DATA ENTRY FOR INCOME TAX STATEMENT FOR 2019-2020

NAME : ASMABEGAM K
Designation : CHIEF CIVIL SURGEON
Department : Medical Department (ESI)
PAN Number:

EARNINGS Mar/2019 Apr/2019 May/2019 Jun/2019 Jul/2019 Aug/2019 Sep/2019 Oct/2019 Nov/2019 Dec/2019 Jan/2020 Feb/2020

Basic Pay 151400 151400 151400 151400 151400 151400 151400 151400 151400 151400 155900 155900

Grade Pay 0 0 0 0 0 0 0 0 0 0 0 0

Dearness Allowance 13626 13626 18168 18168 18168 18168 18168 18168 25738 25738 26503 26503

HRA 8300 8300 8300 8300 8300 8300 8300 8300 8300 8300 8300 8300

CCA 1200 1200 1200 1200 1200 1200 1200 1200 1200 1200 1200 1200

Medical Allowance 300 300 300 300 300 300 300 300 300 300 300 300

Other Allowance 3600 3600 3600 3600 3600 3600 3600 3600 3600 3600 3600 3600

DA percentage 9 9 12 12 12 12 12 12 17 17 17 17

SLS - 1,4,7,10,11 ENTER NO:1 for Mar OR 4 for Apl-June OR 7 for July-Sept OR 10 for Oct-Dec OR 11 for Jan-Feb

Deductions
GPF / CPS - Subs. 19900 19900 20400 20400 20400 20400 20400 20400 20400 20400 20400 20400

FBF 60 60 60 60 60 60 60 60 60 60 60 60

NHIS - 2012 180 180 180 180 180 180 180 180 180 180 180 180

SPF-2000 0 0 0 0 0 0 0 0 0 0 0 0

LIC - Salary Deduction 0 0 0 0 0 0 0 0 0 0 0 0

HBA - Principal-II 0 0 0 0 0 0 0 0 0 0 0 0

HBA - FBF 0 0 0 0 0 0 0 0 0 0 0 0

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

Advance I.T. 20800 20800 26000 26000 26000 26000 26000 26000 26000 26000 26000 0

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

HBA-Interest [Before 1-4-99 Max.30,000/-]

HRA - Exemption if any 8,800 8,800

PLI / LIC - Paid by individual [Total Amount] 0

Proof to be given to the Bills Section

Deductions under Chapter VI-A

(a) 80-C (v) Tuition Fees (Two child only) 0
(a) 80-C (vI) Subscription to Equity Shares /
Debentures or Units of Infrastructure Sector-
0

(b) 80-CCC Annuity Plan for LIC for receiving Pension 0

(c) 80-CCD Contribution to New Pension Schemes 0

(e) 80-D Insurance on Health 0

(f) 80-DD Expediture for Medical Treatment 0

(g) 80-E Repayment of interest on loan taken for higher eduation 0

(h) 80-G Donations made for charitable purposes [CMPRF] 0

(i) 80-U Person with disability 0

Tax paid by the employer on behalf

of employee 0
 INCOME TAX STATEMENT FOR THE FINANCIAL YEAR
2019 - 2020

Name : ASMABEGAM K
Designation : CHIEF CIVIL SURGEON
Department : Medical Department (ESI) PAN No. : A K Q P K 6 3 1 2 B

EARNINGS DEDUCTIONS
Month Pay in GPF / FBF / Adcance
G.P. DA HRA CCA M.A O.A TOTAL CPS P.T. NHIS PLI TOTAL
PB Subs. SPF I.T.

Mar-2022 50400 0 17136 700 300 68536 6754 180 300 1395 8629

Apl-2022 50400 0 17136 700 300 68536 6754 180 300 1395 8629

May-2022 50400 0 17136 700 300 68536 6754 180 300 1395 8629

June-2022 50400 0 17136 700 300 68536 6754 180 300 1395 8629

July-2022 51900 0 17646 750 300 70596 6955 180 300 1395 8830

Aug-2022 51900 0 17646 750 300 70596 6955 180 1250 300 1395 10080

Sep-2022 51900 0 17646 750 300 70596 6955 180 300 1395 8830

Oct-2022 51900 0 17646 750 300 70596 6955 180 300 1395 8830

Nov-2022 51900 0 17646 750 300 70596 6955 180 300 1395 8830

Dec-2022 51900 0 17646 750 300 70596 6955 180 300 1395 8830

Jan-2023 51900 0 19722 750 300 72672 7162 180 1250 300 1395 12480 22767

Feb-2023 51900 0 19722 750 300 72672 7162 180 300 1395 9037
SLS
[30 days]
DA-Arr-I

