Employee's Name

Designation
Date of Birth
Sex (Male / Female)
Financial Year
MTH \ A/C HEAD Apr/14 May/14 Jun/14 Jul/14
Ded. Under Sec. 80 C (Maximum limit Rs. 1 Lac per
annum) - - - -
PPF
Life Insurance
Housing Loan Repayment
Stamp Duty
NSC
ELSS
Fixed Deposit above 5 Yrs.
Any other Investment (cover under section 80 C)
Deduction on Investment in Rajeev Gandhi Equity
Saving Scheme (RGESS) as per Under Sec. 80CCG
Deduction on Medical Insurance/Mediclaim Policy as
per Under Sec. 80 D
Interest on Repayment of Education Loan as per
under section 80 E
Interest on Repayment of Housing Loan as per Under
Section 24
Total Investment
Apr/14 May/14 Jun/14 Jul/14
Rent Receipt to be submitted
2014-15
Aug/14 Sep/14 Oct/14 Nov/14 Dec/14 Jan/15 Feb/15 Mar/15
- - - - - - - -
Aug/14 Sep/14 Oct/14 Nov/14 Dec/14 Jan/15 Feb/15 Mar/15
PAN
Father's Name
Date of Joining
Complete Address
Total
-
-
-
-
-
Total
-
Complete Address