Amt.

(a) 80-C Entitled to deductions for the whole of amounts paid or deposited 68,960 1,00,000
(i) G.P.F. 48,000
(ii) SPF + SPF + HF + HBAFBF 960
(iii) H.B.A. (Principal) 0
(iv) Insurance Premium / CTD / PLI 0
(v) Tuition Fees (Restricted to two children) 20,000
(vi) Subscription to Equity Shares / Debentures or Units of Infrastructure Sector- 0
(b) 80-CCC Annuity Plan of LIC/Others for receiving pension 0 10,000
(c) 80-CCD Contribution to New Pension Scheme [Limited to 10% of Salary] 0 10% Salary
(d) 80-CCE TOTAL of 80C + 80CCC + 80CCD [Limited to Rs.1,00,000/-] 68,960

(e) 80-D Insurance on the Health [dependent also] [Senior Citizen = Rs.15,000] 0 10,000 0
(f) 80-DD Expenditure for medical treatment, being a person with disability 0 50,000 0
(g) 80-E Repayment of interest on loan taken for higher education 0 10,000 0
(h) 80-G Donations made for charitable purposes [CMPRF=100%; Other=50%] 0 0
(i) 80-U Person with disability [Severe disability = Rs.75,000/-] 0 50,000 0
9. TOTAL AMOUNT IN CHAPTER VI-A 68,960
10. TOTAL INCOME [8-9] (NET TAXABLE INCOME) #VALUE!

11. Tax on Total Income

No
(1) On the First Rs.1,00,000/- Being a Woman On the First Rs.1,35,000/ Nil
(2) On the Next Rs.1,00,001 to Rs.1,50,000/- [10%] #VALUE! #VALUE!
(3) On the Next Rs.1,50,001 to Rs.2,50,000/- [20%] #VALUE! #VALUE!
(4) Exceeding Rs.2,50,000/- [30%] #VALUE! #VALUE!
12. Tax payable on Total Income (11) #VALUE!
ADD : Surcharge @ 10% on Net Income Tax #VALUE!
[where Total Income exceeds Rs.8,50,000/-]

ADD : Education Cess on IT @ 2% of IT and Surcharge #VALUE!

13. TOTAL TAX PAYABLE FOR 2005-2006 #VALUE!
14. LESS : (a) Tax deductioned at source under section 192(1) 0
(b) Tax paid by the employer on behalf of employee 0
0
15. Tax Payable / Refundable (13-14) #VALUE!
D.V.GAJENDRAN
 INCOME TAX STATEMENT FOR THE FINANCIAL YEAR
2006-2007

Name : D.V.GAJENDRAN
Designation : P.A. TO MINISTER FOR FOOD [A.S.O.]

Department : PUBLIC DEPARTMENT PAN No. : A M A P G 6 8 5 4 G

EARNINGS DEDUCTIONS

Basic
Month LIC /

CMPRF
Pay FBF IT

P.T.
D.P. SP DA HRA CCA OA TOTAL GPF SPF HBA CTD / TOTAL
+ HBAFBF paid
PLI
PP

Mar-2006 6900 3450 0 ### ### ### 0 ### 4000 90 0 0 0 4090

Apl-2006 6900 3450 200 ### ### ### 330 ### 4000 90 0 0 0 4090

May-2006 6900 3450 200 ### ### ### 330 ### 4000 90 0 0 0 4090

June-2006 6900 3450 200 ### ### ### 330 ### 4000 90 0 0 0 4090

July-2006 6900 3450 200 ### ### ### 330 ### 4000 90 0 0 0 4090

Aug-2006 6900 3450 200 ### ### ### 330 ### 4000 90 ### 0 0 0 ###

Sep-2006 6900 3450 200 ### ### ### 330 ### 4000 90 0 0 0 4090

Oct-2006 6900 3450 200 ### ### ### 330 ### 4000 90 0 0 0 4090

Nov-2006 6900 3450 200 ### ### ### 330 ### 4000 90 0 0 0 4090

Dec-2006 6900 3450 200 ### ### ### 330 ### 4000 90 0 0 0 4090

Jan-2007 6900 3450 200 ### ### ### 330 ### 4000 90 ### 0 0 0 ###

Feb-2007 6900 3450 200 ### ### ### 330 ### 4000 90 0 0 0 4090

SLS 0 0
[15 days]

