PGBRK IPSF|492|10014316|00492000000000000645||W||
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IVY SOFTWARE DEVELOPMENT SERVICES PRIVATE LIMITED IPSF ID : 00492000000000000645
Investment Proofs Submission Form for the Year 2022-2023
Employee ID* 10014316 Gender* M Date of Joining 17/07/2020
Name* Ranjan Patra [Link] Children Going to School 0
PAN* BJIPP7234H [Link] Children Going to Hostel 0
Regime Type Old Regime
Section A - Rent Paid for claiming HRA exemption (Only Rent Receipts will be considered)
From Date To Date Address Rent Paid Per Rent Paid Per Property ID
Month Annual
01/04/2022 31/03/2023 130/100, Patel Chest, Guru Teg 45000.00 540000.00 1
Bahadur Nagar, Outram Lines,
North West Delhi,NEW
DELHI,DELHI
As Per Last Declaration Section B - Chapter VI A - Deductions from Total Income Value of Proof Attached
25148 Medical Insurance - Self / Spouse / Children (<60 yrs) - With Insurance 11476.00
0 Medical Insurance - Self / Spouse / Children (>=60 yrs) - With Insurance 0.00
0 Medical Insurance - Self / Spouse / Children (>=60 yrs) - Without Insurance 0.00
21853 Medical Insurance for Parents (<60yrs) - With Insurance 16272.00
30195 Medical Insurance for Parents (>=60yrs) - With Insurance 34048.00
0 Medical Insurance for Parents (>=60yrs) - Without Insurance 0.00
0 Medical Treatment/Handicapped Dependent (U/s 80DD) < 80% 0.00
0 Medical Treatment/Handicapped Dependent (U/s 80DD) > 80% 0.00
0 Interest on Educational Loan (U/s 80E) 0.00
0 Permanent Physical Disability (80U) < 80% 0.00
0 Permanent Physical Disability Severe Disabilitty (80U) > 80% 0.00
0 Medical Treatment of Specified Diseases (80DDB) 0.00
0 Additional Housing Loan Interest Benefit (U/s 80EE) 0.00
90000 Medical Treatment of senior citizen (80DDB) 0.00
0 Medical Treatment of very senior citizen (80DDB) 0.00
0 Atal Pension Yojana (U/s 80CCD1B) 0.00
0 Additional NPS Employee Contribution (U/s 80CCD1B) 0.00
0 Electric Vehicle Loan Interest Benefit (U/s 80EEB) 0.00
0 Additional Housing Loan Interest Benefit (U/s 80EEA) 0.00
0 Deduction for Interest on Deposits in Savings Account (U/s 80TTA) 0.00
0 Deduction for Interest on Deposits in case of Senior Citizens (U/s 80TTB) 0.00
Section C - Chapter VIA - Section 80C
0 Contribution to Pension Fund ( 80CCC ) 0.00
18500 Life Insurance Premium (Jeevan Dhara, Jeevan Akshay) etc 123990.00
0 Public Provident Fund (PPF) 0.00
0 National Savings Certificate (NSC) 0.00
0 Infrastructure Bonds 0.00
0 Children Education Tuition fees 0.00
0 Equity Linked Savings Scheme (ELSS) 0.00
110000 Mutual Funds 0.00
0 Unit Linked Insurance Plan 0.00
0 5 Year Deposit under Senior Citizen Saving Scheme 0.00
0 Cumulative Term Deposits 0.00
0 Sukanya Samriddhi Scheme 0.00
0 NPS Employee Contribution (U/s 80CCD) 0.00
0 5 Year Time Deposit in Post Office 0.00
0 Atal Pension Yojana (U/s 80CCD) 0.00
0 Fixed Deposit Scheme (Block Period of 5 yrs) 0.00
0 NSC Interest (Will also be considered as Other Income) 0.00
Section G -Other Income
0 Bank Interest (excluding interest on savings account) 0.00
0 Interest on Deposits in Savings Account (Considered as deduction u/s 80TTA upto Rs.10000) 0.00
0 Interest Income to Senior Citizen(Considered as deduction u/s 80TTB upto Rs.50000) 0.00
0 Pension 0.00
Note: This document is computer generated. Hence, does not require manual signature for authentication.
