FILL UP THE DATA IN GREEN CELLS BELOW

1
2
3
4

Name of the Employee

PAN NO.
Designation
Name of the Office

Basic Pay as on JAN-2013

Basic Pay as on FEB-13
Basic Pay as on MAR-13
MONTH OF INCREMENT
PAY AFTER INCREMENT
SP
PP/FP
HMA

6
7
7
8
9

BOLLA PADMA SREE

ABSPN4870G
SGT
M.P.P.S, VAKALAPUDI MAINKAKINADA RURAL

EARNINGS
for the purpose of
DA Arrears
Calculation

15700
15700
15700

RPS-2010

11

HRA %

12

Surrender Leave taken or not

13

Surrender Leave Month

Prepared by: T.PANAKALA REDDY

10

16150

STU GUNTUR DIST

** if your income is more than 5 Lakhs you

should file returns digitally( e-filing)
for e-filing contact 9393632288
or panakalareddytalla@gmail.com

0
20
0

10 CA(PH ALLOWANCE)

EAST GODAVARI

No
0

CCA

NO

No of Days of SL

DEDUCTIONS

ZPPF / CPS Amount

3000

* Select 1 for ZPPF/GPF

** Select 2 for CPS

60

1st DA
2nd DA

54.784
63.344

DA w.e.f January 2013

450
0

IR

27.000

IR w.e.f Jan 2014

2 Select ZPPF / CPS

3
4

GIS
APGLI

DA w.e.f July 2013

ENTER DA1,DA2,& IR IN
ABOVE CELLS

Own /
Rented
House

Rent Paid per Month

*** Important

6000

10

DDO

Smt. S. VIJAYA LAKSHMI

MEO
DEVI

Important
1) You can modify DA arrears,Surrender Leave,
Pay fixation arrears,etc directly in STATEMENT sheet
if neccesary
2)You can also modify earnings or deductions in
STATEMENT

DDO Father Name

3) use legal size paper only

TAN No

OTHER DEDUCTIONS

TDS Deductions

Tution Fee

212000

Mar-2013

Fixed Deposit above 5 years

April-2013

Housing loan principle amount

May-2013

Housing loan Interest amount (Max:Rs 1,50,000 )

June-2013

Housing loan additional Interest amount (80EE)

July-2013

Insurance Premium (Sum of All Policy No's Annually)

Aug-2013

PLI /NSC /PPF

Sept-2013

Bonds

Oct-2013

Equity Shares

Nov-2013

10

Mediclaim Insurance (80-D)

Dec-2013

11

Exception on PHC dependent (80DD)

Jan-2014

12

Exp. On Medical Treatment

Feb-2014

13

Unit Linked Insurance Policy

14

Sainic welfare fund

20

15

Employees welfare fund

20

16

Other donations if any

17

Interest paid for Education Loan 80E

18

*****

80DDB

19

Exception on PHC dependent (80DD)

