FORM NO.

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 paid to an employee under section 192 or pension/interest income
of specified senior citizen under section 194P

Certificate No. FVHNAKA Last updated on 07-Jun-2022

Name and address of the Employer/Specified Bank Name and address of the Employee/Specified senior citizen
RINL,VISAKHAPATNAM STEEL PLANT
PAYAND PF SECTION, NEAR ED WORKS BUILDING,
DAMODAR SURISETTY
VISAKHAPATNAM,
FLATNO 303 HIG 22 23, SAI BHASKAR HOMES, VUDA COLONY
VISAKHAPATNAM, ANDHRA PRADESH - 530031
PHASE 2, OEDAGANTYADA, VISAKHAPATNAM - 530044 Andhra
Andhra Pradesh
Pradesh
+(91)891-0002518432
[email protected]
PAN of the Employee Reference No. provided by the
PAN of the Deductor TAN of the Deductor Employee/Specified senior Employer/Pension Payment order no. provided
citizen by the Employer (If available)

AABCR0435L VPNR00545G DBKPS7123E

CIT (TDS) Assessment Year Period with the Employer

From To
The Commissioner of Income Tax (TDS)
Room No. 411, Income Tax Towers, 10-2-3 A.C. Guard , 2022-23 01-Apr-2021 31-Mar-2022
Hyderabad - 500004

Summary of amount paid/credited and tax deducted at source thereon in respect of the employee

Receipt Numbers of original

Amount of tax deposited / remitted
quarterly statements of TDS Amount of tax deducted
Quarter(s) Amount paid/credited (Rs.)
under sub-section (3) of (Rs.)
Section 200

Q1 QUMYAFJC 362820.31 47354.00 47354.00

Q2 QUPHBCLC 373215.31 49492.00 49492.00
Q3 QUSYHLPG 407360.25 56804.00 56804.00
Q4 QUXZNQMG 380297.79 52280.00 52280.00
Total (Rs.) 1523693.66 205930.00 205930.00
I. DETAILS OF TAX DEDUCTED AND DEPOSITED IN THE CENTRAL GOVERNMENT ACCOUNT THROUGH BOOK ADJUSTMENT
(The deductor to provide payment wise details of tax deducted and deposited with respect to the deductee)

Book Identification Number (BIN)

Tax Deposited in respect of the
Sl. No. deductee Date of transfer voucher Status of matching
Receipt Numbers of Form DDO serial number in Form no.
(Rs.) (dd/mm/yyyy) with Form no. 24G
No. 24G 24G

Total (Rs.)
II. DETAILS OF TAX DEDUCTED AND DEPOSITED IN THE CENTRAL GOVERNMENT ACCOUNT THROUGH CHALLAN
(The deductor to provide payment wise details of tax deducted and deposited with respect to the deductee)

Challan Identification Number (CIN)

Tax Deposited in respect of the
Sl. No. deductee
(Rs.) BSR Code of the Bank Date on which Tax deposited Challan Serial Number Status of matching with
Branch (dd/mm/yyyy) OLTAS*

1 16107.00 0290179 30-04-2021 20094 F

2 15296.00 0290179 07-05-2021 20142 F
3 15951.00 0290179 07-06-2021 24679 F
4 15951.00 0290179 07-07-2021 22911 F

Page 1 of 2
 Certificate Number: FVHNAKA TAN of Employer: VPNR00545G PAN of Employee: DBKPS7123E Assessment Year: 2022-23

Challan Identification Number (CIN)

Tax Deposited in respect of the
Sl. No. deductee
(Rs.) BSR Code of the Bank Date on which Tax deposited Challan Serial Number Status of matching with
Branch (dd/mm/yyyy) OLTAS*

