Form 12BB generated using Myitronline.com
02/26/2022 22:17:23

FORM NO.12BB

[See rule 26C]

Statement showing particulars of claims by an employee for deduction of tax under section 192

Name and address of the employee: BHAGAT RAM
GOVERNMENT PRIMARY SCHOOL, GAUGHAT PO-UTTAM NAGAR, TEH-KICHHA U.S.NAGAR PIN-263148
bhagatgnsso@gmail.com
Permanent Account Number of the employee: BFAPR6704N
Financial Year: 2021-22

Details of claims and evidence thereof

S.No. Nature of claim Amount(Rs.) Evidence/Particulars
1 House Rent Allowance:
(i) Rent paid to the landlord 99600
(ii) Name of the landlord PANULI DEVI
(iii) Address of the landlord VILL-GANDHI NAGAR, BINDUKHATTA NEAR TUTI PULIYA PO-LALKUAN, DIST-NAINITAL UK-262402
(iv) [Permanent Account Number or AadhaarNumber] of the landlord
Note: [Permanent Account Number or Aadhaar Number] shall be furnished if the aggregate rent paid during the previous year exceeds one lakh rupees
2 Leave Travel Allowance / Concession (LTA / LTC)