IT Statement&Relief Calculator FY 15 16 (Ubuntu)

FORMAT FOR THE PREPARATION OF INCOME TAX
CALCULATION STATEMENT FOR FY 2015-16

I General Information :
1 Name NARAYANAN.M.S
2 Whether Gazetted No
3 Sex Male
4 Designation HSST
HSS SREEKRISHNAPURAM
5 Office / Department
SREEKRISHNAPURAM
6 Whether residing in rented house No
7 (a) PAN : ABOPN0296Q (b) TAN :
M.S.N.SUDHAKARAN
8 Name & Address of Employer SANKARANARAYANAN NAMBOODIR
9 Circle of filing Income Tax Return
MONTH OF BILL PAY DA
MARCH 2015 34500 FILL 27600

APRIL 2015 34500 FILL 27600
MAY 2015 34500 FILL 27600
JUNE 2015 34500 FILL 27600
JULY 2015 34500 FILL 27600
AUG. 2015 35320 FILL 30375
SEPT. 2015 35320 FILL 30375
OCTOB. 2015 34143 FILL 29363
NOV. 2015 35320 FILL 30375
DEC. 2015 35320 FILL 32494
JAN. 2016 35320 FILL 32494
FEB. 2016 34181 31447
10 Total Salary during the year (Basic Pay+DA+HRA) 775331
13 DA Arrear To PF 45435
DA Arrear in Cash if any 0
Pay Arrear to PF if any 0
Pay Arrear in Cash 0

TOTAL ARREARS RECEIVED 45435
Festival/Bonus 2400
Other Allowances (CCA/PG/Risk/Uniform/Special. etc.) 0
15 Surrender Leave Salary Received 0
Total 823166
Deduct : HRA-Least of the following if residing in rented house :
(i) Actual HRA received Yearly 0 0
Actual Rent Paid (if residing in

rented house) 0 0
(ii) Rent paid in excess of 10% of salary(Pay + DA)) 0
(iii) 40% or 50% of salary according to the Employee's Location Non-Metro
Agricultural Income If Any 0
Income From House Property If Any 0
Entertainment Allowance 0
III Recoveries & Other Payments :
Number Yearly Subscription
17 PF Contribution T/09016002 120000

18 SLI Premium 6600
19 GIS Premium 3000
LIC Premium (Direct

20
Payment)
LIC Premium (Salary

21
Deduction)
PLI 0
22 FBS 0
Income Tax deducted from

23 50350
Salary Bill Upto Jan.2016
25 Profession Tax Paid 2500
Interest on
If availed before 31/3/99 0
27 Housing Loan
If availed after 31/3/99 0
28 Public PF No : 0
29 NSC 0
30 Mutual funds 0
31 Eductional expenses of children(for 2 children) 0
32 Equity shares & debentures 0
33 Repayment of Housing loan 0

Any other deductions,if
35 any
36 GPAIS
80CCC-Pension Fund(Annuity Plan of LIC or other Insurer)
37 80CCD-Contribution to Pension scheme of Central Govt. Employees
IV OTHER DEDUCTIONS
Medical Insurance Premium u/s 80 D : (Acc.Fund)
38 (Max. Rs. 15000/- or 20000/- as the case may be)
Maintenance and Medical treatment of Handicapped
39 Dependent u/s 80 DD :
(Max. Rs. 50000/- or 75000/- as the case may be)
Medical treatment for certain specified disease or
40 ailment u/s 80 DDB : (Maximum of Rs. 40000/-
and Rs. 60000/- as the case may be)
41 Interest on loan taken for higher education u/s 80 E :
42 Contribution toPolitical Parties u/s 80GGC
Donation to certain funds, charitable institutions etc.: u/s 80G

43 (100% in the case of Special Funds & 50%in other cases)
Deduction inrespect of persons with disability :

44 (Rs. 50000/- or Rs. 75000/- as the case may be)
45 Relief u/s 89(1)