DA-Arr-II

Pay Arr-I

Pay Arr-II

Bonus

TOTAL 616800 0 213864 8800 0 3600 0 843064 83070 2160 2500 3600 16740 12480 120550

ABSTRACT
EARNINGS DEDUCTIONS

Basic Pay : 616,800 GPF / CPS - Subscription : 83,070

Grade Pay : 0 FBF + SPF : 2,160
Dearness Allowance : 213,864 Professional Tax : 2,500

House Rent Allowance : 8,800 NHIS : 3,600

City Compensatory Allowance : 0 PLI : 16,740

Medical Allowance : 3,600 Advance Income Tax : 12,480
Other Allowances / Bonus : 0 :

TOTAL - Earnings : 843,064 TOTAL - Deductions : 120,550

P.T.O.
 DETAILS OF SALARY PAID AND ANY OTHER INCOME AND TAX DEDUCTED

1. GROSS SALARY 8,43,064

2. LESS: Allowance to the extent exempt u/s 10 [WHICHER IS LESS]
(a) H.R.A. exempt u/s 10 (13A) [WHICHER IS LESS]
(a) Actual amount of HRA received 8,800
(b) Expenditure of rent in excess of 10% of salary (including DA)
(c) 50% of salary (including DA) [Metropolitan Cities]
(d) 50% of salary (including DA) [Other Cities]
[whichever is least among c & d]
8,800
3. Balance [1-2] 8,34,264

4. DEDUCTIONS under Section 16

(a) Standard deduction u/s 16A (Maximum of Rs.50,000/-) 50,000
(b) Tax on Employment [Professional Tax u/s 16(iii)] 2,500

AGGREGATE OF 4(a) to (b) 52,500

Income from house property Annual value Nil

LESS: Interest payable on loan u/s 24 0
[Loss from House property [Max. Rs.30,000/- before 1-4-99 After Rs.1.5 lakhs] 0
52,500
5. Income chargeable under the head 'Salaries' [GROSS TOTAL INCOME] 781,764
6. ADD Any other income reported by the employee 0
(a) Income under the head 'Income from House Property
(b) Income under the head 'Income from Other Sources'
(c) Total of (a) + (b) above

7. GROSS TOTAL INCOME [(5) + (6)] 781,764

8. Deductions under Chapter VI-A G. Amt. Q. Amt. D. Amt.

(a) 80-C Entitled to deductions for the whole of amounts paid or deposited 135,834 1,50,000
(i) G P F / C P S (Subscription) 83,070
(ii) Family Benefit fund + Special Provident fund 2,160
(iii) Postal Life Insurance 16,740
(iv) L I C Premium 33,864
(v) Tuition Fees (Restricted to two children) 0
(vi) Sukanya Samriddhi Yojana 0
(b) 80-CCC Annuity Plan of LIC/Others for receiving pension 0 10,000
(c) 80-CCD Contribution to New Pension Scheme [Limited to 10% of Salary] 0 10% Salary
(d) 80-CCE TOTAL of 80C + 80CCC + 80CCD [Limited to Rs.1,50,000/-] 1,35,834
Investment in long-term infra bonds as notified by the Central Govt. 0 20,000 0
(e) 80-D Medical Insurance Premium [ NHIS ] 3,600 3,600 3,600
(f) 80-DD Expenditure for medical treatment, being a person with disability
(g) 80-E Repayment of interest on loan taken for higher education for the purpose of
pursuing his higher education or his spouse or children.
(h) 80-G Donations made for charitable purposes [CMPRF=100%; Other=50%]
(i) 80-U Person with disability [Severe disability = Rs.75,000/-]
9. TOTAL AMOUNT IN CHAPTER VI-A 1,39,434
10. TOTAL INCOME [8-9] (NET TAXABLE INCOME) 6,42,330

11. Tax on Total Income

(1) On the First Rs.2,50,000/- Nil
(2) On the Next Rs.2,50,001 to Rs.5,00,000/- [5%] 250000 12,500
(3) On the Next Rs.5,00,001 to Rs.10,00,000/- [20%] 142330 28,466
(4) Exceeding Rs.10,00,000/- [30%] 0 0
12. Tax payable on Total Income (11) 392330 40,966
Rebate of Rs.12500 for Individuals having Total Income Upto 5 Lakh
0
[Section 87a]
Tax payable on Total Income after Rebate if any 40,966
ADD : Education and Health Cess @ 4% 1,639
13. TOTAL TAX PAYABLE FOR 2019-2020 42,605
14. LESS : Advance Income Tax already paid 12,480
0
12,480
15. Tax Payable / Refundable (2019-2020)
(ASMABEGAM K)
 H.B.A. INTEREST CALCULATION STATEMENT FOR 2013-2014

ASMABEGAM K
CHIEF CIVIL SURGEON

H.B.A. : Rs.0,00,000/-

Differential Rates of Interest on Slab System:

i) for the part of the advance which is upto Rs.50,000/- 7.50

ii) for the part of the advance which exceeds Rs.50,001/- but does not 9.00
exceed Rs.1,50,000/-
iii) for the part of the advance which exceeds Rs.1,50,001/- but 11.00
does not exceed Rs.4,00,000/-
12.00

13.00

Principal Balance as on 01-03-2013 Rs.0,00,000/-

Month (5%) (6.5%) (8.5%)

1 2013 March
2 2013 April
3 2013 May
4 2013 June
5 2013 July
6 2013 Aug.
7 2013 Sept.
8 2013 Oct.
9 2013 Nov.
10 2013 Dec.
11 2014 Jan.
12 2014 Feb.

