Signature of the employeeIndianHyderabadEmployee ......Santhapuri Sunil Kumar 01 April 2017...
Transcript of Signature of the employeeIndianHyderabadEmployee ......Santhapuri Sunil Kumar 01 April 2017...
-
1 FO
RM
NO
. 12B
[See
rule
26A
]Fo
rm fo
r fu
rnis
hing
det
ails
of i
ncom
e un
der
sect
ion
192(
2) fo
r th
e ye
ar e
ndin
g 31s
t Mar
ch, …
……N
ame
and
addr
ess
of th
e em
ploy
eePe
rman
ent A
ccou
nt N
o.R
esid
entia
l sta
tus
Part
icul
ars
of s
alar
y as
def
ined
in s
ectio
n 17
, pai
dor
due
to b
e pa
id to
the
empl
oyee
dur
ing
the
year
Seri
alN
ame
and
TAN
of t
hePe
rman
ent
Peri
od o
fTo
tal a
mou
ntTo
tal a
mou
ntVa
lue
ofTo
tal o
fAm
ount
Tota
l am
ount
Rem
arks
Num
ber
addr
ess
ofem
ploy
eer(
s)Ac
coun
tem
ploy
men
tof
sal
ary
of h
ouse
perq
uisi
tes
colu
mns
dedu
cted
of ta
x de
duct
edEm
ploy
er(s
)as
allo
tted
Num
ber
ofm
ent
excl
udin
gre
nt a
llow
-an
d am
ount
6, 7
in r
espe
ctdu
ring
the
by th
eth
eam
ount
san
ce, c
onve
y-of
acc
re-
and
8of
life
year
(enc
lose
ITO
empl
oyer
(s)
requ
ired
toan
ce a
llow
ance
tion
toin
sura
nce
cert
ifica
tebe
sho
wn
inan
d ot
her
allo
w-
empl
oyee
’s
prem
ium
,is
sued
und
erco
lum
ns 7
ance
s to
prov
iden
tpr
ovid
ent
secg
tion
203)
and
8th
e ex
tent
fund
fund
char
geab
leac
coun
tco
ntri
-to
tax
(giv
e de
tails
butio
n, e
tc.
[See
sec
-in
the
to w
hich
tion
10(1
3A)
Anne
-se
ctio
nre
ad w
ithxu
re)
80C
$
rule
2A
appl
ies
and
sect
ion
(Giv
e10
(14)
deta
ils)
12
34
56
78
910
1112
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.Si
gnat
ure
of th
e em
ploy
ee
userTypewritten Text2017
userTypewritten TextSanthapuri Sunil Kumar
userTypewritten TextPAN number of employee
userTypewritten TextIndian
userTypewritten Text1
userTypewritten TextABC Company Ltd
userTypewritten TextHyderabad
userTypewritten TextTAN NumberOfEmployer
userTypewritten TextPAN Number Of Employer
userTypewritten Text3 yrs
userTypewritten Text72000
userTypewritten Text24000
userTypewritten Text360000
userTypewritten Text456000
userTypewritten Text16000
userTypewritten Text5500
userTypewritten TextEmployee Signature
userTypewritten TextPrevious Employer Details.
-
Ver
ifica
tion
I, ...
......
......
......
......
......
.....…
…………
…………
…………
…….,
do h
ereb
y de
clar
e th
at w
hat i
s st
ated
abo
ve is
true
to th
e be
st o
f my
know
ledg
e an
d be
lief.
Ver
ified
toda
y, th
e ...
......
......
......
......
......
......
. day
of.
………
Plac
e ...
......
......
.....
…………
…………
…….
Sign
atur
e of
the
empl
oyee
ANN
EXU
RE[S
ee c
olum
n 8
of F
orm
No.
12B
]Pa
rticu
lars
of v
alue
of p
erqu
isite
s an
d am
ount
of a
ccre
tion
to e
mpl
oyee
’s p
rovi
dent
fund
acc
ount
Nam
e an
d ad
dres
s of
the
empl
oyee
Perm
anen
t Acc
ount
No.
……
……
……
….
Peri
od: Y
ear
endi
ng 3
1st M
arch
, …...
..