OF INCOME TAX
R FY 2015-16
ANNEXTURE FORM10-E
ARAYANAN.M.S
WELCOME
o
Statement DATA
ale
PRINT
SST
SS SREEKRISHNAPURAM
PRINT STATEMENT
REEKRISHNAPURAM
o Enter Data in White cells
CHNS02939G Statement DATA
M.S.N.SUDHAKARAN PRINCIPAL WELCOME

NKARANARAYANAN NAMBOODIRI ANNEXTURE
PRINT STATEMENT
FORM-16 FORM10-E
DA HRA TOTAL
FILL
27600 250 62350

27600 250 62350
27600 250 62350
27600 250 62350
27600 250 62350
30375 250 65945
30375 250 65945
29363 242 63748
30375 250 65945
32494 250 68064
32494 250 68064
31447 242 65870
775331
45435
0 45435
0
45435
2400
823166
Non-Metro 0
0
2500
0
0
Statement DATA
16838 WELCOME
ANNEXTURE FORM10-E
0
0
PRINT STATEMENT
0
0
04/01/15 03/31/16
2016-17
FORM10-E
M10-E
772347
INCOME TAX CALCULATION STATEMENT
FOR THE YEAR 2015-16
Name : NARAYANAN.M.S Office/Institution/Department
Whether Gazetted : No Sex : Male HSS SREEKRISHNAPURAM
Designation : HSST SREEKRISHNAPURAM
PAN : ABOPN0296Q TAN : CHNS02939G
MONTH OF BILL PAY DA HRA TOTAL
MAR 2015 34500 27600 250 62350
APRIL 2015 34500 27600 250 62350
MAY 2015 34500 27600 250 62350
JUNE 2015 34500 27600 250 62350
JULY 2015 34500 27600 250 62350
AUG. 2015 35320 30375 250 65945
SEPT 2015 35320 30375 250 65945
OCT. 2015 34143 29363 242 63748
NOV. 2015 35320 30375 250 65945
DEC. 2015 35320 32494 250 68064
JAN. 2016 35320 32494 250 68064
FEB. 2016 34181 31447 242 65870
TOTAL 775331
DA+Pay Arrears received in Cash 0
DA+Pay Arrears Mergged to P.F 45435
Surrender 0
FESTIVAL ALLOWANCE/BONUS 2400
Other Allowances if any (CCA/PG/Risk/Uniform/Special. etc.) 0
Total Salary Income (Pay+DA+HRA+Other allowances except
1 PTA/PCA and inclusive of Surrender Leave Salary, Bonus/Spl. 823166
Festival allowances and Arrears of DA/pay and other allowances)
2 Deduct : HRA-Least of the following if residing in rented house
(i) Actual HRA received 0
(ii) Rent paid in excess of 10% of salary(Pay + DA)) 0
(iii) 40% or 50% of salary as the case may be 0 0
3 Balance Gross Income (1 - 2) 823166
4 Less Profession Tax u/s 16(iii) 2500
Less any other if 820666
6 Deduct : Interest on Housing Loan (Maximum Rs. 30000/- or
0 0
Rs. 200000/- as the case may be)
Agricultural Income 0 0
Income from House Property 0 0

7 Gross Total Income 820666
8 Deduction as per Chapter VI A U/s (a) 80 C :
i) Public Provident Fund : No. 0 0
ii) General Provident Fund : No. T/09016002 120000
iii) Pay/DA Arrear merged to PF 45435
iv) Group Insurance Scheme 3000
v) FBS 0
vi) PLI 0
vii) State Life Insurance 6600
viii) LIC Premia (salary deduction) Pol. Nos: 0 0
viii) LIC Premia (Direct deduction) Pol. Nos: 0 0
x) NSC 0
xi) Mutual funds 0
xii) Repayment of Housing Loan 0
xiii)Equity Shares&Debentures 0
xiv) Educational expenses of children 0
xv)GPAIS 0
xvi) Any other item (specify) 0 0
Total Deductions u/s 80C 175035 150000
(b) 80CCC Pension fund (Annuity plan of LIC or any other insurer) 0
Contribution to pension scheme of Central Govt.employees
(c) 80CCD
entering the service on or after Jan.2001 0 0
The aggregate amount of deductions u/s 80C, 80CCC,80CCD
(d) 80CCE shall not, in any case exceed One Lakh and Fifty 175035 150000
Thousand Rupees
Medical Insurance Premium u/s 80 D : (Acc.Fund)
(e) 80D (Max. Rs. 15000/- or 20000/- as the case may be) 16838
Maintenance and Medical treatment of Handicapped Dependent (Max. Rs.
(f) 80DD
50000/- or 75000/- as the case may be) 0
Medical treatment for certain specified disease or ailment
(g) 80DDB
(Maximum of Rs. 40000/- and Rs. 60000/- as the case may be) 0
Repayment of loan taken for higher education

