Signature of the employeeIndianHyderabadEmployee ......Santhapuri Sunil Kumar 01 April 2017...
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1 FORM NO. 12B [See rule 26A] Form for furnishing details of income under section 192(2) for the year ending 31 st March, ……… Name and address of the employee Permanent Account No. Residential status Particulars of salary as defined in section 17, paid or due to be paid to the employee during the year Serial Name and TAN of the Permanent Period of Total amount Total amount Value of Total of Amount Total amount Remarks Number address of employeer(s) Account employment of salary of house perquisites columns deducted of tax deducted Employer(s) as allotted Number of ment excluding rent allow- and amount 6, 7 in respect during the by the the amounts ance, convey- of accre- and 8 of life year (enclose ITO employer(s) required to ance allowance tion to insurance certificate be shown in and other allow- employee’s premium, issued under columns 7 ances to provident provident secgtion 203) and 8 the extent fund fund chargeable account contri- to tax (give details bution, etc. [See sec- in the to which tion 10(13A) Anne- section read with xure) 80C $ rule 2A applies and section (Give 10(14) details) 1 2 3 4 5 6 7 8 9 10 11 12 ............................................................. Signature of the employee
Signature of the employeeIndianHyderabadEmployee ......Santhapuri Sunil Kumar 01 April 2017 Hyderabad Employee Signature Santhapuri\rSunil Kumar PAN of employer\r\(previous\) 72000