Total [1-12] 0 0 0 0 0

0 x 7.5 / 12 x 100 = -
0 x 9 / 12 x 100 = -
0 x 11 / 12 x 100 = -
0 x 12 / 12 x 100 = -
0 x 13 / 12 x 100 = -
Total -
 FORM NO.16
[(See Rule 31(1)(a) of the Income Tax RulesÏ 1962]
Certificate under section 203 of the Income Tax Act, 1961 for tax deducted at source from income
chargeable under the head "Salaries"

Name and address of the Employer Name and address of the Employee

PAN / GIR NO. TAN PAN / GIR NO.

AKQPK6312B
TDS Circle where Annual Return / Statement Period Assessment Year
under section 206 is to be filed
From To
01-03-2011 2/28/2012 2014-2015
DETAILS OF SALARY PAID AND ANY OTHER INCOME AND TAX DEDUCTED

1. Gross Salary
(a) Salary as per provisions contained in Sec.17(1) Rs. 781,764

(b) Value of perquisites u/s 17(2) (as per Form Rs.________

No.12BA, wherever applicable
(c) Profits in lieu of salary under Section 17(3) (as Rs.________
per Form No.12BA, wherever applicable)
(d) Total Rs. 781,764

2. Less: Allowance to the extent under section 10 Rs.________

Rs.________

3. Balance (1-2) Rs. 781,764

4. Deductions:
(a) Standard Deduction Rs.________

(b) Entertainment Allowance Rs.________

(c) Tax on Employment Rs.________

5. Aggregate of 4 (a to c) Rs.________

6. Income chargeable under the Head 'Salaries' (3-5) Rs.________

7. ADD: Any other Income reported by the employee Rs.________

Rs.________

8. Gross Total Income (6+7) Rs.________

9. Deductions under Chapter VI-A Gross Deductible

(A) Section 80C, 80CCC and 80CCD Amount Amount
(a) Section 80C Rs.________ Rs.________

(i) Rs.________ Rs.________

(ii) Rs.________ Rs.________

(iii) Rs.________ Rs.________

(b) Section 80CCC Rs.________ Rs.________

(c) Section 80CCD Rs.________ Rs.________

Note: 1. Aggregate amount deductible under Section 80C shall not exceed one lakh rupees.
2. Aggregate amount deductible under the three Sections, i.e., 80C, 80CCC and 80CCD, shall not exceed one lakh rupees.
 -2-

(B) OTHER SECTIONS (for e.g. 80E, 80G etc.) Gross Qualifying Deductible
UNDER CHAPTER VI-A Amount Amount Amount
(a) Rs.________ Rs.________ Rs.________

(b) Rs.________ Rs.________ Rs.________

(c) Rs.________ Rs.________ Rs.________

(d) Rs.________ Rs.________ Rs.________

(e) Rs.________ Rs.________ Rs.________

10. Aggregate of deductible amount under Chapter VI-A Rs.________

11. Total Income (8-10) Rs.________

12. Tax on Total Income Rs.________

13. Surcharge (on tax computed as S.No.12) Rs.________

14. Education Cess Rs.________

(on tax at S.No.12 and surcharge at S.No.13)
15. Tax Payable (12+13+14) Rs.________

16. Relief under Section 89 (attach details) Rs.________

17. Tax Payable/Refundable (15-16) Rs.________

18. Less: (a) Tax deducted at source u/s 192(1) Rs.________

(b) Tax paid by the employer on behalf of
the employee u/s 192(1A) on
perquisites u/s 17(2) Rs.________

Details of Tax Deducted and Deposited into Central Government Account

Education TOTAL tax Cheque / DD Date on which tax Transfer

Sl. TDS Surcharge
Cess deposited No. BSR Code of Bank branch deposited voucher/Challan
No. Rs. Rs.
Rs. Rs. (if nay) (dd/mm/yy) Identification No.

I ...................................................... son of ..................................... working in the capacity of ..............................

(designation) do hereby certify that a sum of Rs................. (Rupees ...............................(in words) has been deducted at
source and paid to the credit of the Central Government. I further certified that the information given above is true and
correct based on the book of accounts, documents and other available records.

Signature of the person responsible for deduction of tax

Place: Full Name: ________________________

Date : Designation:_______________________