(h) 80E
(Maximum of Rs. 40000/-) 0
(i) 80G Donation to certain funds, charitable institutions etc.: 0
(j) 80GGC Contributions to Political Parties 0
Deduction inrespect of persons with disability :
(Rs. 50000/- or Rs. 75000/-
(k) 80U
as the case may 0
be)
Total 166838 166838
9 Net Taxable Income (Rounded to nearest ten) 653828 653830
10 Income Tax on Total Income : 55766
Rebate u/s 87A 0
Total 55766 55766
11 Add Educational Cess (3% of tax ) 1673
12 Total Tax 57439
13 Less Relief u/s 89(i) 0
14 Balance Tax 57439
15 Less Tax deducted from the salary bill upto Jan 2016 50350
16 Tax Payable 7089
Signature of the Employee:
Place : SREEKRISHNAPURAM Signature of the Head of Office in case of NGO

Date: 02/14/2017 Signature of the Officer in the case of Gazetted Officer.
DATA
DATA SHEET FOR ARREARS RELIEF U/S 89(1)

This Calculation Start From FY 2000 -2001 to FY 2014- 2015
AND Assessment Year 2001 - 2002 to 2015-2016
Employee's Status (Male or Female) Male
DETAILS OF TAXABLE INCOME SINCE FINANCIAL YEAR 2000 TO
Total Income for the Financial Year 2000-01
Total income for the Financial Year 2004-05
Total Income for the Financial Year 2009 - 10
Page 39
DATA
Total Income For The Financial Year2013-14
Total Income For The Financial Year2014-15
DETAILS OF ARREARS RECEIVED
Arrears received For the Financial Year 2000-2001
Arrears received For the Year 2006-2007)
Arrears received For the Year 2007-2008
Page 40
DATA
Actual Arrears Relief U/s 89(1) Entitled
Page 41
DATA
Page 42
DATA
Page 43
DATA
F U/S 89(1)
to FY 2014- 2015
o 2015-2016
AL YEAR 2000 TO 2014
Rs. 0
Rs. 0
Rs. 0
Rs. 0
Rs. 0
Rs. 0
Rs. 0
Rs. 0
Rs. 0
Rs. 0
Page 44
DATA
Rs. 0
Rs. 0
Rs. 0
Rs. 0
Rs. 0
EIVED
Rs. 0
Rs. 0
Rs. 0
Rs. 0
Rs. 0
Rs. 0
Rs. 0
Rs. 0
Page 45
DATA
Rs. 0
Rs. 0 ANNEXTURE
FORM 16
Rs. 0
Form
Rs. 0
WELCOME
Rs. 0
FORM10-E
Total 0
Rs. 0 STATEMENT
Rs. 0
Rs. 0 Not Eligible
Page 46
DATA
Page 47
DATA
Page 48
DATA
Page 49
DATA
Page 50
DATA
ANNEXTURE
FORM 16
Form
WELCOME
FORM10-E
STATEMENT
Page 51
DATA
Page 52
DATA
Page 53
DATA
Page 54
DATA
Page 55
DATA
Page 56
DATA
Page 57
DATA
Page 58
DATA
Page 59
DATA
Page 60
DATA
Page 61
DATA
Page 62
DATA
Page 63
FORM 16-PART B
[See Rule 31(1)(a)]
CERTIFICATE UNDER SECTION 203 OF THE INCOME TAX, 1961 FOR

