ANAND RATHI GROUP

ACTUAL INVESTMENT DECLARATION FORM FOR 2019 - 20

NAME: Nitesh Nianjan Jha

EMPLOYEE CODE: 936403

PAN NO : awvpj6253d
SR.NO INVESTMENTS QUALIFYING FOR DEDUCTION OTHER THAN THOSE RECOVERED FROM SALARY MAXIMUM LIMIT TOTAL AMOUNT
DECLARED

A DEDUCTION UNDER SECTION 10

EXEMPTION IN RESPECT OF HRA U/S 10 (13A)

0
(ATTACH COPY OF REGISTERED LEASE AGREEMENT)
(Submit rent receipt for all months)
1 PERIOD OF RENT PAYMENT
a) FROM TO 0 p.m.

b) FROM TO 0 p.m.
C)Land lord PAN Card No is mandatory if rent amount greater than Rs .8333/-PM LandLoard1 PAN N
LandLoard2 PAN N
Note: 1. PAN No. of Landlord to be mentioned with Proof if Rent Paid by employee exceeds Rs. 100000/- p.a.
ie (Rs.8333/- p.m) and also provide PAN Card Xerox Copy of Landlord . Without PAN card copy we
cannot accept Rent.
2. Rent Agreement is compulsory for rent paid greater than &. equal to Rs. 10000/- p.m.
3. Registered Rental Agreement compulsory for rent paid greater than & equal to Rs.30000/-p.m

B (I) UNDER SECTION 80 C TOTAL INVESTMENT NOT TO EXCEED Rs.1,50,000/- FOR ITEM 1 TO 11

1 Public Provident Fund (Self / Spouse or Minor Child) 150,000 0

2 Life Insurance Premium (Not to exceed 20% of the sum assured) 150,000 80,000

3 ULIP / LIC Mutual Fund 150,000 0

4 Notified Deposit Scheme of the Central Govt. 150,000 0

5 National Saving Certificates (New Purchase) 150,000 0

6 Specified Deposit Scheme or as contribution to any such Pension Fund set up by National Housing Bank / UTI 150,000 0

7 a) Principal repayment of Housing Loan 150,000 14,800

b) Stamp Duty & Registration Fees 150,000 0

8 Notified Equity Linked Saving Schemes 150,000 0

9 Tuition Fee for maximum of two children 150,000 0

10 Contribution to Pension Fund 150,000 0

11 Fixed Deposit 150,000 0

Sukanya Samriddhi Account Scheme 150,000 0
12
Total B (I) (Maximum limit Rs. 1,50,000/- )
B (II) Deduction U/S 80CCG.
Rajiv Gandhi Equity Savings Scheme (Lock In Period 3 Years). 25,000 0
Demat A/C will consider which was opened after 23.11.2012 (No Transaction in equity F & O).
It Is Mandatory To Provide RGESS Form A,Form B,DP Master and DP Holding.
(Notified equity savings scheme - RGESS) eligible for those having annual income less than Rs. 12 lakh.

C DEDUCTION UNDER SECTION 24 (1) (Self Occupied)

Interest paid on borrowed capital of Housing Loan(acquiring, construction, reconstructing or repairs to self
occupied property)
1. Property acquired/constructed before 1-4-1999 30,000 0

2. Property acquired/constructed after 1-4-1999 200,000 0

3. Loss From Let Out House Property (Employee Should Send Separate Declaration Along With The
NO LIMIT 0
Required Documents To Payroll Department)

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 4. Under Section 24 (Housing Loan Interest) -Additional Benefit for first Home Buyer :

a) The loan has been sanctioned by a specified financial institution during the period 1 st April 2013 and
31st March 2014;
b) The amount of loan sanctioned Less than Rs. 25 Lakh;
250000

c) The value of the residential house property Less than Rs.40 Lakhs;

d) Individual does not own any residential property on the date of sanction of the loan.

D DEDUCTION UNDER SECTION 80 D - Mediclaim Premium

Sec 80D - (Medical Insurance Premium) - (for self, spouse & dependent children) - (Max. upto Rs 25,000)
50,000 5,000
Sec 80D - (Medical Insurance Premium) - (for parents) - (Max. upto Rs. 25,000 / Sr. Parents Rs. 30,000)
Sec 80D - (Preventive health check up) - (Max upto Rs. 5,000/-, as part of overall limit of Rs. 25,000/-)

DEDUCTION UNDER SECTION 80 DD - Deduction in respect of maintenance/ medical treatment of dependent

with disability. Deduction is Rs. 75,000. In case dependent has severe disability, deduction is Rs.1,25,000/- 125,000 0
E (Certificate in Form 10 IA is must)

DEDUCTION UNDER SECTION 80 DDB - Deduction in respect of medical treatment of specified diseases for
F self or dependants. Diseases specified are major ailments like Cancer, Dementia, Ataxia, Chorea, Parkinson, 80,000 0
AIDS, Renal failure, Thalassaemia is Rs. 40,000/- in case of senior citizens is Rs. 60,000/-
In case of super senior citizens is Rs. 80000/- (Certificate in Form 10 IA & Medical Bill is must)
DEDUCTION UNDER SECTION 80 U - Deduction of Rs.75,000/- to an individual with disability &
G Rs.125,000/- with severe disability (Certificate in Form 10 IA is must) 125,000 0

H DEDUCTION UNDER SECTION 80 E - Deduction in respect of repayment of interest on loan taken for NO LIMIT 0
higher education .
I Any other income to be added in the Income (Except Capital gain) NO LIMIT 0

J Pls. indicate whether salary of previous employer is applicable or not YES/NO YES

K Medical Reimbursement Bills (If applicable) 15,000 0

L Vechile Reimbursement Bills (If applicable) 1,80,000 0

Employee will be solely responsible for any query of Income tax office

I UNDERTAKE THAT IN CASE OF BOUNCING OF MY CHEQEUS TENDERED FOR INVESTMENT , THE DETAILS WILL BE
INTIMATED TO YOU PROMPTLY
I hereby declare that the investment stated above shall be made by me during the financial year and the proof of the same shall be
furnished to the Payroll Dept. in the month of January. If I fail to submit Investment proof of the above declaration, the same can be
reversed without prior intimation to me.

ENTERED BY: Nitesh Nianjan Jha SIGNATURE OF EMPLOYEE:

ENTERED ON: 19-Jun-2019

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