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T705604 Jan 2023 FY20238137021

Tax Proof FY 22-23

RefNo:7056
Name Raghavendra M R
Employee Code 8137021

400 PAN DPYPR4870B

Department

Rent

Landlord

Landlord Landlord PAN Landlord Landlord Landlord Address

Rental Other Rental Rental
Amount Address Name 1 1 Address 1 Name 2 PAN 2 2
Rent Month Location Location

August Others Bangalore 35000 hayigriva Reddappa AWVPR1835K hayigriva

Nilya, 3rd MV Nilya, 3rd
cross, greens cross, greens

residency. residency,
chimasandra, chimasandra,
bangalore- bangalore-
560049 560049

September Others Bangalore 35000 hayigriva Reddappa AWVPR1835K hayigriva

Nilya, 3rd MV Nilya, 3rd
cross, greens cross, greens

residency. residency.
chimasandra, chimasandra,
bangalore- bangalore
560049 560049

October Others Bangalore 35000 hayigriva Reddappa AWVPR1835K hayigriva

Nilya, 3rd MV Nilya, 3rd
cross, greens cross, greens
residency, residency.
chimasandra, chimasandra,
bangalore bangalore.
560049 560049

November Others Bangalore 35000 hayigriva Reddappa AWVPR1835K hayigriva

Nilya, 3rd MV Nilya, 3rd
cross, greens cross, greens
residency, residency
chimasandra, chimasandra,
bangalore bangalore
560049 560049

December Others Bangalore 35000 hayigriva Reddappa AWVPR1835K hayigriva

Nilya, 3rd MV Nilya, 3rd
cross, greens cross, greens

residency. residency
chimasandra, chimasandra,
bangalore bangalore
560049 560049

Others Bangalore 35000 hayigriva Reddappa AWVPR1835K hayigriva

January
Nilya, 3rd MV Nilya, 3rd
cross, greens cross, greens

residency. residency,
chimasandra, chimasandra,
bangalore bangalore

Employee Code 8137021 Date 09Jan 2023

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560049 560049

February Others Bangalore 35000 hayigriva Reddappa AWVPR1835K hayigriva

Nilya, 3rd MV Nilya, 3rd

cross, greens cross, greens

residency, residency.
chimasandra, chimasandra,
bangalore- bangalore-
560049 560049

March Others Bangalore 35000 hayigriva Reddappa AWVPR1835K hayigriva

Nilya, 3rd MV Nilya, 3rd

cross, greens cross, greens

residency residency.
chimasandra, chimasandra,

bangalore. bangalore
560049 560049

have been incurred by me out of my income chargeable to

Ihereby digitally accept that the investments/expenses provided
income-tax during the financial year. I also certify that the attachments provided are true and correct to the best of my knowledge

I understand that the Company reserves the right to conduct

and understanding. I confirm they are not claimed elsewhere.
documents are ascertained to be un-true or incorrect.
investigation and take appropriate action in case any supporting

will be solely and wholly responsible to handle any queries from any competent officials and I or to submit all relevant original
Idocuments to Income Tax/Competent Authorities. I am fully aware of the relevant income tax laws in force regarding the nature of
proof required to claim the tax exemption and I will be held responsible for any consequences and any liabilities arise out of this.

This declaration is made in electronic form by filling information on the portal after login and hence deemed signed by you on

submission.

Date 09 Jan 2023

Employee Code 8137021
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FORM NO. 12BB
(See rule 26C)
under section 192
Statement showing particulars of claims by an employee for deduction of tax

1 Name and address of the employee: Raghavendra M R

658. Venkateshwara Nilaya, 5th Cross, Nisarga Layout
Basavanpura Main Road, KR Puram, Bangalore Bangalore
560035

Permanent Account Number of the employee: DPYPR4870B

Financial year 2022 -2023

3.

Details of claims and evidence thereof

Nature of claim Amount Evidence/ particulars

SI.No
(Rs.)

(2) (3) (4)

(1)

1. House Rent Allowance:

280000
) Rent paid to the landlord

Gi) Name of the landlord

1. Reddappa M V

Gii) Address of the landlord

1. hayigriva Nilya, 3rd cross,
greens residency,
chimasandra, bangalore
560049

(iv) Permanent Accournt Number of the landlord

1.AWVPR1835K

Note: Permanent Account Number shall be furnished if the

the previous year exceeds one lakh
aggregate rent paid during
rupees

Leave travel concessions or assistance

. Deduction of interest on borrowing:

) Interest payable/paid to the lender

iName of the lender

ii) Address of the lender

(iv) Permanent Account Number of the lender

(a) Financial Institutions(if available)

(b) Employer(if available)

(c) Others

Date : 09 Jan 2023

Employee Code 8137021
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Deduction under Chapter VI-A

(A) Section 80C,80CCC and 80CCD

0 Section 80C

Gi) Section 80CCC

Gii) Section 80CCD

(B) Other sections (e.g. 80E, 80G, 80TTA, etc.) under Chapter V1-A.

Verification
1, Raghavendra MR sonidaughter ofeddappa_do hereby oertity that the information given above is complete and correct

OApelo
Place BLR ATC
Digitally accepted by 8137021, Ragbavendra M R, 09/01/2023,
116.75.68.46
Date 09/01/2023
(Signature of the empiloyee
Full Name: Raghavendra M R
Designation Lead Consultant Technology

Date 09 Jan 2023

Employee Code: 8137021