00000895/EFRPB1817J Abhishek Bansal

PART B (Annexure)
Details of Salary paid and any other income and tax deducted INR INR INR

1. Gross salary

(a) Salary as per provisions contained in sec.17(1) 879898.25

(b) Value of perquisites u/s 17(2) (as per Form No.12BA,

wherever applicable) 153000.00

(c) Profits in lieu of salary under section 17(3) (as per 0.00
Form No.12BA, wherever applicable)

(d) Total
1032898.25

(e) Reported total amount of salary received from other employer(s) 0.00
2. Less: Allowance to the extent exempt u/s 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

(d) Cash equivalent of leave salary encashment under section

10(10AA) 0.00

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

41293.61
(f) Amount of any other exemption under section 10

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

(h) Total amount of exemption claimed under section 10
[2(a)+2(b)+2(c)+2(d)+2(e)+2(g)]
41293.61
3. Total amount of salary received from current employer [1(d)-2(h)]
991604.64
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) 1600.00

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

51600.00

6. Income chargeable under the head "Salaries" [(3+1(e)-5] 940005.00

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

(a) Income (or admissible loss) from house property reported by

employee offered for TDS 0.00

(b) Income under the head Other Sources offered for TDS
0.00
8. Total amount of other income reported by the employee
[7(a)+7(b)] 0.00

9. Gross total income (6+8)

940005.00

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

(a) Ded. in respect of life ins. premia, contr to provident fund etc U/S 80C 154953.00 150000.00

(b) Ded. in respect of contribution to certain pension funds U/S 80CCC 0.00 0.00

(c) Ded. in respect of contr by taxpayer to pension scheme U/S 80CCD(1) 0.00 0.00

(d) Total deduction U/S 80C, 80CCC, 80CCD(1) 154953.00 150000.00

(e) Ded. in respect of amount paid/dep. to pension scheme U/S 80CCD(1B) 50000.00 50000.00

(f) Ded. in respect of contr by employer to pension scheme U/S 80CCD(2) Signature Not Verified 58693.00 39129.00
Signed By:ATUL KUMAR NAYAK
(g) Ded. in respect of health insurance premia U/S 80D Location: New Delhi 1847.00 1847.00
Signing Date:14.06.2024 15:43
00000895/EFRPB1817J Abhishek Bansal

(h) Ded. in respect of interest on loan taken for higher education U/S 80E 0.00 0.00
Gross Amount Qualifying Amount Deductible Amount

(i) Ded. in respect of donations to certain funds, charitable inst, etc. U/S 80G 0.00 0.00 0.00

(j) Ded. in respect of interest on deposits in saving account U/S 80TTA 0.00 0.00 0.00

(k) Amount deductible under any other provision(s) of Chapter VI-A 0.00 0.00 0.00

(l) Total amount deductible under any other provision(s) of Chapter VI-A 0.00 0.00 0.00

11. Aggregate of deductible under Chapter VI-A [10(d)+10(e)+10(f) 240976.00

+10(g)+10(h)+10(i)+10(j)+10(l)

12. Total taxable Income (9-11) 699030.00

13. Tax on total income 52306.00

14. Rebate under section 87A, if applicable 0.00

15. Surcharge, wherever applicable 0.00

16. Health and education cess 2092.24

17. Tax payable (13+15+16-14) 54399.00

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

19. Net Tax Payable (17-18) 54399.00

Verification

I, ATUL KUMAR NAYAK, son/daughter of working in the capacity of DGM (F&A) (designation) do hereby certify that the information given above
is true, complete and correct and is based on the books of account, documents, TDS statements, and other available records.

