30736188/FY:2022-2023/65B502/ANWPB7107N UMASHANKAR B M

Annexure to Form 16 Part B

2(f). Break up for 'Amount of any other exemption under section 10' to be filled in the table below

Particular's of Amount of any other exemption under section 10' INR

Washing allowance Exemptions 21300.00

10(k). Break up for 'Amount deductible under any other provision(s) of Chapter VI-A ' to be filled in the table below

Particular's of amount deductible under any other provision(s) of Chapter VI-A Gross Amount Qualifying Amount Deductible Amount

Place BANGALORE (Signature of person responsible for deduction of tax)

Date 08.06.2023 Full Name: PURUSHOTHAMA M P

 30736188/FY:2022-2023/65B502 UMASHANKAR B M
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 : BOSCH LTD,Hosur Road, Adugodi,,Bangalore,560030,

2. TAN : BLRM01746D
3. TDS Assessment Range of the employer : ITO (TDS), LTU, BANGALORE,100 Feet Ring Road BSK III Stg,Bangalore,560085,
4. Name, designation and Permanent Account Number or
Aadhaar Number of employee
: UMASHANKAR B M,Technician,30736188,ANWPB7107N

5. Is the employee a director or a person with substantial interest

in the company(where the employer is a company) : N

6. Income under the head “Salaries” of the employee

(other than from perquisites)
: 958907.95

7. Financial year : 2022-2023

8. Valuation of Perquisites :

Amount of perquisite
Amount, if any, recovered
S. Value of perquisite as per chargeable to tax
Nature of perquisites (see rule 3) from the employee
No. (Rs.) Col. (3) - Col(4)
(Rs.)
(Rs.)
(1) (2) (3) (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 3946.32 0.00 3946.32
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. 30000.00 0.00 30000.00
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/amenity/service/privilege 0.00 0.00 0.00
16. Stock options allotted or transferred by employer being
0.00 0.00 0.00
an eligible start-up referred to in section 80-IAC.
17. Stock options (non-qualified options) other than ESOP in
0.00 0.00 0.00
col 16 above.
18. Contribution by employer to fund and scheme taxable
under section 17(2)(vii). 0.00 0.00 0.00

19. Annual accretion by way of interest, dividend etc. to the

balance at the credit of fund and scheme referred to in 0.00 0.00 0.00
section 17(2)(vii) and taxable under section 17(2)(viia).

20. Other benefits or amenities 0.00 0.00 0.00

21. Total value of perquisites 33946.32 0.00 33946.32
22. Total value of profits in lieu of salary as per section 17(3) 0.00 0.00 0.00

Details of tax
(a) Tax deducted from salary of the employee under section 192(1) 45540.00
(b) Tax paid by employer on behalf of the employee under section 192(1A) 0.00
(c) Total tax paid 45540.00
(d) Date of payment into Government treasury

DECLARATION BY EMPLOYER
I, PURUSHOTHAMA M P Son/daughter of M R PRABHAKAR working as DEPUTY GENERAL MANAGER (designation ) do hereby declare on behalf
of BOSCH LTD ( 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 of person responsible for deduction of tax

Place : BANGALORE Full Name:PURUSHOTHAMA M P
Date : 08.06.2023 Designation:DEPUTY GENERAL MANAGER
30736188/FY:2022-2023/65B502 UMASHANKAR B M

Annexure to Form No.16

Name: UMASHANKAR B M Emp No.: 30736188

Particulars Amount(INR)

Emoluments paid

Basic Salary 424265.26

Conveyance Allowance 31176.00

House Rent Allowance 186280.20

Children Education Allowance 21600.00

Medical Allowance 29520.00

Bonus 16630.00

Leave Encashment 23734.80

Other Allowances 276565.69

Special Allowance 2400.00

Washing allowances 21300.00

Perquisites

Interest free or concessional loans 3946.32

Gifts, vouchers etc. 30000.00

Gross emoluments 1066554.27

Income from other sources

Income

Deductions u/s 24 - Interest -186415.00

Total income from other sources -186415.00

Exemptions u/s 10

Allowance

Washing allowance Exemptions 21300.00

Total Exemption 21300.00

Date: 08.06.2023 Full Name: PURUSHOTHAMA M P

Place:BANGALORE Designation: DEPUTY GENERAL MANAGER