IT FY 2023-24 AY 2024-25 Assessment for Advance Tax Deductio

Name of the Employee Sri. A Srinu

Personal Info

Designation junior Assistant Gazetted

Place of Working Revenue Divisional Officer, Ghanpur(Stn)
Mandal Stn Ghanpur District Jangaon
PAN 110270092204 Mobile Num 9550699957
Name of the DDO T. Kranthi Kumar
DDO Designation Deputy Tahsildar
DDO Info

DDO Office Revenue Divisional Officer, Ghanpur(Stn)

Mandal & District Stn. Ghnapur, Jangaon District
DDO TAN HYDR11501A
1 Basic Pay For the month of March, 2023 as per RPS 2020 24280
If you got any hike in basic pay, give the details below (DD MM YYYY)
hike due to Increment 1 1 2024
2 hike due to No Hike in Basic 0 0 0
hike due to No Hike in Basic 0 0 0
hike due to No Hike in Basic 0 0 0
3 PHC Allowance claimed, if Yes Percentage of Disability No 80% &above
4 Telangana Increment
5 FPI if any
6 Special Pay If any
7 HM/ Higher Class Allowance
8 (FTA) Conveyance allowance exemption other than PHC allowance
9 Are You CPS employee Yes We demand Scrap the CPS and restore OPS
10 HRA 11% If any Change in HRA (Date & change %)
CCA Received in FY 2022-23 No CCA
11
Any Change in CCA No CCA Change With Effect From
12 Els Surrender No Aug, 23 EL Surrender (Jan,22 to Feb, 23) for DA Arrears
13 Children Tution Fee Reimbursement drawn during the FY 2022-23
Please Enter RPS 2020 (2) months arrears and DA 20.02 % and DA 22.75%

14
 2 Months (Apr,21 & May,21) Gross 1 EMI
RPS,20 Arrears encashed Amount 0 1 EMI 10% CPS Amount 0

Jul,21 to Dec,21 DA Arrears 90% Net EMI Amount

amount for CPS Employees Recieved 0 EMIs 10% CPS Amount 0
14
Jan,22 to May,23 DA Arrears 90% Net EMI Amount
amount for CPS Employees Recieved 0 EMIs 10% CPS Amount 0

IF any Arrears Received during the FY 2022-23

If Arrears any of FY 2022-23 Pay 0 DA 0 HRA 0
If Arrears any of FY 2021-22 Pay 0 DA 0 HRA 0
If Arrears any of FY 2020-21 Pay 0 DA 0 HRA 0

15
Which Regim you want to pay Tax (Old Regim or New Regim)
(In "Old Regim" 1,50,000 Savings, deductions are eligible to deduct but not in "New Re
16 PF deduction 200 Any Change, Month & Amount
17 TSGLI dedctn 750 Any Change, Month & Amount
18 GIS Deduction 30 Any Change, Month & Amount

Savings other than salary deduction U/s 80C

Tuition Fee - LIC Annual Premiums Paid by Hand

19 5Years Fixed Deposits - Investment in Sukanya Samridhi

Interest on Savings Account (not fixed) Public Provident Fund
-
80TTA National Saving Certificate
PLI Annual Insurance Plan - Others (
Are you taken Home Loan if yes in which Financial Year?
No need to enter here Principle Amount 0

20
1. Stamp duty value of the house property should be Rs 45 lakhs or less?. 2. Carpet area should not exceed
90 square meter (968 sq ft)?. 3. no other house property must be owned by you?

Loan Lendar Branch

21 Living in Rented House To get HRA excemption your rent will be Rs.
Medical Insurance Premium paid for self, spouse, children U/s 80D
22 80 D Medical Insurance Senior for Citizen Parents Medical Insurance U/s 80D
Payment made for preventive health check up U/s 80D (upto Rs.5,000/-)
23 Interest Paid on Education Loan U/s 80E
24 Is any Disable Depenent? U/s 80DD
 Are invested in NPS for Additional Benefit U/s 80CCD1(B)
25
Other than CPS employees only (CPS Employees no need to enter here)
26 Intrest Paid for Electric Vehicle (EV) 80EEB (Purchased Between 01.04.2019 to 31.03.2023)
Advance Tax deducted in the Salary or Paid by hand
27 March April May June July Aug Sept Oct Nov Dec

0 0 0 0 0 0 0 0 0 0

Click here for Annex - I Annex - II Form 16 - P1

Your Advance Tax Assessment (Tentatively)

