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Savings proof submission for tax calculation and savings

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Format of Submission of  savings proof for tax calculation purposes

Date
To,

The Account Manager
ABC  Private Limited
Mumbai ,
Subject: -Submission of proof of savings for tax calculation purposes -financial year 2013-14
Please find enclosed herewith my declaration of tax savings and other income
during the financial year 2013-2014 in annexure-I and annexure-II duly supported with the
documentary evidence(s) & self-attested as per the following arrangements:
1.The enclosures are serially numbered and mentioned in the annexure at the relevant point.
2.I also certify that particulars furnished are true and correct to the best of my knowledge and belief.
3.I also certify that these savings have been made by me from my own salary income/ sources & are being claimed by me only & not by any other person.
4.I also certify that rent is paid by me from my own salary income/ sources & are being claimed by me only and not by any other person.
5.I also certify that tuition fee is paid by me from my own salary income/sources & are being claimed by me only and not by any other person.
6.    I understand if I am unable to submit the self-attested saving proofs for the current savings by
& proposed savings evidences by l5th February 2014, due tax may be
deducted from my salary for the month of February and March 2014 without any further intimation
to me.
7.    I will be personally responsible to Income Tax Department, Govt. of India, for all information
pertaining to income tax assessment.
Thanking you 

Yours faithfully

Signature—————
Name —————
PAN
Address
Mobile No———–
E.mail. ID————-

Annexure:
I hereby declare that I propose to invest (during the F Y ending March 31st2014) following amount in tax notified scheme for deduction under Income Tax Act as details given below. I am aware that the  if I fail to provide the same by said date, the tax will be recomputed and difference will be recovered from my salary for the remaining months.
A. Investment U/S 80 C

Particulars Amount (Rs)
Subscription to PPF A/C NO
Life Insurance Premium
Unit-Linked Insurance policy premium
NSC VII issue
Interest accrued on NSC
Deposited in NSS
Cont. to Post Office C.T.D
Payment towards Tuition Fee for Children
Repayment of Principal Amount towards Housing Loan
Payment made directly to LIC towards Jeevan Dhara, Jeevan Akshay Policies
Investments in equity linked saving scheme of UTI and Mutual Funds
Deposit in Home Loan A/c of the National Housing Bank/HDFC etc.
Eligible Bank Deposits
Pension Scheme u/s 80CCC
Others if any

B. Expenditures

Particulars Amount (Rs)
Payment of Rent (Attach Photocopy of Rent Agreement or Rent Receipt duly certified by employee)
Name of the House owner
Address of house
Pan of House owner
Mediclaim Premium u/s 80D
Expenses incurred for Medical Treatment of Handicapped Dependent u/s 80DD
Interest on Housing Loan u/s 24
Others if any

   Signature: _____________________
   Name     :
   Resi Address:

PAN: