FILL UP THE DATA IN GREEN CELLS BELOW

1
2
3
4

Name of the Employee

PAN NO.
Designation
Name of the Office

Basic Pay as on JAN-2013

Basic Pay as on FEB-13
Basic Pay as on MAR-13
MONTH OF INCREMENT
PAY AFTER INCREMENT
SP
PP/FP
HMA

6
7
7
8
9

GEDDADA INDIRA
ARHPG7780K
SGT
MPPUPS F.H.PETA

EARNINGS
for the purpose of
DA Arrears
Calculation

KAKINADA RURAL

21250
21250
21250

RPS-2010
Prepared by: T.PANAKALA REDDY

21820

STU GUNTUR DIST

** if your income is more than 5 Lakhs you

should file returns digitally( e-filing)
for e-filing contact 9393632288
or [email protected]

70

0
20
1

10 CA(PH ALLOWANCE)
11

HRA %

12

Surrender Leave taken or not

13

Surrender Leave Month

EAST GODAVARI

No
0

CCA

YES

15

No of Days of SL

DEDUCTIONS

ZPPF / CPS Amount

1200

* Select 1 for ZPPF/GPF

** Select 2 for CPS

60

1st DA
2nd DA

54.784
63.344

DA w.e.f January 2013

750
0

IR

27.000

IR w.e.f Jan 2014

2 Select ZPPF / CPS

3
4

GIS
APGLI

DA w.e.f July 2013

ENTER DA1,DA2,& IR IN
ABOVE CELLS

Own /
Rented
House

Rent Paid per Month

*** Important

8300

10

DDO

Smt. S. VIJAYA LAKSHMI

MEO
DEVI

Important
1) You can modify DA arrears,Surrender Leave,
Pay fixation arrears,etc directly in STATEMENT sheet
if neccesary
2)You can also modify earnings or deductions in
STATEMENT

DDO Father Name

3) use legal size paper only

TAN No

OTHER DEDUCTIONS

TDS Deductions

Tution Fee

31000

Mar-2013

Fixed Deposit above 5 years

April-2013

Housing loan principle amount

May-2013

Housing loan Interest amount (Max:Rs 1,50,000 )

June-2013

Housing loan additional Interest amount (80EE)

July-2013

Insurance Premium (Sum of All Policy No's Annually)

Aug-2013

PLI /NSC /PPF

Sept-2013

Bonds

Oct-2013

Equity Shares

Nov-2013

10

Mediclaim Insurance (80-D)

Dec-2013

11

Exception on PHC dependent (80DD)

Jan-2014

12

Exp. On Medical Treatment

Feb-2014

13

Unit Linked Insurance Policy

14

Sainic welfare fund

20

15

Employees welfare fund

20

16

Other donations if any

17

Interest paid for Education Loan 80E

18

*****

80DDB

19

Exception on PHC dependent (80DD)

20

RAJIV GANDHI EQUITY SAVING SCHEME (Max Rs.25000)80CCG

Housing Loan sanctioned after

ex: if Interst paid is Rs 235000
Rs 235000 - Rs 150000 = Rs 85

STATEMENT SHOWING SALARY PARTICULARS OF

EARNINGS

MONTH
&
YEAR

PAY

SP

PP/FP

Mar-2013

21250

70

April-2013

21250

70

May-2013

21250

70

June-2013

21250

July-2013

21250

Aug-2013

S.NO

GEDDADA INDIRA FOR THE YEAR MARCH 2013-FEBRUARY 2014 :: PAN NO: ARHPG7780K
DEDUCTIONS
HRA

TOTAL

GPF/
ZPPF

CPS

GIS

APGLI

P.TAX

EWF/SWF

I.T

10186

4250

35756

1200

60

750

200

20

10186

4250

35756

1200

60

750

200

11642

4250

37212

1200

60

750

200

70

11642

4250

37212

1200

60

750

200

70

11642

4250

37212

1200

60

750

200

21250

70

11642

4250

37212

1200

60

750

200

Sept-2013

21820

70

11954

4364

38208

1200

60

750

200

Oct-2013

21820

70

13822

4364

40076

1200

60

750

200

Nov-2013

21820

70

13822

4364

40076

1200

60

750

200

10

Dec-2013

21820

70

13822

4364

40076

1200

60

750

200

11

Jan-2014

21820

70

5891

13822

4364

45967

1200

60

750

200

12

Feb-2014

21820

70

5891

13822

4364

45967

1200

60

750

200

720

9000

2400

MORE EARNINGS

DA

HMA

IR

PHA

DA ARREARS
1/2013 to 4/2013

5824

5824

5824

DA ARREARS
7/2013 to 09/2013

5506

5506

5506

25730

PAY FIXATION

Other Arrears

Surrender Leave

TOTAL

CCA

10910

35

269330

840

Signature of the Employee

11782

5977

2182

19104

165311

53866

501164

20

40

Signature of the D.D.O

CMRF

343

343

INCOME TAX CALCULATION FOR THE YEAR 2013-14

PAN NO: ARHPG7780K
1
2
3
4
5

Name of the Employee

GEDDADA INDIRA

Designation
Name of the Office
Gross salary Income

:
:
:

SGT
MPPUPS F.H.PETA

HRA Exmpted
i) Actual HRA Received

:
: Rs 53866

Rs 501164
###

ii) Rent paid in Excess of 10% of Salary (Pay+DA) @ Rs

: Rs 56136
8300 per month
iii) 40% of Salary
(Deduct least of the above three)

6 Net salary Income(4-5)

7 Deductions
a) Profession Tax(U/S 16(iii)
b) Interest on Housing loan(U/S 24(B)
Total

8 Total Income(6-7)
9 Deductions U/S 80C (Max.Rs.1,00,000)
A)

i)G.P.F/Z.P.P.F/C.P.S
ii)G.I.S
iii)L.I.C
iv)P.L.I/N.S.C/PPF
v) A.P.G.L.I
vi) Tution Fee
vii) Fixed Deposit above 5 years
viii) Housing loan principle amount
ix) Bonds
x) Equity Shares

Total (U/S 80C)

B) Mediclaim Insurance (80-D)
C) Exception on PHC dependent (80DD)
D) Exp. On Medical Treatment
E) Donations (80 G)
i) C.M.Relief Fund
ii) Sainic welfare fund
iii) Employees welfare fund
iv) Other donations if any
F) Deduction on to PHC Employees(80 U)
G) RAJIV GANDHI EQUITY SAVING SCHEME (Max Rs.25000)80CCG

Deductions U/S chapter VI -A

80E ( Interest paid on Education Loan )
80EE
80DDB

: Rs 173856
:
:
:
: Rs 2400
: 0 0
: Rs 2400
:
:
: Rs
: Rs
: 0
: 0

NIL

Rs 66450

: Rs 20
: 0 0
: 0 0
: 0 0

###

: 0
: 0 0
: 0 0
: 0 0
Rs 383
Rs 66833
:
:
:
:

Rs.5,00,001/-to10,00,000/-20%
Rs. 10,00,000-above 30%

:
:
:

TAX Rebate U/S 87A (Max:Rs 2000) below income Rs 500000

13 Education Cess(2%)
14 Secondary&Higher Education Cess 1%
15 Net Tax Payable

720
0
0

: 0 0
: 0 0
: 0
: Rs 343
: Rs 20

Rs, 2,00,001/- to5,00,000/- 10% of amount exceeding 2.0 lakhs

12 Tax on total Income

Rs 444898

25730

: 0 0
: 0 0
: Rs 66450
: 0 0

TOTAL DEDUCTIONS 80C + CHAPTER VI A

Rs. 2,00,000/-

Rs 53866
Rs 447298

: Rs 9000
: Rs 31000
: 0 0
: 0 0

Total(Chapter VI-A)

10 Taxable Income(8-9)
11 Tax on total Income

###
###
###

:
:
:

Rs 378065
0
0

0
0

Rs 17807
0 0
0 0
Rs 17807
Rs 2000
Rs 316

###
###
###
###

Rs 158
Rs 16281

###
###
###

( Rounded ) Rs 16280

###

Signature of the Employee

Form No:16
[See Rule 31(1)a]
Certificate under section 203 of the Income-tax Act, 1961 for Tax deducted at source on Salary
NAME AND ADDRESS OF THE EMPLOYER

NAME AND DESIGNATION OF THE EMPLOYEE

Smt.S.VIJAYA LAKSHMI DEVI M.E.O.

GEDDADA INDIRA

KAKINADA RURAL MANDAL,

SGT

EAST GODAVARI DISTRICT.

MPPUPS F.H.PETA
KAKINADA RURAL EAST GODAVARI

PAN No. of DDO

TAN No.of DDO

PAN of the Employee

ARHPG7780K

CIT (TDS)
Address :

Period

Assessment Year

The Commissioner of Income Tax (TDS)

2014-2015

From

To

March 2013

February 2014

Summery of Tax Deduction at source

Receipt Numbers of original
statements of TDS under subsection (3) of section 200

Amount of tax deducted in respect of the

employee

Amount of tax deposited/ remitted

in respect of the employee

1
2
3

0
0
0

0
0
0

4
Total

0
0

0
0

Quarter

PART B (Refer Note 1)

DETAILS OF SALARY PAID AND ANY OTHER INCOME AND TAX DEDUCTED
1

Gross Salary

Rs.