Developed by P Gross Total Income

Putta Srinivas Reddy U Deductions & Excemptions

98490 25860 T Net Total Income Rounded to nearest

Rs.10

[email protected] T Tax Payable for AY 2022-23

www.putta.in PUTTA A Thank you

e Tax Deduction
Age <60 Telangana
Gazetted

Devolped by
PUTTA SRINIVAS REDDY
98490 25860
[email protected]
www.putta.in

PUTTA

300
0
0
0
0
S and restore OPS
0 No Change 11%

ect From 10 11 2022

DA Arrears No Feb, 23
-
% and DA 22.75% Arrears
 Total amount
0
creditted months
Total Installmens
0
received/ bill Passed
Total Installmens
0
received/ bill Passed

FY 2022-23
CCA 0 CPS 0
CCA 0 CPS 0
CCA 0 CPS 0

Regim) Old Regim

ct but not in "New Regim")

unt No Change -
unt No Change -
unt No Change -

Paid by Hand -
Samridhi
-
cate -
-
No Home loan

0 Interest -

hould not exceed all the 3 conditions are

satisfied

our rent will be Rs. 3200 3,200

-
-
Self -
-
No Disable Dependent
 -

-
aid by hand
Feb (Except Salry
Jan
Deduction, direct payment)

0 0

Form 16 - P1 Form 16 - P2

ly)
ome 174,640

xcemptions 45,600
me Rounded to nearest
129,040

yable for AY 2022-23 -

Thank you
 Statement Showing the Salary Particulars of : Sri. A Srinu, junior Assistant, Revenue Divisional Officer, Ghanpur(Stn), Mandal : Stn Ghanpur
S. FPI + Incm LIC SWF,
Conveyanc Total
Month Pay DA HRA TS INC HMA AHRA Others CCA IR PHC Gross Total CPS TSGLI GIS PT EWF,
No Add. e Allow Tax (SSS) GF Deductions

1 Mar, 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 Apr, 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 May, 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 Jun, 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 Jul, 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 Aug, 23 17231 3920 1895 0 0 0 0 0 0 0 0 0 23046 2115 750 30 200 0 0 50 3145
7 Sep, 23 24280 5524 2671 0 0 0 0 0 0 0 0 0 32475 2980 750 30 200 0 0 0 3960
8 Oct, 23 24280 5524 2671 0 0 0 0 0 0 1214 0 0 33689 2980 750 30 200 0 0 0 3960
9 Nov, 23 24280 5524 2671 0 0 0 0 0 0 1214 0 0 33689 2980 750 30 200 0 0 0 3960
10 Dec, 23 24280 5524 2671 0 0 0 0 0 0 1214 0 0 33689 2980 750 30 200 0 0 100 4060
11 Jan, 24 24280 5524 2671 0 0 0 0 0 0 1214 0 0 33689 2980 750 30 200 0 0 0 3960
12 Feb, 24 24280 5524 2671 0 0 0 0 0 0 1214 0 0 33689 2980 750 30 200 0 0 0 3960
No SL 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

AAS Arrears 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Promotion Arrears 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

RPS 20 Arrears 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

If Old DA Arrears
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
any
DA Arrears
@20.02% 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
DA Arrears
@22.75% 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Arrs FY 22-23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Arrs FY 21-22 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Arrs FY 20-21 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Children Tution Fee
Concession 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

