PROFORMA FOR CALCULATION OF INCOME TAX FOR TAX DEDUCTION AT SOURCE FOR SALARIED PERSONS FOR THE PERIOD FROM _________________________TO ___________________________ . FINANCIAL YEAR: 2010 – 2011 ; ASSESMENT YEAR: 2011 -2012. Name of Officer / Official: Designation of Officer / Official: PAN No.: Office Address: Residential Address: [Own / Rented Accommodation] 1. Salary Received during the Financial year (including HRA & Arrears) Rs. 2. a) Less: HRA permissible [Least of following U/S 10 (13-A)] Rs. i) Actual HRA Received Rs. ii) Rent paid minus 10 % of Salary Pay Rs. iii) 40 % of the Salary Rs. b) Less: Conveyance Allowance / Fixed Travelling expenses / Transport Allowance Rs. c) Less: Special Compensatory Allowance (Remote Allowance) Rs. d) Less: Professional Tax Rs. 3. TOTAL GROSS SALARY Rs. REBATES / DEDUCTIONS ALLOWED 4. Under Section. 80 C Rs. i) GPF Rs. ii) PPF Rs. iii) GIS Rs. iv) PLI Rs. v) LIC Rs. vi) Units / ULIP/ NSS / NSC / CTD / Interest accrued on NSC Rs. vii) Repayment of Housing Loan / Tuition fee for 2 children within India / Others Rs. Gross Total of Deductions under Section 80 C. Rs. 5. Under Section. 80 CCC Rs. 6. Under Section. 80 CCD Rs. 7. Under Section. 80 CCE Rs. 8. Under Section. 80 D Rs. 9. Under Section. 80 DD Rs. 10. Under Section. 80 DDB Rs. 11. Under Section. 80 E Rs. 12. Under Section. 80 G Rs. 13. Under Section. 80 U Rs. 14. TOTAL REBATE / DEDUCTIONS ISSIBLE Rs. 15. TOTAL TAXABLE INCOME Rs. 16. INCOME TAX CALCULATION i) Income upto 1.6 lacs [1.9 lacs for women] – Nil ii) Income above 1.6 lacs & upto Rs.5 lacs – 10 % iii) Income above Rs.5 lacs & upto Rs.8 lacs – 20 % iv) Income above Rs.8 lacs – 30 % INCOME TAX Rs. 17. Surcharge @ 10 % where the total income exceeds Rs.10 lacs. Rs. 18. Education Cess on Income Tax @ 3 % on income tax & Surcharge Rs. 19. Relief on Arrears Salary U/S 89 (i) with rule 21 A Detail enclosed Rs. 20. Income Tax payable for the year ( _____________________________ ) Rs. 21. Income Tax already deducted / deposited Rs. 22. Balance Income Tax to be deducted / deposited refund Rs. List of Enclosures (if any): 1. 2. 3.
4. 5. 6. DECLARATION
I undertake to supply the documentary proofs of the deductions claimed above. I shall be personally responsible to file return with Income tax department as required under law and also liable to face consequences for giving wrong information and income concealed if any. Counter signature Name & Date:
Signature of Officer / Official Name & Date: