House Rent Allowance (HRA) DECLARATION (FY 2021-22)
Self Declaration by Employee
(All the fields below are mandatory)
Employee Number : 5041433……………………………
Employee Name : …Sameer Ahmed Ansari…………………………….
Are you the owner of the rented property: (YES / NO): No
Annual Rent Paid : …1,20,000…………………………………..
Mode of Rent Payment : Cash
Address of Rented Property : …[Link] – 16-2-741/B/41/1, Asmangadh, TV Tower, Malakpet, Hyderabad………..
………………………………………………………..
Name of Landlord : …Sameena Ansari …………………………………
Contact No of Landlord : ……9885086545……………………………… (Mobile)
……………………………………………………… (Residence)
………………………………………………………… (Work)
………………………………………………………… (E-mail)
Landlord address for communication (present address) : … [Link] – 16-2-741/B/41/1, Asmangadh, TV Tower, Malakpet,
Hyderabad, Telangana, 500036 ……………………………………………………………………………………………..
PAN (Permanent Account Number) of Landlord: __AEZPA4203J__________
Further, I hereby declare that I will continue to pay the rent till end of Financial Year 2021-22, as the tax proofs are collected in the month of
December 2021. If the rent agreement period is ending prior to Mar 2022, then I undertake to renew the rent agreement and continue to pay the rent
as per the renewed agreement. The rent amount & period declared in the tool and proof/declaration to be considered for providing HRA exemption.
The above information is complete, true and correct to the best of my knowledge and I have no reason to believe that this information can be
misleading or inaccurate. I shall be personally responsible and liable if the same is found incorrect.
I undertake to provide any further information which Kyndryl Solutions or its authorized representatives may request me to provide in context of my
House Rent Allowance.
I hereby consent to Kyndryl Solutions or its authorized representatives to contact me or my Landlord or their authorized representatives to collect any
information regarding my House Rent Allowance payments.
I acknowledge and understand that, in light of the overall pandemic situation, only for Financial Year 2021-22,Kyndryl Solutions has permitted me to
temporarily submit a soft copy declaration, stating that the details submitted by me are true and correct. I undertake to submit the original/ signed
hard copy documents, duly signed by me and/or my landlord, on demand from Kyndryl Solutions. Notwithstanding the above, I agree and
acknowledge that Kyndryl Solutions may reject my claims if it is not satisfied with the documents, or may require further documents from me,
including original/ signed hard copy documents. I further acknowledge that Kyndryl Solutions may require me to submit such documents even after
I separate from Kyndryl Solutions. If Kyndryl Solutions is not satisfied with my documents, Kyndryl Solutions may, at its option, reject my claims
for tax benefits, recover taxes due from me, or notify the tax authorities. Kyndryl Solutions's discretion in this respect shall be final.
If any part of the information contained herein (including the actual rent paid) is found to be fully or partly incorrect or misleading then I will be
personally liable including filing of original/revised individual tax return payment of any differential tax to the Income-tax Department and any other
consequences.
I acknowledge that any inaccurate/misleading information furnished by me will also amount to violation of the Kyndryl Solutions Business Conduct
Guidelines (BCG) and Kyndryl Solutions can take disciplinary action against me including termination of my services.
(Signature of Employee)