501,164

a)

Salary as per provisions cotained in section 17 (1)

Rs.

b)

Value of percuisites under section 17(2)

(As Per Form No. 12BA, Wherever applicable)

Rs.

c)

Profits in lieu of salary under section 17(3)

(as per Form No. 12BB, Wherver applicable)

Rs.

d)
Total
Less: Allowance to the extent exempted U/s 10
a)
House Rent Allowence

Rs.

501,164

Rs.

53,866

b)

Rs.

Rs.

501,164

Rs.
Rs.

53,866
447,298

Aggreate of 4 (a)&(b)

Rs.

2,400

INCOME CHARGEABLE UNDER THE HEAD SALARIES (3-5)

Add: Any other income reported by the employee

Rs.

444,898
-

Add: Income of Capital Gains

Less:Interest on Housing Loan U/s 24(b)

Rs.
Rs.

8 Gross Total Income (6+7)

9 Deductions Under Chapter VI-A
A) UnderSection 80C,80CCC,80CCD.
a)
Section 80C

Rs.

444,898

3
4

5
6
7

Other Allowance

Balance (1-2)
Deductions
a)

Entertainment Allowence

Rs.

b)

Tax on Employment

Rs.

2,400

Gross

i G.P.F

Rs.

ii A.P.G.L.I

Rs.

iii G.I.S

Rs.

iv LIC Annual Premiums

Rs.

v Equity Linked Savings Scheme

Rs.

vi Repayement of Home Loan Premium

Rs.

vii Tuition Fee

Rs.

viii PLI /NSC/PPF

Rs.

Deductible

Amount
Amount
25,730 Rs.
25,730

9,000 Rs.
720 Rs.
- Rs.

9,000 Rs.
720 Rs.
- Rs.

9,000
720
-

- Rs.
- Rs.

- Rs.
- Rs.

31,000 Rs.
- Rs.

31,000 Rs.
- Rs.

31,000
-

- Rs.
- Rs.

- Rs.
- Rs.

Rs.

x Unit Linked Insurance Plan

Rs.

xi Bonds

Rs.

- Rs.
66,450

- Rs.
66,450

66,450 Rs.

Rs.

Rs.

- Rs.

- Rs.

Rs.

- Rs.

- Rs.

- Rs.

Rs.

66,450

Section 80CCC
i LIC / UTI etc. Pension funds

c)

Qualifying

Amount
25,730 Rs.

ix 5 Years Fixed Deposits

Total Under Section 80C

b)

Rs.

Section 80CCD
i Contribution to Pension Fund

Aggrigate Amount Deductible Under 3 Sections.

Note:

1.aggregate amount deductible under section 80c shall not exceed one lakh rupees.
2.aggregate amount deductible under section 80C,80CCC,80CCD, shall not exceed one lakh rupees.

B) Other Sections Under Chapter VI A

( Under Sections 80E,80G,80DD etc )

Gross

Qualifying

Deductible

Amount

Amount

Amount

Rs

EWF & SWF

40

40

40

Expenditure on medical treatment

Medical Insurance Premium

RAJIV GANDHI EQUITY SAVING SCHEME

Interest on Educational Loan

Housing loan additional Interest amount (80EE)

343

343

343

Rs

C.M.Relief Fund
Medical treatment of Handicapped/Dependent

Maintaince for 80% and above disabled Employee

Total Under Sections 80G,80E,80DD etc..

Aggregate of Deductible Amounts U/Chapter VIA (A+B)

10
11
12
13
14
15

Rs

383

Rs

66,833

Eligible Deductible Amounts U/Chapter VIA (A+B)

TOTAL INCOME (8-10)
TAX ON TOTAL INCOME Rs.

Rs

378,065

Rs

17,807

Education Cess @ 1% (On Tax at S.No.12 )

Rs

158

Secondary and Higher Education Cess @ 2% (On Tax at S.No.12 )

Rs

316

TAX PAYABLE including Education Cess (12+13+14)

Rs

16,281

( Rounded ) Rs

16
17
18

NET TAX PAYABLE (15-16)

Rs

16,280
-

0
0

Employee U/S 192 (1A) on perquisited U/S 17 (2)

TAX PAYABLE /

Less:(a) Tax deducted at source U/s 192(1)

(b)Tax paid by the employer on behalf of the

19

16280
0

Relief under section 89 (attach details)

(17-18)

Rs

16,280

DETAILS OF TAX DEDUCTED AND DEPOSITED INTO CENTRAL GOVERNMENT ACCOUNT

(The employer is to provide tranction - wise details of tax deducted and deposited)
Sl.

