“Provisional Investment” Form for Salary Income Tax - F.Y.2010-2011.

You are requested to read carefully & adhere to the following procedures/rules :

1. Submission of Final Declaration Form should reach the HR/Payroll Department before 15/06/2010

2. For New Joinees or Late submissions or Revisions in declaration, the Forms recd before 15th of Every
month will be considered for Tax calculations.

3. All required details should be neatly/correctly filled in the form, else the same will not be considered.

4. Proofs/attachments are not required to be attached with Form, except the “Provisional
Certificate/Statment” for Interest & Principal paid/payable in F.Y. 2010-11 for Housing Loan and
“Medical / Institute Certificates” for the specified deductions U/s 80DD,80DDB,80U,80E

5. Permanent Account No. (PAN) must be quoted on the Form. Please Note that Forms without PAN,
will not be considered for Tax calculations.

6. Tax once deducted cannot be refunded by Payroll Department/Employer , refund if any, has to be
claimed by the employee from the Income Tax Department at the time of filing the Income tax return.

7. Both HRA exemption and Housing Loan Interest repayment exemption cannot be availed
simultaneously except in following cases……….
A) If it is first year of construction completion & you have not yet occupied the said property for your
residence. In such case both can’t be claimed simultaneously but only for the part of the year.
B) Loan is taken to acquire the house property and the employee could not occupy it due to
employment at any other place & employee has to reside at rented premises.
C) Only one person either Husband/Wife can avail for housing benefit subject to submission of
undertaking.

8. Section 80DD : Provides for deduction in respect of maintenance including medical treatment of
handicapped dependent.(Quantum of deduction is Rs.50,000/- in respect of a dependent being a
person with disability. In respect of dependent being a person with severe disability(80 % or multiple
disability) quantum of deduction is Rs.1,00,000/- as against Rs.50,000/-. The employee is required to
furnish a copy of the certificate issued by the medical authority in the prescribed form.

9. Section 80DDB : Provides for deduction of Rs.40,000/-( Rs.60,000/- for Senior Citizen) in respect of
medical treatment of specified disease or ailment incurred by individual for himself or a dependent .You
are required to furnish a certificate in prescribed Form No.10 –I from doctor prescribed in rule 11DD(2)

10. Section 80U : Provides for deduction to Employee, certified as disable (handicap) by medical
authority(as per rule), deduction of Rs.50,000/- (in case of sever disability Rs.1,00,000/- instead of
Rs.50,000/-.)

11. Section 80E : Provides for deduction of total amount of interest paid on “Loan taken for Higher
Education” for self,relative or dependent from notified Financial Institutions.
12. Section 80CCF : Provides for deduction in respect of investments in Long Term Infrastructure Bond
notified by Central Government, Up to Rs. 20,000/- (Max)

13. Deduction From Salary Income Under Section 80CCE (Maximum up to Rs.1,00,000)

(1) Life Insurance premium paid by an individual on his/her life or on life of his/her spouse or on life of
any child of such individual.(Max Rs. 1,00,000/-)

(2) Contribution to Public Provident Fund in an account standing in the name of individual, the wife or
husband and any child of such individual. (Max Rs.70,000/-)

(3) National Saving Certificate (Max Rs.1,00,000/-)

(4) Payment for the purchase or construction of a residential house property.(Max Rs.1,00,000/-)

(5) Children Education Expenses i.e. full Time tuition fees paid at the time of admission or thereafter, to
any university, college or school, excluding any payments towards any development fees or
donation.or transportation facility ( Max Rs.1,00,000/-)

(6) Contribution to Pension Plan (Max. Rs 100,000/-)

(7) Fixed Deposit scheme with schedule banks with not less than Five Years Account opened in
current year. (Max Rs.1,00,000/-)

(8) Unit link Insurance plan ( Max Rs. 1,00,000/-)

14. The maximum amount of deduction for item no.13(1) to 13(8) is up to Rs.1,00,000/-, Amount invested
in excess of these limits are not eligible for deduction .

