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
Page 1 2

Employer - PAO CODE Name and Rank of the Employee

82 DAMODAR BADHARBHAI HIMATS
PAN of the Deductor TAN of the Deductor PAN of the Employee
ATDPC9675K BLRP11659E BPTPB1250E
CIT(TDS) Address Assessment Year / Tax Option Period
ITO, BENGALURU 2024-2025 / NEW 01/04/2023 TO 31/03/2024
Summary of Tax deducted at Source
Quarter Receipt Numbers of original statements of Amount of tax deducted Amount of tax deducted/remitted
TDS under sub-section(3) of section 200 in respect of the employee in respect of the employee
Quarter 1 0 0
Quarter 2 7720 7720
Quarter 3 2235 2235
Quarter 4 0 0
Total 9955 9955
PART-B
DETAILS OF SALARY PAID AND ANY OTHER INCOME AND TAX DEDUCTED
` ` ` `
1. Gross Salary 717128
2. Standard Deduction 50000
3. Less Allowance to the extent exempt under Section 10 0
4. BALANCE (1 - 2) 667128
5. DEDUCTIONS :
a. Interest payable on loan u/s 24 : 0
6. Aggregate of 5 ( a to b ) 0
7. Income chargeable under the Head 'SALARIES' (3 - 5) 667128
8. Add: Any other income reported by the employee * 0
9. GROSS TOTAL INCOME (6 + 7) 667128
10. DEDUCTIONS UNDER CHAPTER VI-A GROSS AMT QUAL AMT QUAL AMT DEDUCT AMT
a) Qualified under Sec.80C 0 0 0
b) Qualified for 100% deduction 0 0 0
c) Qualified for 50% deduction 0 0 0
d) Qualified under Sec.80DD 0 0 0
e) Qualified under Sec.80U 0 0 0
11. Aggregate of deductible amount under Chapter VI-A 0
12. Total Income (8 - 10) Rounded 667130
12. TAX ON TOTAL INCOME - SEC 87A REBATE(Rs.21713) 0
14. Health & Education Cess @4% (on tax computed at Sl.No.12) 0
15. Tax Payable (12 + 13) 0
16. Less: Relief under Section 89(attach Details) 0
17. Less : Tax Deducted 9955
18. TAX PAYABLE/REFUNDABLE (15 - 16) -9955

**
VERIFICATION
Note : Health and Education Cess @4% Charged On Income Tax (Rounded off to next higher rupee)

I, AVIK CHAKRABORTY, son/daughter of Shri. RAMEN CHAKRABORTY working in the capacity of

AAO do hereby certify that a sum of Rs. 9955 (in words) Rupees Nine Thousand Nine Hundred Fifty Five only
has been deducted and deposited to the credit of Central Government. I further certify that the above information
is true, complete and correct and is based on the books of account, documents, TDS statements, TDS deposited
and other available records.

Note * : Sl.No.8 above Other Income includes taxable interest accrued on Fund Subscription above 500000 Rupees

Place : BENGALURU Signature of the person responsible for deduction of tax

Date : 16/07/2024 Full Name AVIK CHAKRABORTY
Designation AAO
 BREAK UP OF TAXABLE EMOLUMENTS FINANCIAL YEARWISE Page 2 2

Employer - PAO Code Name and Rank of the Employee

82 DAMODAR BADHARBHAI HIMATS
For the financial year from 01/03/2022 to 28/02/2023 = 16457.0
For the financial year from 01/03/2023 to 29/02/2024 = 700671.0
Total taxable emoluments 717128.0