Tds 16 N
Tds 16 N
Tds 16 N
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
Name and address of the Employer Name and designation of the Employee
CIT(TDS)
Assessment Year Period
Address
From To
2011-12
City Pin code
Summary of tax deducted at source
Receipt Numbers of original Amount of tax deducted Amount of tax
Quarter statements of TDS under sub-section in respect of the deposited/remitted in
(3) of section 200. employee respect of the employee
Quarter 1
Quarter 2
Quarter 3
Quarter 4
DETAILS OF SALARY PAID AND ANY OTHER INCOME AND TAX DEDUCTED
1. Gross salary
(a) Salary as per provisions contained in
Rs.
section 17(1)
(b) Value of perquisites u/s 17(2) (as per
Rs.
Form No. 12BB, wherever applicable)
(c) Profits in lieu of salary under section
17(3) (as per Form No. 12BB, Rs.
wherever applicable)
(d) Total Rs. 0
Total 0 Rs. 0
3. Balance (1 – 2) Rs. 0
4. Deductions :
(a) Entertainment allowance Rs.
(b) Tax on Employment Rs.
5. Aggregate of 4(a) and (b) Rs. 0
6. Income chargeable under the head
Rs. 0
‘Salaries’ (3 - 5)
7. Add : Any other income reported by
the employee
Rs.
Total Rs. 0
8. Gross total income (6 + 7) Rs. 0
9. Deductions under Chapter VI-A
(A) sections 80C, 80CCC and 80CCD
(a) section 80C Gross amount Deductible amount
(i) Rs.
(ii) Rs.
(iii) Rs.
(iv) Rs.
(v) Rs.
(vi) Rs.
(vii) Rs. Rs. 0 Rs. 0
Verification
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 books of account, documents, TDS statements, TDS deposited and other available records.
Place
Signature of the person responsible for deduction of tax
2 Government deductors to enclose Annexure‐A if tax is paid without production of an income-tax challan
and Annexure-B if tax is paid accompanied by an income‐tax challan.
3 Non-Government deductors to enclose Annexure-B.
The deductor shall furnish the address of the Commissioner of Income‐tax (TDS) having
4
jurisdiction as regards TDS statements of the assessee.
5 This Form shall be applicable only in respect of tax deducted on or after 1st day of April, 2010.