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Form 16
Form16 Details: Employee Name: Employee PAN: Employee Serial Number: Employee Designation: Form16 Control Number: Assessment Year: GANESH KUMAR M AUZPG7564L
4082 Engineer 4082/AUZPG7564L 2013 - 14
Digitally Signed
Signature Details: This form has been signed and certified using a Digital Signature Certificate as specified under section 119 of the Income-Tax Act, 1961. (Please refer Circular No.2/2007.dated 21-5-2007). The Digital Signature of the signatory has been affixed in the box provided below. To see the details and validate the signature, you should click on the box
Digitally Signed by Digitally Signature Certificate issued by Serial Number of DSC Number of Pages : NATARAJAN LAKSHMI NARAYANAN : mtnlTrustLine Class 2 Individual Subscriber Sub CA G1 : : 4 (including this page)
FORM NO.16
[See rule 31(1)(a)]
Part B (Annexure) Certificate under section 203 of the Income-Tax Act, 1961 for tax deducted at Source on Salary
Name and address of the Employer Collabera Solutions Private Limited Tower D, 6th Floor, Subramanya Arcade, #12, Bannerghatta Road, Bangalore 560 07 GANESH KUMAR M Name and address of the Employee
Employee Reference No. Provided by the Employer (If available) 4082 Period From 01/04/2012 To 31/03/2013
Room # 59, H.M.T. Bhawan, 4th Floor, Bellary Road, Ganganagar Bangalore 560032
Details of Salary paid and any other income and tax deducted
Rs.
Rs.
1. GROSS SALARY (a) Salary as per provisions contained in section 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) Total 2. Less : Allowance to the extent exempt u/s 10
Sl No. Allowance 1 2 3 4 5 6 House Rent Allowance Exemption Transport Exemption Gratuity Exemption Children Education Allowance Leave Encashment LTA exemption Rs. 71400.00 9600.00 0.00 0.00 0.00 0.00
399756.00
Total 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
Income Income / Loss from House Property Income from Other Sources Other_Source_Income2 Other_Source_Income3 Rs 0.00 0.00 0.00 0.00
0.00 316356.00
8. GROSS TOTAL INCOME( 6 + 7 ) 9. DEDUCTIONS UNDER CHAPTER VI-A (A) Sections 80C, 80CCC & 80CCD (a) Section 80C
(i) LIC (ii) Public Provident Fund (iii) National Saving Certificates (iv) Children Tuition Fees (v) Contribution to ULIP (vi) Housing Loan Principal Repayment (vii) Employee Provident Fund (viii) Infrastructure Bonds (ix) Others / (Fixed Deposit (5 Years) , NSS, SCSC,etc ) (x) NSC Interest / Approved Superannuation (xi) Voluntary Provident Fund (xii) Mutual Fund
Gross Amount
Deductible Amount
0.00 0.00 0.00 0.00 0.00 0.00 21420.00 0.00 0.00 0.00 0.00
0.00 0.00 0.00 0.00 0.00 0.00 21420.00 0.00 0.00 0.00 0.00
21420.00
(B) Other Sections(e.g. 80E, 80G, 80TTA etc.) Under Chapter VI-A
Gross Amount
Qualifying Amount
Deductible Amount
(a) 80 CCG (b) 80 D (c) 80 DD (d) 80 DDB (e) 80 E (f) 80 U (g) 80 G (h) 80 GG (i) 80 TTA
Rajiv Gandhi Equity Scheme Medical Claim Handicapped Dependents Medical Expenses, Chronic Diseases Interest on Loan taken for Higher Education Permanent Physical disability Donation Rent paid (HRA not received) Deduction on Interest on saving Account
0.00 9600.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 9600.00 31020.00 285340.00 8534.00 256.00 8790.00 0.00 8790.00 8790.00 0.00
10. Aggregate of deductible amounts under chapter VIA 11. Total Income (8-10 ) 12. Tax on total income 13. Education Cess @ 3% on (on tax computed at S.No.12) 14. Tax Payable (12+13) 15. Less : Relief under section 89 16. Tax Payable (14-15 ) 17. 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) 18. Tax payable / refundable (16-17 )
0.00
Verification Income tax deducted in case of individual employee forms a part of total amount of monthly deposits I, NATARAJAN LAKSHMI NARAYANAN son / daughter of MR.SERUKUDY VENKATRAMAN NATARAJAN working in the capacity of ASSOCIATE VICE PRESIDENT FINANCE, do hereby certify that a sum of Rs.8790.00 [RUPEES EIGHT THOUSAND SEVEN HUNDRED AND NINETY ONLY)] 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 and other available records.
F O P U
In case of non-goverment deductors, payment details of TDS/TCS deposited in bank by deductor have matched with the payment details mentioned in the TDS/TCS statement filed by the deductors. In case of government deductors, details of TDS/TCS booked in Government account have been verified by Pay & Accounts Officer (PAO) Payment details of TDS/TCS deposited in bank by deductor in bank by deductor have matched in the TDS/TCS statement but the amount is over claimed in the statement. Final(F) credit will be reflected only when deductor reduces claimed amount in the statement or makes new payment for excess amount claimed in the statement Provisional tax credit is effected only for TDS/TCS statements filled by Government deductors. P status will be changed to final (F) on verfication of payment details submitted by Pay and Accounts Officer (PAO) Deductors have not deposited taxes or have furnished incorrect particulars of tax payment. Final credit will be refelected only when payment details in bank match with details of deposit in TDS/TCS statement
2. TAN 3. TDS Assessment Range of the Employer 4.Name of Employee Designation PAN 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
Sl No. (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) (14) (15) (16) (17) (18) (19) Nature of perquisite
Accommodation Cars/Other automotive Sweeper,gardener,watchman or personal attendant Gas,electricity,water Interest free or concessional loans Holiday expenses Free or concessional travel Free Meals (Food Coupons Taxable ) Free Education Gifts,vouchers,etc. Credit card expenses Club expenses Use of movable assets by employees Transfer of assets to employees Value of any other benefit/amenity/service/privilege Stock Options (ESOS Perquisites) Other Benefits or amenities (Conveyance Perks) Total Value of Perquisites Value of profits in lieu of salary as per section 17(3)
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00
9. Details of Tax a) Tax Deducted from Salary of Employee u/s 192(1) b) Tax Paid by Employer on behalf of Employee u/s 192(1A) c) Total Tax Paid d) Date of Payment into Government Treasury
: : : :
DECLARATION BY EMPLOYER I,NATARAJAN LAKSHMI NARAYANAN son / daughter of SERUKUDY VENKATRAMAN NATARAJAN working in the capacity of ASSOCIATE VICE PRESIDENT FINANCE do hereby declare on behalf of Collabera Solutions Private Limited 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.