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

Certificate No. AQISHDA Last updated on 09-Jun-2024

Name and address of the Employer Name and address of the Employee
STATE BANK OF INDIA
3RD FLOOR SBI BHAVAN CC, MADAME CAMA ROAD, NARIMAN
POINT, AVISEK ACHERJEE
MUMBAI, MUMBAI - 400021 BAISAKHI APARTMENT, RADHANAGAR ROAD, BURNPUR,
Maharashtra BURDWAN - 713325 West Bengal
+(91)22-22740340
[email protected]
Employee Reference No.
PAN of the Employee
PAN of the Deductor TAN of the Deductor provided by the Employer
(If available)

AAACS8577K MUMS86151C AJQPA1684F 000800566

CIT (TDS) Assessment Year Period with the Employer

From To
The Commissioner of Income Tax (TDS)
Room No. 900A, 9th Floor, K.G. Mittal Ayurvedic Hospital 2024-25 01-Apr-2023 31-Mar-2024
Building, Charni Road , Mumbai - 400002

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 QVKMZHPB 378813.04 39312.00 39312.00

Q2 QVMPENLB 391802.96 41372.00 41372.00
Q3 QVOIQOKB 366674.14 37294.00 37294.00
Q4 QVQZWUYE 745685.18 156596.00 156596.00
Total (Rs.) 1882975.32 274574.00 274574.00
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 8488.00 0005087 06-05-2023 43601 F

2 5650.00 0002271 07-06-2023 55194 F
3 8572.00 0002271 07-06-2023 55194 F
4 5859.00 0002271 07-06-2023 55194 F

Page 1 of 3
 Certificate Number: AQISHDA TAN of Employer: MUMS86151C PAN of Employee: AJQPA1684F 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 2170.00 0002271 07-07-2023 89085 F

6 8573.00 0002271 07-07-2023 89085 F
7 8572.00 0005087 07-08-2023 57664 F
8 3807.00 0005087 07-08-2023 57664 F
9 2170.00 0005087 07-08-2023 57664 F
10 2170.00 0008964 07-09-2023 03614 F
11 12673.00 0008964 07-09-2023 03614 F
12 9820.00 0002271 07-10-2023 56590 F
13 2160.00 0002271 07-10-2023 56590 F
14 9820.00 0005087 07-11-2023 28994 F
15 2170.00 0005087 07-11-2023 28994 F
16 10487.00 0002271 07-12-2023 91403 F
17 2170.00 0002271 07-12-2023 91403 F
18 10487.00 0002271 06-01-2024 76122 F
19 2160.00 0002271 06-01-2024 76122 F
20 8690.00 0002271 07-02-2024 38789 F
21 10486.00 0002271 07-02-2024 38789 F
22 3740.00 0002271 07-03-2024 75396 F
23 10487.00 0002271 07-03-2024 75396 F
24 26880.00 0002271 26-04-2024 27371 F
25 96313.00 0002271 26-04-2024 27371 F
Total (Rs.) 274574.00

Verification

I, RAMESH BABU KONETI, son / daughter of CHENGALRAJU KONETI working in the capacity of DGM TAXATION (designation) do hereby certify that a sum of
Rs. 274574.00 [Rs. Two Lakh Seventy Four Thousand Five Hundred and Seventy Four Only (in words)] has been deducted and a sum of Rs. 274574.00 [Rs. Two Lakh
Seventy Four Thousand Five Hundred and Seventy Four 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 MUMBAI

Date 12-Jun-2024 (Signature of person responsible for deduction of Tax)

Designation: DGM TAXATION Full Name:RAMESH BABU KONETI

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)

Page 2 of 3
Certificate Number: AQISHDA TAN of Employer: MUMS86151C PAN of Employee: AJQPA1684F Assessment Year: 2024-25

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

Document Certified by SBI_TRS

Shri Ramesh Babu Koneti <[email protected]>

Digitally Signed by SBI_TRS

Shri Ramesh Babu Koneti <[email protected]>
Date: 2024.06.14 03:11:49 IST Page 3 of 3
 FORM NO. 16
PART B
Certificate under Section 203 of the Income-tax Act, 1961 for tax deducted at source on salary

Certificate No. AQISHDA Last updated on 09-Jun-2024

Name and address of the Employer Name and address of the Employee
STATE BANK OF INDIA
3RD FLOOR SBI BHAVAN CC, MADAME CAMA ROAD, NARIMAN
POINT, AVISEK ACHERJEE
MUMBAI, MUMBAI - 400021 BAISAKHI APARTMENT, RADHANAGAR ROAD, BURNPUR,
Maharashtra BURDWAN - 713325 West Bengal
+(91)22-22740340
[email protected]
PAN of the Deductor TAN of the Deductor PAN of the Employee

AAACS8577K MUMS86151C AJQPA1684F

CIT (TDS) Assessment Year Period with the Employer

From To
The Commissioner of Income Tax (TDS)
Room No. 900A, 9th Floor, K.G. Mittal Ayurvedic Hospital 2024-25 01-Apr-2023 31-Mar-2024
Building, Charni Road , Mumbai - 400002