BONUS 825 825

Pay Fix
Arrears
18650 9332 8256 4439 0 0 40677

0 0 0 0

TOTAL 101450 50732 2200 ### ### ### 4455 ### 48000 1080 ### 0 0 0 ###

ABSTRACT
EARNINGS DEDUCTIONS

Basic Pay + Dearness Pay : 101,450 48,000 : G.P.F. Subscription

Personal Pay : 50,732 1,080 : FBF+SPF+HF+HBA FBF

Special Pay : 2,200 #VALUE! : P.T.

Dearness Allowance : #VALUE! 0 : HBA Repayment

House Rent Allowance : #VALUE! 0 : LIC - Salary Deduction

City Compensatory Allowance : #VALUE! 0 : IT Paid

Other Allowance : 4,455 0 : CMPRF

TOAL - Earnings : #VALUE! #VALUE! : TOTAL - Deductions

P.T.O.
 DETAILS OF SALARY PAID AND ANY OTHER INCOME AND TAX DEDUCTED
1. GROSS SALARY #VALUE!
2. LESS Allowance to the extent exempt u/s 10 [WHICHER IS LESS]
(a) H.R.A. exempt u/s 10 (13A) [WHICHER IS LESS]
(a) Actual amount of HRA received #VALUE!
(b) Expenditure of rent in excess of 10% of salary (including DA)
(c) 50% of salary (including DA) [Metropolitan Cities]
(d) 50% of salary (including DA) [Other Cities]
[whichever is least among c & d]
#VALUE!
3. Balance [1-2] #VALUE!

4. DEDUCTIONS under Section 16

(a) Entertainment allowance 0
(b) Tax on Employment [PT] #VALUE!

AGGREGATE OF 4(a) to (b) #VALUE!

LOSS ON HOUSE PROPERTY

Gross Annual Value Nil
Interest payable on loan u/s 24 0
Loss from House property [Max. Rs.30,000/- before 1-4-99 After Rs.1.5 lakhs] 0
#VALUE!
5. Income chargeable under the head 'Salaries' [GROSS TOTAL INCOME] #VALUE!

6. ADD Any other income reported by the employee 0

(a) Income under the head 'Income from House Property
(b) Income under the head 'Income from Other Sources'
(c) Total of (a) + (b) above

7. GROSS TOTAL INCOME [(5) + (6)] #VALUE!

8. Deductions under Chapter VI-A G. Amt. Q. Amt. D. Amt.

(a) 80-C Entitled to deductions for the whole of amounts paid or deposited 69,080 1,00,000
(i) G.P.F. 48,000
(ii) SPF + SPF + HF + HBAFBF 1,080
(iii) H.B.A. (Principal) 0
(iv) Insurance Premium / CTD / PLI 0
(v) Tuition Fees (Restricted to two children) 20,000
(vi) Subscription to Equity Shares / Debentures or Units of Infrastructure Sector- 0
(b) 80-CCC Annuity Plan of LIC/Others for receiving pension 0 10,000
(c) 80-CCD Contribution to New Pension Scheme [Limited to 10% of Salary] 0 10% Salary
(d) 80-CCE TOTAL of 80C + 80CCC + 80CCD [Limited to Rs.1,00,000/-] 69,080

(e) 80-D Insurance on the Health [dependent also] [Senior Citizen = Rs.15,000] 0 10,000 0
(f) 80-DD Expenditure for medical treatment, being a person with disability 0 50,000 0
(g) 80-E Repayment of interest on loan taken for higher education 0 10,000 0
(h) 80-G Donations made for charitable purposes [CMPRF=100%; Other=50%] 0 0
(i) 80-U Person with disability [Severe disability = Rs.75,000/-] 0 50,000 0
9. TOTAL AMOUNT IN CHAPTER VI-A 69,080