Nam
e of
the
TAN
/PAN
of t
heVa
lue
of r
ent f
ree
acco
mm
odat
ion
or v
alue
of a
ny c
once
ssio
n in
ren
t for
the
acco
mm
odat
ion
prov
ided
by
the
empl
oyer
(giv
e ba
sis
of c
ompu
tatio
n)em
ploy
eeem
ploy
er[S
ee r
ules
3(a
) and
3(b
)
Whe
re a
ccom
mod
atio
n is
furn
ishe
d
Whe
reVa
lue
as if
Cos
t of f
urni
ture
Perq
uisi
te v
alue
of
Tota
l of c
olum
nsRe
nt, i
f any
, pai
dVa
lue
ofac
com
mod
atio
nac
com
mod
atio
n(in
clud
ing
tele
visi
onfu
rnitu
re (1
0% o
f4
and
6by
em
plye
epr
equi
site
is u
nfur
nish
edis
unf
urni
shed
sets
, rad
io s
ets,
colu
mn
5) O
R(c
olum
n 3
min
usre
frig
erat
ors,
oth
erac
tual
hir
eco
lum
n 8
orho
useh
old
appl
ianc
esch
arge
s pa
yabl
eco
lum
n 7
min
usan
d ai
r-co
nditi
onin
gco
lum
n 8
as m
aypl
ant o
r eq
uipm
ent)
be a
pplic
able
OR
hire
cha
rges
, if
hire
d fr
om a
thir
dpa
rty
12
34
56
78
9
(Con
td. o
n n
ext p
age)
userTypewritten TextSanthapuri Sunil Kumar
userTypewritten Text01 April
userTypewritten Text2017
userTypewritten TextHyderabad
userTypewritten TextEmployee Signature
userTypewritten Text
userTypewritten TextSanthapuriSunil Kumar
userTypewritten TextPAN of employer(previous)
userTypewritten Text72000
userTypewritten Text72000
userTypewritten TextHyderabad
userTypewritten Text72000
-
AN
NEX
UR
E(C
ontd
.)
Whe
ther
any
con
veya
nce
Rem
uner
atio
n pa
id b
yVa
lue
of fr
ee o
rEs
timat
ed v
alue
of a
nyEm
ploy
er’
s co
ntri
butio
nIn
tere
st c
redi
ted
to th
eTo
tal o
f col
umns
9 to
15
has
been
pro
vide
d by
the
empl
oyer
for
dom
estic
conc
essi
onal
pas
sage
s on
othe
r be
nefit
or
amen
ityto
rec
ogni
sed
prov
iden
tas
sess
e’s
acco
unt i
nca
rrie
d to
col
umn
8 of
empl
oyer
free
or
at a
and/
or p
erso
nal s
ervi
ces
hom
e le
ave
and
othe
rpr
ovid
ed b
y th
e em
ploy
er,
fund
in e
xces
s of
10%
of
reco
gnis
ed p
rovi
dent
Form
No.
12B
conc
essi
onal
rat
e or
prov
ided
to th
e em
ploy
eetr
avel
ling
to th
e ex
tent
free
of c
ost o
r at
the
empl
oyee
’s
sala
ryfu
nd in
exc
ess
of th
e ra
tew
here
the
empl
oyee
is(g
ive
deta
ils) [
See
rule
3(g
)]ch
arge
able
to ta
x (g
ive
conc
essi
onal
rat
e no
t[S
ee S
ched
ule
IV –
Par
tfix
sed
by th
e C
entr
alal
low
ed th
e us
e of
one
or
deta
ils)[
See
rule
2B
read
incl
uded
in th
e pr
eced
ing
A]G
over
nmen
t [Se
em
ore
mot
or c
ars
owne
dw
ith s
ectio
n 10
(5)(
ii)]
colu
mns
(giv
e de
tails
), e.
g.Se
ched
ule
IV –
Par
t A]
or h
ired
by
the
empl
oyer
,su
pply
of g
as, e
lect
rici
ty o
res
timat
ed v
alue
of
wat
er fo
r ho
useh
old
perq
uisi
te (g
ive
deta
ils)
cons
umpt
ion,
free
[See
rul
e 3(
c)]
educ
atio
nal f
acili
ties,
tran
spor
t for
fam
ily, e
tc.
[See
rul
es 3
(d),
3(e)
and
3(f)]
1011
1213
1415
16
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Sign
atur
e of
the
empl
oyee
userTypewritten Text-
userTypewritten Text-
userTypewritten Text-
userTypewritten Text-
userTypewritten Text24000
userTypewritten Text-
userTypewritten Text96000
userTypewritten TextEmployee Signature