Details of Salary Paid and any other income and tax deducted

Whether opting for taxation u/s 115BAC No

1. Gross Salary Rs. Rs.

(a) Salary as per provisions contained in section 17(1) 1848856.00

Value of perquisites under section 17(2) (as per Form No. 12BA,
(b) 192710.00
wherever applicable)
Profits in lieu of salary under section 17(3) (as per Form No.
(c) 0.00
12BA, wherever applicable)
(d) Total 2041566.00

(e) Reported total amount of salary received from other employer(s) 0.00

2. Less: Allowances to the extent exempt under section 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

Cash equivalent of leave salary encashment under section 10

(d) 0.00
(10AA)

(e) House rent allowance under section 10(13A) 0.00

Page 1 of 4
Certificate Number: AQISHDA TAN of Employer: MUMS86151C PAN of Employee: AJQPA1684F Assessment Year: 2024-25

Amount of any other exemption under section 10

(f) [Note: Break-up to be filled and signed by employer in the table
provide at the bottom of this form]

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

Total amount of exemption claimed under section 10

(h) 0.00
[2(a)+2(b)+2(c)+2(d)+2(e)+2(g)]

Total amount of salary received from current employer

3. 2041566.00
[1(d)-2(h)]
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) 0.00

5. Total amount of deductions under section 16 [4(a)+4(b)+4(c)] 50000.00

6. Income chargeable under the head "Salaries" [(3+1(e)-5] 1991566.00

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

Income (or admissible loss) from house property reported by

(a) 0.00
employee offered for TDS

(b) Income under the head Other Sources offered for TDS 0.00

Total amount of other income reported by the employee

8. 0.00
[7(a)+7(b)]
9. Gross total income (6+8) 1991566.00

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

Deduction in respect of life insurance premia, contributions to

(a) 0.00 0.00
provident fund etc. under section 80C

Deduction in respect of contribution to certain pension funds

(b) under section 80CCC 0.00 0.00

Deduction in respect of contribution by taxpayer to pension

(c) scheme under section 80CCD (1) 0.00 0.00

(d) Total deduction under section 80C, 80CCC and 80CCD(1) 0.00 0.00

Deductions in respect of amount paid/deposited to notified

pension scheme under section 80CCD (1B)
(e) 0.00 0.00

Page 2 of 4
 Certificate Number: AQISHDA TAN of Employer: MUMS86151C PAN of Employee: AJQPA1684F Assessment Year: 2024-25

Deduction in respect of contribution by Employer to pension

(f) scheme under section 80CCD (2) 111537.00 111537.00

Deduction in respect of health insurance premia under section

(g) 0.00 0.00
80D

Deduction in respect of interest on loan taken for higher

(h) education under section 80E 0.00 0.00

Gross Qualifying Deductible

Amount Amount Amount
Total Deduction in respect of donations to certain funds,
(i) 0.00 0.00 0.00
charitable institutions, etc. under section 80G
Deduction in respect of interest on deposits in savings account
(j) 0.00 0.00 0.00
under section 80TTA

Amount Deductible under any other provision (s) of Chapter VI-A

(k) [Note: Break-up to be filled and signed by employer in the table
provide at the bottom of this form]

Total of amount deductible under any other provision(s) of

(l) 0.00 0.00 0.00
Chapter VI-A

Aggregate of deductible amount under Chapter VI-A

11. 111537.00
[10(d)+10(e)+10(f)+10(g)+10(h)+10(i)+10(j)+10(l)]

12. Total taxable income (9-11) 1880029.00

13. Tax on total income 264008.40

14. Rebate under section 87A, if applicable 0.00

15. Surcharge, wherever applicable 0.00

16. Health and education cess 10560.34

17. Tax payable (13+15+16-14) 274568.74

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

19. Net tax payable (17-18) 274568.74

Verification
I, MANOJ KUMAR SINHA, son/daughter of ASHOK KUMAR SINHA .Working in the capacity of DGM HRMS (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 MUMBAI (Signature of person responsible for deduction of tax)

Full
Date 11-Jun-2024 MANOJ KUMAR SINHA
Name:

Page 3 of 4
 Certificate Number: AQISHDA TAN of Employer: MUMS86151C PAN of Employee: AJQPA1684F Assessment Year: 2024-25

2. (f) Break up for ‘Amount of any other exemption under section 10’ to be filled in the table below
Particular's of Amount for any other
Sl. exemption under section 10 Deductible Amount
No. Gross Amount
Rs. Rs. Qualifying
Rs.Amount Rs.
1.
2..
3.
4.
5.
6.

10(k). Break up for ‘Amount deductible under any other provision(s) of Chapter VIA ‘to be filled in the table below
Particular's of Amount deductible under
Sl. any other provision(s) of Chapter VIA Deductible Amount
Gross Amount
No. Qualifying Amount
Rs. Rs. Rs. Rs.
1.
2.
3.
4.
5.
6.

MUMBAI (Signature of person responsible for deduction of

Place
tax)
Full
Date 11-Jun-2024 MANOJ KUMAR SINHA
Name:

Document Certified by SBI_HRMS Page 4 of 4

Shri MANOJ KUMAR SINHA<[email protected]>

Digitally Signed by SBI_HRMS

Shri MANOJ KUMAR SINHA<[email protected]>
Date: 2024.06.12 11:47:07 IST