Essential Details (*) = required fields.
  Van first made available date Date of Birth
(DD/MM/YYYY)		 Van last used date Date of Birth
(DD/MM/YYYY)
  Employee Van Usage Shared Exclusive Make
  Van Regn. No. Van Usage
  First Regn. Date Date of Birth
(DD/MM/YYYY)		 Standard Charge
  Model Number of Beneficiaries

 
Exclusively Used Van Details  
  Days the van was unavailable exclusively for 30 Days or more consecutively in tax year
  Days the van was a shared van during the benefit availability period
  Total Number of days van was unavailable or shared
  Particulars Amount
  Proportionate Standard charge for actual no. of days benefit was available G1
  Amount of contribution made by the employee for private use of this van G2
  Total Cash Equivalent ( G1 minus G2 ) G
Shared Van Details  
  Days the shared van was unavailable for 30 or more Days consecutively in tax year
  Days the van was put to exclusive use during the benefit availability period
  Total Number of days the van was not shared
  Particulars Amount
  Proportionate Standard charge for actual no. of days benefit was available G1
  Number of Beneficiaries G2
  Benefit Charge Per Employee ( G1 / G2 ) G3
  Amount of contribution made by the employee for private use of this van G4
  Total Cash Equivalent for this Van for the employee ( G3 minus G4 ) G