To:

The Principal,
Andhra Medical College,
Visakhapatnam.

Datet05.12.2022
Respected Sir,

Sub:Dr.S.Shavukath Ali, MD (FM),Associate professor, Department of Forensic

Medicine,Andhra Medical College, Visakhapatnam- Submitting lncome and
savings particulars for the financial year 2022-23, to assess and deduct the TDS
from my salary- Request - Regarding.
Ref: 1. Ref. No. Accounts /2022 , Dt:O1-December, 2022 from O/O principal,
AMC, Visakhapatnam.
2. My PAN No: AZJPS 0370 F, My Cell phone No9490194764, Contact Address:
Dr.S.Shavukath Ali, MD.,FM, D.NO14-77 /1, 1't Floor, Kailashpuram, Durgakailash
nagar, Visakhapatnam-530024.

I am here by submitting my income and savings particulars to the authority with

the reference cited above to give instructions to the concerned for assessment and
deduction of TDS for the financial year 2022 - 23.
1. My House No.6-2-194, Kovur Nagar, Anantapur, House loan A/C N..71O7OOO025Z5
from Llc Housing Finance Ltd. For a period 01-04-2022 to 31{3-2023 of
Rs.16,34,133.28l- towards principal and, Rs. 1, 08, 571.95/_ Towards tnterest.

2 House loan Ac.No:710700004626, Lrc housing finance Ltd for my house No:
6-2-194,
Kovur Nagar, Anantapur repayrnent of roan for the financiar year 2022-2023 i.e.
01-04-2022 to 3'l-03-2023 towards principal : Rs. 1,43,gg5.55/_ and towards Interest

:Rs.Z,24,87 4.45/-.
3. House loan Ac.No:710700005600, LIC Housing Finance LTD, for a period of
01/U/2022 to 31/03/2023 for the property of my house no: 6_2_194,
Kovur nagar,
Anantapuramu. r paid principar amount of RS: 3, 15, 894.gg/- and towards
interest of
Rs:3,77,193.12/-.

4. Property tax for the my house No:6-2194. Kovur Nagar, ward

No.6, Anantapur of
Rs.572Z- for the period 1-4-2022 to 31-03_2023.

5. Water Charge receipt tax for my House N0:6_2-.194 Kovur Nagar,

Anantapur of
Rs.l200l- for a period 01-04_2021 to 31_03_2OZZ (Annually Rs.t200l-).
6. Rental lncome receiving from my House No.6-2{94, Kovur nagar, Anantapur of
Rs.12000/- PM (Annually Rs.1,44,000/-) for the year I-04-2OZZ to 31-03-2023 . Two
portions. Total income: Rs. 2,88,000/- annually.

7. I am residing in rented house and paying rent for the House No:14_7711, ln Floor,
Kailashpuram, Durga Kailashnagar, Visakhapatnam and paying monthly rental of Rs.
'18000/- from April,2022 to March,2023 and. Annually RS.2,16,OOO/-.

8. LIC Policy No: 651902522 of Rs.5,274l- for the fi nancial year 2022_23.
9. SBI life insurance Poliry No. 06018136606 of Rs.8006/- for the fin ancial year 2022-23.
10. Tuition fees for my children S. Mohammed Rahiman Ali (Son) 6s class in Sri
Chaitanya School, Asilmitta, Visakhapatnam of Rs.46,500/- (Annual) for the financial
year 2022-23.

11. My daughter s.suhana Karishma admission in MBBS abroad 2nd year tuition fees in

Cairo Medical University, Egypt for the acad emicyear 2OZ2-23 of 6000 USD.
'12. car vehicle in my wife name s. Mubeena insurance TATA AIG General Insurance Car
Policy No:VPN0048257000104 ,Annual insurance paid of Rs:5533/- for the year 22-

Thanking you sir,

Yours ithfully,

Dr.S.Shavu Ali, MD (FM)