TOTAL 162911 37064 17921 0 0 0 0 0 0 6070 0 0 223966 19995 5250 210 1400 0 0 150 27005
Signature of the DDO Signature of the Assese
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 ANNEXURE - II
INCOME TAX CALCULATION FOR THE FINANCIAL YEAR 2023-24
Name A Srinu, (9550699957) School / Office : Revenue Divisional Officer, Ghanpur(Stn)
Designation junior Assistant Mandal/ Dist. : Stn Ghanpur, Jangaon
1 Living in: Rented House Employee PAN Number 110270092204
2 Gross Salary……… Rs. ```````````````` 223,966
3 H.R.A. Exemption as per eligibility U/s. 10(13-A) Dat
a) Actual HRA received Rs. : 17,921
b) Rent paid in excess of 10% Salary (Rs. 3200 X 12 - 10% Salary) ( 38400 - 19998 ) Rs. : 18,403 Annex
c) 40% of Salary (Salary means Basic Pay+D.A) Rs. : 79,990 17,921
4 Total Salary (2-3) Rs. : 206,045 Form 16
5 Deductions from Salary Income
a) Exemption from Conveyance Allowance U/s. 10(14) (i) Rs. : - Form 16
b) Exemption from Conveyance Allowance U/s. 10(14) (ii) Rs. -
c) Standard deduction U/s 16 (ia) Rs. : 50,000
d) Profession Tax U/s 16 (3) B Rs. : 1,400 51,400
6 Income From Salary (4-5) Rs. : 154,645
7 Add: Income From other sources Rs. :
8 Add: Income From Capital Gains Rs. :
9 Income from House Property U/s 24(vi) Directly enter here Rs. : -
10 Employer Contribution towards NPS (Govt. Contribution) Rs. : 19,995
11 Interest on Savings Account (not fixed) Directly enter here Rs. : -
12 Gross Total Income (6+7+8+9+10) Rs. : 174,640
13 Deductions
a) Medical Insurance Premium for Self, Spouse & Children U/s 80D Rs. : -
b) Senior Citizen Parents Medical Insurance U/s 80D Rs. : -
c) Payment made for preventive health check up (Self) Rs. : -
d) Employer Contribution towards NPS U/s 80CCD 2 (Govt. Contribution) Rs. : 19,995
e) Interest on Educational Loan U/s 80E Rs. : -
f) Interest on Housing Loan Advance U/c 24 Rs. : -
g) Interest on Housing Loan U/s 80EE Rs. : -
h) Disable Dependent U/s 80DD Rs. : -
i) Maintaince for disabled Employee U/s 80U Rs. : -
j) Intrest paid on Electric Vehicle Loan U/s 80EEB Rs. : -
k) E.W.F, S.W.F & CM Relief Fund U/s 80G Rs. : 150
TOTAL----------- Rs. : 20,145 20,145
Shri Ram Janambhoomi Teerth Kshetra under Section 80G(2)(b) Rs. : - -
14 Gross Total Income (12-13) Rs. : 154,495
15 Savings U/s 80C (Limited to One lakh Fifty Thousand)
a) CPS Rs. : 19,995
b) TSGLI Rs. : 5,250
c) GIS Rs. : 210
d) Tuition Fee Rs. : -
e) Repayment of Home Loan Principle Rs. : -
f) 5Years Fixed Deposits Rs. : -
g) National Savings Certificate Rs. : -
h) PLI Annual Insurance Plan Rs. : -
i) LIC Annual Premiums Paid by Hand + LIC (SSS) Rs. : -
j) Investment in Sukanya Samridhi Rs. : -
k) Public Provident Fund Rs. : -
l) Others ( ) Rs. : -
Total Savings Rs. : 25,455 25,455
* Additional benefit under NPS U/s 80CCD(1B) Rs. : - -
* Interest on Savings Account (not fixed) 80TTA Rs. : - -
16 Net Taxable Income (14-15) rounded to nearest Rs.10/- Rs. : 129,040
17 Tax on Income
a) Up to Rs. 2,50,000 Rs. : Nil
b) Rs.2,50,001 To 5,00,000. (@ 5%) Rs. : -
c) Rs.5,00,001 To 10,00,000. (@ 20%) Rs. : -
d) Above Rs.10,00,00 (@ 30%) Rs. : -
Rs. : -
Rs. : -
18 Tax Rebate u/s 87A (Taxable income <5Lakhs/- max of 12,500/-) Rs. : -
19 Health & Education Cess @ 4% Rs. : -
20 Tax Relief U/s 89(1) Rs. : -
21 Total Tax Payable (17-18+19-20) Rs. : -
22 Details of Advance Tax Deductions Rs. : -
23 Tax to be Paid now (21-22) Rs. : 0.00

Signature of the Drawing Officer Signature of the Employee

(A Srinu)

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FORM No. 16
( Vide rule 31(1)(a) of Income Tax Rules, 1962 )
Certificate under section 203 of the Income-tax Act, 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

T. Kranthi Kumar Sri. A Srinu

Deputy Tahsildar junior Assistant
Revenue Divisional Officer, Ghanpur(Stn) Revenue Divisional Officer, Ghanpur(Stn)
Stn. Ghnapur, Jangaon District Stn Ghanpur, Jangaon
TAN No. of DDO HYDR11501A PAN oF Employee 110270092204

Acknowledgement Nos. of all quarterly statements of TDS under sub-section 200 as provided by TIN Facilitation Center or NSDL web-site.