EPSF Confirmed on :03-01-2023 [Link]
0 Others 0.00
0 Interest on PF Account 0.00
0 NSC Interest (Other Income) 0.00
Payroll Deduction
Particulars Amount
Provident Fund 21600.00
Payroll Deduction - Total 21600.00
Dependent Details:
Dependent Name Relationship Age
Ranjan Patra Self 32
Mr Jagannath Patra Father 65
Mrs Kalpana Patra Mother 51
Mrs Babita Patra Spouse 28
Declaration:
1. I hereby declare that I have read and understood the guidelines provided in "Proofs Option Document" and that, all information, documents provided are true and correct in
all respects.
2. LTA exemption claimed by me (if applicable) is as per IT rule which specifies that exemption can be claimed twice in a lock of 4 years (irrespective of the number of
employers in the block period)
3. I also undertake to indemnify the company for any loss/liability that may arise, in the event of any incorrect information, documents provided by me.
* Indicates mandatory fields as per our database. Please verify the same and if blank, please fill and submit the form.
HRA Land Lord Details
Property Id Landlord Name Landlord Pan Landlord Address Annual Rent
1 Janki AORPJ6769G 130/100, Patel Chest, Guru Teg 540000
Bahadur Nagar, Outram Lines,
North West Delhi
Note: This document is computer generated. Hence, does not require manual signature for authentication.
EPSF Confirmed on :03-01-2023 [Link]
HRA FUTURE RENT DECLARATION
IVY SOFTWARE DEVELOPMENT SERVICES PRIVATE LIMITED
EMP ID 10014316
EMP NAME Ranjan Patra
RENT AMOUNT PER MONTH 45000
FOR THE PERIOD 01-01-2023 TO 31-03-2023
LANDLOARD NAME Janki
LANDLOARD PAN AORPJ6769G
The proofs/original rent receipts would be submitted on request along with the copy of the Self declaration.
Employee Declaration
I hereby declare that the information provided above is true and correct and will be solely responsible for any situation arising out of non-payment of the above rent.
Note: This document is computer generated. Hence, does not require manual signature for authentication.
EPSF Confirmed on :03-01-2023 [Link]
FORM NO. 12BB
(See rule 26C)
Statement showing particulars of claims by an employee for deduction of tax under section 192
1. Name and address of the employee : Ranjan Patra
2. Permanent Account Number of the employee : BJIPP7234H
3. Financial year : 2022-2023
Details of claims and evidence thereof
Sl. No. Nature of claim Amount(Rs.) Evidence/Particulars
(1) (2) (3) (4)
House Rent Allowance:
Property No :1
(i) Rent paid to the landlord Rs.540000
(ii) Name of the landlord Janki
1. Rs.540000.0 House Rent Receipts
(iii) Address of the landlord 130/100, Patel Chest, Guru Teg Bahadur
Nagar, Outram Lines, North West Delhi
(iv) Permanent Account Number of the AORPJ6769G
landlord
2. Leave Travel Concessions or Assistance Rs.0.0 Travel Receipts/Tickets
Deduction of Interest on Borrowing:
(i) Interest Payable/Paid to the Lender
(ii) Name of the Lender
(iii) Address of the Lender Provisional Certificate from
3. Rs.0.0
(iv) Permanent Account Number of the Lender Bank/Financial Institution/Lender
(a) Financial Institutions
(b) Employer
(c) Others
Deduction under Chapter VI-A
(A) Section 80C,80CCC and 80CCD
(i) Section 80C
(a) Provident Fund : Rs.21600
(b) Life Insurance Premium (Jeevan Dhara, Jeevan : Rs.123990
Akshay) etc Photocopy of the investment
4. Rs. 207386.0
proofs
(ii) Section 80CCC :
(iii) Section 80CCD
(B) Other sections (e.g. 80E, 80G, 80TTA, etc.) under Chapter VI-A.
(a) Medical Insurance (SEC80D) : Rs.61796
Verification
I, Ranjan Patra, Son/Daughter of Mr Jagannath Patra. do hereby certify that the information given above is complete and correct.
Place : HYDERABAD
Date: 03-01-2023
(Signature of the Employee)
Designation : Systems Analyst Full Name: Ranjan Patra
Note: The information/details above, as required for deduction of tax u/s 192 of the Income Tax Act, has been entered by the employee through an authorized login on
the portal.
Note: This document is computer generated. Hence, does not require manual signature for authentication.
EPSF Confirmed on :03-01-2023 [Link]