TAX DEDUCTED AT SOURCE FROM INCOME CHARGEABLE UNDER
THE HEAD "SALARIES"
Name and address of the Employer Name and Designation of the Employee
M.S.N.SUDHAKARAN NARAYANAN.M.S
PRINCIPAL HSST
HSS SREEKRISHNAPURAM HSS SREEKRISHNAPURAM
SREEKRISHNAPURAM SREEKRISHNAPURAM
PAN: ABOPN0296Q TAN : CHNS02939G
TDS Circle where Annual Return /
Period Assessment Year
Statement under section 206 is to be filled
From To
2016-17
01/04/15 31/03/16
DETAILS OF SALARY AND OTHER INCOME TAX DEDUCTIONS
1 Gross Salary 823166
2 Less Allowance to the extent under section 10 0
3 Net Salary Income (1-2) 823166
4 Add : Any other income reported by the employee
(a) Agriculture Income 0
(b) Income from house property 0
Total 0
5 Total Income (3-4) 823166
6 Deductions : (Under section 16)
(a) Tax on employment 2500
(b) Entertainment allowance 0
Total 6 (a+b) 2500
7 Under section 24
Interest on HBA 0
8 Gross Total Income 820666
9 Under section 80 - C
a) LIC ( i) Salary Deduction 0
(ii) Direct Payment 0
b) GPF Contribution 120000
c) PPF Contribution 0
d) Arrear DA 45435
e) SLI 6600
f) GIS 3000
g)GPAIS 0
h) PLI 0
i) FBS 0
j) HBA 0.00
k) Tution Fee paid (Limited to 2 Children) 0
l) Equity Shares/Debentures 0
m) NSC VIII Issue 0
n) Mutual Fund 0
o) Others 0 0
Total u/s 80C 175035
10 Under section 80 - CCC 0
11 Under section 80 - CCD 175035 0
Under Section 80CCE-limited to 150000 175035 150000
OTHER DEDUCTIONS
12 Under section 80 - CCF
14 Under section 80 - D 16838
15 Under section 80 - DD 0
16 Under section 80 - DDB 0
17 Under section 80 - E 0
18 Under section 80 - G 0
19 Under section 80 - U 0
20 Under section 80 - GGC 0
22 Total deduction admissible 166838 166838
23 Taxable Income (8-22) (Rounded to nearest ten rupee) 653828 653830
24 Income taxpayable 55766

25 Educational Cess @ 3% 1673
26 Total Tax Payable (24+25) 57439
27 Less Relief u/s 89(i) 0
28 Balance Tax 57439
29 Tax already paid / deducted 57439
30 Tax Payable 0
DETAILS OF TAX DEDUCTED AND DEPOSITED INTO CENTRAL GOVERNMENT ACCOUNT
Name of Bank & Branch
Amount Date of Payment
where tax Deposited
57439
I M.S.N.SUDHAKARAN S/D of SANKARANARAYANAN NAMBOODIRI
working in the capacity of PRINCIPAL do hereby certify that sum of Rs 57439
( #VALUE! ) has been
deducted at source and paid to the credit of the Central Government. I further certify 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: SREEKRISHNAPURAM Name: M.S.N.SUDHAKARAN
Date: 02/14/2017 Designation : PRINCIPAL
ANNEXURE&TABLE-A
ANNEXURE-I
[See item 2 of Form No.10E]
Arrears or advance salary
Sl No. Particulars Amount (Rs.)

1 Total income (excluding salary received in arrears or advance) Rs. 653,830
2 Salary received in arrears or advance Rs. 0

Total income (as increased by salary received in arrears or advance) [Add item 1
3 Rs. 653,830
and item 2]
4 Tax on total income [as per item 3] Rs. 57,439
5 Tax on total income [as per item 1] Rs. 57,439
6 Tax on salary received in arrears or advance [Difference of item 4 and item 5] Rs. 0
7 Tax computed in accordance with Table "A" [Brought from column 7 of Table A] Rs. 0
Relief under Section 89(1) [Indicate difference between the amounts mentioned
8 Rs. 0
against item 6 and item 7]
TABLE "A"
[See item 7 of Annexure 1]
Total income (as

