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LTA Declaration Form 2014-2017

This leave travel assistance declaration form requests information from an employee about any leave travel assistance claimed and whether it was taxable or non-taxable from 2014 to 2017. The employee must provide details such as the amount and date of travel for any assistance received during each yearly period. The employee signs to certify the information is true and correct.

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3K views1 page

LTA Declaration Form 2014-2017

This leave travel assistance declaration form requests information from an employee about any leave travel assistance claimed and whether it was taxable or non-taxable from 2014 to 2017. The employee must provide details such as the amount and date of travel for any assistance received during each yearly period. The employee signs to certify the information is true and correct.

Uploaded by

Paymaster Services
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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LEAVE TRAVEL ASSISTANCE DECLARATION FORM:

To
The Payroll Department

Employee's Payroll Code


(As shown on the Payslip)

Dear Sir,

I,

hereby declare the following with respect to

Leave Travel Assistance claimed by me during the block January 1, 2014 to December 31, 2017.

LTA claimed on Taxable Basis

LTA claimed on Non-Taxable Basis

(If Yes then mention amount

(If Yes then mention amount

and the date of travel)

and the date of travel)

January 1, 2014 to

Yes / No

Yes / No

December 31, 2014

Date

Date

Rs.

Rs.

January 1, 2015 to

Yes / No

Yes / No

December 31, 2015

Date

Date

Rs.

Rs.

January 1, 2016 to

Yes / No

Yes / No

December 31, 2016

Date

Date

Rs.

Rs.

January 1, 2017 to

Yes / No

Yes / No

December 31, 2017

Date

Date

Rs.

Rs.

Period

I certify that the above information is true and correct.


Yours faithfully,

Signature of Employee

LTA Declaration.xls LTA Declaration 28/09/2015

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