Form No.
50014
DECLARATION FOR THE PURPOSE OF COMPUTATION OF INCOME TAX
FINANCIAL YEAR 2024-2025 ASSESSMENT YEAR 2025-2026
Staff Code: Staff Name: ________________________________
Evidence / Remarks
Amount (₹) for the Remarks / Details of (For the use of Accounts)
Year Evidences
Details To be filled in by Employees
INCOME FROM OTHER SOURCES OTHER THAN In case of Savings Bank Interest, fill in the with, only the
SALARY (Interest Accrued from NSC, FD etc.) ₹ excess amount over Rs.10,000/-, plus other income.
ALLOWANCES EXEMPT u/s 10 To be filled in by Employees
D1) 1.1 Living in a Rented House (Check YES or NO)
1.2 Place of Residence (Check any one) YES / NO
1.3 Rent Paid/Payable for the Year Chennai / Delhi / Kolkata / Mumbai / Other
₹
Evidence / Remarks
(For the use of Accounts)
Amount (₹) for the Remarks / Details of
Year Evidences
DEDUCTIONS FROM TAXABLE INCOME To be filled in by Employees
D0) Deduction u/s 24(b)
2.1 Interest on House Building Loan from Company ₹
2.2 Interest on House Building Loan
Outside Company ₹
D1) Deduction u/s 80C
3.1 Life Insurance Premium (Excl. Salary Savings) ₹
3.2 Annual Contribution to PPF
3.3 Deposits in PO Saving Bank ₹
3.4 Subscription to NSS, or similar schemes ₹
3.5 Subscription to NSC VIII issue, etc.
3.6 Contribution to Dhanrakhsa 1989, etc. ₹
3.7 Contribution to deposit scheme / NHS
3.8 Mutual Fund notified u/s 10(24D) ₹
3.9 Deposit in an eligible public sector company ₹
3.10 Equity shares/ debentures of eligible issues 3.11
Tuition fees paid for education of any 2 children ₹
3.12 Cost of Residential Property or Repayment of HBL
Principal ₹
3.13 ₹
₹
₹
D2) Deduction u/s 80CCC: Payment of premium for
annuity plan of LIC or any other Pension Funds
₹
D2) Deduction u/s 80CCD (1B): Payment for NPS ₹
For Citizens For Senior Citizens (65
(Below 65 Years) Years & Above)
For the use of Accounts
To be filled in by Employees
D3) Deduction u/s 80D (Premium for Mediclaim, or any
other eligible Medical Insurance schemes) ₹ ₹
6.1 Medical Insurance for self, spouse & children
₹ ₹
6.2 Medical Insurance for Parents
D4) Deduction u/s 80DD: Rehabilitation of eligible Below 80% Remarks / Details of Evidences
Handicapped Dependent Relative (Check any one)
80% or More
D5) Deduction u/s 80U: Rehabilitation of eligible Below 80% Remarks / Details of Evidences
Handicapped Person (Check any one)
80% or More
D6) Deduction u/s 80E: Loan Interest for eligible Higher Interest started in FY
Studies, qualified for deduction up to eighth year from the (YYYY-YY) For the use of Accounts
start year of interest payment
₹ NA
PERMANENT ACCOUNT NO. ____________________________ Signature & Date:
_____________________________