Form 12B:Form for furnishing details of income under sec 192(2)

Company Name(s): 
Documents: 

FORM NO. 12B
[See rule 26A]
Form for furnishing details of income under section 192(2) for the year ending 31st 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
S.
No
Name and
address of
employer(s)
TAN of the
employer(s) as
allotted by the
ITO
Permanent
Account
Number of the
employer(s)
Period of
employment
Total amount
of salary
excluding
amounts
required to be
shown in
columns 7 and
8
Total amount of
house rent
allowance,
conveyance
allowance and
other allowances to
the extent
chargeable to
tax[See section
10(13A) read with
rule 2A and section
10(14)]
Value of
perquisites and
amount of
accretion to
employee's
provident fund
account (give
details in the
Annexure)
Total of
columns 6, 7,
and 8
Amount
deducted in
respect of life
insurance
premium,
provident fund
contribution,
etc., to which
sec. 80C †
applies (Give
details)
Total amount
of tax
deducted
during the
year (enclose
certificate
issued under
section 203)
Remarks
1 2 3 4 5 6 7 8 9 10 11 12
Signature of the employee
With effect from 1-4-1991, section 80C has been replaced by section 88.
Verification
I,______________________________________________________ do hereby declare that what is stated above is true to the best of my knowledge and belief.
Verified today, the_____________________day of______________________
Place
Signature of the employee
ANNEXURE