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FORM NO. 16 |
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[See rule 31(1)(a)] |
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Certificate under section 203 of the Income-tax Act, 1961 |
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for tax deducted at source from income chargeable |
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under the head “Salaries” |
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Name and address of the Employer Name and designation |
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of the Employee |
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…………………………………………………………………………. ……………………………… |
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…………………………………………………………………………. ……………………………… |
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…………………………………………………………………………. ……………………………… |
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…………………………………………………………………………. ……………………………… |
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…………………………………………………………………………. ……………………………… |
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PAN/GIR NO |
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TAN |
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PAN/GIR NO. |
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TDS Circle where Annual Return/Statement under Period Assessment section 206 is to be filed |
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year ………. |
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FROM TO |
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DETAILS OF SALARY PAID AND ANY OTHER INCOME AND TAX DEDUCTED |
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1. Gross salary* |
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Rs. ……… |
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2. Less: Allowance to the extent exempt under |
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section 10 |
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Rs. ……… |
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3. Balance (1-2) |
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Rs. ……… |
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4. Deductions: |
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(a) Standard deduction Rs. ……… (b) Entertainment allowance Rs. ……… (c) Tax on Employment Rs. ……… |
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5. Aggregate of 4 (a) to (c) |
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Rs. ……… |
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6. Income chargeable under the head ‘Salaries’ |
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(3 – 5) |
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Rs. ……. |
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7. Add: Any other income reported by the |
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employee |
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Rs. ……. |
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8. Gross total income (6 + 7) |
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Rs. ……. |
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9. Deductions under Chapter VI-A |
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GROSS QUALIFYING DEDUCTIBLE |
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AMOUNT AMOUNT AMOUNT |
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(a) |
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Rs. ……… Rs. ……… Rs. ……… |
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(b) |
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Rs. ……… Rs. …………. Rs. ……… |
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(c) |
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Rs. ……… Rs. ……… Rs. ……… |
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(d) |
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Rs. ……… Rs. …………. Rs. ……… |
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10. Aggregate of deductible amounts under |
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Chapter VI-A |
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Rs. ……… |
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11. Total income (8 – 10) |
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Rs. ……… |
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12. Tax on total income |
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Rs. ……… |
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13. Rebate and relief under Chapter VIII |
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I. Under section 88 GROSS QUALIFYING TAX REBATE/ |
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(please specify) AMOUNT AMOUNT RELIEF |
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(a) |
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Rs. ……… Rs. ……… |
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(b) |
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Rs. ……… Rs. ……… |
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(c) |
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Rs. ……… Rs. ……… |
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(d) |
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Rs. ……… Rs. ……… |
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(e) |
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Rs. ……… Rs. ……… |
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(f) TOTAL [(a) to (e)] Rs. ……… Rs. ……… Rs. ……… |
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II. Under section 88A GROSS QUALIFYING |
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(please specify) AMOUNT AMOUNT |
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(a) |
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Rs. ……… Rs. ……… |
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(b) |
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Rs. ……… Rs. ……… |
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(c) TOTAL [(a) + (b)] Rs. ……… Rs. ……… Rs. ……… |
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III. Under section 89 |
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(attach details) |
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Rs. ……… |
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14. Aggregate of tax rebates and relief at 13 above |
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[I(f) + II(c) + III)] |
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Rs. ……… |
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15. Tax payable (12 – 14) and surcharge thereon |
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Rs. ……… |
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16. Less Tax deducted at source |
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Rs. ……… |
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17. Tax payable/refundable (15 – 16) |
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Rs. ……… |
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DETAILS OF TAX DEDUCTED AND DEPOSITED INTO |
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CENTRAL GOVERNMENT ACCOUNT |
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AMOUNT DATE OF PAYMENT NAME OF BANK AND BRANCH |
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WHERE TAX DEPOSITED |
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Certified that a sum of Rs. (in words)……………………………………………………….. has been deducted at source and paid to the credit of the Central Government. Further certified that the above information is true and correct as per records. |
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Place ………………. |
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…………………………………….. |
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Signature of the person responsible |
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for deduction of tax |
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Date ……………….. |
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Full Name …………………………………… Designation …………………………………. |
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*See sections 15 and 17 and rule 3. Furnish separate details of value of the perquisites and profits in lieu of or in addition to salary or wages. |
