FORM NO.

16
[See rule 31(1)(a)]

PART A
Certificate under Section 203 of the Income-tax Act, 1961 for tax deducted at source on salary

Certificate No. RJGFPKA Last updated on 24-Jun-2020

Name and address of the Employer Name and address of the Employee

SUMANDEEP VIDYAPEETH
At & Po. Pipariya, Ta. Waghodia, Dist. Vadodara-391760,
ARCHANA BHUPENDRA BEHL
Waghodia, Baroda - 391760
A-3, SHRINATH DUPLEY, NR JUTAN VIDHYALAYA, NEW SAMA
Gujarat
ROAD - 390008 Gujarat
+(91)2668-9879624795
[email protected]

Employee Reference No.

PAN of the Employee
PAN of the Deductor TAN of the Deductor provided by the Employer
(If available)

AAATK4485H BRDK00851E CBIPB4665B

CIT (TDS) Assessment Year Period with the Employer

From To
The Commissioner of Income Tax (TDS)
Room No. 201, 2nd Floor, Navjivan Trust Building, B/h Gujarat 2020-21 01-Apr-2019 31-Mar-2020
Vidhyapith , Ashram Road, Ahmedabad - 380014

Summary of amount paid/credited and tax deducted at source thereon in respect of the employee

Receipt Numbers of original

Amount of tax deposited / remitted
quarterly statements of TDS Amount of tax deducted
Quarter(s) Amount paid/credited (Rs.)
under sub-section (3) of (Rs.)
Section 200

Q1 QTRDRAHC 114600.00 6336.00 6336.00

Q2 QTTYVOLF 176465.00 9186.00 9186.00
Q3 QTWBDQVA 173562.00 8639.00 8639.00
Q4 QTZRIMCB 172293.00 6918.00 6918.00
Total (Rs.) 636920.00 31079.00 31079.00
I. DETAILS OF TAX DEDUCTED AND DEPOSITED IN THE CENTRAL GOVERNMENT ACCOUNT THROUGH BOOK ADJUSTMENT
(The deductor to provide payment wise details of tax deducted and deposited with respect to the deductee)

Book Identification Number (BIN)

Tax Deposited in respect of the
Sl. No. deductee Date of transfer voucher Status of matching
Receipt Numbers of Form DDO serial number in Form no.
(Rs.) (dd/mm/yyyy) with Form no. 24G
No. 24G 24G

Total (Rs.)
II. DETAILS OF TAX DEDUCTED AND DEPOSITED IN THE CENTRAL GOVERNMENT ACCOUNT THROUGH CHALLAN
(The deductor to provide payment wise details of tax deducted and deposited with respect to the deductee)

Challan Identification Number (CIN)

Tax Deposited in respect of the
Sl. No. deductee
(Rs.) BSR Code of the Bank Date on which Tax deposited Challan Serial Number Status of matching with
Branch (dd/mm/yyyy) OLTAS*

1 3220.00 0271852 06-07-2019 50726 F

2 3116.00 0271852 24-07-2019 50757 F
3 3072.00 0271852 05-09-2019 51241 F
4 3072.00 0271852 04-10-2019 50246 F

Page 1 of 2
 Certificate Number: RJGFPKA TAN of Employer: BRDK00851E PAN of Employee: CBIPB4665B Assessment Year: 2020-21

Challan Identification Number (CIN)

Tax Deposited in respect of the
Sl. No. deductee
(Rs.) BSR Code of the Bank Date on which Tax deposited Challan Serial Number Status of matching with
Branch (dd/mm/yyyy) OLTAS*

5 3042.00 0271852 23-10-2019 51051 F

6 2941.00 0271852 04-12-2019 50719 F
7 2899.00 0271852 03-01-2020 51749 F
8 2799.00 0271852 28-01-2020 50078 F
9 2665.00 0271852 07-03-2020 53103 F
10 2127.00 0271852 05-04-2020 50063 F
11 2126.00 0271852 30-04-2020 50498 F
Total (Rs.) 31079.00

Verification

I, CHANDRAMANI BHAGWAN MORE, son / daughter of BHAGWAN MANGA MORE working in the capacity of REGISTRAR (designation) do hereby certify that a sum
of Rs. 31079.00 [Rs. Thirty One Thousand and Seventy Nine Only (in words)] has been deducted and a sum of Rs. 31079.00 [Rs. Thirty One Thousand and Seventy
Nine Only] has been 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 Baroda Digitally signed by Chandramani More