10. TOTAL INCOME [8-9] (NET TAXABLE INCOME) #VALUE!

11. Tax on Total Income
No
(1) On the First Rs.1,00,000/- Being a Woman On the First Rs.1,35,000/ Nil
(2) On the Next Rs.1,00,001 to Rs.1,50,000/- [10%] #VALUE! #VALUE!
(3) On the Next Rs.1,50,001 to Rs.2,50,000/- [20%] #VALUE! #VALUE!
(4) Exceeding Rs.2,50,000/- [30%] #VALUE! #VALUE!
12. Tax payable on Total Income (11) #VALUE!
ADD : Surcharge @ 10% on Net Income Tax #VALUE!
[where Total Income exceeds Rs.8,50,000/-]

ADD : Education Cess on IT @ 2% of IT and Surcharge #VALUE!

13. Tax payable on Total Income and Surcharge thereon #VALUE!
14. LESS : Relief under section 89 (Details attached Form 10E) 0
15. BALANCE TAX PAYABLE #VALUE!
16. LESS : (a) Tax deductioned at source under section 192(1) 0
(b) Tax paid by the employer on behalf of employee 0
0
17. Tax Payable / Refundable (13-14) #VALUE!
D.V.GAJENDRAN
 INCOME TAX STATEMENT FOR THE FINANCIAL YEAR
2007-2008

Name : D.V.GAJENDRAN
Designation : P.A. TO MINISTER FOR FOOD [A.S.O.]

Department : PUBLIC DEPARTMENT PAN No. : A M A P G 6 8 5 4 G

EARNINGS DEDUCTIONS

Basic
Month FBF LIC /

CMPRF
Pay SPF IT

P.T.
D.P. SP DA HRA CCA OA TOTAL GPF HBA CTD / TOTAL
+ HF paid
HBAFBF PLI
PP

Mar-2007 8300 4150 200 ### ### ### 330 ### 4000 90 0 0 0 4090

Apl-2007 8300 4150 200 ### ### ### 330 ### 4000 90 0 0 0 4090

May-2007 8300 4150 200 ### ### ### 330 ### 6000 90 0 0 1000 7090

June-2007 8300 4150 200 ### ### ### 330 ### 6000 90 0 0 1000 7090

July-2007 8300 4150 200 ### ### ### 330 ### 6000 90 0 0 1000 7090

Aug-2007 8300 4150 200 ### ### ### 330 ### 6000 90 ### 0 0 1000 ###

Sep-2007 8300 4150 200 ### ### ### 330 ### 6000 90 0 0 1000 7090

Oct-2007 8300 4150 200 ### ### ### 330 ### 6000 90 0 0 1000 7090

Nov-2007 8300 4150 200 ### ### ### 330 ### 6000 90 0 0 1000 7090

Dec-2007 8300 4150 200 ### ### ### 330 ### 6000 90 0 0 1000 7090

Jan-2008 8300 4150 200 ### ### ### 330 ### 6000 90 ### 0 0 1000 ###

Feb-2008 8300 4150 200 ### ### ### 330 ### 6000 90 0 0 0 6090

SLS ### ###

[15 days]

BONUS 1000 1000

Sectt.
PF Arr.
0 0

TOTAL ### 49800 2400 ### ### ### 4960 ### 68000 1080 ### 0 0 9000 ###

ABSTRACT
EARNINGS DEDUCTIONS

Basic Pay + Dearness Pay : #VALUE! 68,000 : G.P.F. Subscription

Personal Pay : 49,800 1,080 : FBF+SPF+HF+HBA FBF

Special Pay : 2,400 #VALUE! : P.T.

