INVESTMENT AND TAX-CLAIM DECLARATION TO THE EMPLOYER (KNOWN AS FORM 12BB)
Date: 1 April 2026. To: Tricity Software Pvt Ltd.
I, Simran Arora, holding PAN ABCDE1234F, employee code EMP-4471, give you these particulars for the financial year 2026-27 so that you may work out the tax to deduct from my salary. I have chosen the tax regime that allows deductions and exemptions, and I expect to claim the items below.
Rent I will pay in the year: ₹2,40,000 (Rupees Two Lakh Forty Thousand only). Landlord: Rajinder Kumar. Landlord's PAN: ABCDE1234F. Home-loan interest I will pay in the year: ₹1,50,000 (Rupees One Lakh Fifty Thousand only). Lender: Punjab National Bank. Leave or home travel expense: ₹30,000 (Rupees Thirty Thousand only).
Tax-saving investments I will make in the year: ₹1,50,000 (Rupees One Lakh Fifty Thousand only). They are: PPF, life insurance premium, children's tuition fee. Health insurance and pension contributions: ₹50,000 (Rupees Fifty Thousand only). Donations: ₹10,000 (Rupees Ten Thousand only). Other claims: Interest on education loan: 40,000
I will give you the supporting proofs when you ask for them, by the date you set. I understand that you will deduct tax on the basis of these particulars, and that I am responsible for them being correct. If a claim proves wrong or does not go ahead, I will tell you.
This is my own declaration written in my own words. It is not a copy of any prescribed form, and your payroll system or portal may require the prescribed form in its own layout, which I will then fill in and sign. The particulars above are true and correct to the best of my knowledge and belief.
PERSONAL DATA NOTICE
This notice is given under the Digital Personal Data Protection Act, 2023.
Personal data in this document is collected only to let the employer work out the tax to deduct from salary, communicate about that purpose, verify the information expressly supplied, and retain an evidentiary record.
The record will be held by Simran Arora and may be shown only to the employee, the employer named in it and its payroll, accounts and tax staff, and a payroll or tax service provider the employer appoints, and to a statutory or tax authority where disclosure is required for the matter recorded here.
If the matter does not go ahead, or this document is withdrawn before it is used, the personal data will be retained for 90 days from that decision and then erased. If it is used, the record will be retained for 12 months after the matter ends and then erased, except for a record that a statute requires to be kept for a longer named period.
A person named in this document may withdraw consent for future consent-based processing, request correction or erasure when the stated purpose has ended, or raise a grievance by writing to customersupport.kaagazaat@gmail.com. The record-holder should acknowledge and respond within 30 days.