Declaration by Salaried Persons To Be Submitted To The Employer by The Employee
Declaration by Salaried Persons To Be Submitted To The Employer by The Employee
Declaration by Salaried Persons To Be Submitted To The Employer by The Employee
Employee's Name
Name of
Employer's NTN/FTN 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 undertak
to file Income Tax Return under the Income Tax Ordinance 2001.
Following Mobile(s), Motor Vehcile(s), Bank Account(s) are in my name and the Electricity and Telephone connection
mentioned below are installed at my residence. Tax credit as per details given below may please be granted, for whic
evidences are attached:
3 Cash Withdrawal
4 Profit on Debt
Consumer Number
Connsections
Electricity
Phone Number
Connections
Telephone
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 99999-9999999-9 as CNIC of Owner
I, hereby solemnly declare that all the information given above is correct and complete to the best of my knowledge.
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
Rs.
front of employee's record.
Credit Given by Emplo
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
IT-3
oned employer
Amount of Tax
Credit Claimed
838
best of my knowledge.
tures of Employee
Y=Yes, N=No
horized Signatures
at least 5-Years