Dearness Allowance : #VALUE! 0 : HBA Repayment

House Rent Allowance : #VALUE! 0 : LIC - Salary Deduction

City Compensatory Allowance : #VALUE! 9,000 : IT Paid

Other Allowance : 4,960 0 : CMPRF

TOAL - Earnings : #VALUE! #VALUE! : TOTAL - Deductions

P.T.O.
 DETAILS OF SALARY PAID AND ANY OTHER INCOME AND TAX DEDUCTED
1. GROSS SALARY #VALUE!
2. LESS Allowance to the extent exempt u/s 10 [WHICHER IS LESS]
(a) H.R.A. exempt u/s 10 (13A) [WHICHER IS LESS]
(a) Actual amount of HRA received #VALUE!
(b) Expenditure of rent in excess of 10% of salary (including DA)
(c) 50% of salary (including DA) [Metropolitan Cities]
(d) 50% of salary (including DA) [Other Cities]
[whichever is least among c & d]
#VALUE!
3. Balance [1-2] #VALUE!

4. DEDUCTIONS under Section 16

(a) Entertainment allowance 0
(b) Tax on Employment [PT] #VALUE!

AGGREGATE OF 4(a) to (b) #VALUE!

LOSS ON HOUSE PROPERTY

Gross Annual Value Nil
Interest payable on loan u/s 24 0
Loss from House property [Max. Rs.30,000/- before 1-4-99 After Rs.1.5 lakhs] 0
#VALUE!
5. Income chargeable under the head 'Salaries' [GROSS TOTAL INCOME] #VALUE!

6. ADD Any other income reported by the employee 0

(a) Income under the head 'Income from House Property
(b) Income under the head 'Income from Other Sources'
(c) Total of (a) + (b) above

7. GROSS TOTAL INCOME [(5) + (6)] #VALUE!

8. Deductions under Chapter VI-A G. Amt. Q. Amt. D. Amt.

(a) 80-C Entitled to deductions for the whole of amounts paid or deposited 104,540 1,00,000
(i) G.P.F. 68,000
(ii) SPF + SPF + HBAFBF 1,080
(iii) H.B.A. (Principal) 0
(iv) Insurance Premium / CTD / PLI 0
(v) Tuition Fees (Restricted to two children) 35,460
(vi) Subscription to Equity Shares / Debentures or Units of Infrastructure Sector- 0
(b) 80-CCC Annuity Plan of LIC/Others for receiving pension 0 10,000
(c) 80-CCD Contribution to New Pension Scheme [Limited to 10% of Salary] 0 10% Salary
(d) 80-CCE TOTAL of 80C + 80CCC + 80CCD [Limited to Rs.1,00,000/-] 100,000

(e) 80-D Insurance on the Health [dependent also] [Senior Citizen = Rs.15,000] 0 10,000 0
(f) 80-DD Expenditure for medical treatment, being a person with disability 0 50,000 0
(g) 80-E Repayment of interest on loan taken for higher education 0 10,000 0
(h) 80-G Donations made for charitable purposes [CMPRF=100%; Other=50%] 0 0
(i) 80-U Person with disability [Severe disability = Rs.75,000/-] 0 50,000 0
9. TOTAL AMOUNT IN CHAPTER VI-A 100,000

10. TOTAL INCOME [8-9] (NET TAXABLE INCOME) #VALUE!

11. Tax on Total Income
No
(1) On the First Rs.1,10,000/- Being a Woman On the First Rs.1,45,000/ Nil
(2) On the Next Rs.1,10,001 / 1,45,001 to Rs.1,50,000/- [10%] #VALUE! #VALUE!
(3) On the Next Rs.1,50,001 to Rs.2,50,000/- [20%] #VALUE! #VALUE!
(4) Exceeding Rs.2,50,000/- [30%] #VALUE! #VALUE!
12. Tax payable on Total Income (11) #VALUE! #VALUE!
ADD : Surcharge @ 10% on Net Income Tax #VALUE!
[where Total Income exceeds Rs.8,50,000/-]

ADD : Education Cess on IT @ 3% of IT and Surcharge #VALUE!

