TMI BlogStatement 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 ..... ployee 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.) Amount of perquisite chargeable to tax Col. (3) - Col. (4) (Rs.) ..... X X X X Extracts X X X X X X X X Extracts X X X X ..... Use of movable assets by employees 14. Transfer of assets to employees 15. Value of any other benefit/amenity/service/privilege 16. Stock options allotted or transferred by employer being an eligible start-up referred to in section 80-IAC. 17. Stock options (non-qualified options) other than ESOP in col 16 above. ..... X X X X Extracts X X X X X X X X Extracts X X X X ..... ----------- (name of the employer) that the information given above is based on the books of account, documents and other relevant records or information available with us and the details of value of each such perquisite are in accordance with section 17 and rules framed thereunder and that such information is true and correct. Place ------------------------ Date -------------------------- Full Name ------------------------ Designation------------------------- -------------------------------------------------------------------------- Signature of the person responsible for deduction of tax. ] ************ NOTES:- 1. Substituted vide Notification No. 95/2019 dated 06-11-2019 w.e.f. 01-09-2019 bef ..... X X X X Extracts X X X X X X X X Extracts X X X X ..... 4. Gas, electricity, water 5. Interest free or concessional Loans 6. Holiday expenses 7. Free or concessional travel 8. Free meals 9. Free Education 10. ..... X X X X Extracts X X X X X X X X Extracts X X X X ..... (d) Date of payment into Government treasury DECLARATION BY EMPLOYER I . S/o . working as (designation) do hereby declare on behalf of .. .. (name of the employer) that the information given above is based on the books of account, documents and other relevant records or information available with us and the details of value of each such perquisite are in accordance with section 17 and rules framed thereunder and that such information is true and correct. Signature of the person responsible for deduction of tax. Place . ..... X X X X Extracts X X X X X X X X Extracts X X X X
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