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 paid to an employee under section 192 or pension/interest income
of specified senior citizen under section 194P

Certificate No. SBEKQIA Last updated on 07-Jun-2024

Name and address of the Employer/Specified Bank Name and address of the Employee/Specified senior citizen
CBA SERVICES PRIVATE LIMITED
NO 1000,2000,3000,4000, WE WORK, NXT TOWER 1, MANYATA,
TECH PARK ROAD, AMUELA SHAIK
THANISANDRA, BENGALURU - 560045 10 17 11, KANUMARLA VARI STREET, KAVALI, NELLORE -
Karnataka 524201 Andhra Pradesh
+(91)91-9591541641
[email protected]
PAN of the Employee Reference No. provided by the
PAN of the Deductor TAN of the Deductor Employee/Specified senior Employer/Pension Payment order no. provided
citizen by the Employer (If available)

AAHCC5187G BLRC17292C BNTPS8633N

CIT (TDS) Assessment Year Period with the Employer

From To
The Commissioner of Income Tax (TDS)
Room No. 59, H.M.T. Bhawan, 4th Floor, Bellary Road , 2024-25 01-Apr-2023 31-Mar-2024
Ganganagar, Bangalore - 560032

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 QVKNLAIC 745500.00 152460.00 152460.00

Q2 QVMLTGUA 1245945.00 301980.00 301980.00
Q3 QVPHHHMB 809825.00 175838.00 175838.00
Q4 QVRZUGRD 800077.00 235195.00 235195.00
Total (Rs.) 3601347.00 865473.00 865473.00
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 50820.00 0510349 04-05-2023 28704 F

2 50820.00 0510002 06-06-2023 76530 F
3 50820.00 0510002 06-07-2023 09516
Signature Not Verified F
4 50820.00 0510002 04-08-2023 Digitally
35148 signed by F
KASTALA DEEPIKA
Date: 2024.06.12 12:41:36
IST
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 Certificate Number: SBEKQIA TAN of Employer: BLRC17292C PAN of Employee: BNTPS8633N Assessment Year: 2024-25

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 50820.00 0510002 07-09-2023 11557 F

6 200340.00 0510002 06-10-2023 01520 F
7 64270.00 6939001 07-11-2023 28705 F
8 55784.00 0510002 08-11-2023 00832 F
9 55784.00 0510002 05-01-2024 00428 F
10 55783.00 0510002 07-02-2024 97099 F
11 86984.00 0510022 07-03-2024 89186 F
12 92428.00 0510002 23-04-2024 02227 F
Total (Rs.) 865473.00

Verification
I, DEEPIKA KASTALA, son / daughter of VENUGOPAL KASTALA working in the capacity of GENERAL MANAGER FINANCE (designation) do hereby certify that a
sum of Rs. 865473.00 [Rs. Eight Lakh Sixty Five Thousand Four Hundred and Seventy Three Only (in words)] has been deducted and a sum of Rs. 865473.00 [Rs.
Eight Lakh Sixty Five Thousand Four Hundred and Seventy Three 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 BANGALORE

Date 08-Jun-2024 (Signature of person responsible for deduction of Tax)

Designation: GENERAL MANAGER FINANCE Full Name:DEEPIKA KASTALA

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

Signature Not Verified

Digitally signed by
KASTALA DEEPIKA
Date: 2024.06.12 12:41:36
IST
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