Date: 2020.07.03 12:30:40 +05:30
Reason: Digitally signed TDS certificate as per Information Technology
Date 30-Jun-2020 (Signature
Act, 2000. of person responsible for deduction of Tax)
Location:
Designation: REGISTRAR Full Name:CHANDRAMANI BHAGWAN MORE

Notes:
1. Part B (Annexure) of the certificate in Form No.16 shall be issued by the employer.
2. If an assessee is employed under one employer during the year, Part 'A' of the certificate in Form No.16 issued for the quarter ending on 31st March of the financial year shall contain the details
of tax deducted and deposited for all the quarters of the financial year.
3. If an assessee is employed under more than one employer during the year, each of the employers shall issue Part A of the certificate in Form No.16 pertaining to the period for which such
assessee was employed with each of the employers. Part B (Annexure) of the certificate in Form No. 16 may be issued by each of the employers or the last employer at the option of the assessee.
4. To update PAN details in Income Tax Department database, apply for 'PAN change request' through NSDL or UTITSL.

Legend used in Form 16

* Status of matching with OLTAS

Legend Description Definition
Deductors have not deposited taxes or have furnished incorrect particulars of tax payment. Final credit will be reflected only when payment
U Unmatched
details in bank match with details of deposit in TDS / TCS statement
Provisional tax credit is effected only for TDS / TCS Statements filed by Government deductors."P" status will be changed to Final (F) on
P Provisional
verification of payment details submitted by Pay and Accounts Officer (PAO)
In case of non-government deductors, payment details of TDS / TCS deposited in bank by deductor have matched with the payment details
F Final mentioned in the TDS / TCS statement filed by the deductors. In case of government deductors, details of TDS / TCS booked in Government
account have been verified by Pay & Accounts Officer (PAO)
Payment details of TDS / TCS deposited in bank by deductor have matched with details mentioned in the TDS / TCS statement but the
O Overbooked amount is over claimed in the statement. Final (F) credit will be reflected only when deductor reduces claimed amount in the statement or
makes new payment for excess amount claimed in the statement

Page 2 of 2
 FORM NO. 16
PART B
Certificate under Section 203 of the Income-tax Act, 1961 for tax deducted at source on salary

Certificate No. RJGFPKA Last updated on 24-Jun-2020

Name and address of the Employer Name and address of the Employee

SUMANDEEP VIDYAPEETH
At & Po. Pipariya, Ta. Waghodia, Dist. Vadodara-391760,
ARCHANA BHUPENDRA BEHL
Waghodia, Baroda - 391760
A-3, SHRINATH DUPLEY, NR JUTAN VIDHYALAYA, NEW SAMA
Gujarat
ROAD - 390008 Gujarat
+(91)2668-9879624795
[email protected]

PAN of the Deductor TAN of the Deductor PAN of the Employee

AAATK4485H BRDK00851E CBIPB4665B

CIT (TDS) Assessment Year Period with the Employer

From To
The Commissioner of Income Tax (TDS)
Room No. 201, 2nd Floor, Navjivan Trust Building, B/h Gujarat 2020-21 01-May-2019 31-Mar-2020
Vidhyapith , Ashram Road, Ahmedabad - 380014

Details of Salary Paid and any other income and tax deducted Rs. Rs.

1. Gross Salary

(a) Salary as per provisions contained in section 17(1) 639120.00

Value of perquisites under section 17(2) (as per Form No. 12BA,
(b) 0.00
wherever applicable)
Profits in lieu of salary under section 17(3) (as per Form No.
(c) 0.00
12BA, wherever applicable)
(d) Total 639120.00

(e) Reported total amount of salary received from other employer(s) 0.00

2. Less: Allowances to the extent exempt under section 10

(a) Travel concession or assistance under section 10(5) 0.00

(b) Death-cum-retirement gratuity under section 10(10) 0.00

(c) Commuted value of pension under section 10(10A) 0.00

Cash equivalent of leave salary encashment under section 10

(d) 0.00
(10AA)

