PllForm12bb

FORM NO.12BB

FORM NO.12BB
(See rule 26C)
1. Name of the employee:
2. Permanent Account Number of the employee:
3. Financial year 2024-25
Details of claims and evidence thereof
Sl No. Nature of claim Amount (Rs.)
1 House Rent Allowance: (Not Applicable under NEW TAX Regime)  
  (i) Rent paid to the landlord per month
  (ii) Name of the landlord
  (iii) Address of the landlord
  (iv) Permanent Account Number of the landlord
  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 (Not Applicable under NEW TAX Regime)
3 Deduction of interest on Home Loan: (Not Applicable under NEW TAX Regime)  
  (i) Interest payable/paid to the lender
  (ii) Name of the lender
  (iii) Address of the lender
  (iv) Permanent Account Number of the lender
4 Deduction under Chapter VI-A (Not Applicable under NEW TAX Regime)  
  Sec. 80C -LIC/PPF/Housing Loan/Tution Fee etc. up to Rs. 1,50,000/-
  Sec.80CCD (1)b - NPS up to Rs. 50000/-
  Sec. 80D - Medical Insurance & Expenses on Preventive Health Check-up
  Sec. 80DD - Expenses of Rehabilitation of Handicapped dependent
  Sec. 80DDB - Medical Expenses for Self or Dependent (For certain specified diseases only)
  Sec. 80E - Repayment of Interest on Loan for Higher Education
  Sec. 80EE - House Loan Interest Deduction over & above 2 Lacs(Low Cost Housing Loans)
  Sec. 80U - Deduction for Disabled Individual
B Telephone /Mobile/Internet Bills Amount
I, do hereby certify that the information given above is complete and correct.
Place:
Date: 17/09/2024 Full Name:
Designation: Father name:

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