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 Employer PAN No. of the Deductor TAN No. of the Deductor Name and designation of the Employee PAN No. of the Employee
Acknowledgement Nos. of all quarterly statements of TDS under sub-section (3) of section 200 as provided by TIN Facilitation Centre or NSDL web-site Quarter Acknowledgement No. From
Period
Assessment year
To
DETAILS OF SALARY PAID AND ANY OTHER INCOME AND TAX DEDUCTED
1. (a) (b) (c)
(d) 2.
Gross salary Salary as per provisions contained in section 17(1) Value of perquisites u/s 17(2) (as per Form No. 12BA, wherever applicable) Profits in lieu of salary under section 17(3) (as per Form No. 12BA, wherever applicable) Total Less : Allowance to the extent exempt under section 10 Allowance Rs.
Rs.
Rs.
Rs.
Rs.
Rs. Rs.
3. 4.
Balance (1 – 2) Deductions : (a) Entertainment allowance (b) Tax on Employment Aggregate of 4(a) and (b)
Income chargeable under the head ‘Salaries’ (3 - 5)
Rs. Rs.
5. 6. 7.
Rs. . Rs.
Add : Any other income reported by the employee
[TR 62; 16, ] I 1
Printed from Taxmann’s Income-tax Rules, 2007
Rs.
8. 9.
Gross total income (6 + 7) Deductions under Chapter VI-A (A) sections 80C, 80CCC and 80CCD Gross amount (a) section 80C (i) (ii) (iii) (iv) (v) (vi) (b) section 80CCC Rs. Rs. Rs. Rs. Rs. Rs. Rs. Rs.
Rs. Rs. Deductible amount
Rs. Rs.
(c) section 80CCD Rs. Rs. Notes : 1. Aggregate amount deductible under section 80C shall not exceed one lakh rupees. 2. Aggregate amount deductible under the three sections, i.e., 80C, 80CCC and 80CCD, shall not exceed one lakh rupees. (B) other sections (e.g., 80E, 80G etc.) under Chapter VI-A (a) section (b) section (c) section (d) section (e) section
10. 11. 12. 13. Aggregate of deductible amount under Chapter VI-A
Gross amount...