Income from House Property

Capital Borrowed on

Acquisition on Construction is completed on

Self Occupied Leased/Rent

Gross Annual Income -
Less: Municipal Tax -
Gross Income from house - -

Less: Deduction u/s 24

i) Repair and Maintenance -
ii) Insurance Premium
iii) Annual Charges
iv) Ground Rent
v) Interest on Housing loan - -
iv) Others Incl.vacancy allowance Three Months
Total deduction u/s 24 - -

Income from House Property - -

Signature of the Income Tax Assessee

Name

PAN No

Designation

Division

Associate ID no
 FORM No.12 C
[see rule 26B]
FORM FOR SENDING PARTICULARS OF INCOME UNDER SECTION 192(2B) FOR
THE YEAR ENDING 31st MARCH 2019
1. Name and address of the employee
2. Permanent Account Number
3. Residential Status Individual

4. Particulars of income under any head of income other

than "Salaries"(not being a loss under any such head other
than the loss under the head "Income from house
property") received in the financial year
Rs
(i) Income from House Property 0
[in case of loss, enclose computation thereof)
(ii) Profit and gains of business or profession 0
(iii) Capital Gains 0
(iv) Income from Other Sources Rs
(a) Dividends
(b) Interest 0.00
(c) Other Income (Specify)
(b) Interest on housing loan repayment 0.00 0

5. Aggregate of sub-items (i) to (iv) of item 4 TOTAL 0

6. Tax Deducted at source [enclose certificate(s) issued

under section 203]

Place: Chennai Signature of Employee

Date : 31st Jan 2019

VERIFICATION
I, ____________________ Do hereby declare that what is stated above is true to the best of my
knowledge and belief.

Verified today, the 31Jan 2019

Place: Chennai Signature of Employee

Date : 31st Jan 2019