NEW GEN CROP SOLUTIONS PVT LTD

INCOME TAX INVESTMENT DECLARATION FOR THE FINANCIAL YEAR 2013-2014

Employee Identifiation Number Name of the Employee Desingation Mobile No. & E-mail address PAN No: (Mandatory) (if Pan CardCopy : not Enclosed we are not responsible for any mistakes) : Date of Birth (Mandatory) (DD/MM/YY) Male / Female / Senior Citizen 60 To 79 Years / : 80 and above Super Senior Citizen Date of Joining or April 1 2013 : whichever is later (DD/MM//YY) : : :

Dear Sir/Madam, I undertake to make the following investments qualifying under the provisions of Income Tax Act, 1961 during the financial year 20132014 and submit the proof of all Savings and Rent Receipts (if applicable) by 15th Feb, 2014. (If not submitted , we deduct the tax as per the Income Tax rules , further we are not responsible for any consequences)
S.No.

Investment Description MEDICAL PREMIUM : (For Self, Spouse,Dependent Children & Parents) Maximum Limit Rs.15000/-Rs. Rs.20000/- in case of premium on the health of Dependents above 65 years old. EXPENDITURE ON HANDICAPPED DEPENDENTS/Deposits made for maintainance of Handicapped Dependents (LIC,UTI etc.,) Adhoc Amount of Rs.50000/- & disability exceeding 80% the deduction will be Rs. 75000/- (Attach Govt.Hospital Medical Certificate. INTEREST PAID ON HOUSING LOAN. No. Maximum limit for let out property.Maximum Limit for Self Occupied Property Rs.150000/-(from 01.04.1999) (Submit Certificate received from Financial Institution/Banks, Occupation Certificate, Form 12 C declaration, Income from House.Prop.Computation Statement). MEDICAL EXPENSES : Proposed to be incurred ON SPECIFIED DISEASES (Bill to be submitted upto Dec) {AIDS, Cancer, Thalassaemia, Hemophilia, Crnic Renal Failure, Chronic Neurological Diseases) Maximum Rs. 40000/- & Rs.60000/- in case aged above 65 years (Attach Govt.Hospital Medical Certificate PERMANENT DISABILITY BENEFIT (SELF) - Adhoc deduction amount of Rs. 50000/- & Rs.75000/- in case of disability exceeding 80% (Attach Govt.Hospital Medical Certificate). Specified permitted Donations( Proof is required) INTEREST ON EDUCATION LOAN (for self education) - No Maximum Limit Any Other deductions allowable

Section 80 - D

Amount (Rs.)

80 - DD

24(1)vi)

80-DDB

5 6 7 8

80 - U 80-G 80 - E

INVESTMENT UNDER OVERALL LIMIT OF Rs.1 LAKH UNDER SECTION 80 EEC (80 C + 80 CCC + 80 CCD) (A) PENSION SCHEME INVESTMENTS (B) HOUSING LOAN PRINCIPAL REPAYMENT (C) PPF - Public Provident Fund (PPF) (Max Rs 70,000/-p.a.) (D) HOME LOAN ACCOUNT OF NATIONAL HOUSING BANK (E) LIC - LIFE INSURANCE PREMIUM DIRECTLY PAID BY EMPLOYEE (F) ULIP 1971-ULIP LINKED INSURANCE PLAN FROM UTI (G) NSC - NATIONAL SAVING CERTIFICATE Page 1 of 2

Section 80 CCC 80 C 80 C 80 C 80 C 80 C 80 C

Amount

(H) DEPOSIT UNDER POST OFFICE SAVING BANK (CTD) RULES, 1959 (I) NSS - NATIONAL SAVING SCHME (J) UTI - RETIREMENT BENEFIT PLAN (k) MUTUAL FUNDS - NOTIFIED UNDER CLAUSE 23D OF SECTION 10 (l) ELSS - EQUITY LINK SAVING SCHME OF MUTUAL FUNDS (M) Children Education Tuition Fees (The receipt must show the amount paid for the tution fees only.) (N) Contributory Provident Fund (P.F) maintained (O) Fixed Deposits in Banks (Period as per Income Tax Guidelines)(Term Period not less than 5years) (P)Other Deductions Under Chapter VI A GRAND TOTAL OF COLUMN 9 FOR REBATE UNDER Rs. 1,00, 000/- Exemption (Q) INFRASTRUCTURE INVESTMENT - NOTIFIED U/S 10 (23D) (Max :20000/-)

80 C 80 C 80 C 80 C 80 C 80 C 80 C 80 C 80 C

80 CCF

HOUSE RENT PAYMENT :(Relief provided against submission Lease agreement, Proof of Ownership such as copy of share certificate issued by Co--op Hsg.Society or Copy of Property Tax Bill of Copy of Monthly Society 10 Charges bill ). If Rent Lease Agreement is not available, plese attach Rent Self Declaration & Declaration from Landlord. Please Mention No. of Months rent payable during April 2013 to March 2014. Rent Paid ____________ Rs. per month. (Enclose Proof of Payments to be Submitted Quartrly (3Months) 1 Receipt)

10(13A)

VERIFICATION I hereby declare that above mentioned particulare are to the best of my knowledge and belief. Date: Place: Employees' Signature Income

1. Note: Please Fill the above Declaration and Submit back to us (Accounts Dept.) If you doesn't submit TAX will be deducted as per Tax rules (further we are not responsible for any consequences) 2. Note: Please attach all Xerox copies of documnents to this form supporting your savings made.

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