Fill only colored cells

(Company Name)

FORM NO.12BB
(See rule 26C)

Statement showing particulars of tax investment claims by an employee for deduction of tax under section 192 Investment Tax Submission Form - Financial year:
2022-2023

Name Employee Id Date of Joining

Address

Permanent Account Number of the employee:

Contact Number
Gender
No Of School Going Children

Name of the Spouse,Children, Dependents(Parents)

Rent Paid details for claiming HRA Exemption(Note: Land Lord Permanent Account Number shall be furnished if the aggregate rent paid during the financial year(April
2022 to March 2023 exceeds one lakh rupees).
From date To date Location Name Metro/Non Land Lord PAN Land Lord Name and Address Rent Paid per Month(Amount
(City/Town) Metro in Rs.)

Deduction under Chapter VI-A(PF,VPF deducted from Salary will be automatically considered in Rs: 1,50,000 exemption) Amount in Rs.(Per Annum)
(A) Section 80C,80CCC and 80CCD(1) - Overall Deduction limited to Rs. 1,50,000/- Eligible if made in the Deduction Limit
name of
1)Contribution to Pension Fund (U/s 80CCD (1)) Self 10% of Salary

2) PF Contribution Self

3)Life Insurance Premium Self/Spouse/Children

4)Public Provident Fund(PPF) Self/Spouse/Children

5)National Savings Certificate(NSC) Self

6)NSC Interest Self

7)Children Tution Fee-(Only for Children) Only for Children

8)Investment in Term Deposits(Period of 5 yrs or more) in a Scheduled Bank/Post Office Self

9)Equity Linked Savings Scheme(ELSS) Self

10)Housing Loan-Stamp duty/Registration Charges/Principal Amount repayment Self

11)ULIP Self

12)Sukanya Samriddhi Scheme Only for Girl Children

13)Mutual Fund Self

Any others (Provide details)

(B)Section 80CCD(1B)
14) National Pension Scheme U/S 80CCD(1B) Self 50,000
(C) Other sections (e.g. 80E, 80D,80DDB,80U,80DD etc.) under Chapter VI-A
15)Medical Insurance Premium U/s 80D (including Preventive Master Health Check up-
Maximum Limit 5,000) - Overall Deduction limited to Rs. 1,00,000/- as below mentioned
a. In Respect of Parents - Overall Deduction limited to Rs. 50,000/-

(i) Senior Citizen 50,000

(ii) Other than Senior Citizen 25000

b. In Respect of Self, Spouse and Children - Overall Deduction limited to Rs. 50,000/-

(i) Senior Citizen 50,000

(ii) Other than Senior Citizen 25000

16) Medical Treatment/Handicapped Dependent(U/S 80DD)

a. Disability is 40% or more but less than 80% Dependent 75,000

b. Disability is 80% or more Dependent 1,25,000

17) Physical Disability (U/S 80U)

a. Physical disability (including blindness) or mental retardation Self 75,000

b. Severe disability Self 1,25,000

18) Medical Expenditure on Self or Dependent Relative (U/S 80DDB)

a. Other than Senior Citizen Self and Dependent 40,000

b. Senior Citizen Self and Dependent 1,00,000

19) Interest on Educational Loan(U/S 80E) (Only the interest Part is allowed) No Limit
Self/Spouse/Children/D
ependent
20) U/s 80EE :- Extra Rs. 50,000 deduction is available for first time home buyers. Where Loan amount Self 50,000
upto Rs. 35,00,000 and total house value should not exceed Rs.50Lakhs, Loan should be Sanctioned in the
F.Y-2016-17
21) Interest on Saving Account- 80TTA Self (other than Senior 10,000
Citizen)
22) Interest on Deposits- 80TTB (Can not claim Deduction U/s 80TTA) Self (Senior Citizen) 50,000

Other Income
Other Income (Specify Nature)
PREVIOUS EMPLOYER INCOME DETAILS - FORM 16 OR Signed tax computation sheet from the previous employer is must for considering
the declaration. This is applicable for the new Joinees Joined after 1st April 2022 and the Income earned for the period April 2022 to
March 2023

1)Salary Paid by the Previous Employer after Section 10 exemptions before anyother deductions
2)Professional Tax deducted by the Previous Employer
3)Provident Fund deducted by the Previous Employer
4)Income Tax deducted by the Previous Employer
Verification

I,…………………..,son/daughter of……………………….. do hereby certify that the information given above is complete and correct.

Place: Hyderabad

Date: 08/04/2022
(Signature of the employee)
Please fill only coloured Cells
FORM 12C

Applicable Only if the House Property Construction is completed and possession taken
HOUSE PROPERTY INCOME/LOSS DETAILS - Maximum Interest can be allowed Rs. 2,00,000/-
SELF OCCUPIED PROPERTY 1
Address of the Property:

Date of Availing Loan

Date Of Completion/Possession of Property
Name of the Lender(Bank/ NBFC)
Interest Paid to Housing Loan (Enter the value in Positive)
If Joint Property % of share 100%
Income/Loss from House Property 0

SELF OCCUPIED PROPERTY 2

Address of the Property:

Date of Availing Loan

Date Of Completion/Possession of Property
Name of the Lender(Bank/ NBFC)
Interest Paid to Housing Loan (Enter the value in Positive)
If Joint Property % of share 100%
Income/Loss from House Property 0

LET OUT PROPERTY

Address of the Property-1

Date of Availing Loan

Date Of Completion/Possession of Property
Name of the Lender(Bank/ NBFC)
If Joint Property % of share 100%
Rent Received Per Annum 0
Less: Property Tax 0
Net Annual Value 0
Less: Standard Deduction @ 30% 0
Interest Paid to Housing Loan(Enter the value in Positive) 0
Income/Loss from House Property 0
Address of the Property-2

Date of Availing Loan

Date Of Completion/Possession of Property
Name of the Lender(Bank/ NBFC)
If Joint Property % of share 100%
Rent Received Per Annum 0
Less: Property Tax 0
Net Annual Value 0
Less: Standard Deduction @ 30% 0
Interest Paid to Housing Loan(Enter the value in Positive) 0 0
Income/Loss from House Property 0
Address of the Property-3

Date of Availing Loan

Date Of Completion/Possession of Property
Name of the Lender(Bank/ NBFC)
If Joint Property % of share 100%
Rent Received Per Annum 0
Less: Property Tax 0
Net Annual Value 0
Less: Standard Deduction @ 30% 0
Interest Paid to Housing Loan(Enter the value in Positive) 0 0
Income/Loss from House Property 0
TOTAL LOSS/INCOME FROM HOUSE PROPERTY 0

Note:ALL THE FIELDS ARE MANDATORY TO CLAIM EXEMPTION

1. In case of Self-occupied property,(that is Property which is not Let Out for Rent) Annual Lettable value will be NIL .If the
property is let-out,then the annual Lettable Value will be the Actual Rent for which the house is Let Out to be mentioned.

2.The Real Owner of the House Property ( One who has actually financed for the construction/Purchase of the House either
from out of his own funds OR out of Borrowed money from Bank/Finacial Institiution) only will be allowed to claim the
deduction under the income Tax act for the Interest on Home Loan paid for Income tax purpose.

3.In the case of Loan sanctioned on Joint names pl. mention the share % so that deduction can be availed accordingly.

4.As Per Amended Finance act 2017, the maximum limit for exemption under Loss from House property is restricted to (-
200000/-) and further any loss can be carry forwarded for next 8 Years
Place : SIGNATURE OF THE EMPLOYEE
Date :