Quarter Acknowledgement No. Period Assessment

1 From To Year
2
3 April,23 March,24 2024-2025
4
DETAILS OF SALARY PAID AND ANY OTHER INCOME AND TAX DEDUCTED
1 Gross Salary Rs.
a) Salary as per provisions cotained in section 17 (1) Rs. 223,966
b) Value of percuisites under section 17(2) Rs. -
(As Per Form No. 12BA, Wherever applicable)
c) Profits in lieu of salary under section 17(3) Rs. - Tuition Fee
(as per Form No. 12BA, Wherver applicable) National Savings
d) Total Rs. 223,966 Rs. 223,966 Repayment of H

2 Less: Allowance to the extent exempted U/s 10 LIC Insurance pr

a) House Rent Allowence Rs. 17,921 Unit linked Insu
b) Other Allowance Rs. - Rs. 17,921 Public Provident
3 Balance (1-2) Rs. 206,045 ULIP
4 Deductions PLI
a) Entertainment Allowence Rs. - Rs. - Equity linked Sa
b) Section 16(ia). Rs. 50,000 Rs. 50,000 Infrasture Bonds
c) Tax on Employment U/s 16 (3) B Rs. 1,400 Rs. 1,400 5-Years fixed dep
5 Aggreate of 4 (a), (b) &(c) Rs. 51,400 LIC / UTI etc. P
6 INCOME CHARGEABLE UNDER THE HEAD SALARIES (3-5) Rs. 154,645
7 Add: Any other income reported by the employee Rs. -
Add: Income of Capital Gains Rs. -
Add: Income of House Proferty Rs. -
Employer Contribution towards NPS (Govt. Contribution) Rs. 19,995
Interest on Savings Account (not fixed) U/s 80TTA Rs. -
8 Gross Total Income (6+7) Rs. 174,640
9 Deductions Under Chapter VI-A
A) UnderSection 80C,80CCC,80CCD etc Gross Qualifying Deductible
a) Section 80C Amount Amount Amount ###
i G.P.F Rs. - Rs. - Rs. - ###
ii T.S.G.L.I Rs. 5,250 Rs. 5,250 Rs. 5,250 ###
iii G.I.S Rs. 210 Rs. 210 Rs. 210 ###
iv Children Tuition Fee (2Children) Rs. - Rs. - Rs. - ###
v Repayement of Home Loan Premium Rs. - Rs. - Rs. -
vi 5Years Fixed Deposits Rs. - Rs. - Rs. - ###
vii National Savings Certificate Rs. - Rs. - Rs. - ###
viii PLI Annual Insurance Plan Rs. - Rs. - Rs. - ###
ix LIC Annual Premiums Paid by Hand Rs. - Rs. - Rs. - ###
x Investment in Sukanya Samridhi Rs. - Rs. - Rs. - ###
xi Public Provident Fund Rs. - Rs. - Rs. -
xii Others () Rs. - Rs. - Rs. - ###
Total Under Section 80C… Rs. 5,460
b) Section 80CCC ###
i Rs. Rs. - Rs. - Rs. -
c) Section 80CCD (1) ###
i Contribution to Pension Fund Rs. 19,995 Rs. 19,995 Rs. 19,995 Rs. ###
19,995
Aggrigate Amount Deductible Under above 3 Sections Maximum 1.5Lacks ………… Rs. 25,455
###
d) 80 CCD(1B) Rs. - Rs. - Rs. - Rs. -
e) Section 80TTA In Rs. - Rs. Rs. Rs. -
Aggrigate Amount Deductible Under above Sections…………………………………………………. Rs. ###
25,455
Note: 1.aggregate amount deductible under section 80C shall not exceed one lakh fifty thousand rupees.
2.aggregate amount deductible under section 80C,80CCC,80CCD(1), shall not exceed 1.5 lakh rupees. ###
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 B) Other Sections Under Chapter VI A Gross Qualifying Deductible
( Under Sections 80E,80G,80DD etc ) Amount Amount Amount
EWF & SWF U/s 80G Rs. 150 150 150
Medical Insurance Premium for Self, Spouse & Children U/s 80D Rs. - - -
Senior Citizen Parents Medical Insurance U/s 80D Rs. - - -
Payment made for preventive health check up (Self) Rs. - - -
Interest on Educational Loan U/s 80E Rs. - - -
Interest on Housing Loan Advance U/c 24 Rs. - - -
Interest on Housing Loan U/s 80EE Rs. - - -
Employer Contribution towards NPS 80CCD(2) U/s 80CCE Rs. 19,995 19,995 19,995
Disable Dependent U/s 80DD Rs. - - -
Intrest paid on Electric Vehicle Loan U/s 80EEB Rs. - - -
Maintaince for disabled Employee U/s 80U Rs. - - -
Total Under Sections 80G,80E,80DD etc….. Rs. 20,145
10 Aggregate of Deductible Amounts U/Chapter VIA (A+B) Rs. 45,600
11 TOTAL INCOME (8-10) Rs. 129,040
12 TAX ON TOTAL INCOME Rs. Rs. 0.00
(Tax Rebate u/s 87A (Taxable income <500000/- max of 12500/- for old regim, Taxable
income <700000/- max of 25000/- for new regim )) Rs. -
13 Health & Education Cess @ 4% (On Tax at S.No.12 ) Rs. 0.00
14 TAX (12+13) Rs. -
15 Relief under section 89 (attach details) Rs. 0.00
16 TAX PAYABLE (14-15) Rs. -
17 Less:(a) Tax deducted at source U/s 192(1) Rs. 0.00
(b)Tax paid by the employer on behalf of the Rs.
Employee U/S 192 (1A) on perquisited U/S 17 (2) Rs.
18 TAX PAYABLE / REFUNDABLE (16-17) Rs. -

