Income Tax Declaration Form 2022-2023

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INCOME TAX DECLARATION FORM

(FINANCIAL YEAR -2023-2024)

1. Name : ARUN PRAKASH CHAUHAN


2. Permanent Account No. : AKEPC8904B
3. Designation : MANAGER
4. Date of Birth : 10/05/1986
5. Address : FLAT N0: 1207, SUPERNOVA EAST, SECTOR 94,
NOIDA
6. Date of Joining :
(Compulsory in case of new employee)

DECLARATION

To enable the company to determine the appropriate amount of Income Tax to be deducted on my emoluments
during the year ending 31st March 2024, I am providing the following information for the financial year 2023-
2024

A. Income from Previous Employer Rs. NIL

TDS Deducted by Previous Employer Rs.


B. Whether you are in receipt of HRA/ Company leased
accommodation. (If HRA then Rent Paid per month
Rs. 35000/ (Month) totaling to yearly in respect of
Residential Accommodation occupied by me situated at (Address):

ARUN PRAKASH CHAUHAN


FLAT NO: F-29/B3, GALI No:30,
MADHU VIHAR, I.P EXTENSION-110092
__________________________________________________________
(For HRA Exemption provided original rent receipts).

If Company Leased Accommodation then amount paid


By the Company Per Month is Rs. _________________

C. Under Section 80 C
Particulars for Relief
(Provide proof of Investments)
I have paid/shall pay the amount given below:-

 Premium towards Life Insurance Policy Rs. 50000

 Unit Linked Insurance Scheme (ULIP/ DHANRAKSHA) Rs. __________________

 Public Provident Fund (PPF) Rs. __________________

 Repayment of Housing Loan to recognized Financial


Institution Rs. 120000
(Only Principal amount to be taken and interest to be excluded)

 National Saving Certificate VIII issue (NSC) Rs. __________________

 Accrued Interest on NSC (VIII issue) Rs. __________________


(Provide details of the NSC taken last year or before for
Calculation of accrued interest)

 Fixed Deposit in Bank (for more than 5 years) Rs. ___________________

 Equity Plan of Mutual Fund Rs. ___________________

 Infrastructure Bonds for tax saving Rs. ___________________

 Tuition fees paid to educational institute for 2 children Rs. ___________________

 Any other tax savings scheme, with full details Rs. ___________________

____________________________________________

D. Under Section 80 CCC

Pension Annuity Plan Rs. ___________________


Annuity Pension Plan of LIC (Jeevan Suraksha)
(Provide proof of Payment)

E. Under Section 80 D

Mediclaim- I have paid/ shall pay medical insurance Rs. 27000


Premium amounting to (Provide proof of Payment)

F. Under Section 80 ………………..

_________________________________________________ Rs. ___________________

INCOME FROM OTHER SOURCES:-

___________________________________________________

____________________________________________________ Rs. ___________________

INCOME FROM HOUSE PROPERTY:-

Interest Paid on Home Loan


INDIAN BANK
____________________________________________________ Rs. 500000

I, hereby declare that the information given above is correct and true in all respects and I shall be solely
responsible for any misstatement given. I request the company to allow me the appropriate Income Tax
exemption/ relief.

Date: 07/07/2023

Place: DELHI Signature: ARUN

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