TMI BlogIncome-tax (3rd Amendment) Rules, 2021 - Form No 12BA replaced - Statement showing particulars of perquisites, other fringe benefits or amenities and profits in lieu of salary with value thereofX X X X Extracts X X X X X X X X Extracts X X X X ..... ue thereof 1. Name and address of employer : 2. TAN : 3. TDS Assessment Range of the employer : 4. Name, designation and Permanent Account Number or Aadhaar Number of employee : 5. Is the employee a director or a person with substantial interest in the company (where the employer is a company) : 6. Income under the head Salaries of the employee (other than from perquisites) : 7. Financial year : 8. Valuation of Perquisites : S. No. Nature of perquisites ( see rule 3) Value of perquisite as per rules (Rs.) Amount, if any, recovered from the employee (Rs.) ..... X X X X Extracts X X X X X X X X Extracts X X X X ..... bution by employer to fund and scheme taxable under section 17(2)(vii). 19. Annual accretion by way of interest, dividend etc. to the balance at the credit of fund and scheme referred to in section 17(2)(vii) and taxable under section 17(2)(viia). 20. Other benefits or amenities 21. Total value of perquisites 22. Total value of profits in lieu of salary as per section 17( 3 ) (9) Details of tax,- (a) Tax deducted from salary of the employee under section 192(1) (b) Tax paid by employer on behalf of the employee under section 192(1A) (c) Total tax paid (d) Date of payment into Government treasury DECLARATION BY EMPLOYER I, _______, s/o _______________________ working as_________(designation) do hereby declare on behalf of ____________ (na ..... X X X X Extracts X X X X X X X X Extracts X X X X ..... Rs. ... (f) Amount of any other exemption under section 10 clause Rs. ... clause Rs. ... clause Rs. ... clause Rs. ... clause Rs. ... Rs. ... (g) Total amount of any other exemption under section 10 Rs. ... (h) Total amount of exemption claimed under section 10 [2(a)+2(b)+2(c)+2(d)+2(e)+2(g)] Rs. ... 3. ..... X X X X Extracts X X X X X X X X Extracts X X X X ..... Rs. ... Rs. ... (d) Total deduction under section 80C, 80CCC and 80CCD(1) Rs. ... Rs. ... (e) Deductions in respect of amount paid/deposited to notified pension scheme under section 80CCD (1B) Rs. ... Rs. ... (f) Deduction in respect of contribution by Employer to pension scheme under section 80CCCD (2) Rs. ... Rs. ... (g) Deduction in respect of health insurance premia under section 80D Rs. ... Rs. ... (h) Deduction in respect of interest on loan taken for higher education under section 80E Rs. ... Rs. ... Gross Amount Qualifying Amount Deductible Amount (i) Total Deduction in respect of donations to cert ..... X X X X Extracts X X X X X X X X Extracts X X X X ..... Tax payable (13+15+16-14) Rs. ... 18. Less: Relief under section 89 (attach details) Rs. ... 19. Net tax payable (17-18) Rs. ... Verification I, .., son/daughter of .working in the capacity of . ......... (designation) do hereby certify that the information given above is true, complete and correct and is based on the books of account, documents, TDS statements, and other available records. Place ...... (Signature of person responsible for deduction of tax) Date ....... Full Name : Notes: 1. Government deductors to fill information in item I of Part A if tax is paid without production of an income-tax challan and in item II of Part A if tax is paid accompanied by an income-tax challan ..... X X X X Extracts X X X X X X X X Extracts X X X X ..... (332A) (332B) (333) (334) (335) (336) (337) (338) Reported total amount of salary received from other employer(s) (see Note 1 for definition of Salary). Travel concession or assistance under section 10(5). Deathcum- retirement gratuity under section 10(10). Commuted value of pension under section 10(10A). Cash equivalent of leave salary encas-hment under section 10(10AA). House rent allowance under section 10(13A). PAN of landlord, if exemption is claimed under section 10(13A) (see Note 3). Amount of any oth ..... X X X X Extracts X X X X X X X X Extracts X X X X ..... ct of amount paid or deposited under notified pension scheme under section 80CCD(1). Deduction in respect of contribution by employer to notified pension scheme under section 80CCD (2). Deducti on in respect of health insuranc e premia under section 80D. Deduction in respect of interest on loan taken for higher education under section 80E. Total deduction in respect of donations to certain funds, charitable institutions, etc. under section 80G. Deduction in respect of interest on deposits in savings account under section 80TTA. Amount deductible under any other provision (s) of Chapter VI‐A. Total amount deductible under Chapter VI‐A [356+357+358 (limited to ₹ 1,50,000) +359 +360+361+362 +363+36 4+365]. Total taxable income (355-366) Incometax on total income. (359) (360) (361) (362) (363) (364) (365) (366) (367) (368) ..... X X X X Extracts X X X X X X X X Extracts X X X X ..... x in accordance with rule 6 of Part A of the Fourth Schedule of the Income-tax Act, 1961, any sums deemed to be income received by the employee in accordance with sub‐rule (4) of rule 11 of Part A of the Fourth Schedule of the Income-tax Act, 1961, any contribution made by the Central Government to the account of the employee under a pension scheme referred to in section 80CCD or any other sums chargeable to income-tax under the head 'Salaries'. 2. Where an employer deducts from the emoluments paid to an employee or pays on his behalf any contributions of that employee to any approved superannuation fund, all such deductions or payments should be included in the statement. 3. Permanent Account Number of landlord shall be mandatorily furnished where the aggregate rent paid during the previous year exceeds one lakh rupees. 4. Permanent Account Number of lender shall be mandatorily furnished where the housing loan, on which interest is paid, is taken from a person other than a Financial Institution or the Employer. . [F.No. 370142/04/2019-TPL] ANKIT JAIN, Under Secy. (Tax Policy and Legislation) Note: The principal rules were published in th ..... X X X X Extracts X X X X X X X X Extracts X X X X
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