FORM NO.1: |2BB (See rule 260) 1. Name and address of the employee: [KAMIL RAKESHBHAI PATEL 40/A PRABHUNAGAR SOCIE’ -TY,WAGODIYA ROAD, VADODARA-390019, [2. Employee Code : [20054436 [3. Name of the Company INAYARA ENERGY LIMITED 4. Permanent Account Number of the employee: EMZPPO434C 5. Financial year: [2021-22 Details of claims and evi jidence thereof Sr. No. Nature of claim “Amount (Rs) Evidence | particulars: @ (2) (3) (4) (a) Details of Actual Rent paid Rent Period : From To - (i) Rent paid to the landlord per month (i) Name of the landlord (ii) Address of the landlord : (iv) Permanent Account Number of the landlord [Rent Period : From - To - (Rent paid fo the landlord per month : (i) Name of the landlord: (il) Address of the landlord: (iv) Permanent Account Number of the landlord Note: Permanent Account Number shall be furnished ifthe ag¢ 2021-22 ) exceeds one jgregate rent paid during the previous year (Le, FY lakh rupees [Deduction of interest on housing loan : {interest payablelpaid to the lender (i Name of the lender = (li) Address of the lender: () Permanent Account Number ofthe lender (@)_Financial Institutions (b)_ Employer (c)_Others ‘Annual Rent Received for let out property[Section 80 EE - Repayment of interest on hosing loan }( Max 50000, Please read the instructions) loan jsanctioned during FY 2016-17 [Section 80 EEA - Repayment of interest on hosing loan| ( Max 150000, Please read the instructions) loan sanctioned during FY 2019-20 Deduction under Chapter V-A (A) Section 80C,80CCC and 80CCD (i) Section 806 (@) Payment towards Lic (b) Contribution to ULIP (c) Contribution to certified Central Govt Security (¢) Contribution to PPF ( Max 150000) (e) Contribution to NSC Vill issue 30000 PDF ACCOUNT NO.020051 775567) (f) Contribution to notified ULIP of LIC Mutual Fund \(g) Repayment of Housing Loan ( Principal Amt) (hy Interest on NSC VII issue () Contribution to notified annuity plan of LIC |G) Contribution to notified mutual fund (K) Contribution to notified pension Fund [() Tuition Fees - Child 1 - Only Tution Fees (m) Tuition Fees - Child 2 - Only Tuition Fees (a) Term deposit under section 600 (o) Section 80 C5 yrs. term deposit under Post Office [Time deposit rule 1984 (p) Section 80 C - Sr.Citizen savings scheme Rule 2004 |) Sukanya Samriddhi Account (7) Any other Exemption under section 60C ( Please specify ) Section 80CC - Contribution to pension Fund med under. her section Section 80CCD - Contribution to NPS (B) Other sections (e.g. 60D, 80E, 806, BOTTA, etc.) lunder Chapter Vi-A, (Section 80D (a) Medical insurance premium including Preventive |Health check-up (Max 5000) for parents (non {Sr.Citizen) - Max 25000 |b) Medical insurance premium including Preventive Health check-up (Max 5000) for parents (Sr. Citizen) - IMax 50000 (c) Medical insurance premium including Preventive Health check-up (Max 5000) for self and family (non Sr.Citizen) - Max. 25000 (d) Medical insurance premium including Preventive Health check-up (Max 5000) for self and family |(St.Citizen) - Max 50000(i) Section 8000 (2) Deduction for dependent with severe disabilty - Max 125000 (0) Deduction for dependent with disabinty - Max 7000 (il) Section 60U (2) Deduction for self with severe disability - Max 125000 (b) Deduction for self with disability - Max 75000 (iv) Section 80E - Repayment of interest on loan for higher education (v) Section 80DDB (2) Medical Treatment( Max 40000 for Non Sr. Citizen) (®) Medical Treatment (Max 100000 for Sr. Giizen ) (c) Medical Expenditure (Max 50000 for Self Sr. Citizen ) (d) Medical Expenditure ( Max 50000 for Parents Sr. Citizen (vi) Section 80TTA- Interest on savings bank account |(Max - 10000).For Non Sr.Citizen employee (vil) Section 80TTB - Interest on Bank Deposit (savings or fixed ) (Max - 50000) For Sr. Citizen lemployee only ( vill) Section 80GG - Deduction in respect of Rent aid ( in case no HRA paid as part of CTC ) - Max {5000 per month (ix) Section 80EEB -Repayment of interest on loan for purchase of electric vehicles in FY 2019-20 (x) Any other Exemption ( Please specify ) Verification i KAMIL PATEL. son of...AKESHBHAI PATEL.... do hereby cerily thal ihe information given above & complete lend correct Place... JAMNAGAR. Belk Date...09/02/2022... (Signature of the employee) Designation ..M-10, Full Name : KAMIL PATEL