Statement of Particulars of Income Under Heads of Income Other than “Salaries”

For Deduction of Tax at Source.

(See Rule 26B (1) of Income Tax Act, 1961.)

Emp Code:

Name of the Employee: Deptt.:

Address of the property

Date on which Possession of Property Taken :.

Amount of Loan Sanction Sanction Date

Name & Address of Bank

Income From House Property Amount(Rs.) Amount(Rs.)

(a) Gross Rental Value

(As per Section 23 of I.T. Act 1961.)

Less: Municipal Tax Paid

Net Annual Value

(b) Less: Deduction U/S 24:30% of net annual value

Value for repair & renewal

(c) Interest Paid/Payable on Housing Loan

Repayment

(d) Net Income/Loss from house property

a-(b+c)

Tax Deducted on above Income (if any)

Date:

Place: Signature of the Employee

FORM OF VERIFICATION
(See Rule 26B (2) of Income Tax Act,1961 )

I do declare that what is stated above is true to

the best of my information and belief.

Date:

Place: Signature of the Employee