13. Tax payable on Total Income and Surcharge thereon #VALUE!
14. LESS : Relief under section 89 (Details attached Form 10E) 0
15. BALANCE TAX PAYABLE #VALUE!
16. LESS : (a) Tax deductioned at source under section 192(1) 9,000
(b) Tax paid by the employer on behalf of employee 0
9,000
17. Tax Payable / Refundable (13-14) #VALUE!
D.V.GAJENDRAN
 INCOME TAX STATEMENT FOR THE FINANCIAL YEAR
2007-2008

Name : D.V.GAJENDRAN
Designation : P.A. TO MINISTER FOR FOOD [A.S.O.]

Department : PUBLIC DEPARTMENT PAN No. : A M A P G 6 8 5 4 G

EARNINGS DEDUCTIONS

Basic
Month FBF LIC /

CMPRF
Pay SPF IT

P.T.
D.P. SP DA HRA CCA OA TOTAL GPF HBA CTD / TOTAL
+ HF paid
HBAFBF PLI
PP

Mar-2007 8300 4150 200 ### ### ### 330 ### 4000 90 0 0 0 4090

Apl-2007 8300 4150 200 ### ### ### 330 ### 4000 90 0 0 0 4090

May-2007 8300 4150 200 ### ### ### 330 ### 6000 90 0 0 1000 7090

June-2007 8300 4150 200 ### ### ### 330 ### 6000 90 0 0 1000 7090

July-2007 8300 4150 200 ### ### ### 330 ### 6000 90 0 0 1000 7090

Aug-2007 8300 4150 200 ### ### ### 330 ### 6000 90 ### 0 0 1000 ###

Sep-2007 8300 4150 200 ### ### ### 330 ### 6000 90 0 0 1000 7090

Oct-2007 8300 4150 200 ### ### ### 330 ### 6000 90 0 0 1000 7090

Nov-2007 8300 4150 200 ### ### ### 330 ### 6000 90 0 0 1000 7090

Dec-2007 8300 4150 200 ### ### ### 330 ### 6000 90 0 0 1000 7090

Jan-2008 8300 4150 200 ### ### ### 330 ### 6000 90 ### 0 0 1000 ###

Feb-2008 8300 4150 200 ### ### ### 330 ### 6000 90 0 0 0 6090

SLS ### ###

[15 days]

BONUS 1000 1000

Pay
Arrears
130709 10927 0 59805 19205 3210 0 223856 1266 22386

TOTAL ### 60727 2400 ### ### ### 4960 ### 69266 1080 ### 0 0 31386 ###

ABSTRACT
EARNINGS DEDUCTIONS

Basic Pay + Dearness Pay : #VALUE! 69,266 : G.P.F. Subscription

Personal Pay : 60,727 1,080 : FBF+SPF+HF+HBA FBF

Special Pay : 2,400 #VALUE! : P.T.

Dearness Allowance : #VALUE! 0 : HBA Repayment

House Rent Allowance : #VALUE! 0 : LIC - Salary Deduction

City Compensatory Allowance : #VALUE! 31,386 : IT Paid

Other Allowance : 4,960 0 : CMPRF

TOAL - Earnings : #VALUE! #VALUE! : TOTAL - Deductions

P.T.O.
 DETAILS OF SALARY PAID AND ANY OTHER INCOME AND TAX DEDUCTED
1. GROSS SALARY #VALUE!
2. LESS Allowance to the extent exempt u/s 10 [WHICHER IS LESS]
(a) H.R.A. exempt u/s 10 (13A) [WHICHER IS LESS]
(a) Actual amount of HRA received 0
(b) Expenditure of rent in excess of 10% of salary (including DA)
(c) 50% of salary (including DA) [Metropolitan Cities]
(d) 50% of salary (including DA) [Other Cities]
[whichever is least among c & d]
0
3. Balance [1-2] #VALUE!

4. DEDUCTIONS under Section 16

(a) Entertainment allowance 0
(b) Tax on Employment [PT] #VALUE!

AGGREGATE OF 4(a) to (b) #VALUE!

LOSS ON HOUSE PROPERTY

Gross Annual Value Nil
Interest payable on loan u/s 24 0
Loss from House property [Max. Rs.30,000/- before 1-4-99 After Rs.1.5 lakhs] 0
#VALUE!
5. Income chargeable under the head 'Salaries' [GROSS TOTAL INCOME] #VALUE!

