DECLARATION OF PREVIOUS EMPLOYRER'S INCOME 2016-2017
(Self -attested copy of Provisional Income Certificate issued by Previous Employer
after completion full & final Settlement working is attach herewith).
(Applicable for new joinees during 1st April, 2016 to 31st March, 2017)
Name of Employee : ______
Date of Joining : ______/ SAP ID: ______
Department : ______/ Location : ______
Contact No: ______/ PAN No.: ______
Details of Previous Employment
Name of Previous Employer : ______
Address of Employer : ______
Date of Joining : ______/ Date of Leaving : ______
TAN (of Prev.Employer): ______/ PAN (of Prev.Employer): ______
Amount
Taxable Salary Paid / Rs. ______
Exemption for HRA availed / Rs. ______
Profession Tax deducted / Rs.______
Provident Fund deducted / Rs.______
Income tax deducted / Rs.______
Education Cess / Rs.______
Total Income-tax (including Cess) / Rs.______
Leave Encashment Exemption / Rs.______
Gratuity Exemption / Rs.______
Number of LTA Exempt (Count & Year/s of Claim) / ______
(Current Block 2014-2017 - Calendar Year)
Signature ______
Date ______
Place ______
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 ______.
Signature ______
Date ______
Place ______