Statement showing particulars of perquisites, other fringe benefits or amenities and profits in lieu of salary with value thereof

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....sites : S. No. Nature of perquisites (see rule 3) Value of perquisite as per rules (Rs.) Amount, if any, recovered from the employee (Rs.) Amount of perquisite chargeable to tax Col. (3) - Col. (4) (Rs.) (1) (2) (3) (4) (5) 1. Accommodation 2. Cars/Other automotive 3. Sweeper, gardener, watchman or personal attendant 4. Gas, electricity, water 5. Interest free or concessional loans 6. Holiday expenses 7. Free or concessional travel 8. Free meals 9. Free education 10. Gifts, vouchers, etc. 11. Credit card expenses 12. Club expenses 13. Use of movable assets by employees 14. Transfer of assets to employees 15. Value of any other benefit/amenity/service/privilege 16. Stock options allotted or transfer....

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....------------------------------------ Signature of the person responsible for deduction of tax.] ************ NOTES:- 1. Substituted vide Notification No. 95/2019 dated 06-11-2019 w.e.f. 01-09-2019 before it was read as "PAN" 2. Substituted vide NOTIFICATION NO. 15/2021 dated 11-03-2021 w.e.f. 01-04-2021 before it was read as "FORM NO.12BA [See Rule 26A(2)(b)] Statement showing particulars of perquisites, other fringe benefits or amenities and profits in lieu of salary with value thereof 1) Name and address of the employer : 2) TAN: 3) TDS Assessment Range of the employer: 4) Name, designation and 1[Permanent Account Number or Aadhaar Number] of employee : 5) Is the employee a director or a person with: substantial interes....