FORM NO.

16A
[See rule 31(1)(b)]

Certificate under section 203 of the Income-tax Act, 1961 for tax deducted at source

Certificate No. SRKXBLA Last updated on 03-Aug-2020

Name and address of the deductor Name and address of the deductee

ARVIND LIFESTYLE BRANDS LIMITED

INSTAKART SERVICES PRIVATE LIMITED
8TH FLOOR,DUPARC,TRINITY, NO.17 MG ROAD,
ALYSSA, BEGONIA & CLOVER, EMBASSY TECH VILLAGE,
BANGALORE - 560001
OUTER RING ROAD,
Karnataka
DEVARABEESANAHALLIVILLAGE, BANGALORE - 560103
+(91)80-41550346
Karnataka
[email protected]

PAN of the deductor TAN of the deductor PAN of the deductee

AAACH7252A BLRA13429D AADCI8374D

CIT (TDS) Assessment Year Period

The Commissioner of Income Tax (TDS) From To

Room No. 59, H.M.T. Bhawan, 4th Floor, Bellary Road , 2020-21
Ganganagar, Bangalore - 560032 01-Jan-2020 31-Mar-2020

Summary of payment

Deductee Reference No.

Date of payment/ credit
Sl. No. Amount paid/ credited Nature of payment** provided by the Deductor (if
(dd/mm/yyyy)
any)
1 3120.00 194C 16-01-2020
2 438.00 194C 16-01-2020
3 1632.00 194C 16-01-2020
4 6349.00 194C 16-01-2020
5 83049.00 194C 16-01-2020
6 761.00 194C 16-01-2020
7 3688.00 194C 16-01-2020
8 10163.00 194C 16-01-2020
9 40794.00 194C 16-01-2020
10 46255.00 194C 16-01-2020
11 7277.00 194C 16-01-2020
12 176.00 194C 16-01-2020
13 1260.00 194C 16-01-2020
14 12073.00 194C 16-01-2020
15 64993.00 194C 16-01-2020
16 35701.00 194C 16-01-2020
17 282.00 194C 16-01-2020
18 3460.00 194C 16-01-2020
19 697.00 194C 16-01-2020
20 578.00 194C 16-01-2020
21 2796.00 194C 16-01-2020
22 2221.00 194C 16-01-2020
23 100303.00 194C 16-01-2020
24 180.00 194C 16-01-2020
25 2518.00 194C 16-01-2020
26 6122.00 194C 16-01-2020
27 114088.00 194C 16-01-2020

Page 1 of 6
Certificate Number: SRKXBLA TAN of Deductor: BLRA13429D PAN of Deductee: AADCI8374D Assessment Year: 2020-21

Deductee Reference No.

Date of payment/ credit
Sl. No. Amount paid/ credited Nature of payment** provided by the Deductor (if
(dd/mm/yyyy)
any)
28 1880.00 194C 16-01-2020
29 2582.00 194C 16-01-2020
30 111626.00 194C 16-01-2020
31 50.00 194C 16-01-2020
32 1756.00 194C 16-01-2020
33 24976.00 194C 16-01-2020
34 136133.00 194C 16-01-2020
35 31829.00 194C 16-01-2020
36 176.00 194C 16-01-2020
37 1578.00 194C 16-01-2020
38 892.00 194C 27-02-2020
39 633.00 194C 27-02-2020
40 2017.00 194C 27-02-2020
41 8961.00 194C 27-02-2020
42 86918.00 194C 27-02-2020
43 1013.00 194C 27-02-2020
44 4711.00 194C 27-02-2020
45 7594.00 194C 27-02-2020
46 219395.00 194C 27-02-2020
47 4626.00 194C 27-02-2020
48 2464.00 194C 27-02-2020
49 124568.00 194C 27-02-2020
50 320.00 194C 27-02-2020
51 1660.00 194C 27-02-2020
52 25773.00 194C 27-02-2020
53 180966.00 194C 27-02-2020
54 46839.00 194C 27-02-2020
55 718.00 194C 27-02-2020
56 3290.00 194C 27-02-2020
57 701.00 194C 15-03-2020
58 873.00 194C 15-03-2020
59 2233.00 194C 15-03-2020
60 49625.00 194C 15-03-2020
61 384.00 194C 15-03-2020
62 3073.00 194C 15-03-2020
63 1570.00 194C 15-03-2020
64 1240.00 194C 15-03-2020
65 68852.00 194C 15-03-2020
66 713.00 194C 15-03-2020
67 9888.00 194C 15-03-2020
68 7014.00 194C 15-03-2020
69 176598.00 194C 15-03-2020
70 5034.00 194C 15-03-2020
71 2199.00 194C 15-03-2020
72 125863.00 194C 15-03-2020
73 296.00 194C 15-03-2020
74 1720.00 194C 15-03-2020
75 16079.00 194C 15-03-2020
Page 2 of 6
Certificate Number: SRKXBLA TAN of Deductor: BLRA13429D PAN of Deductee: AADCI8374D Assessment Year: 2020-21

Deductee Reference No.