5 15390.00 0290179 07-08-2021 26441 F

6 18151.00 0290179 07-09-2021 25568 F
7 18213.00 0290179 07-10-2021 22398 F
8 21251.00 0290179 06-11-2021 20411 F
9 17340.00 0290179 07-12-2021 23349 F
10 17402.00 0290179 07-01-2022 23594 F
11 16729.00 0290179 07-02-2022 24252 F
12 18149.00 0290179 07-03-2022 22253 F
Total (Rs.) 205930.00

Verification

I, RAJAKUMAR RENTAPALLI, son / daughter of SUDARSANA RAO RENTAPALLI working in the capacity of SENIOR MANAGER (designation) do hereby certify that
a sum of Rs. 205930.00 [Rs. Two Lakh Five Thousand Nine Hundred and Thirty Only (in words)] has been deducted and a sum of Rs. 205930.00 [Rs. Two Lakh Five
Thousand Nine Hundred and Thirty Only] has been deposited to the credit of the Central Government. I further certify that the information given above is true,
complete and correct and is based on the books of account, documents, TDS statements, TDS deposited and other available records.

Place VISAKHAPATNAM

Date 20-Jun-2022 (Signature of person responsible for deduction of Tax)

Designation: SENIOR MANAGER Full Name:RAJAKUMAR RENTAPALLI

Notes:
1. Part B (Annexure) of the certificate in Form No.16 shall be issued by the employer.
2. If an assessee is employed under one employer during the year, Part 'A' of the certificate in Form No.16 issued for the quarter ending on 31st March of the financial year shall contain the details
of tax deducted and deposited for all the quarters of the financial year.
3. If an assessee is employed under more than one employer during the year, each of the employers shall issue Part A of the certificate in Form No.16 pertaining to the period for which such
assessee was employed with each of the employers. Part B (Annexure) of the certificate in Form No. 16 may be issued by each of the employers or the last employer at the option of the assessee.
4. To update PAN details in Income Tax Department database, apply for 'PAN change request' through NSDL or UTITSL.

Legend used in Form 16

* Status of matching with OLTAS

Legend Description Definition
Deductors have not deposited taxes or have furnished incorrect particulars of tax payment. Final credit will be reflected only when payment
U Unmatched
details in bank match with details of deposit in TDS / TCS statement
Provisional tax credit is effected only for TDS / TCS Statements filed by Government deductors."P" status will be changed to Final (F) on
P Provisional
verification of payment details submitted by Pay and Accounts Officer (PAO)
In case of non-government deductors, payment details of TDS / TCS deposited in bank by deductor have matched with the payment details
F Final 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 have matched with details mentioned in the TDS / TCS statement but the
O Overbooked 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

Digitally signed
by RAJA
KUMAR R
Date:
Page2022.06.29
2 of 2
13:06:41 PDT
 FORM NO. 16
PART B
Certificate under section 203 of the Income-tax Act, 1961 for tax deducted at source on salary paid to an employee under section 192 or pension/interest income
of specified senior citizen under section 194P

Certificate No. FVHNAKA Last updated on 07-Jun-2022

Name and address of the Employer/Specified Bank Name and address of the Employee/Specified senior citizen
RINL,VISAKHAPATNAM STEEL PLANT
PAYAND PF SECTION, NEAR ED WORKS BUILDING,
DAMODAR SURISETTY
VISAKHAPATNAM,
FLATNO 303 HIG 22 23, SAI BHASKAR HOMES, VUDA COLONY
VISAKHAPATNAM, ANDHRA PRADESH - 530031
PHASE 2, OEDAGANTYADA, VISAKHAPATNAM - 530044 Andhra
Andhra Pradesh
Pradesh
+(91)891-0002518432
[email protected]
PAN of the Deductor TAN of the Deductor PAN of the Employee/Specified senior citizen

AABCR0435L VPNR00545G DBKPS7123E

CIT (TDS) Assessment Year Period with the Employer

From To
The Commissioner of Income Tax (TDS)
Room No. 411, Income Tax Towers, 10-2-3 A.C. Guard , 2022-23 01-Apr-2021 31-Mar-2022
Hyderabad - 500004