15. Rates Of Income Tax ( i.e. Slab of Income for tax calculations)
For Males below 65 Yrs. For Females below 65 Yrs.
Income Category Tax Rate Income Category Tax Rate
0 to 1,60,000 Nil ( No Tax ) 0 to 1,90,000 Nil ( No Tax )
1,60,000 to 5,00,000 10 % 1,90,000 to 5,00,000 10 %
5,00,000 to 8,00,000 20 % 5,00,000 to 8,00,000 20 %
8,00,000 & Above 30% 8,00,000 & Above 30%
Notes :
1) Additional Surcharges as applicable
2) Income category is the Net Taxable Income after allowed Deductions.

16. Its fully Employees’s responsibility to check the details in Tax Computation Sheet (in the next month of
submission of Form) for the correctness of the information he submitted to HR/Payroll & updates in his Tax
computation. If any difference found he need to highlight the same to HR & Payroll Dept immediately, to
avoid any dispute.

17. The above instructions are only for Employees of CMS Info Systems Pvt Ltd & the information mentioned
above is extracted from the Budget 2010-11 & IT Act, hence if any changes/corrections found, the
rules/statements in Budget/Act will/should be referred.
 Provisional Investments Declaration Form for the year F.Y.2010-2011

I hereby submit my Provisional declaration of investments Form during the F.Y 2010-11 out of my Taxable
Income with a request to consider the same while computing tax to be deducted from my salary for the period
Apr10-Mar11.

Name of Employee :_______________________ Emp.Code : ______________

Job Location :______________________ Dt.of Join_______________

Present Residential Address :_______________________ PAN No.: ________________

_______________________
_______________________ Gender : ________________

I. Deduction under section 80 CCE

1. Contribution to Pension Fund Rs._________

2. Life Insurance Premium details as under:

Policy No. For (Relationship) Policy Amount Total Premium
Paid / Payable
a. ________ _______________ Rs._________ Rs.__________
b.________ _______________ Rs._________ Rs.__________
c.________ ________________ Rs._________ Rs.__________
Total Premium Paid (a+b+c)Rs.__________

3. Public Provident Fund Rs.__________

4. ULIP Rs.__________

5. VIII Issue of NSC Rs.__________

6. Repayment of Housing Loan Principal Rs.__________

7. Fixed Deposit more than 5 Yr’s Rs.__________

8. Children’s Education Expenses (Restricted to Two children) Rs.__________

9. Other ( Pls Specify _______________ ) Rs. __________

TOTAL (1 TO 9 ) Rs.__________

Allowable Deduction u/s 80CCE (Max to Rs.1,00,000/-) Rs.__________

II. Deduction under section 80 CCF

Name of Infrastructure Bond Amount Allowable Deduction Max Rs.20,000/-
Invested
III. Deduction under Section 80 D – Mediclaim Premium (excluding paid through CMS)
Note : Deduction restricted to Rs.15,000/-p.a. & Premium Paids includes Senior Citizens premisible
deduction is Rs.20,000/- p.a.
Policy No. For (Relationship) Policy Amount Total Premium
Paid / Payable
a. ________ _______________ Rs._________ Rs.__________
b.________ _______________ Rs._________ Rs.__________

Total Rs.__________(Total premium pd p.a.)

IV. Deduction U/s 80DD,80DDB,80U & 80E

U/S Description Amt Eligible Amt for
Paid Dedcuction
80DD Maintenance of handicapped
dependent
80DDB Medical Exp for Specified Disease
80U Handicapped Employee
80E Int of Loan for Higher Education
Note : Copy of Certification is compulsory required for above deductions.

V. HOUSE RENT ALLOWANCE EXEMPTION u/s 10(13A)

Rent Payable/Paid Per Mth From Month To Month Owner’s Name Address of Rented Premises

VI. Interest paid on Housing Loan from approved Financial Institution.

Address of Property Amount of Loan Date of Loan Interest

___________________ Rs.___________ ___________ Rs._________

(Pls attach latest copy of the Provisional certificate for the F.Y. 2010-2011 from respective Financial Inst)

UNDERTAKING BY EMPLOYEE
I hereby declare that above information is correct and I shall be solely responsible for any queries that may be
raised by Income Tax dept. related to my Investment Proofs/Declaration. And I SHALL INDEMNIFY the
Income Tax Liability if any asked by I. Tax Dept.

Place :
___________________________
Date : Signature of the Employee(CISPL)

VERIFICATION BY HR REPRESENTATIVE
I hereby declare that I have verified the above form & they are properly filled in.
Place :
________________________________
Date : Signature of the HR Representative(CISPL)
Name :