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["Annexure IIA"]
["FORM NO.12BB\n(See rule 26C)"]
["Statement showing particulars of claims by an employee for deduction of tax under\nsection 192"]
["1. Name and address of the employee:"]
["2. Permanent Account Number or Aadhaar\nnumber of the employee:"]
["3. Financial year:"]
[]
["Details of claims and evidence thereof"]
["Sl No.","Nature of claim",null,null,"Amount (Rs.)","Evidence / particulars"]
[{"v":-1,"d":"(1)"},{"v":-2,"d":"(2)"},null,null,{"v":-3,"d":"(3)"},{"v":-4,"d":"(4)"}]
[1,"House Rent Allowance:"]
[null,"(i) Rent paid to the landlord"]
[null,"(ii) Name of the landlord"]
[null,"(iii) Address of the landlord"]
[null,"(iv) Permanent Account Number or Aadhaar number, as the case may be,of the landlord"]
[null,"Note: Permanent Account Number or Aadhaar number, shall be furnished if the aggregate rent paid during the previous year exceeds one lakh rupees"]
[2,"Leave travel concessions or assistance"]
[3,"Deduction of interest on borrowing:"]
[null,"(i) Interest payable/paid to the lender"]
[null,"(ii) Name of the lender"]
[null,"(iii) Address of the lender"]
[null,"(iv) Permanent Account Number or Aadhaar number of the lender"]
[null,"(a) Financial Institutions(if available)"]
[null,"(b) Employer(if available)"]
[null,"(c)    Others"]
[4,"Deduction under Chapter VI-A"]
[null,"(A) Section 80C,80CCC and 80CCD"]
[null,"(i) Section 80C"]
[null,"(a)"]
[null,"(b)"]
[null,"(c)"]
[null,"(d)"]
[null,"(e)"]
[null,"(f)"]
[null,"(g)"]
[null,"(ii) Section 80CCC"]
[null,"(iii) Section 80CCD"]
[null,"(B) Other sections (e.g. 80E, 80G, 80TTA, etc.) under Chapter VI-A."]
[null,"(i) section………………."]
[null,"(ii) section………………."]
[null,"(iii) section………………."]
[null,"(iv) section………………."]
[null,"(v) section………………."]
["Verification"]
["I,…………………..,son/daughter of…                                   do hereby certify that the\ninformation given above is complete and correct."]
["Place……………………………………………..."]
["Date……………………………………………....",{"$nulls":3},"(Signature of the employee)"]
["Designation ……………………………….….",{"$nulls":3},"Full Name"]
[null,"www.simpletaxindia.net"]