Annexure - I

Details of Salary Paid and any other income and tax deducted

Whether opting for taxation u/s 115BAC No

1. Gross Salary Rs. Rs.

(a) Salary as per provisions contained in section 17(1) 1353162.00

Value of perquisites under section 17(2) (as per Form No. 12BA,
(b) 170532.00
wherever applicable)
Profits in lieu of salary under section 17(3) (as per Form No.
(c) 0.00
12BA, wherever applicable)
(d) Total 1523694.00

(e) Reported total amount of salary received from other employer(s) 0.00

2. Less: Allowances to the extent exempt under section 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

Cash equivalent of leave salary encashment under section 10

(d) 0.00
(10AA)

(e) House rent allowance under section 10(13A) 0.00

Page 1 of 4
Certificate Number: FVHNAKA TAN of Employer: VPNR00545G PAN of Employee: DBKPS7123E Assessment Year: 2022-23

Amount of any other exemption under section 10

(f) [Note: Break-up to be filled and signed by employer in the table
provide at the bottom of this form]

(g) Total amount of any other exemption under section 10 61332.00

Total amount of exemption claimed under section 10

(h) 61332.00
[2(a)+2(b)+2(c)+2(d)+2(e)+2(g)]

Total amount of salary received from current employer

3. 1462362.00
[1(d)-2(h)]
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] 1409962.00

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

Income (or admissible loss) from house property reported by

(a) 0.00
employee offered for TDS

(b) Income under the head Other Sources offered for TDS 25063.00

Total amount of other income reported by the employee

8. 25063.00
[7(a)+7(b)]
9. Gross total income (6+8) 1435025.00

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

Deduction in respect of life insurance premia, contributions to

(a) 355010.10 150000.00
provident fund etc. under section 80C

Deduction in respect of contribution to certain pension funds

(b) under section 80CCC 0.00 0.00

Deduction in respect of contribution by taxpayer to pension

(c) scheme under section 80CCD (1) 0.00 0.00

(d) Total deduction under section 80C, 80CCC and 80CCD(1) 355010.10 150000.00

Deductions in respect of amount paid/deposited to notified

pension scheme under section 80CCD (1B)
(e) 0.00 0.00

Page 2 of 4
 Certificate Number: FVHNAKA TAN of Employer: VPNR00545G PAN of Employee: DBKPS7123E Assessment Year: 2022-23

Deduction in respect of contribution by Employer to pension

(f) scheme under section 80CCD (2) 0.00 0.00

Deduction in respect of health insurance premia under section

(g) 0.00 0.00
80D

Deduction in respect of interest on loan taken for higher

(h) education under section 80E 0.00 0.00

Gross Qualifying Deductible

Amount Amount Amount
Total Deduction in respect of donations to certain funds,
(i) 0.00 0.00 0.00
charitable institutions, etc. under section 80G
Deduction in respect of interest on deposits in savings account
(j) 0.00 0.00 0.00
under section 80TTA

Amount Deductible under any other provision (s) of Chapter VI-A

(k) [Note: Break-up to be filled and signed by employer in the table
provide at the bottom of this form]

Total of amount deductible under any other provision(s) of

(l) 0.00 0.00 0.00
Chapter VI-A

Aggregate of deductible amount under Chapter VI-A

11. 150000.00
[10(d)+10(e)+10(f)+10(g)+10(h)+10(i)+10(j)+10(l)]

12. Total taxable income (9-11) 1285025.00

13. Tax on total income 198007.50

14. Rebate under section 87A, if applicable 0.00

15. Surcharge, wherever applicable 0.00

16. Health and education cess 7921.00

17. Tax payable (13+15+16-14) 205928.50

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

19. Net tax payable (17-18) 205928.50

Verification
I, RAJAKUMAR RENTAPALLI, son/daughter of SUDARSANA RAO RENTAPALLI .Working in the capacity of SENIOR
MANAGER (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 VISAKHAPATNAM (Signature of person responsible for deduction of tax)

