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IT Declaration - Form 12BB

The document provides details on an income tax form for employees to claim deductions from their taxable income. The form includes sections for employee information, claims being made including house rent allowance, leave travel concessions, interest deductions, and deductions under Chapter VI-A such as those allowed for insurance premiums, tuition fees, investments and medical expenses.

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37 views4 pages

IT Declaration - Form 12BB

The document provides details on an income tax form for employees to claim deductions from their taxable income. The form includes sections for employee information, claims being made including house rent allowance, leave travel concessions, interest deductions, and deductions under Chapter VI-A such as those allowed for insurance premiums, tuition fees, investments and medical expenses.

Uploaded by

mkharb941
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as DOC, PDF, TXT or read online on Scribd
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INCOME-TAX RULES ,1962

FORM NO.12BB
(See rule 26C)
Statement showing particulars of claims by employee for deduction of tax under section 192

Employee ID: _______________

1. Name and address of the employee:

2. Permanent Account Number of the employee:


2021-22
3. Financial year

Details of claims and evidence thereof

Sl No. Nature of claim Amount Evidence /


(Rs.) particulars
1 House Rent Allowance:

(i) Rent paid to the landlord 0

(ii) Name of the landlord

(iii) Address of the landlord

(iv) Permanent Account Number of the landlord:

Note: Permanent Account Number shall be furnished if the aggregate rent


paid during the year exceeds one lakh rupees
2 Leave travel concessions or assistance 0

3 Deduction of interest on borrowing:

(i) Interest payable/paid to the lender 0

(ii) Name of the lender

(iii) Address of the lender

(iv) Permanent Account Number of the lender

(a) Financial Institutions(if available)

Unrestricted
(b) Employer(if available)

(c) Others

4 Deduction under Chapter VI-A

(A) Section 80C,80CCC and 80CCD

(i)Section 80C

a LIC Premium Paid 0

b Unit Linked Insurance Plan (ULIP) 0

c Public Provident Fund (PPF) 0

d Investment in Term Deposits (5 Years and Above) 0

e Housing Loan - Principal Repayment (Possession or completion of 0


certificate mandatory) and payment towards stamp duty/ registration
fees towards cost of residential property purchased
f Mutual Funds- Tax saver Scheme/ELSS (Only actual amount invested 0
in the current FY will be considered)
g Other Investments U/S 80C 0

h Tuition Fees (Only tuition fees component of school fees paid ) 0

I Purchase of NSC VIII issue 0

J Post Office Saving Scheme - Only actual amount invested in the 0


current FY will be considered
K Investment in NPS - (National Pension Scheme) – Only investment 0
made outside SIEMENS
L Sukanya Samriddhi Scheme 0

(ii) Section 80CCC

Contribution to Pension Fund 0

(iii) Section 80D

Medical Insurance Premium - Self & Spouse – Only Insurance availed 0


outside SIEMENS
Medical Insurance Premium – Parents - Only Insurance availed 0
outside SIEMENS Senior CTZN
Preventive Health Check up 0

(iv) Section 80DD

Medical treatment of a dependent who is a person with disability 0

(v) Section 80E

Unrestricted
Repayment of Interest on Loan for Higher Education 0

Verification

I, ___________________________, son/daughter of____________________________ do hereby certify that


the information given above is complete and correct.

Place:

Date: 11/04/2024
(Signature of the employee)

Designation:

Unrestricted
Unrestricted

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