Annexure

(Cond…)
Whether any Remuneration paid by Value of free or Estimated value of any Employer's contribution Interest credited to the Total of columns 9 to 15
conveyance has been employer for domestic concessional passages other benefit or amenity to recognised provident assessee's account in carried to column 8 of
provided by the employer and / or personal on home leave and provided by the fund in excess of 10% of recognised provident Form No 12B
free or at a concessional services provided to the other travelling to the employer, free of cost or the employee's salary fund in excess of the rate
rate or where employee employee (give details) extent chargeable to tax at concessional rate not [See Schedule IV - Part fixed by the Central
is allowed the use of one [See rule 3(g)] (give details) [See rule included in the A] Government [See
or more motor cars 2B read with section preceeding columns Scgedule IV - PartA]
owned or hired by the 10(5)(ii)] (give details), e.g. supply
employer, estimated of gas, electricity, or
value of perquisites (give water for household
details [See rule 3© consumption, free
educational facilities,
transport for family, etc.
[See rules 3(d), 3(e) and
3(f)

10 11 12 13 14 15 16
0
 Annexure
[See column 8 of Form No 12B]
Particulars of value of perquisites amount of accretion to employee's fund account
Name of the employee 0
Address of the employee 0 31st March, 2016
Name & Address of Employer(s) TAN /PAN of the Value of rent-free accomadtion or value of of any concession in rent for the accomadation
employer provided by the employer
Where (give basis of is
Where accomadation computation)
furnished [see rulesRent,
3(a) and
if 3(b)]
Value of
accomadation Value as if Cost of Perquisite Total of any, paid perquisite
is unfurnished accomadati furniture value of Columns 4 by the (column 3
on is (including furniture to 6 employee minus
unfurnished television (10% of column 8 or
sets, radio column 5) column 7
sets, Or actual minus 8, as
refrigerators, hire may be
other charges applicable)
household payable
appliances
and air-
conditioning
plant or
equipment)
Or Hire
Charges, if
hired from a
third party

1 2 3 4 5 6 7 8 : 9
0 0 only if rent is
To be filled
deducted by the employer
against residence
provided by employer
 See rule 26A
Form for furnishing details of income under section 192(2) for the year ending 31st March, 2021
Name of the employee 0 Permanent Account No 0
Address of the employee Residential Status Resident
Sl No Name & Address of TAN of the Permanent Period of Particulars of salary as defined in Total of Amount Total Remarks
Employer(s) employer( Account employment section
Total 17, paid or due
Total to be paid
Value ofto columns 6, deducted in amount of
s) as Number of amount of amount of perquisites 7 and 8 respect of tax
allotted by the salary house rent and amount life deducted
the ITO employer(s excluding allowance, of accretion insurance during the
) amounts and other to provident premium, year
required to allowances fund provident (enclose
be shown to the account contribution certificate
in columns extent (give detail etc to issued
7 and 8 chargeable in which 80C under
to tax {See Annexure) applies section
sec (Give 203)
10(13A) details)
read with
rile 2A and
sec 10(14)}

1 2 3 4 5 6 7 8 9 10 11 12
1 4/1/2020 0 0 0 0 0 0
To
12/30/1899

I, _________________________________, do hereby declare that what is stated above is true to the best of my knowledge & belief, verified today

Signature of employee
 Name of past employer
TAX CALCULATOR
Financial Year 2020-21 (1st April' 2020 to 31st March'2021)
Assessment Year 2021-22
For the period 1st April-20 till date of joining to Bhilwara Infotechnology Limited
Name of the Employee
Employee Code
PAN No.( Mandatory requirement)
Male (M) / Female (F) M
Date of Joining ( Pls Mention Dates in the same format MM-DD-YY) * 1-Apr-20
Date of leaving ( Pls Mention Dates in the same format MM-DD-YY) *
Do you have PF in your Salary (Y/N) N
Details of Salary
Per Month Per Month Yearly
1 Basic Salary -
2 HRA
Less HRA Exemption U/s 10(13)(A) - - -
Place of Stay
(For Delhi/Bombay/Calcutta/Madras Say "Y" otherwise "N") N
Actual rent paid
Rent paid in excess of 10% of Basic -
50%(for D/B/C/M)/otherwise 40% of Basic -
Actual HRA -
3 Conveyance Allowance -
4 Special Allowance/ MGB -
5 Allowance in lieu of Super Annuation / CCA -
6 Medical Allowance ( paid with monthly salary) -
7 Project Completion Bonus / Incentives ( if any) -
8 Mobile /Telephone Allowance ( if any) -
9 Other Taxable Incomes (Such as arrears etc) -
10 Other Annual Perks -
Sub total - -

Taxable Salaries -
Per Month

Professional Tax -

Net Income -

Less Investments
Section 80 C (Investments)
PF (Employee Share by Past employer) - -
-

Tax Deducted at Source (Past employer)

Date : Signature of Employee