MAHANAGAR TELEPHONE NIGAM LIMITED

INCOME TAX SAVING FORM 2016-17 (last date 15 may 2016)

PLEASE SUBMIT THE FORM UPTO 15-05-2016 ALONGWITH ALL DOCUMENTS OTHERWISE FORM WILL NOT BE ACCEPTED
To, Name:
The Accounts Officer (P&A), Unit :
………………………………………….. Employee No. VR No.
MTNL, New Delhi PAN No. DOB
Sub. :- Details of other income earned/to be earned and savings made/proposed to be made during the FY 2016-17 for the purpose of
deduction of Income Tax from salary.
The details of income (other than salary) and the saving for the purpose mentioned above may kindly be
considered as detailed below.

S. NO. Particulars Amount

A Income other than salary
1.Interest on NSC
2.Interest on bank Accounts (Savings A/C only)
3.Prorata Pension/Family pension(If applicable)
4. Interest on fixed deposit
5. Any other Income ( FD/RD) etc.

6. Total Income (Other than Salary)

B (i)Income from House property (Rent etc.)
(ii)The interest on HBA(MAX. 1,50,000) should be shown as negative income.
C 1.Amount of monthly House rent receipt(produced/to be produced) to claim deduction from salary
on account of rent paid for rented house.
2.Name and address of the landlord(Please attach proof of ownership)i.e. Telephone bill/ electricity
bill/property tax receipt/etc.
3.Copy of RSTC Bill(i.e. Residential telephone connection(Employee)
4.Telephone no. of landlord
(Rent receipt for the month of April may be attached. In case of revision of rent during the year ,the
revised rent receipt should be produced in the same month as revision from back date is not allowed
in WFMS)
D Saving ,Donation etc. (Other than recovered from through salary bill)
1.Deduction under Chapter VI-A.
a.Physically disability of any independent(Max 50000/1,00,000 U/S 80 DD)
b.Medical insurance(Max 15000/35000(as case may be) U/S 80-D)
c.Repayment of interest on Educational Loan(U/S 80E)
2.Saving
a.Life Insurance policy Premium
b.Postal Life Insurance premium
c.ULIP
d.HBA Principal
e.Mutual Fund investment(Equity Linked)
f.Reinvestment of interest on NSC.
g.PPF
h.NSC
i.Pension Policy
j.Tution Fee
k.Any Other(please specify)
Total admissible(Limited to Rs. 1,50,000)
E Tax Relief (U/S 89) if any.
I will produce the documentary proof for income/deduction claimed above as and when the same are available with me but before the
end of the FY 2016-17.
Residential Address Signature:

Mobile No.

Signature and Seal of the Unit Officer Landline No.(R)

T. No.(O)

NOTE: ENCL. ATTESTED COPY OF PAN NO.