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Declaration format to claiming deduction u/s. 80GG by the Assessee.

In the Finance Act, 2012 the Income Tax Department suggest the Assessee while claiming Deduction u/s. 80GG i.e. Declaration in Form 10BA under rule 11B of Income Tax Act which is as under:

ANNEXURE-VIII
FORM NO. 10BA
(See rule 11B)
DECLARATION TO BE FILED BY THE ASSESSEE
CLAIMING DEDUCTION U/S 80 GG
I/We.......................................................................................................
(Name of the assessee with permanent account number)
do hereby certify that during the previous Year..............I/We had occupied the premise..............(full address of the premise) for the purpose of my/our own residence for a period of...........months and have paid Rs.................... In cash/through crossed cheque, bank draft towards payment of rent to Shri/Ms/M/s..........(name and complete address of the landlord).
It is further certified that no other residential accommodation is owned by
(a)  me/my spouse/my minor child/our family (in case the assessee is HUF), at .................where I/we ordinarily reside/perform duties of officer or employment or carry on business or profession, or
(a)  me/us at any other place, being accommodation in my occupation, the value of which is to be determined u/s 23(2)(a)(i) of u/s 23(2)(b).