INVESTMENT DECLARATION FORM FOR CLAIMING TAX BENEFITS For the Finan

PERSONAL INFORMATION (ALL FIELDS ARE MANDATORY)

EMPLOYEE ID

NAME

FATHER/HUSBAND NAME

DATE OF BIRTH

GENDER

PAN

CONTACT NO.

DATE OF JOINING

SECTION-I (Only original Rent receipts will be considered)

RENT PAID FOR THE PURPOSE OF CLAIMING BENEFIT OF HRA U/S 10(13A) OF THE ITA

From date To date Full Address Rent Paid Per month

*PAN of Land Lord is mandatory if rent exceeds Rs. 100000/- annual (8333/- P.M)
*Please submit hardcopy of declaration from landlord that he/she has not been allotted PAN from Income Tax Department
SECTION-II (Photocopies to be attached)
(DECLARATION OF SAVING ALLOWED U/S 80 OF THE IT ACT, 1961) In respect of Saving al
S.No Description

1 U/s 80D- Medical Insurance Premium- Individual, Spouse & Children

2 U/s 80D- Medical Insurance Premium- Parents

3 Section 80E- Payment of interest on loan taken for Higher Education

SECTION-III (saving u/s 80C OF THE IT ACT, 1961) (Photocopies to be a

Total Amount of Deduction allowed up to Rs. 1,50,000/- (Including Provident Fund dedu

S.No Description
1
Investment Declaration Page 1
 2

SECTION-IV (Saving U/S-80CCG & 80TTA)

1. Equity Saving Scheme(U/S 80CCG)-50% of the Amount Invested or 25000 whichever is less

.
2 Deduction I.R.O. Interest in Saving A/C(80TTA)

SECTION-V (DEDUCTION U/S 24 OF THE IT ACT, 1961 INTEREST ON HOUSI

With respect of the amount of any interest payable on borrowed capital for acquiring, constructing , renewal, repairi

1. Address of the Property against which Loan taken : _________________________________________________

____________________________________________________________________________________________
____________________________________________________________________________________________

2. Status of Property (Self-Occupied/Rented and vacant :________________________(if Rented/Vacant, details m

Annexure-B For any other income)
3. Amount of Loan issued, Date of loan availed and Name and the address of the lender (loan Provider): - ________
____________________________________________________________________________________________
____________________________________________________________________________________________

4. Purpose of the Loan (construction / Acquiring property) _____________________________________________

6. Date on which Construction has Completed (expected date, if not already completed):______________________

7. Date of Possession of Property : _________________________

9. Total amount of interest paid (post construction/possession) during the financial year (April
2018 to March 2019)

10. Specify amount of interest paid for pre-construction/possession period.

11. Ownership ( Joint or Sole)

12. If Joint Ownership Name and Relationship with Owner(s)

Share of Joint Owner(s) in Property

Whether any sum Contributed by Joint Owner in Acquiring Property (if Join
submit
Name(s) of Joint Owner(s) (Apart from the Employee) Who are Repaying
Aforesaid Housing Loan
Whether Joint Owner(s) is/are claiming Deduction Under Income Tax Act , 1961
On Account of Housing Loan Taken for Aforesaid Property

Investment Declaration Page 2

 SECTION-VI (DEDUCTION U/S 80EE OF THE IT ACT, 1961 INTEREST ON HOU
With respect of the amount of any interest payable on loan sanctioned during the F.Y. 2013-14 for the purpose of ac
100000)

1. Amount of Loan sanctioned : ________________________________________________________

2. Value of Property : _______________________________________________________

3. Any property owned by employee at the date of sanction of loan (Yes/No) : ____________________________

4. Total amount of interest paid during the financial year (April 2018 to March 2019)

SECTION-VII
Medical Expense Reimbursement

Leave Travel Allowance

Other Income details to be accounted for tax calculation

SECTION-VIII
I, __________________________________ , do hereby declare that the aforesaid information is true and c

and belief and I shall indemnify the company against all costs and consequences if any information is later on found

Signature of Employee :______________________

Date :______________________

Place :______________________

Note: Please read & understand the guidelines provided in Instruction for filling Investment proof form

Investment Declaration Page 3

 ING TAX BENEFITS For the Financial Year 2018-19
(ALL FIELDS ARE MANDATORY)

al Rent receipts will be considered)

ENEFIT OF HRA U/S 10(13A) OF THE ITAX ACT, 1961

PAN OF LANDLORD*

hotocopies to be attached)
HE IT ACT, 1961) In respect of Saving allowed under Chapter VI

Amount

THE IT ACT, 1961) (Photocopies to be attached)

00/- (Including Provident Fund deducted through salary)

Amount

Investment Declaration Page 4

g U/S-80CCG & 80TTA)

THE IT ACT, 1961 INTEREST ON HOUSING LOAN)

for acquiring, constructing , renewal, repairing or re-constructing property.

__________________________________________
____________________________________________________
___________________________________________________

_____________(if Rented/Vacant, details must be submitted in attached

ss of the lender (loan Provider): - _________________________

_______________________________________________________
_______________________________________________________

_____________________________________________

eady completed):______________________________________

______________

Amount

(if Joint Owner, Declaration must be

submitted )

Investment Declaration Page 5

OF THE IT ACT, 1961 INTEREST ON HOUSING LOAN)
uring the F.Y. 2013-14 for the purpose of acquiring property. (Max limit-

_________________________

________________

/No) : ____________________________
Amount

ION-VII

ION-VIII
e that the aforesaid information is true and correct to the best of my informati

equences if any information is later on found to be incorrect.

uction for filling Investment proof form before submitting

Investment Declaration Page 6