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Page 1 of 3
All the proofs have to be uploaded using the scan image option using the link "Upload IPSF Proof Images". Any proofs that are
dropped in the IPSF drop-box will not be accounted. Please ensure to consolidate all the images of your investment proofs; scan
the duly signed IPSF form & annexures (if any); create a ZIP file & upload.
Hewlett Packard Globalsoft Private Limited
Employee ID * 60106737
Name *
Bhavik Bhatt
PAN *
Gender *
IPSF ID : 0094813046
Date of Joining
ALUPB7201M
Section A - Rent Paid for claiming HRA exemption (Only Rent Receipts will be considered)
From Date
To Date
23/11/2016
As Per Last
Declaration
Address
0 Medical Insurance Premium (U/s 80D) - Parents not being Senior Citizens
0 Medical Insurance Premium (U/s 80D) - Parents being Senior Citizens
0 Medical Treatment/Handicapped Dependent (U/s 80DD) < 80%
0 Medical Treatment/Handicapped Dependent (U/s 80DD) > 80%
0 Interest on Educational Loan (U/s 80E)
23/11/2016
0
0
PAN of
Landlord
ATXPD4354L
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0 Pension
0.00
0 Interest on Deposits in Savings Account (Considered as deduction u/s 80TTA upto Rs.10000)
0 Others
https://ess.excelityglobal.com/EPSF/EPSF_Report_FY_09_10.jsp?cuen=null
0.00
0.00
12/13/2016
HR WorkWays
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Declaration:
1. I hereby declare that I have read and understood the guidelines provided in 'Proofs Option Document' and that, all
information,documents provided
above is true and correct in all respects.
2. 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.
Date:
Place:
* Indicates mandatory fields as per our database. Please verify the same and if blank, please fill and submit the form.
https://ess.excelityglobal.com/EPSF/EPSF_Report_FY_09_10.jsp?cuen=null
12/13/2016
HR WorkWays
Page 3 of 3
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
Bhavik Bhatt
3. Financial year
2016-2017
Sl.
Nature of claim
No.
1
Amount Evidence /
(Rs.)
particulars
Rs.59733
House Rent
Receipts
Note: Permanent Account Number shall be furnished if the aggregate rent paid during
the previous year exceeds one lakh rupees
Leave travel concessions or assistance
Deduction of interest on borrowing:
Rs.0
Travel
Receipts/Tickets
Rs.0.0
Provisional
Certificate from
Bank/Financial
Institution/Lender
Rs. 0.0
Photocopy of the
investment
proofs
(B) Other sections (e.g. 80E, 80G, 80TTA, etc.) under Chapter VI-A.
(a) Additional NPS Employee Contribution(80CCD1B)
Verification
:
: Rs.0
I, Bhavik Bhatt ,son/daughter of Kirit Bhatt . do hereby certify that the information given above is complete and correct
Place : Bangalore
Date : 13/12/2016
(Signature of the
employee)
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. The information
submitted above is deemed to be e-signed by the employee.
https://ess.excelityglobal.com/EPSF/EPSF_Report_FY_09_10.jsp?cuen=null
12/13/2016