(e) House rent allowance under section 10(13A) 0.00

Page 1 of 3
Certificate Number: RJGFPKA TAN of Employer: BRDK00851E PAN of Employee: CBIPB4665B Assessment Year: 2020-21

Amount of any other exemption under section 10

[Note: Break-up to be prepared by employer and issued to the
(f)
employee, where applicable, before furnishing of Part B to the
employee]

(g) Total amount of any other exemption under section 10 0.00

Total amount of exemption claimed under section 10

(h) 0.00
[2(a)+2(b)+2(c)+2(d)+2(e)+2(g)]

Total amount of salary received from current employer

3. 639120.00
[1(d)-2(h)]
4. Less: Deductions under section 16
(a) Standard deduction under section 16(ia) 50000.00

(b) Entertainment allowance under section 16(ii) 0.00

(c) Tax on employment under section 16(iii) 2200.00

5. Total amount of deductions under section 16 [4(a)+4(b)+4(c)] 52200.00

6. Income chargeable under the head "Salaries" [(3+1(e)-5] 586920.00

7. Add: Any other income reported by the employee under as per section 192 (2B)

Income (or admissible loss) from house property reported by

(a) 0.00
employee offered for TDS

(b) Income under the head Other Sources offered for TDS 0.00

Total amount of other income reported by the employee

8. 0.00
[7(a)+7(b)]
9. Gross total income (6+8) 586920.00

10. Deductions under Chapter VI-A Gross Amount Deductible Amount

Deduction in respect of life insurance premia, contributions to

(a) 0.00 0.00
provident fund etc. under section 80C

Deduction in respect of contribution to certain pension funds

(b) under section 80CCC 0.00 0.00

Deduction in respect of contribution by taxpayer to pension

(c) scheme under section 80CCD (1) 0.00 0.00

(d) Total deduction under section 80C, 80CCC and 80CCD(1) 0.00 0.00

Deductions in respect of amount paid/deposited to notified

pension scheme under section 80CCD (1B)
(e) 0.00 0.00

Page 2 of 3
 Certificate Number: RJGFPKA TAN of Employer: BRDK00851E PAN of Employee: CBIPB4665B Assessment Year: 2020-21

Deduction in respect of contribution by Employer to pension

(f) scheme under section 80CCD (2) 0.00 0.00

Deduction in respect of health insurance premia under section

(g) 0.00 0.00
80D

Deduction in respect of interest on loan taken for higher

(h) education under section 80E 0.00 0.00

Gross Qualifying Deductible

Amount Amount Amount
Total Deduction in respect of donations to certain funds,
(i) 0.00 0.00 0.00
charitable institutions, etc. under section 80G
Deduction in respect of interest on deposits in savings account
(j) 0.00 0.00 0.00
under section 80TTA

Amount Deductible under any other provision (s) of Chapter VI-A

[Note: Break-up to be prepared by employer and issued to the
(k)
employee, where applicable , before furnishing of Part B to the
employee]

Total of amount deductible under any other provision(s) of

(l) 0.00 0.00 0.00
Chapter VI-A

Aggregate of deductible amount under Chapter VI-A

11. 0.00
[10(d)+10(e)+10(f)+10(g)+10(h)+10(i)+10(j)+10(l)]

12. Total taxable income (9-11) 586920.00

13. Tax on total income 29884.00

14. Rebate under section 87A, if applicable 0.00

15. Surcharge, wherever applicable 0.00

16. Health and education cess 1195.00

17. Tax payable (13+15+16-14) 31079.00

18. Less: Relief under section 89 (attach details) 0.00

19. Net tax payable (17-18) 31079.00

Verification
I, CHANDRAMANI BHAGWAN MORE, son/daughter of BHAGWAN MANGA MORE .Working in the capacity of
REGISTRAR (Designation) do hereby certify that the information given above is true, complete and correct and is based on the books
Digitally signed by Chandramani More
of account, documents, TDS statements, and other available records. Date: 2020.07.03 12:30:40 +05:30
Reason: Digitally signed TDS certificate as per Information Technology
Act, 2000.
Location:
Place Baroda (Signature of person responsible for deduction of tax)
Full
Date 30-Jun-2020 CHANDRAMANI BHAGWAN MORE
Name:

Page 3 of 3
Name : DR. ARCHANA B BEHL PAN : CBIPB4665B AY : 2020-2021

PART B [2(f) and 10(k) details]

1. Less: Allowances to the extent exempt under section 10 - 2(f)

Total amount of any other exemption under section 10

2. Deductions under Chapter VI-A as per 10(k) Gross Qualifying Deductible

Amount Amount Amount
(a) Amount deductible under any other provision(s) of Chapter VI-A
Total of amount deductible under any other provision(s) of Rs. 0 Rs. 0 Rs. 0
Chapter VI-A

Tax Deducted Summary

(Summary of Tax Payable and Tax Deducted Information)

Sl. No. Particulars Amount

1 Tax payable as per Part-B 31079

2 Tax Deducted at Current Employment 31079

3 Tax Deducted at Previous Employment 0

4 Total Tax Deducted (2 + 3) 31079

5 Net Tax Payable / (Refundable) (1 - 4) 0

Digitally signed by Chandramani More

Date: 2020.07.03 12:30:40 +05:30
Reason: Digitally signed TDS certificate as per Information Technology
Act, 2000.
Place VADODARA Location:

Date 31/03/2020 (Signature of person responsible for deduction of tax)

 FORM No. 12 BA
[See rule 26A(2) (b)]
Statement showing particulars of perquisites, other fringe benefits or
amenities and profits in lieu of salary with value thereof

1 Name and address of Employer: Sumandeep Vidyapeeth Deemed to be University

At & Po. Pipariya,Ta. Waghodia
Dist. Vadodara-391760
Waghodia
Baroda
GUJARAT - 391760

2 TAN: BRDK00851E
3 TDS Assessment Range of the employer:
4 Name, designation and PAN of employee: DR. ARCHANA B BEHL,R1,CBIPB4665B
5 Is the employee a director or a person with
substantial interest in the company (where No
the employer is a company):
6 Income under the head “Salaries” of the 586920
employee ( other than from perquisites):
7 Financial Year: 2019 - 2020

8 Valuation of Perquisites:
Sl Nature of perquisite Value of Amount, if any Amount, if any
No. (See rule 3) perquisite recovered perquisite
as per from the chargeable
rules employee to tax
Col.(3) – Col.(4)
(Rs.) (Rs.) (Rs.)
(1) (2) (3) (4) (5)
1 Accommodation Nil Nil Nil
2 Cars/Other automotive Nil Nil Nil
3 Sweeper, gardener, watchman or personal Nil Nil Nil
attendant
4 Gas, electricity, water Nil Nil Nil
5 Interest free or concessional loans Nil Nil Nil
6 Holiday expenses Nil Nil Nil
7 Free or concessional travel Nil Nil Nil
8 Free meals Nil Nil Nil
9 Free education Nil Nil Nil
10 Gifts, vouchers, etc. Nil Nil Nil
11 Credit card expenses Nil Nil Nil
12 Club expenses Nil Nil Nil
13 Use of movable assets by employees Nil Nil Nil
14 Transfer of assets to employees Nil Nil Nil
15 Value of any other benefit / amenity Nil Nil Nil
/ service / privilege
16 Stock options ( non-qualified options) Nil Nil Nil
17 Other benefits or amenities Nil Nil Nil
18 Total value of perquisites
19 Total value of Profits in lieu of salary as
per section 17(3)
9 Details of tax:
(a) Tax deducted from salary of the employee under section 192 (1) 31079
(b) Tax paid by employer on behalf of the employee under section 192(1A) Nil
(c) Total tax paid 31079
(d) Date of payment into Government treasury
Declaration by Employer

I Dr. Chandramani More son of Bhagwan More working as REGISTRAR (designation) do hereby declare on behalf of Sumandeep Vidyapeeth
(name of the employer) that the information given above is based on the books of account, documents and other relevant records or information
available with us and the details of value of each such perquisite are in accordance with section 17 and rules framed there under and that such
information is true and correct.

Digitally signed by Chandramani More

Date: 2020.07.03 12:30:40 +05:30
Place : VADODARA Reason: Digitally signed TDS certificate as per Information Technology
Signature of person responsible for deduction of tax
Act, 2000.
Date : 31/03/2020 Location:

Full Name : Dr. Chandramani More

Designation : REGISTRAR