(The employer is to provide tranction - wise details of tax deducted and deposited)
Sl. TDS Surcharge Education Total Tax Cheque/DD BSR Code Date on Transfer
No. Rs. Rs. Cess Deposited No. (if any) of Bank Which Tax vocher/chalana
Rs. Rs. Branch Deposited Identification No
1 0
2 0
3 0
4 0
5 0
6 0
7 0
8 0
9 0
10 0
11 0
12 - 0.00 -

I T. Kranthi Kumar working as Deputy Tahsildar do hereby certify that the sum of Rs. 0/- Rupees in words (Zero
rupees only) deducted at source and paid to the credit of the central Government. I further certify that the
Informtion given above is true and correct based on the books of account, documents and other available records.

Sign--
Place: Revenue Divisional Officer, GSignature of the person responsible for deduction of tax
Date: 18-Jul-2024 Full Name-- T. Kranthi Kumar
Designation- Deputy Tahsildar

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 RECEIPT OF HOUSE RENT
(Under Section 10 (13-A) of Income Tax Act )

This is to certify that Sri. A Srinu, junior Assistant, Revenue Divisional Officer,
Ghanpur(Stn), Mandal Stn Ghanpur, District Jangaon has paid an amount of Rs. 38400/-Inwords:
((Thirty eight Thousand Four Hundred rupees only) towards Annual House Rent @ Rs. 3200/- per
month during the FY 2023-24 in respect of H.No. ____________ Located at
__________________________________, ________________________,
________________________. My PAN card number is ________________________.