Tax on total Difference in tax
Salary received in increased by Tax on total
income [as [Amount under
arrears or advance salary received in income[as per
per column column (6)
relating to the arrears or column (4) After
Total income of the (2)-After minus amount
Previous relevant previous advance) of the Rebate and
relevant previous Rebate and under column
year year as mentioned relevant previous including Edn
year (Rs.) including Edn (5)]
in column (1) year mentioned in Cess and
Cess and
column (1) Surcharge]
Surcharge]
(Rs.) (Rs.)
(Rs.) (Rs.)
(Rs.)
1 2 3 4 5 6 7
2000-01 Rs. 0 Rs. 0 Rs. 0 Rs. 0 Rs. 0 Rs. 0
2001-02 Rs. 0 Rs. 0 Rs. 0 Rs. 0 Rs. 0 Rs. 0
2002-03 Rs. 0 Rs. 0 Rs. 0 Rs. 0 Rs. 0 Rs. 0
2003-04 Rs. 0 Rs. 0 Rs. 0 Rs. 0 Rs. 0 Rs. 0
2004-05 Rs. 0 Rs. 0 Rs. 0 Rs. 0 Rs. 0 Rs. 0
2005-06 Rs. 0 Rs. 0 Rs. 0 Rs. 0 Rs. 0 Rs. 0
2006-07 Rs. 0 Rs. 0 Rs. 0 Rs. 0 Rs. 0 Rs. 0
2007-08 Rs. 0 Rs. 0 Rs. 0 Rs. 0 Rs. 0 Rs. 0
2008-09 Rs. 0 Rs. 0 Rs. 0 Rs. 0 Rs. 0 Rs. 0
2009-10 Rs. 0 Rs. 0 Rs. 0 Rs. 0 Rs. 0 Rs. 0
2010-11 Rs. 0 Rs. 0 Rs. 0 Rs. 0 Rs. 0 Rs. 0
2011-12 Rs. 0 Rs. 0 Rs. 0 Rs. 0 Rs. 0 Rs. 0
2012-13 Rs. 0 Rs. 0 Rs. 0 Rs. 0 Rs. 0 Rs. 0
2013-14 Rs. 0 Rs. 0 Rs. 0 Rs. 0 Rs. 0 Rs. 0
2014-15 Rs. 0 Rs. 0 Rs. 0 Rs. 0 Rs. 0 Rs. 0
TOTAL Rs. 0 Rs. 0 Rs. 0 Rs. 0 Rs. 0 Rs. 0
Signature :-
Place: SREEKRISHNAPURAM
Page 66
ANNEXURE&TABLE-A
Name :- NARAYANAN.M.S
Date :- 2/14/17 Designation :- HSST
Department :- HSS SREEKRISHNAPURAM
SREEKRISHNAPURAM
Page 67
ANNEXURE&TABLE-A
Col 1
6-May 0
Page 68
ANNEXURE&TABLE-A
FORM STATEMENT
FORM10-E DATA 653,830 0
FORM 16 WELCOME
Page 69
ANNEXURE&TABLE-A
2495
Page 70
ANNEXURE&TABLE-A
Page 71
ANNEXURE&TABLE-A
Page 72
ANNEXURE&TABLE-A
Page 73
ANNEXURE&TABLE-A
Page 74
ANNEXURE&TABLE-A
Page 75
ANNEXURE&TABLE-A
Page 76
ANNEXURE&TABLE-A
Page 77
ANNEXURE&TABLE-A
Page 78
ANNEXURE&TABLE-A
Page 79
ANNEXURE&TABLE-A
Page 80
ANNEXURE&TABLE-A
Page 81
ANNEXURE&TABLE-A
Page 82
ANNEXURE&TABLE-A
Page 83
FORM-10E
FORM NO.10 E
[ See rule 21AA]
Form for furnishing particulars of income under section 192(2A) for the year ending 31 st
March, 2014 for claiming relief under section 89(1) by a Government servant or an employee
in a 2[company,co-operative society,local authority ,university, institution,association or
body]
NARAYANAN.M.S
1 Name and Designation of the employee
HSST
2 PERMANENT ACCOUNT NUMBER ABOPN0296Q
3 RESIDENTIAL STATUS PERMANENT RESIDENT
Particulars of income referred to in rule 21A of the Income-tax Rules, 1962,during the
previous year relevant to assessment year 2014-15
Salary received in arrears or in advance in accordance with the provisions of

