Form 16
Form 16
Form 16
Certificate under section 203 of the Income-tax Act, 1961 for tax deducted at source from income chargeable under the head "Salaries"
PART A (Refer Note 1) Name & Designation of the Employee Ratna Kishore A Technical Associate 703066774 PAN No. of the Employee APPPA5515C Assessment Year To 2012-2013
Name & Address of the Employer Genpact India Delhi Information Technology ParkShastri Park New Delhi - 110053 India
PAN No. of the Deductor TAN No. of the Deductor AAACG9163H DELG04341B Address: The Commissioner of Income Tax (TDS) Aayakar Bhawan, District Centre, 4th Floor, Luxmi Nagar, Delhi : 110092
31-MAR-12
Summary of tax deducted at source Quarter Quarter 1 : Quarter 2 : Quarter 3 : Quarter 4 : Total : Receipt No. of original statement of TDS under sub-section(3) of section 200 BMRXXNEC BMRXCUPG BMRXFETE MBFXXELC
925 3456 4381 PART B (Refer Note 1) DETAILS OF SALARY PAID AND ANY OTHER INCOME AND TAX DEDUCTED
1. Gross Salary * (a) Salary as per provision contained in sec.17(1) (b) Value of perquisites under section 17(2) (as per Form No.12BA, wherever applicable) (c) Profits in lieu of salary under section 17(3) (as per Form No. 12BA, wherever applicable) (d) Total : 2. Less : Allowance to the extent Exempt under Section 10 3. Balance(1-2) 4. Deductions : (a) Entertainment Allowance (b) Tax on Employment 5. Aggregate of 4(a) and (b) 6. Income chargeable under the head 'Salaries' (3 - 5) 7. Add : Any other income reported by the Employee (a) Other Income (b) Income under the head House Property (c) Total 8. Gross total Income(6+7) 9. Deduction Under Chapter VI-A (A) Section 80C, 80CCC and 80CCD (a) Section 80C PF
Amount in Rs.
Amount in Rs.
Amount in Rs.
7033 7033 Total of 9A (b) Section 80CCC (c) Section 80CCD Note : 1. aggregate amount deductible under sections 80C shall not exceed one lakh rupees. 2. aggregate amount deductible under the three sections, i.e., 80C, 80CCC, and 80CCD, shall not exceed one lakh rupees. (B) other section (for e.g. 80E,80G etc. under chapter VIA) Deductions Sec 80D Total of 9B 10 Aggregate of deductible amount Under Chapter VI-A 11. Total Income (8-10) 12. Tax on Total Income 13. Edu. + HE. Cess @3%(tax at S.No 12) 14. Tax payable (12+13) 15. Relief under section 89(attach details) 16. Tax Payable (14-15) Gross Amount Qualifying Amount Deductible Amount 4481 4481 4481 4481 4481 4481 11514 222526 4253 128 4381 0 4381
Page: 2
I Sachin Khungar son of Mr.S.P. Khungar working in the capacity of Vice President do hereby certify that a sum of Rs.4381 (Four thousand Three Hundred Eighty-One) has been deducted at source and paid to the credit of the Central Government. I further certify that the information given above is true and correct based on the book of accounts, documents, TDS statement, TDS deposited and other available records. Signature of the person Responsible for deduction of Tax
Place : New Delhi Date : 16-MAY-12 Full Name : Sachin Khungar Designation : Vice President DETAILS OF TAX DEDUCTED AND DEPOSITED INTO CENTRAL GOVERNMENT ACCOUNT (The Employer as to provide transaction-wise details of tax deducted and deposited)
Srl. No 1 2 3 4 5 Total:
Surcharge (Rs.) 0 0 0 0 0 0
Date on which Tax Deposited (dd/mm/yyyy) 06/12/2011 03/11/2011 06/01/2012 07/06/2011 06/03/2012
Transfer Voucher/ Challan Ident No. 01208 01158 05065 17646 09871
Total :
Notes: 1- If an assessee is employed under more than one employer during the year, each of the employers shall issue part A of the certification in Form No. 16 pertaining to the period for which such assessee was employed with each of the employers. Part B may be issued by each of the employer at the option of the assessee. 2- Government dedutors to enslose Annexure - A if tax is paid without production of an income-tax challan and Annexure-B if tax is paid accompained by an income-tax challan. 3- Non- Government dedutors to enclose Annexure-B. 4- The dedutors shall furnish the address of the commissionerof income-tax (TDS) having jurisdication as regards TDS statement of the assessee. 5- This form shall be applicable only in respect of tax deducted on or after 1st day of April, 2010.
FORM NO. 12BA { See rule 26A(2)(b) } Statement showing particulars of perquisites, other fringe benifits or amenities and profits in lieu of salary with value thereof 1. Name & Address of the Employer : Genpact India Delhi Information Technology ParkShastri Park New Delhi - 110053 India : DELG04341B : DCIT, Circle 49(1),N.D. : Ratna Kishore A, 703066774 Technical Associate APPPA5515C : No : 269078 (As Per Clause 1(a) of form 16) : 2011-2012 Value of perquisite as per rules (Rs.) Amount, if any Recovered from Employee (Rs.) Amount of perquisite Chargeable to tax Col.(3)-Col.(4) (Rs.) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4381 0 4381 As per Form16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2. TAN 3. TDS Assessment Range of the employer 4. Name,Designation and PAN of the Employee
5. Is the employee a director or a person with substantial interest in the company (where the employer is a company) 6. Income under the head "Salaries" of the employee (other than from perquisites ) 7. Financial Year 8. Valuation of Perquisites Sno. Nature of perquisite (see rule 3)
1. Accomodation 2. Cars 3. Sweeper, gardener, watchman or personal attendant 4. Gas, electricity, water 5. Interest free or concessional loans 6. Holiday expenses 7. Free or concessional travel 8. Free meals 9. Education 10. Gifts, vouchers etc. 11. Credit card expenses 12. Club expenses 13. Use of movable assets by employees 14. Transfer of assets to employees 15. Value of any other benefit/amenity/service/privilege 16. Stock options (non-qualified options) 17. Other benefits or amenities 18. Total value of perquisites 19. Total value of profits in lieu of salary as per section 17(3) 9. Details of Tax:(a) Tax deducted from salary of the employee under section 192(1) : (b) Tax paid by employer on behalf of the employee under section 192(1A) : (c) Total tax paid : (d) Date of payment into Government treasury : DECLARATION BY EMPLOYER
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
I Sachin Khungar son of Mr.S.P. Khungar working as Vice President do hereby declare on behalf of Genpact India that the information given above is based on the books of account, documents and other relevant records orinformation 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.