Place DELHI

(Signature of person responsible for deduction of tax)

Date 12.06.2024 Full Name: ATUL KUMAR NAYAK

Signature Not Verified

Signed By:ATUL KUMAR NAYAK
Location: New Delhi
Signing Date:14.06.2024 15:43
00000895/EFRPB1817J Abhishek Bansal

FORM No.12BA
{See Rule 26A(2)(b)}
Statement showing particulars of perquisities, other fringe
benefits or amenities and profits in lieu of salary with value thereof

1) Name and address of employer :

Petronet LNG Limited, WorldTradeCentre,1stFloor,BabarRoadBarakhamba Lane, New Delhi-110001, Delhi
2) TAN: DELP05642A
3) TDS Assessment Range of the employer :
, CIRCLE 51(1), NEW DELHI, , 110001,
4) Name, designation and PAN of employee :
Mr/Ms: Abhishek Bansal, Desig.:GET (Mechanical), Emp #:00000895, PAN:EFRPB1817J
5) Is the employee a director or a person with :
substantial interest in the company (where the
employer is a company)
6) Income under the head "Salaries" of the employee : 787004.64
(other than from perquisites)
7) Financial year : 2023-2024
8) Valuation of Perquisites

S.No Nature of perquisites Value of perquisite Amount, if any, recovered Amount of perquisite
(see rule 3) as per rules(INR) from the employee(INR) chargeable to tax(INR)
(1) (2) (3) (4) Col(3)-Col(4) (5)
1 Accommodation 0.00 0.00 0.00
2 Cars/Other automotive 0.00 0.00 0.00
Sweeper , gardener , watchman or
3 0.00 0.00 0.00
personal attendant
4 Gas , electricity , water 0.00 0.00 0.00
5 Interest free or concessional loans 0.00 0.00 0.00
6 Holiday expenses 0.00 0.00 0.00
7 Free or concessional Travel 0.00 0.00 0.00

8 Free meals 0.00 0.00 0.00

9 Free Education 0.00 0.00 0.00

10 Gifts,vouchers etc. 153000.00 0.00 153000.00
11 Credit card expenses 0.00 0.00 0.00
12 Club expenses 0.00 0.00 0.00
13 Use of movable assets by employees 0.00 0.00 0.00
14 Transfer of assets to employees 0.00 0.00 0.00
15 Value of any other benefit
0.00 0.00 0.00
/amenity/service/privilege

16 Stock options ( non-qualified options ) 0.00 0.00 0.00

17 Other benefits or amenities 0.00 0.00 0.00
18 Total value of perquisites 153000.00 0.00 153000.00
19 Total value of Profits in lieu of salary
0.00 0.00 0.00
as per section 17 (3)

Details of tax
(a) Tax deducted from salary of the employee under section 192(1) 55930.00
(b) Tax paid by employer on behalf of the employee under section 192(1A) 0.00
(c) Total tax paid 55930.00
(d) Date of payment into Government treasury
DECLARATION BY EMPLOYER
I, ATUL KUMAR NAYAK Son/daughter of working as DGM (F&A) (designation ) do hereby declare on behalf of Petronet LNG Limited
( 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 thereunder and
that such information is true and correct. Signature Not Verified
Signed By:ATUL KUMAR NAYAK
Location: New Delhi
Signing Date:14.06.2024 15:43
Signature of person responsible
Place : DELHI for deduction of tax
Date : 12.06.2024 Full Name:ATUL KUMAR NAYAK
Designation:DGM (F&A)
00000895/EFRPB1817J Abhishek Bansal

Annexure to Form No.16

Name: Abhishek Bansal Emp No.: 00000895

Particulars Amount(INR)

Emoluments paid

Basic Salary 391289.68

Conveyance Allowance 86466.06

House Rent Allowance 117386.90

Other Allowances 117386.90

Special Allowance 86751.16

Tele. Exp/News Periodical 21924.55

NPS 58693.00

Perquisites

Gifts, vouchers etc. 153000.00

Gross emoluments 1032898.25

Income from other sources

Income
Total income from other sources 0.00

Exemptions u/s 10

Allowance

House Rent allowance u/s 10(13A) 41293.61

Total Exemption 41293.61

Signature Not Verified

Signed By:ATUL KUMAR NAYAK
Location: New Delhi
Signing Date:14.06.2024 15:43

Date: 12.06.2024 Full Name: ATUL KUMAR NAYAK

Place:DELHI Designation: DGM (F&A)