Rs. 1/-
Revenue
Stamp

Sign--
Date : (House Owner)
________________________
S/o / H/o . ________________________
H.No. ____________
 INCOME-TAX RULES, 1962
FORM NO.12BB
(See rule 26C)
Sri. A Srinu, junior Assistant, Revenue Divisional
1. Name and address of the employee:
Officer, Ghanpur(Stn)
2. Permanent Account Number of the employee : 110270092204
3. Financial year : FY 2023-2024 - AY 2024-25
Details of claims and evidence thereof
Amount Evidence /
Sl No. Nature of claim
(Rs.) particulars
(1) (2) (3) (4)
1 House Rent Allowance:
(i) Rent paid to the landlord ₹ 3,200 X 12 38,400
(ii) Name of the landlord : ________________________
H.No. ____________,
Receipt Produced
__________________________________,
(iii) Address of the landlord:
________________________,
________________________
(iv) Permanent Account Number of the landlord : ________________________
Permanent Account Number shall be furnished if the aggregate rent paid during the previous year
Note :
exceeds one lakh rupees
2 Leave travel concessions or assistance
3 Deduction of interest on borrowing:
(i) Interest payable/paid to the lender Certificate Produced
(ii) Name of the Lender :
(iii) Address of the lender :
(iv) Permanent Account Number of the lender :
a) Financial Institutions(if available)
b) Employer(if available)
4 Deduction under Chapter VI-A
(A) Section 80C,80CCC and 80CCD
(i) a) CPS 19,995 Salary Deduction
b) TSGLI 5,250 Salary Deduction
c) GIS 210 Salary Deduction
d) Children Tuition Fee (2Children) - -
e) Repayment of Home Loan Principle Reciept produced
f) 5Years Fixed Deposits - -
g) LIC Annual Premiums Paid by Hand - -
h) Investment in Sukanya Samridhi - -
i) Public Provident Fund - -
j) Others () - -
(ii) Section 80CCC -
a) National Savings Certificate - -
b) PLI Annual Insurance Plan - -
(B) Other sections (e.g. 80E, 80G, 80TTA, etc.) under Chapter VI-A.
(i) Interest on Housing Loan Advance U/s 24[B] Certificate produced
(ii) 80E-Interest on Educational Loan - -
(iii) Interest on Housing Loan U/s 80EE - -
(iv) 80TTA-Interest on Savings account -
(v) Handicapped Dependent - U/s 80DD - -
(vi) E.W.F, S.W.F, G.F & CM Relief Fund U/s 80G 150 Salary Deduction
(vii) Medical Insurance Self+Parents+Preventive Health checkup - -
(viii) Investments in NPS - -
Verification
I, A Srinu, junior Assistant, Revenue Divisional Officer, Ghanpur(Stn) do hereby certify that the information given above is
complete and correct.
Place Stn Ghanpur, Jangaon
Date 7/18/2024
(Signature of the employee)
Designation : junior Assistant Full Name : A Srinu
 No need to Print this papers
FORM NO.10E
[ See rule 21AA ]

1 Name and address of the Employee A Srinu, junior Assistant

Revenue Divisional Officer, Ghanpur(Stn)

2 Permanent Account Number 110270092204

3 Residential status Indian Resident

Particulars of income referred to in rule 21A of the Income Tax rules, 1962, during
the previous year relevent to Assessment Year 2021-22

Salary received in arrears or in advance in accordance with the

1 a. Rs. 0
provisions of sub-rule (2) of rule 21A

Pament in the nature of gratuity in respect of past services,

b. extending over a period of not less than 5 years in accordance with Rs. Not Applicable
the provisions of sub-rule (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 less than 3 years or
c. Rs. Not Applicable
where the unexpired portion of term of employment is also not less
than 3 years in accordancewith the provisions of sub rule (4) of the
21A

Payment in commutation of pension in accordance with the

d. Rs. Not Applicable
provisions of sub-rule (5) of rule 21A

Detailed particulars of payments refered to above may be given in

2 Annexure-I
Annexure-I, II, IIA, III, or IV, as the case may be

Verification

I A Srinu, junior Assistant do here by declare that what is stated above is true to the best of my knowledge
and belief. Verified today.

Place :
Date: 7/18/2024
Signature of the employe
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Annexure - I
(See item 2 of Form No. 10E)

ARREARS OR ADVANCE SALARY

1 Total income (excluding salary received in arrars or advance) Rs. 129,040.00

2 Salary received in arrears or advance Rs. -

3 Total income (as increased by salary received in arrears or advance) Rs. 129,040.00

4 Tax on total income (as per item 3) Rs. -

5 Tax on total income (as per item 1) Rs. -

6 Tax on salary received in arrears or advance

Rs. -
(Difference of item 4 and item 5)

7 Tax computed in accordance with table "A"

Rs. -
(Brought from column 7 of Table "A")

Relief under section 89(1) [Indicate the difference between the amounts
8 Rs. -
mentioned against items 6 and 7]

TABLE "A"
{See item 7 of Annexure I}

Total income (as Difference in

Salary received in
increased by salary tax {amount
Total income of arrears or advance Tax on total Tax on total
received in arrears under column
the relevent relating to the income {as income {as per
Previous Year(s) or advance) of the (6) minus
previous year previous year as per column column (4)}
relevent previous amount under
(Rs.) mentioned in (2)} (Rs.) (Rs.)
year mentioned in column (5)}
column(1) (Rs)
column 1 (Rs.) (Rs.)

1 2 3 4 5 6 7

FY 2020-21 - - - - - -

FY 2021-22 - - - - - -

FY 2022-23 - - - - - -

Total -
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