INCOME­TAX RULES,1962

FORM No. 12BB

(See rule 26C)

Statement showing particulars of claims by an employee for deduction of tax under section 192
Company Name :­ PAYSQUARE CONSULTANCY LTD

1. Name and address of the employee: Mr. Amol Kolhe

2. Permanent Account Number of the employee: DTQPK4272L
3. Financial year: 2023­2024

Details of claims and evidence thereof

Amount Evidence/
Sl.No. Nature of claim
(Rs.) Particulars
(1) (2) (3) (4)
1. House Rent Allowance: 0 Landlord Declaration
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 0.00

3. Deduction of interest on borrowing:

4. Deduction under Chapter VI­A

(A) Section 80C,80CCC and 80CCD
(i) Section 80C
(a) Provident Fund:
(b) Voluntary Provident Fund:
(c) Employee's National Pension Scheme
80CCD(1):
(d) Housing Loan Principal:
(e) Life Insurance Premium:
(f) National Saving Certificate:
(g) National Saving Certificate Accrued Interest:
(h) Public Provident Fund:
(i) Unit Linked Insurance Plan:
(j) E.L.S.S (Tax Saving Mutual Fund):
(k) Tuition fees for 2 children:
(m) Tax Saving Shares/NABARD and Other Bonds:
(n) Tax saving Fix Deposits (Tenure ­5 years or
more):
(o) Stamp Duty & Registration:
(p) Other Investment:
(q) Post Office Time Deposit Scheme:
(r) Senior Citizen Saving Scheme:
(s) Sukanya Samriddhi Scheme:

(ii) Section 80CCC

(a) Pension Plan from Insurance
Companies/Mutual Funds :
(iii) Section 80CCD
(a) Employer's National Pension Scheme
80CCD(2):
(B) Other sections (e.g. 80E, 80G, 80TTA, etc.) under
Chapter VI­A
(a) Equity Savings Scheme (80­CCG):
(b) Additional contribution to NPS 80CCD (1B):
(c) Mediclaim (80­D):
(d) Handicapped Dependent (80­DD):
(e) Treatment of Specified Diseases (80­DDB):
(f) Interest on Educational Loan (80­E):
 (g) Donation (80­G):
(h) Physically Handicapped (80­U):
(i) Interest on deposit in Saving account
(80TTA):
(j) Interest on deposit For Senior citizen only
(80TTB):
(k) Interest on loan for purchase of Electric
Vehicle (80EEB):
(l) Donations for scientific research / rural
development (80GGA):
(m) Donation to registered political party /
electoral trust (80GGC):
5. Income From Let Out House Property:

Verification
I, Mr. Amol Kolhe ,son/daughter of Bhausaheb _______________________________________________ do
hereby certify that the information given above is complete and correct.

Place:
Date:26/06/2023 (Signature of the employee)
Designation:Analyst Full Name:Mr. Amol Kolhe