Professional Documents
Culture Documents
12B
[See rule 26A]
Form for furnishing details of income under section 192(2) for the year ending 31st March, 2013
Name and address of the employee
EMP ID
..
Permanent Account No.
Residential Status
TAN of the
Permenent
Period of
Total amount
Total amount
Value of
Total of
Amount
Total amount
Number
of employer(s)
employer(s)
Account
employment
of salary
of house rent
perquisites and
columns
deducted
of tax deducted
as allotted
Number
exculding
allowance,
amount of
6, 7 and 8
in respect
during the
by the ITO
of the
amounts
conveyance
accretion to
of life
year (enclose
employer(s)
required to
allowance and
employee's
insurance
certificate
be shown in
other allowances
provident fund
premium,
issued under
section 203)
columns 7
to the extent
account
provident fund
and 8
chargeable to
(given details
contribution,
in the Annexure)
etc, to which
10(13A) read
section 80C
with Rule 2A
Applies (Give
and section
details)
Remarks
10(14)
1
10
11
.
Signature of the employee
Verification
I,.. do hereby declare that what is stated above is true to the best of my knowledge and belief.
verified today, the .. day of ..20
Signature of the employee
12
ANNEXURE
[See column 8 of Form No. 12B]
Particulars of value of perquisites and amount of accretion to employee's provident fund account
Name and address of the employee
TAN/PAN
Value of rent-free accomodation or value of any concession in rent for the accommodation provided by the employer (give basis of computation)
of the
employer
Value as if
Cost of furniture
Perquisite value
Total of
Rent, if any
Value of
mmodation
accummodation
(including Television
of furniture (10% of
columns
paid by the
perquisite
is unfurnished
is unfurnished
4 and 6
employee
(column 3
column 5) OR
refrigerators, other
actual hire
minus
household appliances
charges
column 8 or
and air-conditioning
payable
column 7 minus
plant or equipment)
column 8 as
OR hire charges,if
as may be
applicable
party
ANNEXURE
(Contd.)
Whether any conveyance has been
provided by the employer free or at a
concessional rate or whre the employee
is allowed the use of one or more motor
cars owned or hired by the employer,
estimated value of perquisite (give
details) [See rule 3 (c )]
Value of free or
concessional
passages on home
leave and other
travelling to the
extent chargable to
tax (give details)
[See rule 2B read
with
section
10(5)(ii)]
Employer's
contribution
to
recognised providend
fund in excess of
12%
of
the
employee's
salary
(See Schedule IVPart A
10
11
12
13
14
15
16