Associate Professor,
Department of Forensic Medicine,
Andhra Medical Collegg
Visakhapatnam.
 Form No. 16 Certificate L)nder Section 203 of the Income tax Act,
Scc l{r.rlc l1 (l)(a) 19(rl [or tax deducted at source from income
cl-rargeable under the head "Salaries"
Nirrlrc- and acldrc'ss of thc Llmplo.ver Narne and Destgnauon oI the Employee
O/o Principal
Andhra Medical College, DR SHAVUKATH ALI
Visakhapatnam
PAN No PAN/GIR No. AZ]PSO37OF
TAN No. VPNPOO54SC
'I.I)S Circle where Annual Rerurn/Statement PERIOD ASSESSMENT \'EAR
rrnder Scction 206 is to be filed FRONI TO
2023-2024
01-04-2022 3l-03-2023
I)['I"\II-S OF SALARY PAID .{ND,\NY OTHER INCON{E AND T,\X DEDUCTED AT SOURCE
r. GROSS SALARY * 2513512
Stand ared Deduc tion 16 (1a) (Rs. 50000) (B ud get 2019) 50000 2463512
a) SalaLl as per provisions contained in S. 17(1)
b) \'alue of perquisites LI/s 1712; (as per Form 12 BA. rvherever applicable)
cl Profits in lieu of salary U / s 17(3) (as per Form 12 BA. rvherever applicable)
<l) Total 2463512
2. LESS : Allowance to the extent exempt U/s 10
a) I'lotrsc llent Allowance U/s 10(13)(A)
b)Special Allowances exempt U/s lt)(la)
9D,
3. BAr-ANCE (t-2) u6?sw
4. DEDUCTONS
a) L,nrertainment allowance
b) Tax on employment (?rofessional Tax) 24m
& (b) (aa+ab)
5. Aggreate of 4(a)
6. TNCOME UNDER THE HEAD SALARIES (3-s) 2460190
7. ANY OTHER TNCOME REPORTED BY THE EMPLOYEE
a) Income from other sources
b) Income tiom Oapital Gains
c) Income/Losss Irrom f'Iouse Properry U/s 24(vi)
8, GROSS TOTAL INCOME (6+7) 2460190
9. DEDUCTIONS T]NDER CHAPTER VI A:
A). Under Section 80C,80CCC, 80CCD, 80CCF
rr) 80C GPI.]//CPS 1 80000
t)) tt0c Al'}GLI 60000
c) 80(. GIS 1.440
d) 8oc Lrc 0
e) 80C Postal Life Insurance @LI/RPLI) 150000
t) 80C Sukanva Samridhi Yoiana 0
u) 8{)(- Trrtion Fec 0
h) 80C Principal on Housing Loan 0
Aggregate of deductible amount under Chapter VIA (A) 391440 L50000
2310190
80CCD (1B) National Pension Scheme (CPS) 0 2310190
B). Other sections under Section Chapter VIA
al 80(l E\X'l; & Flag fund 150
lrr 8,()1. lrrtrcst on I Iorrsing loan 200000
c 8( l'l"I'.'\ lnlrcst on Savir.rg.\ccount 0
d) 80Li l)eduction for Disabled 0
e) ttOD Medical Insurance Premium 0
0 80G Donation of charitible Trust 0
g) 80 D limployee Health Scheme(EHS) 3600
Aggregate of deductible amount under Chaptet VIA (B) 203750 203750
10. TOTAL INCOME 8- rounded 2706440
 11. Tax on Total income 2106440 444432

12. Rebate and Relief under Chapter VIII

L Under Section 88 (?lease Speci$,)

Total [(a) to (e)]

TAX CALICUI.ATION
a) SI-AB A (R.s.00000 - Rs.250000) Nil 250000 0
b) SLAB B (X.s.250001- Rs.500000) 50h 250000 12500
c) SLAB C (R.s.500001- Rs.1000000) 20%o 500000 100000
d) SLAB D (Rs.1000001 & ABOVE) 30%o 1106440 331932
Tax on Total income 2106440 444432 o
13. Health and Education cess @ 4%
17777
14. Aggregate of tax rebates and relief at 13 above
g1$+II( a)+II@) +IIII Restricted to

15. Tax Payable (12-14) and surcharge rhereon

462209

16. Less: Tax Deducted at source

462500

lT.Taxpayable / refundable (15-16) (2et)

DETAI LS OF T AX D E D UCTE D AND DE POS ITED INTO CENTRAL GO VE RN MENT ACCO UNT
Amount Date of Name of bank and branch where tax c.l ircrl
42,000 MARCH 2022
42,000 Apnl2022
42,000 May 2022
42,000 une 2022
42,000 uly 2022
42,000 August 2022 DTO, VSP
42,000 September 2022
42,000 OCTBER 2022
42,000 November 2022
42,000 December 2022
42,000 anuarv 2023
500 February 2023
Arrear 08/06 2022 to 30/09/2022
I, Sri.E. Lo ganathan, S/o N G Ealumala, in my
capacity as Assist.Director (Admn.) do hereby certify that a sum of Rs.
462500 (Rupees four lakhs sixty two thousand and five hundred onty)
has been deducted at source and paid to the credit of the Central Government. I
further certify that the given above is true and correct based on the books of
accounts, documents and other available records

of the
Signature on responsible r deduetion o[ tax
Place: VISAKHAPATNAM Full Name : A anl Dlrootor E
Date : f)es oil trli' '

r
 ANDHRA MEDICAL COLLEGE, VISAKHAPATNAM

NAME : DITS}IAVUKATH AI-I t INAN( rAI YL.AR 2022-2023 I'A N No A4r'S0l70l

SEX I MAI,E ASSI.M ITNl YEAR 2OZ3-2O24

EMP If] NO 10054r 1

EWF & Total
(;l,F I nr onrr'
Month Basic Pay t)A |,1, l;1, SP (-('n } II{A Allowan
-t'otal
CPI: AI'(;I ,I CIS IJ'I' Flag I IRIt I.,I IS \(;() Deducati Net Salary

--r
Ioatr [.rr
Fund ons

I
H 300 {2000 62670 '12798t1
MARCI I 2022 121200 3ri502 3600 2000 22356 190658 15000 5000 120 200 50

April 2022 121200 38502 3600 2000 22356 190658 15000 5000 120 200 300 42000 62620 r28038
I

L] H
May 2022 38502 22356 90658 15000 5000 120 200 300 12000 62620 r 28038
12.1200 = 3600 2000 |

June 2022
't21200 38502 3600 2000 22356 '190658 r5000 5000 120 200
-T 300 .12000 62620 r2803n

H
I

120 200 300 {2000 62620 133551

July 2O22 727900 3961q 3600 2000 23022 796177 15000 = 5000 t
August 2022 127900 39649 [:
ll
3600 2000 2jo22 ll 19617't i5000 5000 120 200

H 300 .12000
.12000
I]
62620 133551

!lE
796771 5000 720 200 300 62620 133551

I]
September 2022 127900 39619 3600 2000 23022 15000
OCTBER 2022
November 2022
December 2022
135300
135300
135300
.119.13

41943
.11943
,11943
3600
3600
3600
2000
2000
2000
II
II
24354
24354
24354
Fi 207"197
207"197
207"197
15000
15000
15000
5000
5000
5000
5000
120
120
-t20

120
200 I
200
200
200
tI 100
300
300
300
300
12000
12000
.12000
,12000
t-
62620
62620
62720
62620
144577
144577
744477
144577
January 2023 135300 3600 2000 24354 207197 15000
February 2023
SL
Arrear
135300
62100
4.1943
19251 H 3600

I
2000 I 24354
111,78
4090
207"197
92529
15000
=
5000 720 200 300 500 I 2t"t20
0
786077
92529

08 / 06 / 2022 ro
0 3385.3

t--l---T_1 tT
30 / 09 /2022 22720 7043 33E53
_-_-
I I
.13200 2513512 180000 60000 7440 2400 150 0 3600 .162500 0 710090 1aoi422
7641820 0 24000 295528 0 0

t--f-f ]
50896,1 0

1,647820 508964 0 43200 24000 0

TT
295528 0 25135^t2 180000 0 60000 "t440 2.100 150 0 3600 r62500 0 7i0090 r803422

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 RENT RECEIPT

WHOM SO EVER IT MAY CO NCERN

This is to certify that r Mr. Masood, tenant residing in the house D.No:6-z-194
Kovur Nagar,

Anantapur in first portion and tam paying the rent Rs.12ooo/- ) per month (Annually Rs.1,44,000/ -

for the year 1-04-2022 to 3'l-03-2023 to owner of the house Dr.S.Shavukath Ali, MD.,FM ,

Associate Professor, Andhra Medical College, Anantapur from March ZO22 Onwards.

Date: Signature:
I
Name: (Masood)

Cell No:9440732236
 RENT RECEIPT

WHOM TO SO EVER IT MAY CONCERN

This is to certify that r Mr. c. Neerima D/o of sridhar Reddy, tenant residing
in the house

D.No:6'2-194, Kovur Nagar, Anantapur in 2nd portion and r am paying the rent Rs.12,ooo/- per

month, Annually Rs.1,44,000/- for the year 1-04-2022 to 3r-03-2023 to the owner of house

Dr.s.shavukath Ali, MD.,FM , Associate professor, Andhra Medicar colege, Anantapur

from March
2022 Onwards.

Date: Signature: C ) sg\-"A6-

Name: (C.Neelima D/O Sridhar Reddy)

Cell No:9963503854
 Anantapur Municipal Corporation
WATER CHARGE RECEIPT

Receipt No: 0412023-24122507 Receipt Date: 27-04-2023 09:51:34

Name: Dr S Shoukath Ali
Address: 6-2-194, Kovour Nagar, Revenue Ward No 6, Anantapur
Payment Description: Water Charge H.S.C No: 1001001092
Details: Paid By: Dr S Shoukath Ali
Description Head of A/C Amount (in Rupees)
Water Charges - 2023-2024-1 # 2023-2024-l 600.00
Water Charges - 2023-2024-2 # 2023-2024-l 600.00
Total: 1,200.00
Amount (in words): Rupees One Thousand Two Hundred Only
Paid From 0110412023 To 3110312024

Onl in e Trans acti on Numb er: 70 0237 7 I 3 52023,P ay ment Dated : 27 -0 4 -2023

This is computer generated receipt. Signature is not required.

Collected By : Anonymous Commissioner

'Asking Bribe? Call 14400'
'J$po. oorjSo es&R,$ es$S&S $erl>6,$ e"f.5 Lt, Foa6 t44oo 5D !>o"s6 dc$o&'
 Anantapur Municipal Gorporation
REGEIPT

Receipt No 04t2023-24122497 Purpose : Property Tax

Date: 27-04-2023 09:45:45
Assessment No. : 1 001 030720
Payee Details
Name & Address : Dr S Shoukath Ali Period: Paid From 01-04-2023 to 31-03-2024
6-2-194, Kovour Nagar, Revenue Ward
No 6, Anantapur Amount Payable
Arrears Current lnterest Rebate Total

Place of Payment SYSTEM 0.00 6924.00 0.00 336.00 6588.00

Payment Mode

Cheque IDD lBank Challan / Online

Mode Bank Name & Branch
Transaction Number & Date

Transaction No: 700237 17 1 02023

online NA
Dated: 27-04-2023

Payment Details

Amount Paid (Rs.)

Cheque Bounce Rebate / Waiver
Arrears Current lnterest Penalty Advance Total

0.00 6924.00 0.00 0.00 336.00 0.00 6588.00

Balance

0.00 0.00 0.00 0.00 0.00 0.00 0.00

Amount Paid (in words): Rupees Six Thousand Five Hundred Eighty Eight Only

This is a computer generated receipt, signature is not required.

I i -t-:--. Fr-:l- _at A-at ) , ut\t\t

 03-12-2022

MT.SHAVUI(ATH ALI SHATK

D NO &2.194
KOvt,RNAGAR
ANANTAPUR 61500I
Andhra Pradesh
LIFE INSURANCE PREMIUM PAID CERTIFICATE FOR THE2021-22

This is to certifo that the following payments have been made under life insurance poticies held by

ALI SHAIK
Policy No. Product Name Sum Assured(Rs) Mode Premlum Due Premlum Premlum Amt(Rs)
Date Allocatlon Date
060r8136606 SudarshanEndow 300000 Yearly 0743-2022 1443-2022 8006
ment
8006

Total Premium paid Under Pension plan is: 0.00

Total Premium paid Under Non Pension plan is: 8006
Total Premium paid Under Critical lllness / Health Plan ls : 0

Tota! Amount pald towards Premlum ls : 8006

Premium paid under Pension plan is provided exemption under section 80 CCC(I) of the lT act 1961
Premium paid under other plan ls provlded exemption under Sec g0 c of lhe lrAct 1961
Premium Amount for Critical lllness & Health plan are exempt under 80 D of thE lT Act 1961

Thls ls a computer generated statement and does not require any stgnature

service Tax is charged at the rate as notified by Govt. of lndia from time to time

SBI Llfe lnsurance Company Umlled, Reglstorod offlcs: 'Natraj', M.v. Road & Westem Express Highway
Junc,tlon, Andherl (East), Mumbal-400069
Cenbal Processing Contre, 8th Level, Ssawoods Grand Cenbal, Tower 2, Plot No : R.1, Sector 40, Soawoods,
Nerul Node, Navi Mumbai- 400706
Tel.: (022) 6645 6000 Fax (022) 6645 6i0S
Webslte:wur.sbilife.co.ln Emall:lnfo@sbillfe.co.in
Corporate ldentity Number: CIN: L99999MH2@OPLC I 291 1 3
 L ,{$*"
7W
c{I-gil!-{tmr
-
3{Td qErdss

Collecting Branch : EPS'l Servicing Branch : LIC of lndia, Anantapur Branch

LIC OF INDIA,ANANTAPUR BRANCH
Transaction No : 30888975
POST BOX NO 12
\t
Date ( Time 0110112022 ( 10:59:20 ) ,515001
Email: B0_658@LICINDIA.COM
ReceiptNo : PR3088897500012122 Call Center No: 022 6827 6827

RENEWAL PREMIUM RECEIPT

Received with thanks < 5,274.00 through Payment Gateway over the lnternet from:

Smt./Ms.lShri : Shavukath Ali Shaik

towards the following :

Policy No Plan / Term lnst. Premium No Of lnst Total Premium CGST Branch
Name D.O.C. Mode Due From Late Fee Next Due
Sum Assured Due To CD Charges TotalAmt Reg. No.
Revival
(Yes/No)
Agency Code
(<) , (<) (()
0,00 658
651902522 93 125 5,274.00 1 5,274.OO

Shavukath Ali 28101/1 999 YLY 01122 ' o.oo 0.00 o'i23
No 02377658 1,00,000 01t22 0.00 5,274.0A

Page Total (t) 5,274.00 5,274.00 0.00

0.00 0.00
0.00 5,274.00

Grand Total (t) 5,274.00 5,274.00 0.00

0.00 0.00

0.00 5,274.01

GST borne by LIC of lndia t 118.66

FIVE THOUSAND TWO HUNDRED SEVENTY FOUR RUPEES AND ZERO PAISE ONLY

Shavukath Ali Shaik

Consolidated Stamp Duty Paid
Dr.S.S.Ali
D.No.6-2-1 94,Kovur Nagar csDlT 012021 12092 DATED - 24.06.2021
Anantapuramu

515001 Payment Acknowledgement generated through

on 01-Jan-22 Time : 11:00:56.
Onfine Portal
Mobile: 94******64
Email: sh***"*"**li@gmail.com
For Payment related queries-Email: bo-eps1 @licindia.com

:
This receipt is electronically generated and no signature is requiled

Har Pal Aapke Saathl

 0311212O22, 11.,22 LIC HFL

ts} LIU Hr l-I

w6tu
Lrc UgI}IG F'FIAH LTF
LIC Housing Finance Ltd

Ref. LA.71070000s600
03-12-2022

MR SHAVUKATH ALI SHAIKA4S SHAIK ZEENAB KARISHMA

D.NO. 14.77 -1, I ST FLOOR,DURGA

KAILASH NAGAR,
SALAGRAMAPURAM,
VI SAKAPATNAM, S IVALAYAM
ROAD, VISAKHAPATNAM,
ANDHRA PRADESH . 530024

Dear Sir/Madam,
Re: Provisional Certificate of installment amount under your Loan A/C No.710700005600
of MS SHAIK ZEENAB KARTSHMA, PAII : GUUps3xzg,MR SHAVUKATH ALI
SHAIK, PAN : AZJPS0370F for the financial year 2022-2023

This is to certi& that we would have received from you the following amounts in respect
of
your above loan account during the period from 0l/04lzozz to 3llCf,72023.

Toward Principal : 291707.85 Toward Interest : 4013g0.15

Towards Premium :0

Date Of Loan Sanctioned: 1010312022 Sanction Amount : 5200000

Purpose : Home Entity Loan

LIC Housing Finance Ltd.

LIC HFL PAN: AAACLITI}C

This is a computer generated statement hence does not require

signature.

hft ps ://cu stomer. lichousing.com/authorized/repay_certificate. php

1t1
 0311212022, 11:21 LIC HFL

L
I$
ustFIs
HTL
Fr
LIC Housing Finance Ltd

Ref. LA.710700004626 03-12-2022

MR SHAWKATHALI SHAIK

D.NO. 14-77 -1, lST FLOOR,DURGA

KAILASH NAGAR,
SALAGRAMAPURAM,
VISAKAPATNAM, S IVALAYAM
ROAD, VISAKHAPATNAM,
ANDHRA PRADESH - 530024

Dear Sir/\rladam,
Re: Provisional Certificate of installment amount under your Loan A/C No.710700004626
of MR SHAVUKATH ALI SHAIK, PAN : AZJPS0370F for the financial year 2022-2023

This is to certiff that we would have received from you the following amounts in respect of
your above loan account during the period from 01104/2022 to 3110312023.

Toward Principal : 132992.39 Toward Interest :235767.61

Towards Premium :0

Date Of Loan Sanctioned: llll2l2020 Sanction Amount : 2500000

Purpose : Home Entity Loan

LIC Housing Finance Ltd.

LIC HFL PAN: AAACLIT99C

This is a computer generated statement hence does not require signature.

https://customer. lichousing.com/authorized/repay_certifi cate. php

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Beneficiary name : CAIRO UNIV EGypT r'{i

Bent-.ficiary Bank name : CENTRAL BANK OF EGypT CATRO !
2 0 JUN 2023
\
Type of request: Outward Remittance of USD 3000 1

i
i
Date of receipt: 20-06-2023 J
rl.i
tto t,

Signature of the authorized official

Notr::- iienlittance Charges include charges up to beneficiary bank/correspondent

Bank only
Als f 'l asc'. note that your remittance ap-plication will b_e processed at our Global
Market Unit,Kolkata. As your account
will q' t iebited a lrttle later, at the tlme 6tprocessing of the remittance oJring the course
oiin'u'0"v,'iruase ensure that
tlte.rr litct'inyouraccountisadequate.ifyourtraisactionriitsorJto-insrftici'";,..li01"""#yo"rfily"nrr"tobear
excharntle loss, if any.
Pleas': also note that in the..event of-your remittances being.returned by the overseas
bank, there may be charges
deductcd by that bank. Further, the foreign currencytmouit on return'wirr u" i"-"i"oit;'ilil;#;unt
whicli r,;ay entail exchange loss. in rupees

Thank ,.,ou.

in
Beneficiary name : CARTO UNtV EeypT
Beneficiary Bank name : CENTRAL BANK OF EGypT CAIRO
Type of request: Outward Remittance of USD 3000
Date of receipt: 20-06-2023

Signature of the authorized official

Note:- Remittance include charges up to beneficiary banUcorrespondent Bank only

Also Please note that

nt is

Please also note that in the event of remittances being returned by the overseas bank, there may be charges
deducted by that bank. Further, the cy amount on return will be re-credited to your account in rupees
which may entail exchange loss.
Thank you.

State Bank of lndia to use, share,

any manner in connection with the
and that
its

in
Cusic'rner Acknowledgement copy (to be returned to the customer)
sTR.. 0111123T55290823
/VC trr:: 00000020073185918 tuC Holder Name: SHAIK SHAVUKATH ALI
Belr..r,.iary Account No : EG380001000'100000004082177481
SBI l.-orex Outward Remittance

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r
o Name SHAIK MOHAMMED RAHIMAN ALI
) Father's Name SHAIK SHAYUKATH ALI )
Othar Fees- Rs.5500.00
Tutlon Fee-Term-l Rs.160t)0.0(}
) )
Total Psiqi Rr.21 500
Balance Rs,30500.00
) Totrl Peld Amount Tb'cnty OnC TlroUsurd Fivc Hundrcd Rupecri only/-
)
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arcd Bv NEXGEN EDUCATIONAL
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)
Parent