TDS

No.

Rs.

1
2
3
4
5
6
7
8
9
10
11
12

0
0
0
0
0
0
0
0
0
0
0
0

Surcharge
Rs.

Education

Total Tax

Cheque/DD

BSR Code

Date on

D.D.O Serial

Cess

Deposited

No. (if any)

Receipt
Number

Which Tax

Number/chalana

Rs.

Rs.

Deposited

Identification No

0
0
0
0
0
0
0
0
0
0
0
0

I
Smt. S. VIJAYA LAKSHMI DEVI S/O working as MEO do hereby certify that the sum of Rs. 16280 Rupes
in words sixteen thousand two hundred and eighty deducted at source and paid to the credit of the central
Government. I further certify that the Informtion givin above is true and correct based on the books of account,
documents, TDS statement, TDS deposited and other available records.

Place:
Date:

MPPUPS F.H.PETA

Signature of the person responsible for deduction of tax

Full Name:
Smt. S. VIJAYA LAKSHMI DEVI
Designation:
MEO

Number
16,280
456
45687
45688
45689
45690
45691
45692
45693
45694
45695

In Words( Lower Case )

sixteen thousand two hundred and eighty
four hundred and fifty six
forty five thousand six hundred and eighty seven
forty five thousand six hundred and eighty eight
forty five thousand six hundred and eighty nine
forty five thousand six hundred and ninety
forty five thousand six hundred and ninety one
forty five thousand six hundred and ninety two
forty five thousand six hundred and ninety three
forty five thousand six hundred and ninety four
forty five thousand six hundred and ninety five

Prepared by
T.Panakala Reddy S.A (PS)

9393632288
Z.P.H.S,Nambur

In Words (Upper Case)

In Words
0.1628AND EIGHTY
0
16.28
SIXTEEN THOUSAND TWO HUNDRED
SIXTEEN
AND EIGHTY
THOUSAND TWO HUNDRED
0.00456
0
0.456
FOUR HUNDRED AND FIFTY SIX
FOUR HUNDRED AND FIFTY SIX
0.45687 AND EIGHTY
0
45.687
FORTY FIVE THOUSAND SIX HUNDRED
FORTY
AND
FIVE
EIGHTY
THOUSAND
SEVEN SIX HUNDRED
SEVEN
0.45688 AND EIGHTY
0
45.688
FORTY FIVE THOUSAND SIX HUNDRED
FORTY
AND
FIVE
EIGHTY
THOUSAND
EIGHT SIX HUNDRED
EIGHT
0.45689
0
45.689
FORTY FIVE THOUSAND SIX HUNDRED
FORTY
AND
FIVE
EIGHTY
THOUSAND
NINE SIX HUNDRED AND EIGHTY NINE
0.4569 AND NINETY
0
45.69
FORTY FIVE THOUSAND SIX HUNDRED
FORTY
AND
FIVE
NINETY
THOUSAND SIX HUNDRED
0.45691 AND NINETY
0
45.691
FORTY FIVE THOUSAND SIX HUNDRED
FORTY
AND
FIVE
NINETY
THOUSAND
ONE
SIX HUNDRED
ONE
0.45692 AND NINETY
0
45.692
FORTY FIVE THOUSAND SIX HUNDRED
FORTY
AND
FIVE
NINETY
THOUSAND
TWO SIX HUNDRED
TWO
0.45693
0
45.693
FORTY FIVE THOUSAND SIX HUNDRED
FORTY
AND
FIVE
NINETY
THOUSAND
THREE SIX HUNDRED AND NINETY THREE
0.45694 AND NINETY
0
45.694
FORTY FIVE THOUSAND SIX HUNDRED
FORTY
AND
FIVE
NINETY
THOUSAND
FOUR SIX HUNDRED
FOUR
0.45695 AND NINETY
0
45.695
FORTY FIVE THOUSAND SIX HUNDRED
FORTY
AND
FIVE
NINETY
THOUSAND
FIVE
SIX HUNDRED
FIVE

y S.A (PS)

