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Single copy ( to be sent to the ZAO )

Tax Applicable ( Tick One )


TAX DEDUCTED / COLLECTED AT SOURCE FROM ( 0020 ) Tax Deduction Account Number Full Name Complete Address with City & State COMPANIES ( 0021) NON-COMPANIES * Assessment Year

CHALLAN NO. ITNS

281

Nature of Payment (Tick One)


DETAILS OF PAYMENTS

Code FOR USE IN RECEIVING BANK


Amount ( in Rs.Only )

Debit to A/c / Cheque credited on

Income Tax Surcharge Education Cess Interest Penalty Others Total Total ( in words)
CRORES LACS THOUSANDS HUNDREDS TENS UNITS

DD MM YY SPACE FOR BANK SEAL -

Err:511

Err:511

Err:511

Err:511
Dated

Err:511

Err:511

Paid in Cash/Debit to A/c./Cheque no. Drawn on

(Name of the Bank and Branch)

Date :-

Signature of person making payment

Taxpayers Counterfoil ( To be filled up by the tax payer ) TAN Received from Cash / Debit to A/c / Cheque No. Rs.(in words):- Err:511 drawn on
on account of

0 0
(Name)

SPACE FOR BANK SEAL

for Rs.

0
(Name of the Bank and Branch)

TDS from

Companies IT

Non-Companies -

(Strike out whichever is not applicable)

for the Assessment Year

SC ED CESS

Single copy ( to be sent to the ZAO ) CHALLAN NO. ITNS 280

Tax Applicable ( Tick One )


TAX DEDUCTED / COLLECTED AT SOURCE FROM ( 0020 ) COMPANIES ( 0021) NON-COMPANIES *

Assessment Year

Parmanent Account Number Full Name Complete Address with City & State

Nature of Payment (Tick One) Advance Tax (100) Self Assessment Tax (300) Tax on Regular Assessment (400) Surtax (102) Tax on Distributed Profits of Domestic Companies (106) Tax on Distributed Income to Unit Holders (107)
FOR USE IN RECEIVING BANK
Amount ( in Rs.Only )

DETAILS OF PAYMENTS Income Tax Surcharge Education Cess Interest Penalty Others Total Total ( in words)
CRORES LACS THOUSANDS HUNDREDS TENS UNITS

Debit to A/c / Cheque credited on

DD MM YY SPACE FOR BANK SEAL -

Err:511

Err:511

Err:511

Err:511
Dated

Err:511

Err:511

Paid in Cash/Debit to A/c./Cheque no. Drawn on

(Name of the Bank and Branch)

Date :-

Signature of person making payment

Taxpayers Counterfoil ( To be filled up by the tax payer ) PAN Received from Cash / Debit to A/c / Cheque No. Rs.(in words):- Err:511 drawn on
on account of

0 0
(Name)

SPACE FOR BANK SEAL

for Rs.

0
(Name of the Bank and Branch)

Companies IT 0

Non-Companies -

(Strike out whichever is not applicable)

Type of Payment for the Assessment Year

SC ED CESS

Form No. 16 [ See rule 31 (1) (a) ]

Certificate under section 203 of the Income-tax Act, 1961 for tax deducted at source from income chargeable under the head " Salaries " Name and Designation of the Employee 1

Name and Address of the Employer

Form 24 Seq. No. : PAN / GIR No. TAN No Period From To PAN / GIR No. Assessment Year

TDS Circle where Annual Return/Statement under Sec.206 is to be filed.


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 1st Quarter 2nd Quarter 3rd Quarter 4th Quarter Acknowledgement No.

1/4/2005

3/31/2006

2006-2007

DETAILS OF SALARY PAID AND ANY OTHER INCOME AND TAX DEDUCTED

1 GROSS SALARY a) Salary as per provisions contained in sec.17(1) b) Value of perquisites u/s 17(2) (as per FormNo.12BA, wherever applicable) c) Profits in lieu of salary under section 17(3) (as per Form No.12BA, wherever applicable) d) Total 2 LESS : Allowances to the extent exempt under section 10 Allowance Conveyance Allowance 3 BALANCE (1-2)

Rs.108,000 Rs.0 Rs.0 Rs.108,000

Amount Rs.9,600 Rs.9,600 Rs.98,400

4 DEDUCTION (a) Tax on employment (b) Entertainment Allowance 5 AGGREGATE OF 4 ( a to b ) 6 INCOME CHARGEABLE UNDER THE HEAD SALARIES ( 3 - 5) 7 ADD Any other income reported by the employee 8 GROSS TOTAL INCOME ( 6 + 7 ) 9 DEDUCTION UNDER CHAPTER VI - A (A) Sections 80C, 80CCC and 80CCD A. Section 80C (a) (b) (c) (d) B. Section 80 CCC C. Section 80 CCD (B) Other Sections (e.g. 80E, 80G etc.) under chapter VI A

Rs.0 Rs.0 Rs.0 Rs.0 Rs.98,400 Rs.0 Rs.98,400

Gross Amt

Deductible Amt

Gross Amt (a) (b) (c) (d) 10 Aggregate of Deductible amount under Chapter VI - A 11 TOTAL INCOME ( 8 - 10 ) 12 TAX ON TOTAL INCOME Rs.0 Rs.0 Rs.0 Rs.0

Qualify Amt

Deductible Amt Rs.0 Rs.0 Rs.0 Rs.0 Rs.0 Rs.98,400 Rs.0

Page 2 :

0.00 0.00 0.00

13 SURCHARGE ( ON TAX COMPUTED AT SR.NO.12) 14 EDUCATION CESS @ 2% ON (TAX AT S. NO. 12 PLUS SURCHARGE AT S. NO.13) 15 TAX PAYABLE (12+13+14) 16 Relief under section 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 Sr.No. 1 2 3 4 5 6 7 8 9 10 TDS 0.00 Surcharges Education Cess Total Tax Deposited 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Chq No./ DD No. BSR Code of Bank Branch Date on which tax deposited (DD/MM/YY) Rs.0 Rs.0

Rs.0 Rs.0

Rs.0 Rs.0

Transfer voucher/Challan Identification No.

, son/daughter of working in the capacity of I 0.00 Err:511 (Designation) do hereby certify that a sum of Rs. 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 and other available records

Place : Date :

Full Name : Designation :

Signature of the person responsible for the deduction of tax. 0.00 0.00

Certificate No. 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

Name and address of the person to whom payment made or in whose account it is credited Gautam Balakrishnan

Tax Deduction a/c no of the deductor

Nature of Payment

PAN/GIR No. of the Payee

PAN/GIR No. of the Deductor

For The Period

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.

Education Total Tax Cheque/DD Cess Rs. Deposited Rs. No (if any)

BSR Code of Bank Branch

Date on which tax was deposited

Transfer Voucher/Challan Identification No

1 2 3 4 5 6 7 8 9 10 11 18 12 13 Total -

Certified that a sum of Rs. (in words). Err:511 has been deducted at source and paid to the credit of the Central Government as per details given above.

Place Mumbai Date:

______________________________________________ Signature of person responsiblefor deduction of tax Full Name: Designation: