Sr. No.

Ca

sh

co

mp

on

en

ts

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17

18

19 20 21 22

Va

ria

ble

23 24 25 26 27 28 29

Be

ne

fits

30

Re

tire

me

nt

be

ne

fits

Be

ne

fits

31 32 33 34 35 36 37

38

Note:

Documents Required

1) Last 2 months Pay Slip (mandatory)

2) Offer / Latest Increment Letter (mandatory)

3) F&F Settelement (in case presently unemployed)

4) Form 16

5) If for certain components, no documentation is available; then bank statement of deposits by the company

Components

BasicHRAMedical reimbursement/allowanceConveyanceSkill allowance/skill premiumSpecial allowance/other allowance/personal pay/personal allowanceProfessional development allowanceTransport allowanceLTA (LeaveTravel Allowance)Telephone reimbursementFood subsidyChildren Education AllowanceCar reimbursement / car lease (Actual amount recd p.a)Fixed Dearness Allowance

Other component (if any please name it)Other component (if any please name it)

Gross Salary(sum of 1 to 17)

Employer's contribution to PFGratuityBonusTotal fixed compensation ( sum of 18 to 21)

Voice AllowancePerformance bonus/Variable bonus (actual amount recd.)Statutory bonusEx - gratiaSuper annuationShift AllowanceTotal Cash Compensation (sum of 22 and 24 to 28)

Mediclaim premium (not coverage amount)

Accidental Insurance premium (not coverage amount)Life insurance premium (not coverage amount)Home Loan interest subsidy - actual amount received as benefitVehicle Car Loan interest subsidy - actual amount received as benefitPersonal Loan interest subsidy - actual amount received as benefitOther component (if any please name it)Other component (if any please name it)

Total Cost to Company (sum of 29 to 36)

Documents Required

1) Last 2 months Pay Slip (mandatory)

2) Offer / Latest Increment Letter (mandatory)

3) F&F Settelement (in case presently unemployed)

5) If for certain components, no documentation is available; then bank statement of deposits by the company

You need to produce supporting documents for components you have mentioned above. In case you don't have document for particular component to support please declare now in column F against that component

Amount Per annum (Yearly component)

14509 174,108 1899 22,788 1187 14,244

- - 475 5,700

1187 14,244

1100 13,200 -

244,284 -

1873 22,476 751 9,012

1200 14,400 290,172 -

2500 30,000

- - - -

500 6,000 - 296,172 -

Salary break up (Per month)

To be Filled by the candidate.(Per annum)

To be Filled by the Recruiter (verified wrt documents)

-

Vehicle Car Loan interest subsidy - actual amount received as benefit

296,172 -

5) If for certain components, no documentation is available; then bank statement of deposits by the company

You need to produce supporting documents for components you have mentioned above. In case you don't have document for particular component to support please declare now in column F against that