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FORM NO. 10E
[See rule 21AA]
1. Name and address of the employee :
2. Permanent account number :
3. Residential status RENTED / SELF
OCCUPIED
Particulars of income referred to in rule 21A of the Income tax rules, 1962, during the previous year relevant to assessment year
1. a. Salary received in arrears or in advance in accordance with the provisions of sub-
rule (2) of rule 21A
b. Payment in the nature of gratuity in respect of past services, extending over a period of not
less than 5 years in accordance with the provisions of sub-rule (3) of rule 21A
c. Payment in the nature of compensation from the employer or former employer at or in
connection with termination of employment after continuous service of not less than 3 years or
where the unexpired portion of term of employment is also not less than 3 years in accordance
with the provisions of sub-rule(4) of rule 21A
d. Payment in commutation of pension in accordance with the provisions of sub-rule (5) of rule
21A
2. Detailed particulars of payments referred to above may be given in Annexure I, II,IIA, III or IV,
as the case may be.
Signature of the employee
ANNEXURE I
(See item 2 of Form No. 10E)
ARREARS OR ADVANCE SALARY
1 Total income (excluding salary received in arrears or advance)
2 Salary received in arrears or advance
3 Total income (as increased by salary received in arrears or advance)
4 Tax on total income (as per item 3)
5 Tax on total income (as per item 1)
6 Tax on salary received in arrears or advance [Difference of item 4 and item 5]
7 Tax computed in accordance with Table “A” [Brought from column 7 of Table “A”]
0
8 Relief under section 89(1)
0
TABLE “A”
[See item 7 of Annexure I]
Previous Total income of the Salary received in Total income (as Tax on total Tax on total Difference in tax [Amount
year(s) relevant previous arrears or advance increased by salary income [as per income [as per under column (6) minus
year (Rs.) relating to the received in arrears or column (2)] column (4)] (Rs.) amount under column (5)]
previous year as advance) of the relevant (Rs.) (Rs.)
mentioned in column previous year
(1) (Rs) mentioned in column 1
(Rs.)
1 2 3 4 5 6 7
TOTAL 0 0 0
DIFFERENCE 0
Note : In this Table, details of salary received in arrears or advance relating to different previous years may be furnished.
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
Place:
Date: Signature of the employee
ARREAR MAY BE SPLIT UP FOR GETTING REBATE U/S 89 OF INC
YELLOW COLOUR CELLS ONLY ARE OPERATBLE
Ea ASSESMENT YEAR 2006-07 2007-08
FINANCIAL YEAR Easy to 2005-06 2006-07
Mrs Shukla Sarkar
TAXBLE
INCOME
Desgn.
Assistant ARREARS
Period of 2005-06 to 2011-12
Arrear
TOTAL 0 0
It is computed as per following steps; - FEMAL
1. Calculate the tax payble on the total
income, including the arreas, in the year in
which the same is received A
2. Calculate the tax payble on the total
income, excluding the arrears, in the year in
which the same is received B
3. Difference between the tax at 1 and 2
(i.e.(A-B) C
4. Compute the tax on the total income after
excluding the arrears in the year to which the
same relates D 0 0
5. Compute the tax on the total income after
including the arrears in the year to which the
same reltes E 0 0
6. Difference between the tax at 4 and 5 (i.e
(E-D) F 0 0
7. Excess of tax computed at 3 over tax
computed at 6 i.e. C - F G
Current Year
Net Tax to be paid Due Tax
G is the amount of relief admissible under the
Act.
If G is a minus figure, no relief is admissible
The form 10 E for applyinPrepared by : G.Kondal Rao,UDC,KV,IIT,KHARAGPURg reb
GETTING REBATE U/S 89 OF INCOME TAX RULES
THIS CALCULATOR WORKS UP TO Rs.10,00,000/- INCOME P.A
2008-09 2009-10 2010-11 2011-12 2012-13 2012-13
2007-08 2008-09 2009-10 2010-11 2011-12 2011-12
178257 352816 302206 376003 376003
7470 14034 16293 4305 42102
0 185727 366850 318499 380310 418110
FEMALE
23495
19158
4337
0 0 22210 11784 19158 53152
0 590 25101 18231 19602 63524
0 590 2891 6447 444 10372
FALSE
Current Year
Due Tax
23495
0
us figure, no relief is admissible
ao,UDC,KV,IIT,KHARAGPURg rebate u/s 89 is attached with next sheet
