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
Page 1 3

Employer - PAO Code Name and Rank of the Employee

78 INDRA BAHADUR BASNET
PAN of the Deductor TAN of the Deductor PAN of the Employee
AJJPK0499D ALDO00369F DWXPB8804H
CIT(TDS) Address Assessment Year / Tax Option Period
PAO ORS 39 GTC 2023-2024/OLD 01/04/2022 TO 31/03/2023
Summary of Tax deducted at Source
Quarter Receipt Numbers of original statements of Amount of tax deducted Amount of tax deducted/remitted
TDS under sub-section(3) of section 200 in respect of the employee in respect of the employee
Quarter 1 QUYUQGUD 0 0
Quarter 2 QVCFSMDA 0 0
Quarter 3 QVFZQWBB 0 0
Quarter 4 QVHVETDA 46543 46543
Total 46543 46543
PART-B
DETAILS OF SALARY PAID AND ANY OTHER INCOME AND TAX DEDUCTED
` ` ` `
1. Gross Salary 838167
2. Standard Deduction 50000
3. Less Allowance to the extent exempt under Section 10 8410
4. BALANCE (1 - 2) 779757
5. DEDUCTIONS :
a. Interest payable on loan u/s 24 : 0
6. Aggregate of 5 ( a to b ) 0
7. Income chargeable under the Head 'SALARIES' (3 - 5) 779757
8. Add: Any other income reported by the employee * 0
9. GROSS TOTAL INCOME (6 + 7) 779757
10. DEDUCTIONS UNDER CHAPTER VI-A GROSS AMT QUAL AMT QUAL AMT DEDUCT AMT
a) Qualified under Sec.80C 118500 118500 118500
b) Qualified for 100% deduction 0 0 0
c) Qualified for 50% deduction 0 0 0
d) Qualified under Sec.80DD 0 0 0
e) Qualified under Sec.80U 0 0 0
11. Aggregate of deductible amount under Chapter VI-A 118500
12. Total Income (8 - 10) Rounded 661260
13. TAX ON TOTAL INCOME 44752
14. Health & Education Cess @4% (on tax computed at Sl.No.12) 1791
15. Tax Payable (12 + 13) 46543
16. Less: Relief under Section 89(attach Details) 0
17. Less : Tax Deducted 46543
18. TAX PAYABLE/REFUNDABLE (15 - 16) 0

VERIFICATION
 BREAK UP OF TAXABLE EMOLUMENTS FINANCIAL YEARWISE Page 2 3

I, PRAMOD KUMAR Sr, son/daughter of JAI NARAYAN working in the capacity of AAO do hereby
certify that a sum of Rs. 46543 (in words) Rupees Forty Six Thousand Five Hundred Forty Three only. has been
deducted and deposited to the credit of Central Government. I further certify that the above information is true,
complete and correct and is based on the books of account, documents, TDS statements, TDS deposited and
other available records.

Note * : Sl.No.8 above Other Income includes taxable interest accrued on Fund Subscription above 500000 Rupees

Place : VARANASI Signature of the person responsible for deduction of tax

Date : 01/06/2023 Full Name PRAMOD KUMAR Sr
Designation AAO
 BREAK UP OF TAXABLE EMOLUMENTS FINANCIAL YEARWISE Page 3 3

Employer - PAO Code Name and Rank of the Employee

78 INDRA BAHADUR BASNET
For the financial year from 01/03/2021 to 28/02/2022 = 254023.0
For the financial year from 01/03/2022 to 28/02/2023 = 584144.0
Total taxable emoluments 838167.0