Date of payment/ credit
Sl. No. Amount paid/ credited Nature of payment** provided by the Deductor (if
(dd/mm/yyyy)
any)
76 166487.00 194C 15-03-2020
Total (Rs.) 2227360.00

Summary of tax deducted at source in respect of Deductee

Receipt Numbers of Original

Quarterly Statements of TDS Amount of Tax Deducted in respect of Amount of Tax Deposited / Remitted in
Quarter
Under sub-section (3) of Section Deductee respect of Deductee
200

Q4 FXHLVXFH 44583.00 44583.00

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
Sl. No. Status of Matching
deductee (Rs.) Receipt Numbers of Form DDO serial number in Form No. Date of Transfer
with Form No. 24G
No. 24G 24G voucher (dd/mm/yyyy)

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 63.00 6910333 07-02-2020 13107 F

2 9.00 6910333 07-02-2020 13107 F
3 33.00 6910333 07-02-2020 13107 F
4 127.00 6910333 07-02-2020 13107 F
5 1661.00 6910333 07-02-2020 13107 F
6 16.00 6910333 07-02-2020 13107 F
7 74.00 6910333 07-02-2020 13107 F
8 204.00 6910333 07-02-2020 13107 F
9 816.00 6910333 07-02-2020 13107 F
10 926.00 6910333 07-02-2020 13107 F
11 146.00 6910333 07-02-2020 13107 F
12 4.00 6910333 07-02-2020 13107 F
13 26.00 6910333 07-02-2020 13107 F
14 242.00 6910333 07-02-2020 13107 F
15 1300.00 6910333 07-02-2020 13107 F
16 715.00 6910333 07-02-2020 13107 F
17 6.00 6910333 07-02-2020 13107 F
18 70.00 6910333 07-02-2020 13107 F
19 14.00 6910333 07-02-2020 13107 F
20 12.00 6910333 07-02-2020 13107 F
21 56.00 6910333 07-02-2020 13107 F
22 45.00 6910333 07-02-2020 13107 F
23 2007.00 6910333 07-02-2020 13107 F
24 4.00 6910333 07-02-2020 13107 F
25 51.00 6910333 07-02-2020 13107 F
26 123.00 6910333 07-02-2020 13107 F
27 2282.00 6910333 07-02-2020 13107 F
28 38.00 6910333 07-02-2020 13107 F

Page 3 of 6
Certificate Number: SRKXBLA TAN of Deductor: BLRA13429D PAN of Deductee: AADCI8374D Assessment Year: 2020-21

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*

29 52.00 6910333 07-02-2020 13107 F

30 2233.00 6910333 07-02-2020 13107 F
31 1.00 6910333 07-02-2020 13107 F
32 36.00 6910333 07-02-2020 13107 F
33 500.00 6910333 07-02-2020 13107 F
34 2723.00 6910333 07-02-2020 13107 F
35 637.00 6910333 07-02-2020 13107 F
36 4.00 6910333 07-02-2020 13107 F
37 32.00 6910333 07-02-2020 13107 F
38 18.00 0013283 07-03-2020 13577 F
39 13.00 0013283 07-03-2020 13577 F
40 41.00 0013283 07-03-2020 13577 F
41 180.00 0013283 07-03-2020 13577 F
42 1739.00 0013283 07-03-2020 13577 F
43 21.00 0013283 07-03-2020 13577 F
44 95.00 0013283 07-03-2020 13577 F
45 152.00 0013283 07-03-2020 13577 F
46 4388.00 0013283 07-03-2020 13577 F
47 93.00 0013283 07-03-2020 13577 F
48 50.00 0013283 07-03-2020 13577 F
49 2492.00 0013283 07-03-2020 13577 F
50 7.00 0013283 07-03-2020 13577 F
51 34.00 0013283 07-03-2020 13577 F
52 516.00 0013283 07-03-2020 13577 F
53 3620.00 0013283 07-03-2020 13577 F
54 937.00 0013283 07-03-2020 13577 F
55 15.00 0013283 07-03-2020 13577 F
56 66.00 0013283 07-03-2020 13577 F
57 15.00 0011352 29-06-2020 04871 F
58 18.00 0011352 29-06-2020 04871 F
59 45.00 0011352 29-06-2020 04871 F
60 993.00 0011352 29-06-2020 04871 F
61 8.00 0011352 29-06-2020 04871 F
62 62.00 0011352 29-06-2020 04871 F
63 32.00 0011352 29-06-2020 04871 F
64 25.00 0011352 29-06-2020 04871 F
65 1378.00 0011352 29-06-2020 04871 F
66 15.00 0011352 29-06-2020 04871 F
67 198.00 0011352 29-06-2020 04871 F
68 141.00 0011352 29-06-2020 04871 F
69 3532.00 0011352 29-06-2020 04871 F
70 101.00 0011352 29-06-2020 04871 F
71 44.00 0011352 29-06-2020 04871 F
72 2518.00 0011352 29-06-2020 04871 F
73 6.00 0011352 29-06-2020 04871 F
Page 4 of 6
 Certificate Number: SRKXBLA TAN of Deductor: BLRA13429D PAN of Deductee: AADCI8374D Assessment Year: 2020-21

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*

74 35.00 0011352 29-06-2020 04871 F

75 322.00 0011352 29-06-2020 04871 F
76 3330.00 0011352 29-06-2020 04871 F
Total (Rs.) 44583.00

Verification

I, MANIKANDAN BALASUBRAMANIAN, son / daughter of BALASUBRAMANIAN HARIHARAN working in the capacity of FINANCE CONTROLLER (designation) do
hereby certify that a sum of Rs. 44583.00 [Rs. Fourty Four Thousand Five Hundred and Eighty Three Only (in words)] has been deducted and a sum of Rs. 44583.00
[Rs. Fourty Four Thousand Five Hundred and Eighty 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 19-Aug-2020 (Signature of person responsible for deduction of tax)

Designation: FINANCE CONTROLLER Full Name: MANIKANDAN BALASUBRAMANIAN

Notes:
1. Form 16A contains the latest transaction reported by the deductor in the TDS / TCS Statement. For further details please view your 26AS for same AY on the website https://www.tdscpc.gov.in
2. To update the PAN details in Income Tax Department database, apply for 'PAN change request' through NSDL or UTITSL
3. In items I and II, in column for tax deposited in repect of deductee, furnish total amount of TDS, surcharge (if applicable) and education cess (if applicable).

Legend used in Form 16A

* 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

** Nature of Payment

Section Code Description Section Code Description

193 Interest on Securities 195 Other sums payable to a non-resident
194 Dividends 196A Income in respect of units of non-residents
194A Interest other than 'Interest on securities' 196B Payments in respect of units to an offshore fund
194B Winning from lottery or crossword puzzle Income from foreign currency bonds or shares of Indian company payable to
196C
194BB Winning from horse race non-residents
194C Payments to contractors and sub-contractors 196D Income of foreign institutional investors from securities
194D Insurance commission 206CA Collection at source from alcoholic liquor for human consumption
194E Payments to non-resident sportsmen or sports associations 206CB Collection at source from timber obtained under forest lease
194EE Payments in respect of deposits under National Savings Scheme Collection at source from timber obtained by any mode other than a forest
206CC
Payments on account of repurchase of units by Mutual Fund or Unit Trust of lease
194F
India
206CD Collection at source from any other forest produce (not being tendu leaves)
194G Commission, price, etc. on sale of lottery tickets
194H Commission or brokerage 206CE Collection at source from any scrap
194I Rent Collection at source from contractors or licensee or lease relating to parking
206CF
194I(a) Payment of Rent for the use of any machinery or plant or equipment lots
Payment of Rent for the use of land or building or land appurtenant or
194I(b) 206CG Collection at source from contractors or licensee or lease relating to toll plaza
furniture or fittings
194J Fees for professional or technical services Collection at source from contractors or licensee or lease relating to mine or
206CH
Income payable to a resident assessee in respect of units of a specified mutual quarry
194K
fund or of the units of the Unit Trust of India 206CI Collection at source from tendu Leaves
194LA Payment of compensation on acquisition of certain immovable property 206CJ Collection at source from on sale of certain Minerals
194LB Income by way of Interest from Infrastructure Debt fund 206CK Collection at source on cash case of Bullion and Jewellery

Page 5 of 6
Certificate Number: SRKXBLA TAN of Deductor: BLRA13429D PAN of Deductee: AADCI8374D Assessment Year: 2020-21

206CL Collection at source on sale of Motor vehicle

194LC Income by way of interest from specified company payable to a non-resident
Collection at source on sale in cash of any goods(other than
206CM
194LBA Certain income from units of a business trust bullion/jewelry)
194LBB Income in respect of units of investment fund Collection at source on providing of any services (other than
206CN
194LBC Income in respect of investment in securitization trust Ch-XVII-B)

Signature Not Verified

Digitally signed by
Manikandan
Date: 2020.08.19 22:20:34
IST
Page 6 of 6