Full
Date 20-Jun-2022 RAJAKUMAR RENTAPALLI
Name:

Page 3 of 4
Digitally signed
by RAJA
KUMAR R
Date:
2022.06.29
13:06:41 PDT
 Certificate Number: FVHNAKA TAN of Employer: VPNR00545G PAN of Employee: DBKPS7123E Assessment Year: 2022-23

2. (f) Break up for ‘Amount of any other exemption under section 10’ to be filled in the table below
Particular's of Amount for any other
Sl. exemption under section 10 Gross Amount Qualifying Amount Deductible Amount
No.
Rs. Rs. Rs. Rs.
1.
2..
3.
4.
5.
6.

10(k). Break up for ‘Amount deductible under any other provision(s) of Chapter VIA ‘to be filled in the table below
Particular's of Amount deductible under
Sl. any other provision(s) of Chapter VIA Gross Amount Qualifying Amount Deductible Amount
No.
Rs. Rs. Rs. Rs.
1.
2.
3.
4.
5.
6.

VISAKHAPATNAM (Signature of person responsible for deduction of

Place
tax)
Full
Date 20-Jun-2022 RAJAKUMAR RENTAPALLI
Name:

Page 4 of 4
Digitally signed
by RAJA
KUMAR R
Date:
2022.06.29
13:06:41 PDT
00122726/DBKPS7123E DAMODAR SURISETTY
Annexure to Form 16 Part B
2(f). Break up for 'Amount of any other exemption under section 10' to be filled in the table below

Particular's of Amount of any other exemption under section 10' INR

Professional Dev 22672.00

Professional Attire 8000.00

Washing Allw 6000.00

Child Education Scholarship 24660.00

10(k). Break up for 'Amount deductible under any other provision(s) of Chapter VI-A ' to be filled in the table below

Particular's of amount deductible under any other provision(s) of Chapter VI-A Gross Amount Qualifying Amount Deductible Amount

Place VISAKHAPATNAM (Signature of person responsible for deduction of tax)

Date 01.06.2022 Full Name: RAJA KUMAR RENTAPALLI

Digitally signed
by RAJA
KUMAR R
Date:
2022.06.29
13:06:41 PDT
 00122726/DBKPS7123E DAMODAR SURISETTY
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
RASHTRIYA ISPAT NIGAM LTD.,VISAKHAPATNAM STEEL PLANT,,
1. Name and address of employer : VISAKHAPATNAM,530031,
2. TAN : VPNR00545G
3. TDS Assessment Range of the employer : ,,,,
4. Name, designation and Permanent Account Number or
Aadhaar Number of employee
: DAMODAR SURISETTY,SR. MANAGER(ELEC),00122726,DBKPS7123E

5. Is the employee a director or a person with substantial interest

in the company(where the employer is a company) : N

6. Income under the head “Salaries” of the employee

(other than from perquisites)
: 1239429.80

7. Financial year : 2021-2022

8. Valuation of Perquisites :

Amount of perquisite
Amount, if any, recovered
S. Value of perquisite as per chargeable to tax
Nature of perquisites (see rule 3) from the employee
No. (Rs.) Col. (3) - Col(4)
(Rs.)
(Rs.)
(1) (2) (3) (4) (5)
1. Accommodation 129308.26 1530.00 127778.26
2. Cars/Other automotive 23744.00 0.00 23744.00
Sweeper, gardener, watchman or
3. 0.00 0.00 0.00
personal attendant
4. Gas, electricity, water 5476.09 5476.09 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 19009.60 0.00 19009.60
9. Free education 0.00 0.00 0.00
10. Gifts, vouchers, etc. 0.00 0.00 0.00
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 0.00 0.00 0.00
14. Transfer of assets to employees 0.00 0.00 0.00
15. Value of any other benefit/amenity/service/privilege 0.00 0.00 0.00
16. Stock options allotted or transferred by employer being
0.00 0.00 0.00
an eligible start-up referred to in section 80-IAC.
17. Stock options (non-qualified options) other than ESOP in
0.00 0.00 0.00
col 16 above.
18. Contribution by employer to fund and scheme taxable
under section 17(2)(vii). 0.00 0.00 0.00

