Electronic Data Systems (India) Pvt. Ltd

DECLARATION FORM FOR INVESTMENTS TO BE MADE BY AN EMPLOYEE IN TAX SAVING SCHEMES FOR THE FINANCIAL YEAR 2012-13

To:

I wish to declare that I shall invest the following amounts in tax saving schemes during the financial year 2012-13 in addition to the Provident Fund deduction being made by the company for the purpose of computation and deduction of tax at source from my salary.

(Amount in Rs.)

Whether you will be claiming Deduction for HRA

IF Yes Give the amount of Monthly Rent payable during various month

of the year 2012-2013

U/S 80D ______

Premium to be paid for Medical Insurance

(Deduction allowed up to maximum of Rs. 15,000/-)

U/S 80DD ______

Expenditures incurred for permanent physical disability

(Deduction allowed up to maximum of Rs. 1,00,000/-)

U/S 80C

1. LIC Premium______

2. Deposits in Public Provident Fund______

3. Contribution to UTI in ULIP Scheme______

4. Deposit in National Savings Certificate______

5. Interest on National Saving Certificate______

(Attach photocopy of NSC purchased)

6. Payment made for construction/purchase of House/ ______

Repayment of housing loan(Only Principal Amount)

7. Tution Fee(maximum upto 2 Children)______

8. Others (Please Specify)______

(Deduction allowed 80C and 80CCC up to maximum of Rs. 100,000/- incl. PF Ded.)

Exemption from House Property Income

Payment made for construction/purchase of House/______

Repayment of housing loan(Only Interest amount)

(Deduction allowed up to maximum of Rs. 150,000/- )

Name of the Employee

Signature ______

Emp. ID______(Mandatory)

Date ______

PAN No. ______(Mandatory)

(Please attach self attested photocopies of all the certificates)

DECLARATION FORM FOR RENT PAYMENT BY AN EMPLOYEE

FOR THE FINANCIAL YEAR – 2012-13

To:

This is to inform you that, I am paying a rent of Rs. ______per month from my salary.

My residential address is ______

______

______

You are requested to consider this rent payment when you calculate tax on my salary income.

I declare that I shall immediately inform the company about any change in my address or the amount of rent paid.

I further declare that, I shall submit the proof of payment of the rent at the end of every quarter.

I undertake that the above statement is correct and any Income tax liability arising due to my failure in submitting the rent receipts or due to any misdeclaration will be my responsibility and the company will be authorized to deduct tax on my income as if I am not paying any rent.

Name of the Employee

Signature ______

Emp. ID______

Date ______

PAN No. ______

(Please attach self attested photocopies of Rent receipts)

DECLARATION IN FORM NO. 12 C (VOLUNTARY)

[See rule 26B]

Form for sending particulars of income under section 192(2B) for the year ending 31st March, 2013

1.Name and address of the employee______

______

______

______

2.Permanent Account Number______

3.Residential status______

4.Particulars of income under any head of

income other than “salaries” (not being a

loss under any such head other than the

the loss under the head “ Income from

house property”) received in the F.Y

(i) Income from house property ______

(In case of loss, enclose computation thereof)

(ii)Profits and gain of business or profession ______

(iii)Capital gains______

(iv)Income from other sources

(a)Dividends______

(b)Interest______

(c)Others (specify)______

5.Aggregate of sub-items (i) to (iv) of item 4 ______

6.Tax deducted at source

[enclose certificate(s) issued under section 203]

Place ______

Date ______ Signature of the employee

Verification

I, ______do hereby declare that what is stated above is true to the best of my knowledge and belief.

Verified today, the ______day of ______2012

Place ______

Date ______