Tt)RM NO.

l2BB
(See rule 26C)

Statement showing particulars of claims by an employee for

deduction of tax under section 192

1. Name and address of the emPloYee:

Puneet Gupta (4'l 29)

Room No.205, Telone Stay, oYo Townhouse- 818 P Sector 47, Bakhtawar chowk,
'122018
, Gurugram, HarYana, lndia,

2. Permanent Account Number of the employee:

AITPG5523F

3. Financial Year'. 2023'

2024

4. Submission Stage: Submitted with

proofs

Details of claims and evidence thereof

Amount Evidence /
Sl.No Nature of claim (Rs.) particulars

(1) (2) (3) (4)

'i
House Rent Allowance:

Reni 1

(i) Rent paid to the landlord 144000.00

(ii) Name of the landlord AMIT SHARMA

 Details of claims and evidence thereof

Sl.No Nature of claim Amount Evidence /

(Rs.) particulars

(1) (2) (3) (4)

oYo
TOWNHOUSE
(iii) Address of the landlord
818P SECTOR
47 GURUGRAM

(iv) Permanent Account Number of the

AAlCC5260B
landlord

Note: Permanent Account Number shall be furnished if

the aggregate rent paid during the previous year
exceeds one lakh rupees

2 Section 80D - Medical lnsurance for

Parent(s) if Senior Ciiizen(s)

(i) Health lnsurance Premium for Parent(s)

30000.00
lf Senior Citizen(s)

3 Section 80D - Medical lnsurance for Self,

Spouse and Dependent children

(i) Health lnsurance premium for Self,

10136.00
Spouse and Dependent Children

4 EXEMPT U/S 80C, 80CCC & 80 CCD

(i) Tuition Fees for Children (Upto 2) 182000.00

5 LTA

(i) LTA Claim 80471.00

2
 Details of claims and evidence thereof

Sl.No Nature of claim Amount Evidence /

(Rs.) particulars

(1) (2) (3) (4)

Verification

l, Puneet Gupta, son/daughter of Ramesh Gupta do hearby certify that the information given
above is complete and correct.

Place: Gurgaon

Dale:.13-02-2024

Designation: Research Analyst

(AGCON.COMRES. RESANDCON.RESANL)

This has been submitted online from the lP 122.185.56.86