Proforma for Submission of information for Income Tax on Salary for the financial year 2006-07 (Assessment Year 2007-08) Name and Designation: PAN No.: Address: Tel. No. (EPABX): Employees Code No.: 1. Income from Salary 2. Value of perquisites 3. Total 4. Less Allowances under Section 10 i) HCA ii) HRA (Attach Calculations) 5. Less deductions (Professional/Entertainment allows.) 6. Total Salary Income 3-(4+5) 7. Add any other income reported by the Employee i. Income from house property (+ or -) ii. Pension iii. Interest Income (as per Form- 12C) 8. Gross Total Income (6+7) 9. Deductions under chapter VI-A i. Rebate for savings under section (1) GPF- Rs. ii. 80CCE (80C, 80CCC and 80CCD) (2) PPF- Rs. (3) LICs- Rs. (4) PLI - Rs. (5) GSLIS -Rs. _______________________ Total Savings Rs. ____________________ iii. Under Section 80D to 80U 10. Taxable Income (8-9) 11. Income Tax 12. Surcharge 13. Total Income Tax (11+12) 14. Education Cess on total income Tax at Sr. No. 13 15. Rebate Under section 89(i) if any (attach Form 10E) 16. Total Income Tax Payable (14-15) 17. Income Tax already paid i. Salary ii. Others 18. Income Tax to be paid in Feb. 2007 (Refund, if any) Dated: Signature
