FORM 16
Certificate under section 203 of the Income-tax Act, 1961 for Tax deducted at source on Salary
Name and address of the Employer Name and designation of the Employee
PAN of the Deductor TAN of the Deductor PAN of the Employee
CIT (TDS) Assessment Year Period
Address: From To
2022-21
City: Pincode:
PART B
Details of Salary Paid and any other income and tax deducted
Rs. Rs. Rs.
1. Gross Salary
(a) Salary as per provisions contained in sec. 17(1) -
(b) Value of perquisites u/s 17(2) (as per Form No. 12BB, wherever
-
applicable)
(c) Profits in lieu of salary under section 17(3)(as per Form No. 12BB,
-
wherever applicable
(d) Total -
2. Less: Allowance to the extent exempt U/s 10
Allowances Rs.
House Rent Allowance 0.00
Leave Travel Allowance 0.00
Gratuity Payment 0.00
Leave Encashment Payment 0.00
Uniform/Professional Devop.Allowance 0.00
Children Education Allowance 0.00 -
3. Balance (1-2) -
4. Deductions :
(a) Entertainment allowance
(b) Standard Deduction -
(c) Tax on employment -
5. Aggregate of 4(a) and (b) -
6. Income chargebale under the head 'Salaries' (3-5) -
7. Add: Any other income reported by the employee
Income Rs.
Income from House Property 0.00
Income from Other Sources 0.00
-
8. Gross Total income (6+7) -
9. Deductions under Chapter VI A
(A) sections 80C, 80CCC and 80CCD
Deductibl
Gross
e
Amount
Amount
(a) Section 80 C
Employees Provident Fund 0 -
Voluntary Provident Fund 0 -
Public Provident Fund 0 -
National Saving Certificate (NSC) 0 -
Tax Saving Mutual Funds 0 -
Insurance Premium Paid 0 -
Savings in Pension Plans 0 -
Tax Saving Fixed Deposit with Banks 0 -
Unit Linked Insurance Plan 0 -
Senior Citizens Savings Scheme 0 -
Sukanya Samriddhi Yojana 0 -
Children Education Fee 0 -
Housing Loan Principal Repayment/Stamp Duty Paid 0 -
Total - -
Note: 1. Aggregate amount deductible under section 80 C shall not
exceed one lakh Fifty Thousand rupees.
2. Aggregate amount deductible under the three sections, i.e.
80C,80CCC,80CCD shall not exceed one lakh rupees.
Qualifyin
(B) other sections (e.g. 80E,80G etc.) under g Deductibl
Chapter VI-A Gross Amount Amount e Amount
Contribution to NPS (Sec 80CCD (1b) -
Employer Contribution to NPS (Sec 80CCD (2) -
Medical Insurance Premium (Sec 80D) -
Medical treatment for handicapped dependents (Sec 80DD) -
Medical treatment for specified diseases (Sec 80DDB) -
Interest on Higher Education Loan(Sec 80E) -
Interest on Housing loan (Sec 80EE) -
Donations to charitable institutions and others (Sec 80G) -
Deductions in respect of rents paid (Sec 80GG) -
Interest income from bank deposits (80TTA/80TTB) -
Deduction for permanent disability (80U) -
Total -
11. Total Income (8-10) -
12. Tax on total income -
13. Relief under Sec 87a -
13b. Less rebate on Agricultural Income -
14. Total tax Due -
14b. Surcharge -
15. Education cess @ 3% -
16. Tax Payable (14+16) -
Verification
I, ------------------------, son / daughter of -------------------- working in the capacity of ---------------------- (designation) do
hereby certify that a sum of Rs.--------------------------------------------------- [Rs.
------------------------------------------------------------------------------ (in Words) has been deducted and deposited to the
credit of the Central Government. I further certify that the information given above is true, complete and correct
and is based on the books of account, documents, TDS statements, TDS deposited and other available records.
Place :
Date :
Signature of person responsible for deducti
Designation: Full Name:
