Future proof declaration format

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INVESTMENT DECLARATION FORM FOR THE YEAR 2024-25

Company Name
Employee Code
Employee Name
Employee PAN
Employee DOB Gender

I hereby declare that the following investment will be made by me during the financial year 2024-
25 starting from 10th January 2025 to 31st of March 2025

Item Name Particulars Eligibility(Rs.) Amoun


t
Exemption u/s 10
House Rent I am staying in a Rented
Allowance House and I agree to submit
Rent receipts or Rent
Agreement with the Metro/Non Metro
Landlord when required.
Rent Paid
is x_12 Months

LTA Proposed travel for LTA Planning to claim LTA this year
Exemption for the
Block 2022-2025
Claims during the year 2022 Yes/No
Claims during the year 2023 Yes/No
Claims during the year 2024 Yes/No
Claims during the year 2025 Yes/No
Purchase of asset in the name Yes/No
of employee
If I do not produce the bills to
the satisfaction of the
company, then the Company
can consider the amount Yes/No
paid towards LTA for tax
Purpose
Deduction u/s 24
1 Interest on Housing Loan u/s 24(If the house is
Self-Occupied and the loan was taken
before 1st April 1999) Upto Rs.30000/- (If
Bankers Certificate to be Submitted) Self-Occupied)
2 Interest on Housing Loan u/s 24(If the house is
Self-Occupied and the loan was taken after 1st
April 1999) Upto Rs.200000/- (If
Bankers Certificate to be Submitted) Self-Occupied)
3 Interest on Housing Loan u/s 24(Let-
out/Deemed to be Let-out)
(If the property is LET-OUT-Rental income
need to be specified)

Deduction u/s 80C(Maximum Amount Upto Rs.150000/-)

1 Life Insurance Premium (LIC)


2 Provident Fund (PF)
3 Public Provident Fund (PPF)
4 Voluntary Provident Fund (VPF)
5 National Pension scheme (NPS)
6 Interest accrued on NSC(Re-invested)
7 Unit Linked Insurance Policy (ULIP)
8 Equity Linked Savings Scheme (ELSS)-Mutual
Fund
9 Payment for Tuition Fees for Children (Max.
2
Children)
10 Principal Repayment of Housing Loan
11 Stamp Duty, Registration charges incurred for
Buying House (1st Year Only)
12 Infrastructure Bonds
13 Bank Fixed Deposit For 5 Years & Above
14 Post Office Term Deposit For 5 Years & Above

Other deduction u/s 80

80 D Medical Insurance (Max. Limit-Rs.25000/-if any person


Premium- Individual, insured is other than
Spouse & Children Senior Citizen)
80 D Medical Insurance Premium-Parents (Max. Limit-Rs.50000/-if any
person insured is a Senior
Citizen)
80 D Preventive Health Check-up Max. Rs.5000/- (inclusive in overall
limit of Rs.25000/50000)
80 E Interest for Loan taken for Higher No Limit (Only Interest
Education portion)
Others
(Please
Specify)

Income from Previous Employment:

1. Income after exemptions

2. Provident Fund (PF)

3. Professional Tax (PT)

4. Tax Deducted at Source (TDS)

Declaration:

I hereby declare that the information given above is correct and true in all respects. I also undertake to
indemnify the company for any loss/liability may arise in the event of the above information being incorrect.

Date:

Place:

Signature of the employee

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