Progressive Infotech Private Limited

Declaration of Savings made during the financial year 2013-2014 Name of the Associate Date of Joining Address Aditi Mahendru 22nd Aug 2013 558,Sec-19A, Noida, 201301

Emp Code:

Are you Claiming HRA exemption ? yes If Yes, Basic salary House Rent Allowance 7000 Monthly Rent 8000 Savings U/s 80C (A) LIC/ULIP
Policy No Name Relationship Receipt no date Amount Remarks

LIC ULIP

Sanjay Mahendru

Father

100000

Total (B) NSC

100000

upto 1 Lakh Investment U/s 80C

NSC No

Name

Relationship

Date of purchase

Amount

Mode

( C ) PPF
PPF A/c no Name Relationship Date of Deposit Amount Mode

(D) Infrastructure Bonds/ Mutual Fund ( As per Income Tax Act)

Bond No Name Relationship Date of purchase Amount Mode

(E) Tution Fees allowed for two children

(F) Repayment of Housing Loan if any ?

(G) (LIC pension scheme-annuity plan) Policy No Name

Relationship

Receipt no

date

Amount

Mode

upto 15 k

Savings u/s80D Policy No

(medical insurance) Name

Upto Rs. 15,000 p.a Relationship Receipt no

date

Amount

Mode

Total Others

Please provide complete details Note : copies of abovementioned documents should be enclosed self certified This is to certify that : 1. The above payments have been made out of the Income chargeable to tax under Income Tax Act 1961. 2. Further the certificates/receipts included above are NOT claimed earlier by me or by any of my dependents for computation of Income Tax. 3. The particulars furnished above are true and correct. Signature Date :