6. ADD Any other income reported by the employee 0

(a) Income under the head 'Income from House Property
(b) Income under the head 'Income from Other Sources'
(c) Total of (a) + (b) above

7. GROSS TOTAL INCOME [(5) + (6)] #VALUE!

8. Deductions under Chapter VI-A G. Amt. Q. Amt. D. Amt.

(a) 80-C Entitled to deductions for the whole of amounts paid or deposited 105,806 1,00,000
(i) G.P.F. 69,266
(ii) SPF + SPF + HBAFBF 1,080
(iii) H.B.A. (Principal) 0
(iv) Insurance Premium / CTD / PLI 0
(v) Tuition Fees (Restricted to two children) 35,460
(vi) Subscription to Equity Shares / Debentures or Units of Infrastructure Sector- 0
(b) 80-CCC Annuity Plan of LIC/Others for receiving pension 0 10,000
(c) 80-CCD Contribution to New Pension Scheme [Limited to 10% of Salary] 0 10% Salary
(d) 80-CCE TOTAL of 80C + 80CCC + 80CCD [Limited to Rs.1,00,000/-] 100,000

(e) 80-D Insurance on the Health [dependent also] [Senior Citizen = Rs.15,000] 0 10,000 0
(f) 80-DD Expenditure for medical treatment, being a person with disability 0 50,000 0
(g) 80-E Repayment of interest on loan taken for higher education 0 10,000 0
(h) 80-G Donations made for charitable purposes [CMPRF=100%; Other=50%] 0 0
(i) 80-U Person with disability [Severe disability = Rs.75,000/-] 0 50,000 0
9. TOTAL AMOUNT IN CHAPTER VI-A 100,000

10. TOTAL INCOME [8-9] (NET TAXABLE INCOME) #VALUE!

11. Tax on Total Income
NO
(1) On the First Rs.1,10,000/- Being a Woman On the First Rs.1,45,000/- Nil
(2) On the Next Rs.1,10,001 / 1,45,001 to Rs.1,50,000/- [10%] #VALUE! #VALUE!
(3) On the Next Rs.1,50,001 to Rs.2,50,000/- [20%] #VALUE! #VALUE!
(4) Exceeding Rs.2,50,000/- [30%] #VALUE! #VALUE!
12. Tax payable on Total Income (11) #VALUE! #VALUE!
13. LESS : Relief under section 89 (Details attached Form 10E) #VALUE!
14. Tax payable on Total Income after Relief #VALUE!
ADD : Surcharge @ 10% on Net Income Tax [where Total Income exceeds Rs.8,50,000/-] 0
ADD : Education Cess on IT @ 3% of IT and Surcharge #VALUE!
15. BALANCE TAX PAYABLE, Surcharge and Education Cess thereon #VALUE!
16. LESS : (a) Tax deductioned at source under section 192(1) 31,386
(b) Tax paid by the employer on behalf of employee 0
31,386
17.### #VALUE!
D.V.GAJENDRAN
 FORM NO. 10E
[See rule 21AA]

Form for furnishing particulars of income under section 192(2A) for the year ending 31st March,
2007 for claiming relief under section 89(1) by a Government servant or an employee in a
company, co-operative society, local authority, university, institution, association or body

1. Name and Address of the Employee : D.V.GAJENDRAN

P.A. TO MINISTER FOR FOOD [A.S.O.]
PUBLIC DEPARTMENT
Chennai-600 009.

