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 and address of the Employee Name and designation of the Employee
   
   
   
   
PAN / GIR NO. TAN PAN / GIR NO.


TDS Circle where Annual Return/ State under section 206 is to be filed Period Assessment year 19
From To
     


DETAILS OF SALARY PAID AND ANY OTHER INCOME AND TAX DEDUCTED
 

1. Gross salary   Rs.  
2. Less: Allowance to the extent exempt under section 10 Rs.    
3. Balance (1-2)      
4. Deduction:      
  (a) Standard deduction Rs.       
  (b) Entertainment allowance Rs.      
  (c ) Tax on Employment Rs.       
5. Aggregate of 4 (a to c) Rs. Rs.  
6. Income chargeble under the head  
"Salaries" (3-5)		     Rs.
7. Add: Any other income reported by the employee     Rs.
8. Gross total income (6+7)     Rs.
9. Deduction under chapter vi-A GROSS AMMOUNT QUALIFYING AMMOUNT DEDUCTIBLE AMMOUNT  
  (a) Rs. Rs. Rs.  
  (b) Rs. Rs. Rs.  
  (c)  Rs. Rs. Rs.  
  (d) Rs. Rs. Rs.  
10. Aggregate of deductible amount under Chapter vi-A        
11. Total income (8-10)        
12. Tax on total income        
13. Rebate and relief under Chapter viii        
  I. Under section 88 (Please specify) GROSS AMOUNT QUALIFYING AMOUNT TAX REBATE / RELIEF  
  (a) Rs. Rs.    
  (b) Rs. Rs.    
  (c ) Rs. Rs.    
  (d) Rs. Rs.    
  (e) Rs. Rs.    
  (f) TOTAL (a to e ) Rs. Rs. Rs.  
  II. Under section 88A (please specify) GROSS AMOUNT QUALIFYING AMOUNT    
  (a) Rs. Rs.    
  (b) Rs. Rs.    
  (c ) TOTAL [ (a) + (b) ] Rs. Rs. Rs.  
  III. Under section 89 (attach details)     Rs.  
14. Aggregate of tax rebates and relief at 13 above [ I(f) + II(c) + III ]       Rs.
15. Tax payble (12-14) and surcharge thereon       Rs.
16. Less: Tax deduct at source       Rs.
17. Tax payable / refundable (15-16)       Rs.


DETAILS OF TAX DEDUCTED AND DEPOSITED INTO CENTRAL GOVERNMENT ACCOUNT  

AMOUNT DATE OF PAYMENT NAME OF BANK AND BRANCH WHERE TAX DEPOSITED
     

 
 

Certified thata sum of Rs. (in words) _____________________________ has been

deducted at source and paid to the credit of the Central Government. Futher certified that the above information is true and currect as per records.
 

Place  
Date  

 

 
Signature of the person responcible for deduction of tax

 

Full Name  
Designation