Spreadsheet: d7b3f74b-0133-476f-883e-4a820c1695c1
Sheet: Sheet1

Unnamed: 0 | Unnamed: 1 | Unnamed: 2 | Unnamed: 3 | Unnamed: 4 | Unnamed: 5 | Unnamed: 6 | Unnamed: 7 | Unnamed: 8 | Unnamed: 9 | Unnamed: 10 | Unnamed: 11 | Unnamed: 12 | Unnamed: 13 | Unnamed: 14 | Unnamed: 15 | Unnamed: 16 | Unnamed: 17 | Unnamed: 18 | Unnamed: 19 | Unnamed: 20 | Unnamed: 21 | Unnamed: 22 | Unnamed: 23 | Unnamed: 24 | Unnamed: 25 | Unnamed: 26 | Unnamed: 27 | Unnamed: 28 | Unnamed: 29 | Unnamed: 30 | Unnamed: 31 | Unnamed: 32 | Unnamed: 33 | Unnamed: 34
 |  |  |  |  |  |  | DECLARATION BY SALARIED PERSONS |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | IT-3
 |  |  |  |  |  |  | To be submitted to the Employer by the Employee
 | Employee's NTN |  |  |  |  |  |  |  |  |  |  |  |  | - |  |  |  |  |  |  |  |  |  | Tax Year
 | Employee's CNIC |  |  |  |  |  |  |  |  |  |  | - |  |  |  |  |  |  |  | - |  |  |  | Employee No.
 | Employee's Name
 | Designation |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | Posting City
 | Department |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | Section
 | Employer's NTN/FTN |  |  |  |  |  |  |  |  |  |  |  |  | - |  | Name of Employer
 |  | I, the undersigned whose particulars are given above, solemnly declare that:
 |  |  |  |  | I do not have any source of income other than the salary paid by the above mentioned employer
 |  |  |  |  | I also have source(s) of income other than the salary paid by the above mentioned employer, and undertake to file Income Tax Return under the Income Tax Ordinance 2001.
 |  |  |  |  | I am liable to file Wealth Statement as my total income is Rs. 500,000 or more.
 |  | Following Mobile(s), [NAME]), Bank Account(s) are in my name and the Electricity and Telephone connections mentioned below are installed at my residence. Tax credit as per details given below may please be granted, for which evidences are attached:
 |  | Sr. | Category |  |  |  |  |  |  | Mobile/Vehicle/Bank Account/Electricity Consumer/Phone/CNIC Numbers |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | Amount of Tax Credit Claimed
 |  |  |  |  |  |  |  |  |  | 1st |  |  |  |  |  |  |  | 2nd |  |  |  |  |  |  |  | 3rd
 |  | 1 | [NAME] Bill
 |  | 2 | Motor Vehicle Tax
 |  | 3 | Cash Withdrawal
 |  | 4 | Profit on Debt
 |  | Electricity Connsections | Consumer Number
 |  |  | CNIC/NTN of Premises Owner
 |  |  | Name of Premises Owner
 |  | Telephone Connections | Phone Number
 |  |  | CNIC/NTN of Premises Owner
 |  |  | Name of Premises Owner
 |  | Note | 1) Attach more sheets if more than three (3) numbers are to be stated in any category |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | Total Claim
 |  |  | 2) For Government residences, write [PHONE]-9 as CNIC of Owner
 |  | I, hereby solemnly declare that all the information given above is correct and complete to the best of my knowledge.
 |  | Date : |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | Signatures of Employee
 |  | To be Completed by the Employer
 |  | a) | Declaration of the Employee regarding other source(s) of income will be recorded in Col-23 of Annual Employer Statement mentioned in the box given in front of this statement as Y or N.
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | Y=Yes, N=No
 |  | b) | Tax Credit as given in front of this statement has been given to the aforementioned employee, as Tax Credit within the Tax Period, after examining all the evidences provided which are found to be in accordance with the claim and Income Tax Ordinance 2001. An entry to this extent will be made in Col-21 of the Annual Employer Statement in front of employee's record.
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | Rs.
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | Credit Given by Employer
 |  | Date : |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | Authorized Signatures
 |  | This Declaration is for Employer's record and should be maintained for at least 5-Years
 | This form can be donwloaded from FBR website www.fbr.gov.pk