2. Permanent Account Number [PAN] : AMAPG6854G

3. Residential Status : Own

1. (a) Salary received in arrears or in advance in : 2,23,856

accordance with the provisions of sub-rule (2) of rule
21A

(b) Payment in the nature of gratuity in respect of past : -Nil-

services, extending over a period of not less than 5
years in accordance with the provisions of sub-rule (3)
of rule 21A

(c) Payment in the nature of compensation from the : -Nil-

employer or former employer at or in connection with
termination of employment after continuous service of
not less than 3 years or where the unexpired portion
of term of employment is also not less than 3 years in
accordance with the provisions of sub-rule (4) of rule
21A

(d) Payment in commutation of pension in accordance : -Nil-

with the provisions of sub-rule (5) of rule 21A

2. Detailed particulars of payments referred : Annexure-I enclosed

to above may be given in Annexure I, II,
IIA, III or IV, as the case may be

Signature of the employee

Verification
I, D.V.GAJENDRAN__ do hereby declare that what is stated above is true to the best of my knowledge
and belief.

Verified today, the________________day of_______________

Place : Chennai-600 009.

Date : -02-2008.
Signature of the employee
 ANNEXURE I
[See item 2 of Form No. 10E]
ARREARS OR ADVANCE SALARY

1. Total income : Rs. #VALUE!

(excluding salary received in arrears or advance)

2. Salary received in arrears or advance : Rs. 2,23,856

3. Total Income : Rs. #VALUE!

(as increased by salary received in arrears or
advance)[Add item 1 and item 2]

4. Tax on total income (as per item 3) : Rs. #VALUE!

5. Tax on total income (as per item 1) : Rs. #VALUE!

6. Tax on salary received in arrears or advance : Rs. #VALUE!

[Difference of item 4 and item 5]

7. Tax computed in accordance with Table "A" : Rs. #VALUE!

[Brought from column 7 of Table "A"]

8. Relief under section 89(1) : Rs. #VALUE!

[Indicate the difference between the amounts
mentioned against items 6 and 7]

TABLE "A"
[See item 7 of Annexure I]

Salary recieved in
Total income (as increased Tax on total
arrears or Tax on total
Total income of by salary received in income
advance relating income
the relevant arrears or advance) of the (after Rebate)
Previous year(s) to the relevant (after Rebate)
previous year relevant previous year [as per
previous year as [as per
(Taxable Income) mentioned in column(1) column(2)]
mentioned in column(4)]
[Add columns (2) and (3)]
column(1)

(Rs.) (Rs.) (Rs.) (Rs.) (Rs.)

(1) (2) (3) (4) (5) (6)

1998-1999 #VALUE! 16,625 #VALUE! ... #VALUE!

1999-2000 #VALUE! 21,356 #VALUE! ... #VALUE!
2000-2001 #VALUE! 22,960 #VALUE! ... #VALUE!
2001-2002 #VALUE! 21,192 #VALUE! ... #VALUE!
2002-2003 #VALUE! 22,157 #VALUE! ... #VALUE!
2003-2004 #VALUE! 24,056 #VALUE! ... #VALUE!
2004-2005 #VALUE! 25,217 #VALUE! ... #VALUE!
2005-2006 #VALUE! 29,616 #VALUE! ... #VALUE!
2006-2007 #VALUE! 40,677 #VALUE! ... #VALUE!

#VALUE! 2,23,856 #VALUE! ... #VALUE!

Note: In this Table, details of salary received in arrears or advance relating to different previous years may be furnished.

Signature of the employee

 FORM NO. 10E
[See rule 21AA]

f income under section 192(2A) for the year ending 31st March,
section 89(1) by a Government servant or an employee in a
y, local authority, university, institution, association or body

D.V.GAJENDRAN
P.A. TO MINISTER FOR FOOD [A.S.O.]
PUBLIC DEPARTMENT
Chennai-600 009.

Verification
y declare that what is stated above is true to the best of my knowledge
 ANNEXURE I
[See item 2 of Form No. 10E]
ARREARS OR ADVANCE SALARY

TABLE "A"
[See item 7 of Annexure I]

Difference in
tax[Amount under
column(6) minus
amount under
column (5)]

(Rs.)
(7)

#VALUE!
#VALUE!
#VALUE!
#VALUE!
#VALUE!
#VALUE!
#VALUE!
#VALUE!
#VALUE!

