FORM NO.

16
[See rule 31( I) (a)

Certificate under section 203 of the Income-tax Act, 1961 for tax deducted at source from income chargeable under the head "Salaries"
NAME & ADDRESS OF THE EMPLOYER NAME & DESIGNATION OF THE EMPLOYEE

PAN/GIR NO.

TAN

PAN/GIR NO. AGHPR7439P

TDS Circie where Annual Return/Statement under section 208 is to be filed TDS II (11) QUARTER
ACKNOWLEDEMENT NO.

PERIOD From To 01.04.2009 31.3.2010 FROM TO

DETAILS OF SALARY PAID AND ANY OTHER INCOME AND TAX DEDUCTED 1. Gross salary (a) Salary as per provisions contatined in sec 17(1) (b) Value of perquisites u/'s 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

245484

245484

2. Less : Allowance to the extent exempt under section 10 Allownce Rs. 9600

Transporation Eduction Allownce 3. Balance (1-2) 4. Deductions : (a) Entertainment allowance (b) Tax on Employment 5. Aggregate of 4 (a) to (b) 6. Income chargeable under the head 'Salaries' (3-5)

9600 235884 0 2600 2600

7. Add : Any other income reported by the employee Income Source Rs. 0 8. Gross total Income (6 + 7) 9. Deductions under Chapter VI-A (A) Sections 80C,80CCC, Gross Amount and 80CCD. (A) Sections 80C (i) Provident Fund(EPF) (ii) P.P.F (iii) LIC (iv) (v) (vi) (b) Senctions 80CCC (c) Senctions 80CCD (B) Others Senctions (e.g.80E,80G etc.) a.Section_________ b.Section_________ c.Section_________ d.Section_________ 10. Aggregate of deductible amounts under Chapter VI-A 11. Total Income (8-10) 12. Tax on total Income 13. Surcharge thereon 14. Education Cess @ 2% 15. Tax payable (12+13+14) 16. Relief under sectin 89 (attach details) 17. Tax payable (15-16) 18. Less : (a) Tax deducted at source u/s 192 (1) (b) Tax paid by the employer on behalf of the employee u/s 192 (1A) on perquisites u/s 17(2) 19. Tax Payable/Refundable (17-18) DETAILS OF TAX DEDUCTED AND DEPOSITED INTO CENTRAL GOVERNMENT ACCOUNT TDS Amount Rs. Challan No. Sr.No./ Date of Deposit Cheque /DD No. Not Applicable 43284 19656 11000 13144

(Rs.)

Qualifying Amount (Rs.) 19656 11000 12628 0 0 0

Deductible Amount (Rs.) 19656 11000 12628 0 0 0

I ================ Son of =============== working in the capacity of Programme Coordiantor (Finance & Accounts) do hereby certify that a sum of Rs.NIL [Rupees (in words)NIL ] has been deducted at source and paid to the credit of the Central Governmen.I further certify that information given above is ture and correct based on the books of accounts, documents and other available records.

Place : Date 5.5.2010

Signature of the person responsible for deduction of tax Full Name : Designation :

for tax deducted at source "Salaries"

SIGNATION OF THE EMPLOYEE

PAN/GIR NO. AGHPR7439P ASSESSMENT YEAR 2010-2011

ME AND TAX DEDUCTED

20475

233284

233284

43284 30656 12628

190000 0 0 0

RAL GOVERNMENT ACCOUNT Che. No. & BSR Code of Bank

of Programme Coordiantor (Finance & ] has been deducted at source and paid en above is ture and correct based on the

responsible for deduction of tax

FORM NO. 16A [See rule31(l)(b )] Certificate of deduction of tax at source under section 203 of the Income-tax Act, 1961 For interest on securities; dividends; interest other than interest on securities; winnings from lottery or crossword puzzle ; winnings from horse race; payments to contractors and sub-contractors; insurance commission; payments to non-resident sportsmen/sports associations; payments in respect of deposits under National Savings Scheme; payments on account of repurchase of units by Mutual Fund or Unit Trust of India; commission, remuneration or prize on sale of lottery tickets; commission or brokerage; rent; fees for professional or technical services; royalty and any sum under section 28(va); income in respect of units; payment of compensation on acquisition of certain immovable property; other sums under section 195; income in respect of units of non-residents referred to in section 196A; income from units referred to in section 196B; income from foreign currency bonds or shares of an Indian company referred to in section 196C; income of Foreign Institutional Investors from securities referred to in section 196D Name and address of the person deducting tax Acknowledgement Nos. of all Quarterly Statements of TDS under sub-section (3) of section 200 as provided by TIN Facilitation Centre or NSDL web-site Quarter Acknoweldgement No Q1 0 Q2 0 Q3 0 Q4 0 Nature of Payment Name and address of the person to whom payment made or in whose account it is credited

Tax Deduction a/c no of the deductor

PAN/GIR No. of the Payee

PAN/GIR No. of the Deductor

For The Period 1.7.2009 to 30.09.2009

Details of payment, tax deduction and deposit of tax into central government account

Sr. No.

Amount paid /credit

Date of Payment/ Credit

TDS Rs.

Surcharge Rs.

Educatio n Cess Rs.

Total Tax Deposited Rs.

Cheque/DD BSR Code of No (if any) Bank Branch

Date on which tax was deposited

1 2 3 4 5 Total

39,326

10-Aug-2009

3,933

118

39,326

3,933

118

4,051 Cash 4,051

0270475

7.9.2009

Certified that a sum of Rs. (in words). has been deducted at source and paid to the credit of the Central Government as per details given above.

Place : Date:

Signature of person responsiblefor deduction of tax Full Name : Designation : ( Finance & Accounts)

zzle ; winnings from horse race;

ciations; payments in respect of

ndia; commission, remuneration

d any sum under section 28(va);

ection 195; income in respect of

currency bonds or shares of an 196D

e person to whom payment account it is credited

o. of the Payee

he Period

to 30.09.2009

nt Transfer Voucher/Chall an Identification No 00006 3,933 4,051 (118)

nsiblefor deduction of tax