6/21/2020 Form-B

FORM NO. 12BB

(See Rule 26C of Income tax Rules, 1962)
1. Name and address of the employee: Saad Yusuf
2. Permanent Account Number of the employee: AFHPY9638N
3. Financial year: April,2020-March,2021
Details of claims and evidence thereof
Sl
Nature of claim Amount (₹) Evidence/particulars
No.
(1) (2) (3) (4)
House Rent Allowance:
(i) Rent paid to the landlord
274500
(ii) Name of the landlord
Gaurav Khera
(iii) Address of the landlord
1 R/O 17/1 Kalkaji Firsy Floor Opp. Deshbandhu
(iv) Permanent Account Number of the landlord
college new delhi 110019
Note: Permanent Account Number shall be furnished if the
AKTPK1851G
aggregate rent paid during the previous year exceeds one
lakh rupees
2 Leave travel concessions or assistance

Deduction of interest on borrowing:

(i) Interest payable/paid to the lender 0
(ii) Name of the lender
(iii) Address of the lender
3
(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
(i) Section 80C
(ii) Section 80CCC 0
(ii) Section 80CCD 0
(B) Other sections (e.g. 80E, 80G, 80TTA, etc.)
under Chapter VI-A.
Verification
I,Saad Yusuf,son/daughter of .... do hereby certify that the information given above is complete and correct.
Place.............................
Date: ..21/06/2020.. (Signature of the employee)
Designation: ..-.. Full Name: Saad Yusuf

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