#VALUE!
 FORM NO.16
[(See Rule 31(1)(a) of the 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
Secretary to Government
Public Department
Secretariat, Chennai-600 009.
PAN NO. OF THE DEDUCTOR
Name and address of the Employee
D.V.GAJENDRAN
P.A. TO MINISTER FOR FOOD [A.S.O.]
PUBLIC DEPARTMENT
TAN NO OF THE DEDUCTOR PAN NO. OF THE EMPLOYEE

AMAPG6854G
Acknowledgement Nos. of all Quarterly
Statements of TDS under sub-section (3) of
section 200 as provided by TIN Facilitation Period
Centre or NSDL web-site. Assessment Year
Quarter Acknowledgement No. From To
01-03-2007 3/31/2008 2008-2009

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. ###

(b) Value of perquisites u/s 17(2) (as per Form Rs.

No.12BA, wherever applicable
(c) Profits in lieu of salary under Section 17(3) (as Rs.
per Form No.12BA, wherever applicable)
(d) Total #VALUE!

2. Less: Allowance to the extent under section 10 Rs. 0

Rs.0

3. Balance (1-2) #VALUE!

4. Deductions:
(a) Entertainment Allowance Rs.

(b) Interest payable on loan u/s 24 Rs. 0

(c) Tax on Employment Rs. #VALUE!

5. Aggregate of 4 (a to c) #VALUE!

6. Income chargeable under the Head 'Salaries' (3-5) #VALUE!

7. ADD: Any other Income reported by the employee Rs.

8. Gross Total Income (6+7) #VALUE!

9. Deductions under Chapter VI-A Gross Deductible

(A) Section 80C, 80CCC and 80CCD Amount Amount
(a) Section 80C Rs. 105,806 Rs.100000

(b) Section 80CCC Rs. Rs.________

(c) Section 80CCD Rs. Rs.________

Note: 1. Aggregate amount deductible under Section 80C shall not exceed one lakh rupees.
2. Aggregate amount deductible under the three Sections, i.e., 80C, 80CCC and 80CCD, shall not exceed one lakh rupees.
 -2-

(B) OTHER SECTIONS (for e.g. 80E, 80G etc.) Gross Qualifying Deductible
UNDER CHAPTER VI-A Amount Amount Amount
(a) Rs.________ Rs.________ Rs.________

(b) Rs.________ Rs.________ Rs.________

(c) Rs.________ Rs.________ Rs.________

(d) Rs.________ Rs.________ Rs.________

(e) Rs.________ Rs.________ Rs.________

10. Aggregate of deductible amount under Chapter VI-A Rs.100000

11. Total Income (8-10) #VALUE!

12. Tax on Total Income #VALUE!

13. Surcharge (on tax computed as S.No.12) Rs._____

14. Education Cess #VALUE!

(on tax at S.No.12 and surcharge at S.No.13)
15. Tax Payable (12+13+14) Rs. #VALUE!

16. Relief under Section 89 (attach details) Rs. #VALUE!

17. Tax Payable (15-16) Rs. #VALUE!

18. Less: (a) Tax deducted at source u/s 192(1) Rs. 31,386
(b) Tax paid by the employer on behalf of
the employee u/s 192(1A) on
perquisites u/s 17(2)
17. #VALUE! Rs. #VALUE!

Details of Tax Deducted and Deposited into Central Government Account

Education TOTAL tax Date on which tax Transfer

Sl. TDS Surcharge Cheque / DD No.
Cess deposited BSR Code of Bank Branch deposited Voucher/Challan
No. Rs. Rs. (if nay)
Rs. Rs. (dd/mm/yy) Identification No.

1. 22386 -- 22386
2. 9000 -- 9000

I ______________________ son of ___________________ working in the capacity of Section Officer [Bills],

Public Department (designation) do hereby certify that a sum of Rs................. (Rupees ...............................(in words) has
been deducted at source and paid to the credit of the Central Government. I further certified that the information given above
is true and correct based on the book of accounts, documents and other available records.

Signature of the person responsible for deduction of tax

Place: Full Name: ______________________

Date : SEAL