FORM NO. 16 [See rule 31(1) (a)] Certificate under section 203 of the Income-tax Act, 1961, for tax deducted at source from income chargeable under the head "Salaries" Name & address of the employer Name & Designation of the employee TAN: PAN/GIR No.: TDS circle where annual return/statement Assessment Year under section 203 is to be filled. 2007-08 Details of salary paid and any other income and tax deducted 1 Gross salary (a) Salary as per provisions contained in section 17(1) Rs (b) Value of perquisites under section 17(2) (as per Form No. 12 BA, wherever applicable) Rs (c) Profits in lieu of salary under section 17(3) (as per Form No. 12BA, wherever applicable) Rs (d) Total Rs 2. Less : Allowance to the extent exempt under section 10 (a) HCA Rs. (b) T.A Rs. (c) C.A Rs. (d) HRA Rs. (e) Misc Rs. Rs. 3. Balance (1-2) Rs. 4. Deductions : (a) Entertainment allowance Rs. (b) Tax on employment Rs. 5. Aggregate of 4 (a to b) Rs. 6. Income chargeable under the head "Salaries" (3-5) Rs. 7. Add (i) Any other income reported by the employee (a) House Property Rs. (b) Interest Rs. (c) Any other Rs. Rs. 8. Gross total income (6+7) Rs. 9. Deductions under Chapter VI-A Gross amount Deductible amount (A) Sections 80C, 80CCC and 80CCD (a) section 80C, GPF (i) LIC/PLI/GIS/IGPAI Rs. (ii) NSC/PPF Rs (iii) H.B.L. repayment Rs (iv) Tuition Fee Rs (v) Bonds Rs (vi) NSC Reinvestment Rs. Rs. Rs. (b) section 80CCC (Pension Fund) Rs. Rs. Rs. (c) section 80CCD (A New Pension Fund) Rs. Rs. Note : 1. aggregate amount deductible under section 80C shall not exceed one lakh rupees 2. aggregate amount deductible under the three section, i.e. 80C, 80CCC and 80CCD, shall not exceed one lakh rupees. (B) other sections (for e.g., 80E, 80G etc.) under Chapter VIA Gross amount Qualifying amount Deductible amount (a) section 80D Rs. Rs. (b) section 80G (100%) Rs. Rs. (c) section 80U Rs. Rs. (d) section 80DD Rs. Rs. (e) section 80DDB Rs. Rs. (f) section 80G (50%) Rs. Rs. (e) section 80E Rs. Rs. Rs. 10 Aggregate of deductible amount under Chapter VI-A Rs. 11 Total income (8-10) Rs. 12 Tax on total income Rs. 13 Surcharge (on tax computed at S.No. 12) Rs. 14 Education Cess (on tax at S.No. 12 and surcharge at S.No. 13) Rs. 15 Tax payable (12+13+14) Rs. 16 Relief under section 89 (attach details) Rs 17 Tax payable (15-16) Rs 18 Less : (a) Tax deducted at source u/s 192(1) by employer Rs (b) Tax paid by the employer on behalf of the employee u/s 192(1A) on perquisites u/s 17(2) Rs (c) By other Institution Rs (b) By Employee Rs Rs 19. Tax payable/ refundable (17-18) Rs DETAILS OF TAX DEDUCTED AND DEPOSITED INTO CENTRAL GOVERNMENT ACCOUNT IN RESPECT OF Sh./Dr/Smt./______________________ PAN No. _____________for the year 2007-08 S.No. TDS Rs. Surcharge Rs. Education Cess Rs. Total tax deposited Rs. Cheque/ DD No. (if any) BSR Code of Bank branch Date on which tax deposited (dd/mm/yy) Transfer voucher/ challan Identification No. 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. Total I .................. son of .............. working in the capacity of ...............................(designation) do hereby certify that a sum of Rs........ [Rupees........ ........................... (in words)] has been deducted at source and paid to the credit of the Central Government. I further certify that the information given above is true and correct based on the books of account, documents and other available records. Place : Signature of the person responsible for deduction of tax Date:
