13 FORM 16 Formet
13 FORM 16 Formet
16
[See rule 31(1)(a)]
Certificate under section 203 of the Income-tax Act, 1961 for tax deducted at source
from income chargeable under the head “Salaries”
Name and address of the Employer Name and designation of the Employee
PAN No. of the Deductor TAN No. of the PAN No. of the Employee
Deductor
DETAILS OF SALARY PAID AND ANY OTHER INCOME AND TAX DEDUCTED
1. Gross salary
(a) Salary as per provisions contained in
section 17(1) Rs.
(b) Value of perquisites under section 17(2)
(as per
Form No. 12BA, wherever applicable) Rs.
(c) Profits in lieu of salary under section
17(3) (as per Form No. 12BA,
wherever applicable) Rs.
(d) Total Rs.
2. Less : Allowance to the extent exempt
under section 10
Allowance Rs.
Rs.
3. Balance (1 – 2) Rs.
4. Deductions :
(a) Entertainment
allowance Rs.
(b) Tax on
Employment Rs.
Rs.
8. Gross total income (6 + 7) Rs.
9. Deductions under Chapter VI-A
S. No. TDS Surcharge Education Total tax Cheque/DD No. (if BSR Code of Date on which Transfer voucher/
Cess deposited any) Bank branch tax deposited Challan Identification
Rs. Rs. (dd/mm/yy) No.
Rs. Rs.
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
Full Name
Designation