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Assessment Year
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2015-16
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Name (*)
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Assessee Type (*)
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Age (*)
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Residing City (*)
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Items
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Actual
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Gross Salary /Income (*)
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Basic Salary (Basic + DA)
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(*)
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Exemptions under section 10 & 17
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Annual Rent Paid
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Actual HRA Received (From Employer)
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Conveyance Allowance
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Medical Reimbursement
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LTA Exemption
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Children's Education Allowance Exemption
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Vehicle Maintenance (petrol/maint. Bills) only if Conveyance Allowance not claimed
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Other exemptions (gratuity, VRS, etc.)
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Professional Tax
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House/property income or loss (enter loss as negative)
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Interest on housing loan (for tax exemption)
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Income/Loss on Equity Shares & Equity Linked Mutual Funds (STT Paid)
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Short Term Capital Gains, if holding period of shares is less than 1 year (Tax @15%
p.a.)
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Long Term Capital Gains, if holding period of shares is more than 1 year (NIL)
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Other Income
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Bank (Saving/FD/Rec)
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N.S.C. (Accrued/Recd)
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Post office M.I.S. (6 years)
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Post office Recurring Deposit (5 years)
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Term Deposit (1 to 5 years)
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Saving Bonds (6 years)
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Kisan Vikas Patra
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Any Other Income
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Deductions under Chapter VI (sec 80C) upto Rs.1,50,000/-
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NSC & NSS
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Public Provident Fund
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Employees Provident Fund & Voluntary PF
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Pension scheme (sec 80CCC)
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Children's Education (Upto RS 200/-)
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Housing loan principal repayment
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Insurance premium (After 1st April 12)
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Infrastructure Bonds & others (MF, ULIP, FD, etc.)
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FD for 5 years
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Post office saving in 10/15 years
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Tuition fees (Excluding donation, development fees upto Rs 24,000/-
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Deduction Under 80CCG (Rajiv Gandhi Equity Saving Scheme)
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Annual income is < Rs. 10 lakh can invest in this scheme up to Rs. 50,000 and get
a deduction of 50% of the investment
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Deductions under Chapter VI-A (sec 80D to 80U)
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Medical Insurance Premium for self & family (sec 80D)
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Medical Insurance Premium for parents (sec 80D)
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Medical for handicapped dependents (Sec 80DD)
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Medical for specified diseases (Sec 80DDB)
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Deduction for permanent disability (80U)
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Education Loan Interest Repayment (Sec 80E)
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Donation to approved fund and charities (sec 80G)
(Contribution to exempt charities – 25/50/75/100% depending
on the charity & 100% exemption on donation to political parties)
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Deductions under (Sec. 80TTA)
(Interest earned on balance in savings bank account
subject to a maximum of Rs. 10,000 per year.)
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Deduction under 80RRB section in respect of any Income by way of Royalty of a Patent
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Rent deduction (sec 80GG) only if HRA not received
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Any other deductions
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Interest on up to Rs 1.50 lac Housing Loans Section
(Excluding Rs. 1 lac p.a. u/s 80c Saving)
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