JKT/JKTC

Investment Proofs Form - FY. 2019-2020

EMPLOYEE CODE : 4346 NAME : Karthik L Contact No. : ______________

7353333853

PAN ( Mandatory ) : BESPK6384J DOJ: 20-05-1988

ADDRESS : #43,2nd floor Ramya Nilaya,9th cross,2nd block Akashayanagara,Ramamurthynagar,Banglore:560016

I. A. Deduction to be Claimed U/S 80 as per specified limit: Relation of

policy holder
with employee Amount (Rs.)

1 Mediclaim Policy Premium for Self/Spouse/ Children [u/s 80D]-upto Rs. 25,000/-
2 Mediclaim Policy Premium for Non Senior citizen parents( Age below 60 years) [u/s 80D]-upto Rs. 25,000/- Father 25000

3 Mediclaim Policy Premium/medical expenses for Senior citizen parents(age above 60 years) [u/s 80D]-upto Rs. 50,000/- Father 50000

4 Medical treatment of handicapped dependent [u/s 80DD]- upto Rs. 75,000/-

5 Payment of interest amount on loan taken for higher education [U/s 80 E]
6 Ragiv Gandhi Equity Saving Scheme [80CCG]upto Rs. 50,000/-

7 National Pension Scheme [80CCD-1B] upto Rs.50000/-

B Deduction U/S 80C/ 80CCC limit up to 1.5 lac.

1 Life Insurance Pension Scheme Premium

2 Sukanya Samriddhi Deposit
3 Life Insurance Premium Self 4500

4 Deposit in Public Provident Fund Self 80000

5 Purchase of National Saving Certificates

6 Payment of Unit Linked Insurance plan ( ULIP )
7 Payment of Equity linked Mutual Fund (Only Eligible Tax Saver Fund ) (ELSS)
8 Payment of tuition fees for any of two children
Child 1: (Amount in Rs) Child 2: (Amount in Rs)
9 Repayment of Principal Amount of Housing Loan During the F.Y. 2019-2020

10 Fixed Deposit with Bank/ Post Office for lockin period 5 years or more and Tax saver only.
11 Others (Please provide details)
Total Amount from 1 to 11 (Restricted to Rs. 1,50,000/- encluding Employee PF amt, would be added from payroll)
155000
II. Deduction to be Claimed U/s 24 for Housing Loan

Do you have possession of the Property (Yes / No), if Yes date of Possession
Name of owner & Address of the Property

Interest amount paid on Housing Loan for the F.Y. 2019-20120 - limit upto Rs. 200,000/-

Note: 1- The employee who is claiming benefit of home loan first time in current employment or possession got in current FY, ownership and possession proofs
to be submitted with interest & principal certificate from bank.
2- If employee not having possession of house , interest benefit can not be claimed.
III. RENT FOR THE PURPOSE OF HRA EXEMPTION U/S 10(13A)
Name & Address of Address of accommodation PAN of landlord Rent Amount p.m Period
Landlord
Owner : Ramya, From 20-May-15
#43,Ramya Nilaya,9th Owner : Ramya, #43,2nd floor Ramya
cross,2nd block Nilaya,9th cross,2nd block ANLPV9625Q 17000 To TILL DATE
Akashayanagara,Rama Akashayanagara,Ramamurthynagar,Ban
murthynagar,Banglore: glore:560016

Note :1-To get the HRA exemption every employee needs to submit one rent payment receipt of each of four Quarter for financial year 2019-20.
2-if annual rent above 1lakh , PAN copy of landlord mandatory requirement to be enclosed with rent receipts.
3-HRA exemption and home loan benefits can not be claimed for the same city hence please do not submit the same for tax benefits.
IV. (Any other income other than salary income.

(ii) Income from other sources

(a) Saving Interest
(b) Other incomes
Total
V. Any investment's payment due after 5th of Feb'2020, kindly fill up details below and submit proofs for this before 8th of March 2020. Relation of
Particulars Amounts policy holder Due Dates
1
2
3
4

I hereby declare that all the information given by me is true and correct & that the investments declared above, will not be used anywhere else to get income tax.
benefit. Banglore
Place :
Dated : Signature