1(a) 0
sub-rule (2) of Rule 21A.
Payment in the nature of gratuity in respect of past services, extending over a

Not
(b) period of not less than 5 years in accordance with the provisions of sub-rule
Applicable
(3) of rule 21A.
Payment in the nature of compensation from the employer or former employer

at or in connection with termination of employment after continuous service of Not
(c)
not less than 3 years or where the unexpired portion of term of employment is Applicable
also not less than 3 years
Payment in commutation of pension in accordance with the provisions of sub- Not

(d)
rule (5) of rule 21A Applicable
Detailed particulars of payments referred to above may be given in Annexure

2 ANNEX-I
I,II,IIA,III, or IV as the case may be.
Verification
I NARAYANAN.M.S do here by declare that what is stated above is true to the best
of my knowledge and belief.
Verified Today, the day of: 2/14/17
Place: SREEKRISHNAPURAM
Date: 2/14/17 Signature of the Employee
Page 84
FORM-10E
Page 85
FORM-10E
Page 86
FORM-10E
WELCOME
STATEMENT
ANNEXTURE DATA
FORM FORM 16
Page 87
FORM-10E
Page 88
FORM-10E
Page 89

IT Statement&Relief Calculator FY 15 16 (Ubuntu)

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FORMAT FOR THE PREPARATION OF INCOME TAX

CALCULATION STATEMENT FOR FY 2015-16

6 Whether residing in rented house No

7 (a) PAN : ABOPN0296Q (b) TAN :

8 Name & Address of Employer SANKARANARAYANAN NAMBOODIR

9 Circle of filing Income Tax Return

MONTH OF BILL PAY DA

MARCH 2015 34500 FILL 27600

MAY 2015 34500 FILL 27600

JUNE 2015 34500 FILL 27600

JULY 2015 34500 FILL 27600

AUG. 2015 35320 FILL 30375

SEPT. 2015 35320 FILL 30375

OCTOB. 2015 34143 FILL 29363

NOV. 2015 35320 FILL 30375

DEC. 2015 35320 FILL 32494

JAN. 2016 35320 FILL 32494

FEB. 2016 34181 31447

10 Total Salary during the year (Basic Pay+DA+HRA) 775331

DA Arrear in Cash if any 0

Pay Arrear to PF if any 0

Pay Arrear in Cash 0

Other Allowances (CCA/PG/Risk/Uniform/Special. etc.) 0

15 Surrender Leave Salary Received 0

Deduct : HRA-Least of the following if residing in rented house :

(i) Actual HRA received Yearly 0 0

Actual Rent Paid (if residing in

(ii) Rent paid in excess of 10% of salary(Pay + DA)) 0

(iii) 40% or 50% of salary according to the Employee's Location Non-Metro

Agricultural Income If Any 0

Income From House Property If Any 0

III Recoveries & Other Payments :

Number Yearly Subscription

17 PF Contribution T/09016002 120000

19 GIS Premium 3000

LIC Premium (Direct

LIC Premium (Salary

Income Tax deducted from

25 Profession Tax Paid 2500

31 Eductional expenses of children(for 2 children) 0

32 Equity shares & debentures 0

33 Repayment of Housing loan 0

80CCC-Pension Fund(Annuity Plan of LIC or other Insurer)

37 80CCD-Contribution to Pension scheme of Central Govt. Employees

41 Interest on loan taken for higher education u/s 80 E :

42 Contribution toPolitical Parties u/s 80GGC

Donation to certain funds, charitable institutions etc.: u/s 80G

Deduction inrespect of persons with disability :

45 Relief u/s 89(1)

o Enter Data in White cells

CHNS02939G Statement DATA

M.S.N.SUDHAKARAN PRINCIPAL WELCOME

27600 250 62350

27600 250 62350

27600 250 62350

27600 250 62350

30375 250 65945

30375 250 65945

29363 242 63748

30375 250 65945

32494 250 68064

32494 250 68064

31447 242 65870