00000874/EXWPR9467M Ravi .

PART B (Annexure)
Details of Salary paid and any other income and tax deducted INR INR INR

1. Gross salary

(a) Salary as per provisions contained in sec.17(1) 1689345.00

(b) Value of perquisites u/s 17(2) (as per Form No.12BA,

wherever applicable) 158000.00

(c) Profits in lieu of salary under section 17(3) (as per 0.00
Form No.12BA, wherever applicable)

(d) Total
1847345.00

(e) Reported total amount of salary received from other employer(s) 0.00
2. Less: Allowance to the extent exempt u/s 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

(d) Cash equivalent of leave salary encashment under section

10(10AA) 0.00

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

187320.00
(f) Amount of any other exemption under section 10

Tele Exp./News Periodcial Exemption 35000.00

(g) Total amount of any other exemption under section 10 35000.00

(h) Total amount of exemption claimed under section 10
[2(a)+2(b)+2(c)+2(d)+2(e)+2(g)]
222320.00
3. Total amount of salary received from current employer [1(d)-2(h)]
1625025.00
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) 2400.00

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

52400.00

6. Income chargeable under the head "Salaries" [(3+1(e)-5] 1572625.00

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

(a) Income (or admissible loss) from house property reported by

employee offered for TDS 0.00

(b) Income under the head Other Sources offered for TDS
0.00
8. Total amount of other income reported by the employee
[7(a)+7(b)] 0.00

9. Gross total income (6+8)

1572625.00

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

(a) Ded. in respect of life ins. premia, contr to provident fund etc U/S 80C 77616.00 77616.00

(b) Ded. in respect of contribution to certain pension funds U/S 80CCC 0.00 0.00

(c) Ded. in respect of contr by taxpayer to pension scheme U/S 80CCD(1) 50004.00 50004.00

(d) Total deduction U/S 80C, 80CCC, 80CCD(1) 127620.00 127620.00

(e) Ded. in respect of amount paid/dep. to pension scheme U/S 80CCD(1B) 0.00 0.00

(f) Ded. in respect of contr by employer to pension scheme U/S 80CCD(2) Signature Not Verified 97020.00 64680.00
Signed By:ATUL KUMAR NAYAK
(g) Ded. in respect of health insurance premia U/S 80D Location: New Delhi 0.00 0.00
Signing Date:17.06.2024 12:42
00000874/EXWPR9467M Ravi .

(h) Ded. in respect of interest on loan taken for higher education U/S 80E 0.00 0.00
Gross Amount Qualifying Amount Deductible Amount

(i) Ded. in respect of donations to certain funds, charitable inst, etc. U/S 80G 0.00 0.00 0.00

(j) Ded. in respect of interest on deposits in saving account U/S 80TTA 0.00 0.00 0.00

(k) Amount deductible under any other provision(s) of Chapter VI-A 0.00 0.00 0.00

(l) Total amount deductible under any other provision(s) of Chapter VI-A 0.00 0.00 0.00

11. Aggregate of deductible under Chapter VI-A [10(d)+10(e)+10(f) 192300.00

+10(g)+10(h)+10(i)+10(j)+10(l)

12. Total taxable Income (9-11) 1380330.00

13. Tax on total income 226599.00

14. Rebate under section 87A, if applicable 0.00

15. Surcharge, wherever applicable 0.00

16. Health and education cess 9063.96

17. Tax payable (13+15+16-14) 235663.00

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

19. Net Tax Payable (17-18) 235663.00

Verification

I, ATUL KUMAR NAYAK, son/daughter of working in the capacity of DGM (F&A) (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 DELHI

(Signature of person responsible for deduction of tax)

Date 12.06.2024 Full Name: ATUL KUMAR NAYAK

Signature Not Verified

Signed By:ATUL KUMAR NAYAK
Location: New Delhi
Signing Date:17.06.2024 12:42
00000874/EXWPR9467M Ravi .

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 :

Petronet LNG Limited, WorldTradeCentre,1stFloor,BabarRoadBarakhamba Lane, New Delhi-110001, Delhi
2) TAN: DELP05642A
3) TDS Assessment Range of the employer :
, CIRCLE 51(1), NEW DELHI, , 110001,
4) Name, designation and PAN of employee :
Mr/Ms: Ravi ., Desig.:Management Trainee (F&A), Emp #:00000874, PAN:EXWPR9467M
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 : 1414625.00
(other than from perquisites)
7) Financial year : 2023-2024
8) Valuation of Perquisites

S.No Nature of perquisites Value of perquisite Amount, if any, recovered Amount of perquisite
(see rule 3) as per rules(INR) from the employee(INR) chargeable to tax(INR)
(1) (2) (3) (4) Col(3)-Col(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 0.00 0.00 0.00
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. 153000.00 0.00 153000.00
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 5000.00 0.00 5000.00
14 Transfer of assets to employees 0.00 0.00 0.00
15 Value of any other benefit
0.00 0.00 0.00
/amenity/service/privilege

16 Stock options ( non-qualified options ) 0.00 0.00 0.00

17 Other benefits or amenities 0.00 0.00 0.00
18 Total value of perquisites 158000.00 0.00 158000.00
19 Total value of Profits in lieu of salary
0.00 0.00 0.00
as per section 17 (3)

Details of tax
(a) Tax deducted from salary of the employee under section 192(1) 235663.00
(b) Tax paid by employer on behalf of the employee under section 192(1A) 0.00
(c) Total tax paid 235663.00
(d) Date of payment into Government treasury
DECLARATION BY EMPLOYER
I, ATUL KUMAR NAYAK Son/daughter of working as DGM (F&A) (designation ) do hereby declare on behalf of Petronet LNG Limited
( 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 Not Verified
Signed By:ATUL KUMAR NAYAK
Location: New Delhi
Signing Date:17.06.2024 12:42
Signature of person responsible
Place : DELHI for deduction of tax
Date : 12.06.2024 Full Name:ATUL KUMAR NAYAK
Designation:DGM (F&A)
00000874/EXWPR9467M Ravi .

Annexure to Form No.16

Name: Ravi . Emp No.: 00000874

Particulars Amount(INR)

Emoluments paid

Basic Salary 646800.00

Conveyance Allowance 138053.00

House Rent Allowance 194040.00

Leave Travel Allowance 121185.00

Bonus 98319.00

Other Allowances 194040.00

Special Allowance 148884.00

Arrears from previous yr/s 2000.00

Tele. Exp/News Periodical 35004.00

Other Allowances(PLL) 5000.00

Refreshment Allowance 9000.00

NPS 97020.00

Perquisites

Gifts, vouchers etc. 153000.00

Use of movable assets by employees 5000.00

Gross emoluments 1847345.00

Income from other sources

Income
Total income from other sources 0.00

Exemptions u/s 10

Allowance

House Rent allowance u/s 10(13A) 187320.00

Tele Exp./News Periodcial Exemption 35000.00

Total Exemption 222320.00

Signature Not Verified

Signed By:ATUL KUMAR NAYAK
Location: New Delhi
Signing Date:17.06.2024 12:42

Date: 12.06.2024 Full Name: ATUL KUMAR NAYAK

Place:DELHI Designation: DGM (F&A)