| 1. | Employee PAN | String | Yes | Permanent Account Number of the employee (‘PANAPPLIED’ or ‘PANNOTAVBL’ in case of no valid PAN) |
| 2. | PAN Ref. No. | String | Yes | Reference number in case of PAN applied |
| 3. | Name of Employee | String | Yes | Mention the Name of the employee |
| 4. | Period of Employment From - Date | Date | Yes | Date from which employed with the current Employer (DDMMYYYY) |
| 5. | Period of Employment To - Date | Date | Yes | Date to which employed with the current Employer (DDMMYYYY) |
| 6. | Total deduction under section 16(ii) | Number | Yes | Entertainment Allowance received |
| 7. | Total deduction under section 16(iii) | Number | Yes | Professional tax paid |
| 8. | Income (including admissible loss from house property) under any head other than income under the head “salaries” offered for TDS [section 192 (2B)] | Number | Yes | Any other Income except salary Income |
| 9. | Deduction in respect of life insurance premia, contributions to provident fund etc. (section 80C) (Gross Amount) | Number | Yes | Actual amount of contribution made to Life Insurance schemes |
| 10. | Deduction in respect of contribution to certain pension funds (section 80CCC) (Gross Amount) | Number | Yes | Actual amount of contribution made to any pension funds |
| 11. | Deduction in respect of contribution by taxpayer to notified pension scheme [section 80CCD(1)] (Gross Amount) | Number | Yes | Actual amount of contribution made to National Pension Fund |
| 12. | Deduction in respect of amount paid or deposited under notified pension scheme [section 80CCD(1B)] (Gross Amount) | Number | Yes | Actual amount of contribution made to New Pension Scheme account regardless of contribution under section 80CCD(1) |
| 13. | Deduction in respect of contribution by employer to notified pension scheme [section 80CCD(2)] (Gross Amount) | Number | Yes | Actual amount of contribution made by employer to notified Pension Scheme under section 80CCD(2) |
| 14. | Deduction in respect of health insurance premia [section 80D] (Gross Amount) | Number | Yes | Actual amount of contribution to medical insurance premium, medical expenditure, preventive health checkup |
| 15. | Deduction in respect of interest on loan taken for higher education (section 80E) (Gross Amount) | Number | Yes | Actual amount of Interest paid on higher education loan |
| 16. | Total deduction in respect of donations to certain funds charitable institutions (section 80G) (Gross Amount) | Number | Yes | Actual amount of donations made to certain relief funds and charitable institutions |
| 17. | Deduction in respect of interest on deposits in savings account (section 80TTA) (Gross Amount) | Number | Yes | Actual amount of Interest received from Savings account |
| 18. | Deduction in respect of interest on deposits in savings account (section 80TTB) (Gross Amount) | Number | Yes | Actual amount of Interest received from Savings account (Senior Citizen) |
| 19. | Deduction in respect of maintenance including medical treatment of a dependent who is a person with disability (section 80DD) (Gross Amount) | Number | Yes | Actual amount of expenses incurred on the medical treatment of differently abled dependents |
| 20. | Deduction in respect of interest on loan taken for residential house property (section 80EE) (Gross Amount) | Number | Yes | Actual amount of interest paid on a home loan taken by a first-time homeowner |
| 21. | Deduction in respect of interest on loan taken for certain house property (section 80EEA) (Gross Amount) | Number | Yes | Actual amount of interest paid on a home loan taken by a first-time homeowner under Affordable Housing |
| 22. | Deduction in respect of rents paid (section 80GG) (Gross Amount) | Number | Yes | Actual amount of Rent paid for furnished or unfurnished accommodation |
| 23. | Deduction in respect of contributions given by any person to political parties (section 80GGC) (Gross Amount) | Number | Yes | Donations to a political party or candidate |
| 24. | Deduction in case of a person with disability (section 80U) (Gross Amount) | Number | Yes | Expenses incurred on the medical treatment of disabled |
| 25. | Income Tax Relief u/s 89 when salary etc is paid in arrear or advance | Number | No | Salary paid in arrear or advance and hence government gives relief for change in slab rates |
| 26. | Total Amount of tax deducted at source by the current employer for the whole year | Number | Yes | TDS deducted by the current employer for the employment period in the whole year |
| 27. | PAN of landlord | String | No | PAN of landlord (subject to when yearly rent paid exceeds Rs. 1 lakh) |
| 28. | Name of landlord | String | No | Name of Landlord |
| 29. | In case of deduction of interest under the head income from house property - PAN of lender | String | No | PAN of lender |
| 30. | In case of deduction of interest under the head income from house property - Name of lender | String | No | Name of Lender |
| 31. | Gross Salary as per provisions contained in sec.17(1) | Number | Yes | Includes Basic salary, DA, conveyance allowance, HRA, etc. |
| 32. | Value of perquisites [section 17(2)](as per Form No.12BA) | Number | Yes | Includes accommodation, free travel, free meal, holiday expense, stock options, etc. |
| 33. | Profits in lieu of salary [section 17(3)](as per Form No.12BA) | Number | Yes | Includes terminal compensation, keyman Insurance policy, unrecognized PF, etc. |
| 34. | Travel concession or assistance [section 10(5)] | Number | Yes | LTA (Leave Travel Allowance) is paid by employers to their employees when they are on leave and traveling either alone or with family within India |
| 35. | Death-cum-retirement gratuity [section 10(10)] | Number | Yes | Gratuity is received as a lump sum amount for at least completing 5 years |
| 36. | Commuted value of pension [section 10(10A)] | Number | Yes | Pension value received in advance as a lump sum payment |
| 37. | Cash equivalent of leave salary encashment[section 10(10AA)] | Number | Yes | Income from cashing out unused leaves |
| 38. | House rent allowance [section 10(13A)] | Number | Yes | Allowance received to cover the rent expenses for accommodation |
| 39. | Amount of any other exemption under section 10 | Number | Yes | Any other exemption received |
| 40. | Income under the head other sources offered for TDS [section 192 (2B)] | Number | Yes | Income from Other Sources |
| 41. | Whether opting for taxation u/s 115BAC | String | No | Opt for taxation under the new regime |
