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FORM NO.

128B
[SNnJe26CJ

tax under sec tion 192


lars of claims by an employee for deduction of
Statement showing particu
Abhay Tamaria
loyee:
1. Name and address of the emp
AVEPK0612M
of the employee:
2. Permanent Account Number
2024-25
3. Financial Year:

EVIDENCE THEREOF
DETAILS OF CLAIMS AND

Am otn t (Rs.) Evidencs/particulars

SI. No. Nature of clai m


(3) (4)

(1) (2)

1. House Rent Allowance:


MOJ'D oo
stance
Leave travel concessions or assi

)
2.

g:
3. Deduction of interest on borrowin

(i) Interest payable/paid to the


lender ~f qu er D
~(V tJ.
(ii) Name of the lender
1 t_ ,ll· f.
(iii) Address of the lender ~' 0 -\\ c,,c'l/L-

ber of the lender


(,v) Permanent Accot.nt Num

ilable)
(a) Financial Institutions {if ava

(b) Employer (d available)

(c) Others

4. Deduction &.nder Chapter VI-A

(A) Sections SOC and 80C CD

(i) Section 80C

(ii) Section 80C CD


VI-A
SOE. 80G, etc.) Lnder Chapter
(B) Other sections (e.g. 800 ,
~u ,0- 0
(i) section 800
0
(Ii) section 800 0
0

(ix) section 800 0B


0

(iii) section SOE


~0 1 0() 0
(1v) section SOE.£ 0

(v) ooction 80G 0

(vi) ooct,on sou


. --
(vii) sectiOn 80EEA
1fo1 CJVO
0
(viii) section 80EEB
0
(X) section 80TTA
0
(xi) sectk)n 80TTB

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