20

RAJIV GANDHI EQUITY SAVING SCHEME (Max Rs.25000)80CCG

Housing Loan sanctioned after

ex: if Interst paid is Rs 235000
Rs 235000 - Rs 150000 = Rs 85

STATEMENT SHOWING SALARY PARTICULARS OF

EARNINGS

MONTH
&
YEAR

PAY

SP

PP/FP

CCA

HMA

Mar-2013

15700

130

April-2013

15700

May-2013

15700

June-2013

15700

July-2013

15700

Aug-2013

S.NO

BOLLA PADMA SREE FOR THE YEAR MARCH 2013-FEBRUARY 2014 :: PAN NO: ABSPN4870G
DEDUCTIONS
HRA

TOTAL

GPF/
ZPPF

CPS

GIS

APGLI

P.TAX

EWF/SWF

I.T

7526

3140

26496

3000

60

450

200

20

7526

3140

26366

3000

60

450

200

8601

3140

27441

3000

60

450

200

8601

3140

27441

3000

60

450

200

8601

3140

27441

3000

60

450

200

15700

8601

3140

27441

3000

60

450

200

Sept-2013

15700

8601

3140

27441

3000

60

450

200

Oct-2013

16150

10230

3230

29610

3000

60

450

200

Nov-2013

16150

10230

3230

29610

3000

60

450

200

10

Dec-2013

16150

10230

3230

29610

3000

60

450

200

11

Jan-2014

16150

4361

10230

3230

33971

3000

60

450

200

12

Feb-2014

16150

4361

10230

3230

33971

3000

60

450

200

720

5400

2400

MORE EARNINGS

DA

PHA

DA ARREARS
1/2013 to 4/2013

4300

4300

4300

DA ARREARS
7/2013 to 09/2013

4032

4032

4032

44332

PAY FIXATION

Other Arrears

Surrender Leave

TOTAL

IR

190650

130

Signature of the Employee

8722

117539

38130

355171

20

40

Signature of the D.D.O

CMRF

253

253

INCOME TAX CALCULATION FOR THE YEAR 2013-14

PAN NO: ABSPN4870G
1
2
3
4
5

Name of the Employee

BOLLA PADMA SREE

Designation
Name of the Office
Gross salary Income

:
:
:

SGT
M.P.P.S, VAKALAPUDI MAIN

HRA Exmpted
i) Actual HRA Received

:
: Rs 38130

Rs 355171
###

ii) Rent paid in Excess of 10% of Salary (Pay+DA) @ Rs

: Rs 41181
6000 per month
iii) 40% of Salary
(Deduct least of the above three)

6 Net salary Income(4-5)

7 Deductions
a) Profession Tax(U/S 16(iii)
b) Interest on Housing loan(U/S 24(B)
Total

8 Total Income(6-7)
9 Deductions U/S 80C (Max.Rs.1,00,000)
A)

i)G.P.F/Z.P.P.F/C.P.S
ii)G.I.S
iii)L.I.C
iv)P.L.I/N.S.C/PPF
v) A.P.G.L.I
vi) Tution Fee
vii) Fixed Deposit above 5 years
viii) Housing loan principle amount
ix) Bonds
x) Equity Shares

Total (U/S 80C)

B) Mediclaim Insurance (80-D)
C) Exception on PHC dependent (80DD)
D) Exp. On Medical Treatment
E) Donations (80 G)
i) C.M.Relief Fund
ii) Sainic welfare fund
iii) Employees welfare fund
iv) Other donations if any
F) Deduction on to PHC Employees(80 U)
G) RAJIV GANDHI EQUITY SAVING SCHEME (Max Rs.25000)80CCG

Deductions U/S chapter VI -A

80E ( Interest paid on Education Loan )
80EE
80DDB

: Rs 123276
:

Rs 38130
Rs 317041

:
:
: Rs 2400
: 0 0
: Rs 2400
:
:
: Rs
: Rs
: 0
: 0

Rs 314641

44332
720
0
0

: Rs 5400
: Rs 212000
: 0 0
: 0 0
: 0 0
: 0 0
: Rs 262452
: 0 0

Rs 100000

: 0 0
: 0 0
: 0
: Rs 253
: Rs 20
: Rs 20
: 0 0
: 0 0
: 0 0

###

: 0
: 0 0
: 0 0
: 0 0
Rs 293

Total(Chapter VI-A)

Rs 100293

TOTAL DEDUCTIONS 80C + CHAPTER VI A

10 Taxable Income(8-9)
11 Tax on total Income
Rs. 2,00,000/-

NIL

:
:

Rs, 2,00,001/- to5,00,000/- 10% of amount exceeding 2.0 lakhs

:
:

Rs.5,00,001/-to10,00,000/-20%
Rs. 10,00,000-above 30%

:
:

12 Tax on total Income

Rs 214348
0
0

0
0

Rs 1435
0 0
0 0
Rs 1435

TAX Rebate U/S 87A (Max:Rs 2000) below income Rs 500000

13 Education Cess(2%)
14 Secondary&Higher Education Cess 1%
15 Net Tax Payable

###
###
###

Rs 1435
0 0

:
:
:
( Rounded )

###
###
###
###

0
0

0
0

###
###
###

###

Signature of the Employee

Form No:16
[See Rule 31(1)a]
Certificate under section 203 of the Income-tax Act, 1961 for Tax deducted at source on Salary
NAME AND ADDRESS OF THE EMPLOYER

NAME AND DESIGNATION OF THE EMPLOYEE

Smt.S.VIJAYA LAKSHMI DEVI M.E.O.

BOLLA PADMA SREE

KAKINADA RURAL MANDAL,

SGT

EAST GODAVARI DISTRICT.

