Page No : 1

T5002431622 Dec 2023 FY2024101112489

Tax Proof FY 23-24
RefNo:50024316
Employee Code 101112489 Name Iqtehdar Saiyed

Department PAN FXGPS3987A

Life Insurance Premium

Declared Proof Cleared Remarks

125944 121440

Amoun
Number of Amoun t
Name of Number of Installmen t Paid Payabl
the Installmen t Payable on or e on or Total
Insuranc Date of t Paid on on or after before Amount FY
e Commenceme Sum or after before 1st Apr 31st 23-24 Paid
Compan nt Assure Premiu Frequenc 1st Apr 23 31st Mar 23(Amt Mar AmtPayabl Relationshi
y Policy No. (dd/mm/yyyy) d m Amt y Count 24 Count ) 24Amt e Amt p

LIC 919451603 28/02/2022 3440000 15180 Quarterly 3 1 45540 15180 60720 Self

LIC 928899167 28/02/2022 3440000 15180 Quarterly 3 1 45540 15180 60720 Self

80D - Medical Insurance

Declared Proof Cleared Remarks

25000 25000

Number Amou
of Amou nt
Number Installm nt Paya
of ent Paid ble
Name Installm Payable on or on or Total
of the ent Paid on or after befor Amount
Insuran Premi on or before 1st e 31st FY 23-24
ce Co / Date um / after 1st 31st Mar Apr Mar Paid Age
Catego Instituti (dd/mm/yy Bill Freque Apr 23 24 23(A 24Am AmtPaya Gro Relations
ry on Policy/Bill No yy) Amt ncy (Count) Count mt) t ble Amt up hip Mode

Medical National NICHLIP21558V06 05/04/2023 25000 Yearly 1 0 25000 0 25000 Belo Self / Cheq
Insuran Insuranc 2021 w 60 Spouse / ue
ce e Year Children
Compan s
y
Limited

Medical insurance premium paid for Parent

Employee Code : 101112489 Date : 22 Dec 2023

 Page No : 2

Declared Proof Cleared Remarks

50000 45389

Number Amou Amou

Number of nt nt
of Installme Paid Payab
Name of Installme nt on or le on Total
the nt Paid Payable after or Amount
Insuran on or on or 1st before FY 23-24
ce Co / Date Premiu after 1st before Apr 31st Paid Age
Catego Instituti Policy/Bil (dd/mm/yy m / Bill Frequen Apr 23 31st Mar 23(Am Mar AmtPaya Grou Relations
ry on l No yy) Amt cy (Count) 24 Count t) 24Amt ble Amt p hip Mode

Medical Tata AIG 70001932 18/12/2023 45389 Yearly 1 0 45389 0 45389 60 Parents Chequ
Insuranc General 46 Year e
e Insuranc s and
e Abov
Compan e
y
Limited

80G

Declared Proof Cleared Remarks

150000 150000

Name of the Approved Charitable Percentage of Amount donated to Approved Charitable Benefit allowed for tax
Fund/Institution Benefit Fund/Institution for FY2324 purpose

An approved university/educational institution of 100 150000 150000

National eminence_100

Rent

Landlor
Rental Other Rental Landlord Landlor Landlor d
Rent Locatio Locatio Amou Landlord Landlord Address d Name d PAN Addres
Month n n nt Rental Address Name 1 PAN 1 1 2 2 s2

