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Form No.12Bb: Details of Claims and Evidence Thereof

The form requests information such as the employee's name, PAN number, and financial year. It then lists various types of claims that can be made including house rent allowance, leave travel concessions, interest deductions on loans, and deductions under Section 80C, 80CCC, 80CCD of Chapter VI-A of the Income Tax Act. For each claim, the employee must provide details like amount, recipient/lender name and address, and PAN as applicable. The employee also needs to verify the information and sign with their designation and full name.

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46 views

Form No.12Bb: Details of Claims and Evidence Thereof

The form requests information such as the employee's name, PAN number, and financial year. It then lists various types of claims that can be made including house rent allowance, leave travel concessions, interest deductions on loans, and deductions under Section 80C, 80CCC, 80CCD of Chapter VI-A of the Income Tax Act. For each claim, the employee must provide details like amount, recipient/lender name and address, and PAN as applicable. The employee also needs to verify the information and sign with their designation and full name.

Uploaded by

sujups
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as XLSX, PDF, TXT or read online on Scribd
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FORM NO.

12BB
(See rule 26C)

1. Name and address of the employee:


2. Permanent Account Number of the employee:
3. Financial year:

Details of claims and evidence thereof


Sl No. Nature of claim Amount (Rs.) Evidence / particulars

(1) (2) (3) (4)


1 House Rent Allowance:
(i) Rent paid to the landlord
(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
previous year exceeds one lakh rupees

2 Leave travel concessions or assistance


3 Deduction of interest on borrowing:
(i) Interest payable/paid to the lender
(ii) Name of the lender
(iii) Address of the lender
(iv) Permanent Account Number of the lender
(a) Financial Institutions(if available)
(b) Employer(if available)
(c) Others
4 Deduction under Chapter VI-A
(A) Section 80C,80CCC and 80CCD
(i) Section 80C
(a) ………………..
(b) ………………..
(c) ………………..
(d) ………………..
(e) ………………..
(f) ………………..
(g) ………………..
(ii) Section 80CCC
(iii) Section 80CCD
(B) Other sections (e.g. 80E, 80G, 80TTA, etc.)
under Chapter VI-A.
(i) section……………….
(ii) section……………….
(iii) section……………….
(iv) section……………….
(v) section……………….
Verification
I,…………………..,son/daughter of……………………….. do hereby certify that the information given above
is complete and correct.
Place……………………………………………...
Date…………………………………………….... (Signature of the employee)
Designation ……………………………….…. Full Name

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