16
0
45
45
45
45
45
45
45
45
45

16
0
45
45
45
45
45
45
45
45
45

162.8
4.56
456.87
456.88
456.89
456.9
456.91
456.92
456.93
456.94
456.95

162
4
456
456
456
456
456
456
456
456
456

2
4
6
6
6
6
6
6
6
6
6

80
56
87
88
89
90
91
92
93
94
95

ZERO
ZERO
ZERO
ZERO
ZERO
ZERO
ZERO
ZERO
ZERO
ZERO
ZERO

SIXTEEN TWO
ZERO
FOUR
FORTY FIVE
SIX
FORTY FIVE
SIX
FORTY FIVE
SIX
FORTY FIVE
SIX
FORTY FIVE
SIX
FORTY FIVE
SIX
FORTY FIVE
SIX
FORTY FIVE
SIX
FORTY FIVE
SIX

EIGHTY
FIFTY SIX
EIGHTY SEVEN
EIGHTY EIGHT
EIGHTY NINE
NINETY
NINETY ONE
NINETY TWO
NINETY THREE
NINETY FOUR
NINETY FIVE

SIXTEEN THOUSAND
TWO
FOUR
FORTY FIVE
THOUSAND
SIX
FORTY FIVE
THOUSAND
SIX
FORTY FIVE
THOUSAND
SIX
FORTY FIVE
THOUSAND
SIX
FORTY FIVE
THOUSAND
SIX
FORTY FIVE
THOUSAND
SIX
FORTY FIVE
THOUSAND
SIX
FORTY FIVE
THOUSAND
SIX
FORTY FIVE
THOUSAND
SIX

HUNDREDEIGHTY
FALSE
HUNDREDFIFTY SIX
FALSE
HUNDREDEIGHTY SEVEN
FALSE
HUNDREDEIGHTY EIGHT
FALSE
HUNDREDEIGHTY NINEFALSE
HUNDREDNINETY
FALSE
HUNDREDNINETY ONE FALSE
HUNDREDNINETY TWO FALSE
HUNDREDNINETY THREE
FALSE
HUNDREDNINETY FOUR
FALSE
HUNDREDNINETY FIVE FALSE

AND
AND
AND
AND
AND
AND
AND
AND
AND
AND
AND

AND
AND
AND
AND
AND
AND
AND
AND
AND
AND
AND

0
1
2
3
4
5
6
7
8
9
10
11

ZERO
ONE
TWO
THREE
FOUR
FIVE
SIX
SEVEN
EIGHT
NINE
TEN
ELEVEN

LAKHS
THOUSAND
HUNDRED
AND

12 TWELVE
13 THIRTEEN
14 FOURTEEN
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46

FIFTEEN
SIXTEEN
SEVENTEEN
EIGHTEEN
NINETEEN
TWENTY
TWENTY ONE
TWENTY TWO
TWENTY THREE
TWENTY FOUR
TWENTY FIVE
TWENTY SIX
TWENTY SEVEN
TWENTY EIGHT
TWENTY NINE
THIRTY
THIRTY ONE
THIRTY TWO
THIRTY THREE
THIRTY FOUR
THIRTY FIVE
THIRTY SIX
THIRTY SEVEN
THIRTY EIGHT
THIRTY NINE
FORTY
FORTY ONE
FORTY TWO
FORTY THREE
FORTY FOUR
FORTY FIVE
FORTY SIX

47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99

FORTY SEVEN
FORTY EIGHT
FORTY NINE
FIFTY
FIFTY ONE
FIFTY TWO
FIFTY THREE
FIFTY FOUR
FIFTY FIVE
FIFTY SIX
FIFTY SEVEN
FIFTY EIGHT
FIFTY NINE
SIXTY
SIXTY ONE
SIXTY TWO
SIXTY THREE
SIXTY FOUR
SIXTY FIVE
SIXTY SIX
SIXTY SEVEN
SIXTY EIGHT
SIXTY NINE
SEVENTY
SEVENTY ONE
SEVENTY TWO
SEVENTY THREE
SEVENTY FOUR
SEVENTY FIVE
SEVENTY SIX
SEVENTY SEVEN
SEVENTY EIGHT
SEVENTY NINE
EIGHTY
EIGHTY ONE
EIGHTY TWO
EIGHTY THREE
EIGHTY FOUR
EIGHTY FIVE
EIGHTY SIX
EIGHTY SEVEN
EIGHTY EIGHT
EIGHTY NINE
NINETY
NINETY ONE
NINETY TWO
NINETY THREE
NINETY FOUR
NINETY FIVE
NINETY SIX
NINETY SEVEN
NINETY EIGHT
NINETY NINE