April Mumbai 25000 A-501,Suba Zirkon Apartments, Reshmaba DSAPS2789 A-

Chakala, Mumbai nu Saiyed K 502,Suba
Zirkon
Apartment
s,
Chakala,
Mumbai

May Mumbai 25000 A-501, Suba Zirkon Apartments, Reshmaba DSAPS2789 A-

Chakala, Mumbai nu Saiyed K 502,Suba
Zirkon
Apartment
s,

Employee Code : 101112489 Date : 22 Dec 2023

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Chakala,
Mumbai

June Mumbai 25000 A-501,Suba Zirkon Apartments, Reshma DSAPS2789 A-

Chakala, Mumbai Saiyed K 502,Suba
Zirkon
Apartment
s,
Chakala,
Mumbai

July Mumbai 25000 A-501, Suba Zirkon Apartments, Reshmaba DSAPS2789 A-

Chakala, Mumbai nu Saiyed K 502,Suba
Zirkon
Apartment
s,
Chakala,
Mumbai

August Mumbai 25000 A-501, Suba Zirkon Apartments, Reshmaba DSAPS2789 A-

Chakala, Mumbai nu Saiyed K 502,Suba
Zirkon
Apartment
s,
Chakala,
Mumbai

Septembe Mumbai 25000 A-501, Suba Zirkon Apartments, Reshmaba DSAPS2789 A-502,
r Chakala, Mumbai nu Saiyed K Suba
Zirkon
Apartment
s,
Chakala,
Mumbai

October Mumbai 25000 A-501, Suba Zirkon Apartments, Reshmaba DSAPS2789 A-502,
Chakala, Mumbai nu Saiyed K Suba
Zirkon
Apartment
s,
Chakala,
Mumbai

November Mumbai 25000 A-501, Reshmaba DSAPS2789 A-502,

SubaZirkonApartments,Chakala,Mu nu Saiyed K Suba
mbai Zirkon
Apartment
s,
Chakala,
Mumbai

December Mumbai 25000 A-501, Reshmaba DSAPS2789 A-502,

SubaZirkonApartments,Chakala, nu Saiyed K Suba
Mumbai Zirkon
Apartment
s,
Chakala,
Mumbai

Employee Code : 101112489 Date : 22 Dec 2023

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January Mumbai 25000 A-501, Suba Zirkon Apartments, Reshmaba DSAPS2789 A-502,
Chakala, Mumbai nu Saiyed K Suba
Zirkon
Apartment
s,
Chakala,
Mumbai

February Mumbai 25000 A-501, Suba Zirkon Apartments, Reshmaba DSAPS2789 A-502,
Chakala, Mumbai nu Saiyed K Suba
Zirkon
Apartment
s,
Chakala,
Mumbai

March Mumbai 25000 A-501, Suba Zirkon Apartments, Reshmaba DSAPS2789 A-502,
Chakala, Mumbai nu Saiyed K Suba
Zirkon
Apartment
s,
Chakala,
Mumbai

Employee Code : 101112489 Date : 22 Dec 2023

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FORM NO. 12BB

(See rule 26C)
Statement showing particulars of claims by an employee for deduction of tax under section 192

1. Name and address of the employee: Iqtehdar Saiyed

2. Permanent Account Number of the employee: FXGPS3987A

3. Financial year: 2023 - 2024

Details of claims and evidence thereof

SI.No Nature of claim Amount Evidence / particulars

(Rs.)

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

1. House Rent Allowance:

(i) Rent paid to the landlord 300000

(ii) Name of the landlord

1. Reshmabanu Saiyed

(iii) Address of the landlord

1. A-502, Suba Zirkon
Apartments, Chakala,
Mumbai

(iv) Permanent Account Number of the landlord

1. DSAPS2789K

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

Employee Code : 101112489 Date : 22 Dec 2023

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(i) Section 80C

Life Insurance Premium 121440

(ii) Section 80CCC

(iii) Section 80CCD 0

(B) Other sections (e.g. 80E, 80G, 80TTA, etc.) under Chapter VI-A.

(i) Sec 80D - Medical Insurance 70389

Verification

Irshadali Saiyed
I, Iqtehdar Saiyed ,son/daughter of ____________________ do hereby certify that the information given above is complete and correct.

Place : MUMBAI
Date : 22/12/2023 (Signature of the employee)
Designation : Senior Associate Full Name: Iqtehdar Saiyed

Employee Code : 101112489 Date : 22 Dec 2023