19. Annual accretion by way of interest, dividend etc. to the

balance at the credit of fund and scheme referred to in 0.00 0.00 0.00
section 17(2)(vii) and taxable under section 17(2)(viia).

20. Other benefits or amenities 0.00 0.00 0.00

21. Total value of perquisites 177537.95 7006.09 170531.86
22. Total value of profits in lieu of salary as per section 17(3) 0.00 0.00 0.00

Details of tax
(a) Tax deducted from salary of the employee under section 192(1) 205930.00
(b) Tax paid by employer on behalf of the employee under section 192(1A) 0.00
(c) Total tax paid 205930.00
(d) Date of payment into Government treasury

DECLARATION BY EMPLOYER
I, RAJA KUMAR RENTAPALLI Son/daughter of SUDARSANA RAO R working as SENIOR MANAGER (F&A) (designation ) do hereby declare on
behalf of RASHTRIYA ISPAT NIGAM LTD. ( 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.
Digitally signed
by RAJA
Signature of person responsible for deduction of tax KUMAR R
Date:
Place : VISAKHAPATNAM Full Name:RAJA KUMAR RENTAPALLI 2022.06.29
Date : 01.06.2022 Designation:SENIOR MANAGER (F&A) 13:06:41 PDT
 RINL- VISAKHAPATNAM STEEL PLANT
ANNEXURE TO FORM 16 (A.Y 2022-23)

Name : 122726
Employee No : DAMODAR SURISETTY
PAN Number : DBKPS7123E
Dept.Code : 3370
Dept.Name : B F ELECT
Assessment Year : 2022-2023

Income u/s 17(1) - Break-up Exemptions u/s 10 - Break-up

Description Amount(Rs.) Description Amount(Rs.)
Basic Salary 452,209.03 LTC U/s 10(5) 0.00
Dearness Allowance 779,376.77 Gratuity U/s 10 (10) 0.00
House Rent Allowance 0.00 Leave Salary U/s 10(10AA) 0.00
Leave Travel Concession 22,672.00 House Rent Allow. U/s 10(13A) 0.00
Children Education Allowance 0.00 Uniform Allowance U/s 10(14)(i) 8,000.00
Gratuity 0.00 Washing Allowance U/s 10(14)(i) 6,000.00
Leave Encashment 0.00 Professional Devp. Allow. U/s 10(14)(i) 22,672.00
Other Allowances 98,904.20 Transport Allowance U/s 10(14)(ii) 0.00
Others 0.00 Children Education Allow. U/s 10(14)(ii) 0.00
Children Hostel Allow. U/s 10(14)(ii) 0.00
Children Edu. Scholarhip U/s 10(16) 24,660.00
Total Exemptions u/s 10 61,332.00
Total Income u/s 17(1) - (A) 1,353,162.00

Perquisites u/s 17(2) - Break-up

Description Amount (Rs.)
Accommodation 127,778.26
Cars/Other automotive 23,744.14
Gas, Electricity, Water 0.00
Interest free or concessional loans 0.00
Free meals 19,009.60
Use of movable assets by Employees 0.00
Transfer of assets to employees 0.00
Contribution by employer to fund and scheme 0.00
taxable u/s 17(2)(vii) - (Pension Arrears)
Total value of Perquisites u/s 17(2) - (B) 170,532.00

Gross Salary - (A) + (B) 1,523,694.00

Digitally signed
by RAJA
KUMAR R
Date:
2022.06.29
13:06:41 PDT