ISGEC HEAVY ENGINEERING LTD.

Noida
FORM NO. 12B
[See rule 26A]

Form for furnishing details for income under section 192(2) for the year ending 31st March, 2022
[To be filled by the employee, joined after 1st April 2018 only.]
Name and address of the employee : KIRAN KUMAR PATRA
Permanent Account No. : BRVPP9060J
Residential status :
Date of Joining : 22/03/2021

Serial Name and TAN of the Permanent Period of Particulars of salary as defined in section 17, paid or due to Total of Amount deducted Total Remarks
Number address of employeer(s) Account Employment(For be paid to the employee during the year columns in respect of life Amount of
Employer(s) as allotted Number of Current Year 6, 7 and insurance tax
Total amount of Total amount of Value of
by the ITO the only) 8 premium,provident deducted
salary excluding house rent allow- perquisites and
employer(s) fund contri-bution, during the
amounts ance, convey- amount of accre-
etc. to which year
required to be ance allowance tion to employee’s
section 80C$ (enclose
shown in and other allow- provident fund
applies (Give certificate
columns 7 and 8 ances to the account(give
details) issued
extent chargeable details in the
under
to tax[See section Anne-xure)
secgtion
10(13A) read with
203)
rule 2A and
section 10(14)

1 2 3 4 5 6 7 8 9 10 11 12

1 , To 0.0 0.0 0.0

2 , To 0.0 0.0 0.0

KIRAN KUMAR PATRA

Signature of the employee

Phone: 0120-408-5428 • Email: tds@isgec.co.in • Website: http://www.isgec.com

Page: 1 / 3
 ISGEC HEAVY ENGINEERING LTD.
Noida

Verification

I, KIRAN KUMAR PATRA , do hereby declare that what is stated above is true to the best of my knowledge and belief. Verified today, the 04-07-21 day of Sunday .
Place ....................
KIRAN KUMAR PATRA
Signature of the employee

ANNEXURE
[See column 8 of Form No. 12B]

Particulars of value of perquisites and amount of accretion to employee’s provident fund account
Name and address of the employee KIRAN KUMAR PATRA
Permanent Account No. : BRVPP9060J Period: Year ending 31st March : 2022

Name of the TAN/PAN of Value of rent free accommodation or value of any concession in rent for the accommodation provided by the employer (give basis of computation) [See rules 3(a) and
employee the employer 3(b)

Where Where accommodation is furnished Rent, if Value of

accommodation any, prequisite(column
Value as if accommodation is Cost of furniture(including Perquisite value of Total of
is unfurnished paid by 3 minus column 8
unfurnished television sets, radio furniture (10% of column columns
emplyee or column 7
sets,refrigerators, other household 5) OR actual hire charges 4 and 6
minus column 8
appliances and air- payable
as may be
conditioningplant or equipment)OR
applicable
hire charges, if hired from a third
party

1 2 3 4 5 6 7 8 9

KIRAN
KUMAR
PATRA

Phone: 0120-408-5428 • Email: tds@isgec.co.in • Website: http://www.isgec.com

Page: 2 / 3
ISGEC HEAVY ENGINEERING LTD.
Noida

ANNEXURE
(Contd.)

Whether any conveyance has been Remuneration Value of free or Estimated value of any other benefit or amenity Employer’s Interest credited to the Total of
provided by the employer free or at a paid by employer concessional passages provided by the employer,free of cost or at contribution to assesse’s account in columns
concessional rate or where the for domestic on home leave and concessional rate not included in the preceding recognised recognised provident 9 to 15
employee is allowed the use of one or and/or personal other travelling to the columns (give details), e.g. supply of gas, provident fund in fund in excess of the carried
more motor cars owned or hired by the services provided extent chargeable to electricity or water for household consumption, excess of 10% of rate fixsed by the to
employer, estimated value of perquisite to the tax (give details)[See free educational facilities, transport for family, etc. the employee’s Central Government column
(give details) [See rule 3(c)] employee(give rule 2B read with [See rules 3(d), 3(e) and 3(f)] salary [See [See Sechedule IV – 8 of
details) [See rule section 10(5)(ii)] Schedule IV – Part A] Form
3(g)] PartA] No. 12B

10 11 12 13 14 15 16

Phone: 0120-408-5428 • Email: tds@isgec.co.in • Website: http://www.isgec.com

Page: 3 / 3