M.P.P.S, VAKALAPUDI MAIN

KAKINADA RURAL EAST GODAVARI

PAN No. of DDO

TAN No.of DDO

PAN of the Employee

ABSPN4870G

CIT (TDS)
Address :

Period

Assessment Year

The Commissioner of Income Tax (TDS)

2014-2015

From

To

March 2013

February 2014

Summery of Tax Deduction at source

Receipt Numbers of original
statements of TDS under subsection (3) of section 200

Amount of tax deducted in respect of the

employee

Amount of tax deposited/ remitted

in respect of the employee

1
2
3

0
0
0

0
0
0

4
Total

0
0

0
0

Quarter

PART B (Refer Note 1)

DETAILS OF SALARY PAID AND ANY OTHER INCOME AND TAX DEDUCTED
1

Gross Salary

Rs.

355,171

a)

Salary as per provisions cotained in section 17 (1)

Rs.

b)

Value of percuisites under section 17(2)

(As Per Form No. 12BA, Wherever applicable)

Rs.

c)

Profits in lieu of salary under section 17(3)

(as per Form No. 12BB, Wherver applicable)

Rs.

d)
Total
Less: Allowance to the extent exempted U/s 10
a)
House Rent Allowence

Rs.

355,171

Rs.

38,130

b)

Rs.

Rs.

355,171

Rs.
Rs.

38,130
317,041

Aggreate of 4 (a)&(b)

Rs.

2,400

INCOME CHARGEABLE UNDER THE HEAD SALARIES (3-5)

Add: Any other income reported by the employee

Rs.

314,641
-

Add: Income of Capital Gains

Less:Interest on Housing Loan U/s 24(b)

Rs.
Rs.

8 Gross Total Income (6+7)

9 Deductions Under Chapter VI-A
A) UnderSection 80C,80CCC,80CCD.
a)
Section 80C

Rs.

314,641

3
4

5
6
7

Other Allowance

Balance (1-2)
Deductions
a)

Entertainment Allowence

Rs.

b)

Tax on Employment

Rs.

2,400

Gross

i G.P.F

Rs.

ii A.P.G.L.I

Rs.

iii G.I.S

Rs.

iv LIC Annual Premiums

Rs.

v Equity Linked Savings Scheme

Rs.

vi Repayement of Home Loan Premium

Rs.

vii Tuition Fee

Rs.

viii PLI /NSC/PPF

Rs.

Deductible

Amount
Amount
44,332 Rs.
44,332

5,400 Rs.
720 Rs.
- Rs.

5,400 Rs.
720 Rs.
- Rs.

5,400
720
-

- Rs.
- Rs.

- Rs.
- Rs.

212,000 Rs.
- Rs.

212,000 Rs.
- Rs.

212,000
-

- Rs.
- Rs.

- Rs.
- Rs.

Rs.

x Unit Linked Insurance Plan

Rs.

xi Bonds

Rs.

- Rs.
262,452

- Rs.
100,000

100,000 Rs.

Rs.

Rs.

- Rs.

- Rs.

Rs.

- Rs.

- Rs.

- Rs.

Rs.

100,000

Section 80CCC
i LIC / UTI etc. Pension funds

c)

Qualifying

Amount
44,332 Rs.

ix 5 Years Fixed Deposits

Total Under Section 80C

b)

Rs.

Section 80CCD
i Contribution to Pension Fund

Aggrigate Amount Deductible Under 3 Sections.

Note:

1.aggregate amount deductible under section 80c shall not exceed one lakh rupees.
2.aggregate amount deductible under section 80C,80CCC,80CCD, shall not exceed one lakh rupees.

B) Other Sections Under Chapter VI A

( Under Sections 80E,80G,80DD etc )

Gross

Qualifying

Deductible

Amount

Amount

Amount

Rs

EWF & SWF

40

40

40

Expenditure on medical treatment

Medical Insurance Premium

RAJIV GANDHI EQUITY SAVING SCHEME

Interest on Educational Loan

Housing loan additional Interest amount (80EE)

253

253

253

Rs

C.M.Relief Fund
Medical treatment of Handicapped/Dependent

Maintaince for 80% and above disabled Employee

Total Under Sections 80G,80E,80DD etc..

Aggregate of Deductible Amounts U/Chapter VIA (A+B)

10
11
12
13
14
15

Eligible Deductible Amounts U/Chapter VIA (A+B)

TOTAL INCOME (8-10)
TAX ON TOTAL INCOME Rs.

Rs

293

Rs

100,293
0

Rs
Rs

Education Cess @ 1% (On Tax at S.No.12 )

Secondary and Higher Education Cess @ 2% (On Tax at S.No.12 )

TAX PAYABLE including Education Cess (12+13+14)

Relief under section 89 (attach details)

NET TAX PAYABLE (15-16)

Less:(a) Tax deducted at source U/s 192(1)

(b)Tax paid by the employer on behalf of the

Employee U/S 192 (1A) on perquisited U/S 17 (2)

19

1,435
0

( Rounded )

16
17
18

214,348

TAX PAYABLE /

(17-18)

DETAILS OF TAX DEDUCTED AND DEPOSITED INTO CENTRAL GOVERNMENT ACCOUNT

(The employer is to provide tranction - wise details of tax deducted and deposited)
Sl.

TDS

No.

Rs.

1
2
3
4
5
6
7
8
9
10
11
12

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

Surcharge
Rs.

Education

Total Tax

Cheque/DD

BSR Code

Date on

D.D.O Serial

Cess

Deposited

No. (if any)

Receipt
Number

Which Tax

Number/chalana

Rs.

Rs.

Deposited

Identification No

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

I
Smt. S. VIJAYA LAKSHMI DEVI S/O working as MEO do hereby certify that the sum of Rs. 0 Rupes in
words deducted at source and paid to the credit of the central Government. I further certify that the
Informtion givin above is true and correct based on the books of account, documents, TDS statement, TDS deposited
and other available records.

Place:
Date:

M.P.P.S, VAKALAPUDI MAIN

Signature of the person responsible for deduction of tax

Full Name:
Smt. S. VIJAYA LAKSHMI DEVI
Designation:
MEO

Number

In Words( Lower Case )

456
45687
45688
45689
45690
45691
45692
45693
45694
45695

four hundred and fifty six

forty five thousand six hundred and eighty seven
forty five thousand six hundred and eighty eight
forty five thousand six hundred and eighty nine
forty five thousand six hundred and ninety
forty five thousand six hundred and ninety one
forty five thousand six hundred and ninety two
forty five thousand six hundred and ninety three
forty five thousand six hundred and ninety four
forty five thousand six hundred and ninety five

Prepared by
T.Panakala Reddy S.A (PS)

9393632288
Z.P.H.S,Nambur

In Words (Upper Case)

In Words

0
0.00456
FOUR HUNDRED AND FIFTY SIX
FOUR HUNDRED AND FIFTY SIX
0.45687
FORTY FIVE THOUSAND SIX HUNDRED
FORTY
AND
FIVE
EIGHTY
THOUSAND
SEVEN SIX HUNDRED
0.45688
FORTY FIVE THOUSAND SIX HUNDRED
FORTY
AND
FIVE
EIGHTY
THOUSAND
EIGHT SIX HUNDRED
0.45689
FORTY FIVE THOUSAND SIX HUNDRED
FORTY
AND
FIVE
EIGHTY
THOUSAND
NINE SIX HUNDRED
0.4569
FORTY FIVE THOUSAND SIX HUNDRED
FORTY
AND
FIVE
NINETY
THOUSAND SIX HUNDRED
0.45691
FORTY FIVE THOUSAND SIX HUNDRED
FORTY
AND
FIVE
NINETY
THOUSAND
ONE
SIX HUNDRED
0.45692
FORTY FIVE THOUSAND SIX HUNDRED
FORTY
AND
FIVE
NINETY
THOUSAND
TWO SIX HUNDRED
0.45693
FORTY FIVE THOUSAND SIX HUNDRED
FORTY
AND
FIVE
NINETY
THOUSAND
THREE SIX HUNDRED
0.45694
FORTY FIVE THOUSAND SIX HUNDRED
FORTY
AND
FIVE
NINETY
THOUSAND
FOUR SIX HUNDRED
0.45695
FORTY FIVE THOUSAND SIX HUNDRED
FORTY
AND
FIVE
NINETY
THOUSAND
FIVE
SIX HUNDRED

y S.A (PS)

AND
AND
AND
AND
AND
AND
AND
AND
AND

0
0
0
0.456
0
45.687
EIGHTY
SEVEN
0
45.688
EIGHTY
EIGHT
0
45.689
EIGHTY NINE
0
45.69
NINETY
0
45.691
NINETY
ONE
0
45.692
NINETY
TWO
0
45.693
NINETY THREE
0
45.694
NINETY
FOUR
0
45.695
NINETY
FIVE

0
0
45
45
45
45
45
45
45
45
45

0
0
45
45
45
45
45
45
45
45
45

0
4.56
456.87
456.88
456.89
456.9
456.91
456.92
456.93
456.94
456.95

0
4
456
456
456
456
456
456
456
456
456

0
4
6
6
6
6
6
6
6
6
6

0
56
87
88
89
90
91
92
93
94
95

ZERO
ZERO
ZERO
ZERO
ZERO
ZERO
ZERO
ZERO
ZERO
ZERO
ZERO

ZERO
ZERO
FORTY
FORTY
FORTY
FORTY
FORTY
FORTY
FORTY
FORTY
FORTY

ZERO
FOUR
FIVE
SIX
FIVE
SIX
FIVE
SIX
FIVE
SIX
FIVE
SIX
FIVE
SIX
FIVE
SIX
FIVE
SIX
FIVE
SIX

ZERO
FIFTY SIX
EIGHTY SEVEN
EIGHTY EIGHT
EIGHTY NINE
NINETY
NINETY ONE
NINETY TWO
NINETY THREE
NINETY FOUR
NINETY FIVE

FORTY
FORTY
FORTY
FORTY
FORTY
FORTY
FORTY
FORTY
FORTY

FOUR
FIVE
THOUSAND
SIX
FIVE
THOUSAND
SIX
FIVE
THOUSAND
SIX
FIVE
THOUSAND
SIX
FIVE
THOUSAND
SIX
FIVE
THOUSAND
SIX
FIVE
THOUSAND
SIX
FIVE
THOUSAND
SIX
FIVE
THOUSAND
SIX

TRUE
HUNDREDFIFTY SIX
FALSE
HUNDREDEIGHTY SEVEN
FALSE
HUNDREDEIGHTY EIGHT
FALSE
HUNDREDEIGHTY NINEFALSE
HUNDREDNINETY
FALSE
HUNDREDNINETY ONE FALSE
HUNDREDNINETY TWO FALSE
HUNDREDNINETY THREE
FALSE
HUNDREDNINETY FOUR
FALSE
HUNDREDNINETY FIVE FALSE

AND
AND
AND
AND
AND
AND
AND
AND
AND
AND

AND
AND
AND
AND
AND
AND
AND
AND
AND
AND

0
1
2
3
4
5
6
7
8
9
10
11

ZERO
ONE
TWO
THREE
FOUR
FIVE
SIX
SEVEN
EIGHT
NINE
TEN
ELEVEN

LAKHS
THOUSAND
HUNDRED
AND

12 TWELVE
13 THIRTEEN
14 FOURTEEN
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46

FIFTEEN
SIXTEEN
SEVENTEEN
EIGHTEEN
NINETEEN
TWENTY
TWENTY ONE
TWENTY TWO
TWENTY THREE
TWENTY FOUR
TWENTY FIVE
TWENTY SIX
TWENTY SEVEN
TWENTY EIGHT
TWENTY NINE
THIRTY
THIRTY ONE
THIRTY TWO
THIRTY THREE
THIRTY FOUR
THIRTY FIVE
THIRTY SIX
THIRTY SEVEN
THIRTY EIGHT
THIRTY NINE
FORTY
FORTY ONE
FORTY TWO
FORTY THREE
FORTY FOUR
FORTY FIVE
FORTY SIX

47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99

FORTY SEVEN
FORTY EIGHT
FORTY NINE
FIFTY
FIFTY ONE
FIFTY TWO
FIFTY THREE
FIFTY FOUR
FIFTY FIVE
FIFTY SIX
FIFTY SEVEN
FIFTY EIGHT
FIFTY NINE
SIXTY
SIXTY ONE
SIXTY TWO
SIXTY THREE
SIXTY FOUR
SIXTY FIVE
SIXTY SIX
SIXTY SEVEN
SIXTY EIGHT
SIXTY NINE
SEVENTY
SEVENTY ONE
SEVENTY TWO
SEVENTY THREE
SEVENTY FOUR
SEVENTY FIVE
SEVENTY SIX
SEVENTY SEVEN
SEVENTY EIGHT
SEVENTY NINE
EIGHTY
EIGHTY ONE
EIGHTY TWO
EIGHTY THREE
EIGHTY FOUR
EIGHTY FIVE
EIGHTY SIX
EIGHTY SEVEN
EIGHTY EIGHT
EIGHTY NINE
NINETY
NINETY ONE
NINETY TWO
NINETY THREE
NINETY FOUR
NINETY FIVE
NINETY SIX
NINETY SEVEN
NINETY EIGHT
NINETY NINE