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. Last Updated On
Name and address of the Employer/Specified Bank Name and designation of the Employee/ Specified senior
citizen
DDO BEO PHANDA BHOPAL NIDHI LITORIYA
CM RISE HR. SEC. SCHOOL BARKHEDI BHOPAL MP
PAN No. of the Deductor TAN of the Deductor PAN No. of the Employee/ Employee Reference No./
specificed senior citizen Pension Payment order
no.provided by the
Employer (If available)
ADFPL3151P 0A55274E2
CIT (TDS) Assessment year Period with the Employer
Address:The Commissioner of Income Tax (TDS),Aayakar Bhawan, From To
Hoshangabad Road,Bhopal
City:Bhopal Pin Code:462011 2023-2024 01/04/2022 31/03/2023
Summary of amount paid/credited and tax deducted at source thereon in respect of the employee
Quarter(s) Receipt Numbers of Amount paid/credited Amount of tax deducted ( Amount of tax deposited/
original quarterly Rs. ) remitted (Rs. )
statements of TDS under
sub-section (3) of section
200
Quarter 1 0 0 0
Quarter 2 0 0 0
Quarter 3 0 0 0
Quarter 4 Not Available as the 0 0 0
last Quarterly
Statement is yet to be
furnished
Total 0 0 0
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)
S. No. Tax Deposited in Book identification number (BIN)
respect on of the
deductee (Rs.)
Receipt numbers of DDO Sequence Number Date of Transfer Status of matching with
form No. 24G in Form No. 24G Voucher (dd/mm/yyyy) Form No.24G
TOTAL 0

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)
S. No. Tax Deposited in Challan identification number (CIN)
respect on of the
employee (Rs.)
BSR Code of the Bank Date on which tax Challan Serial Number Status of matching with
Branch deposited(dd/mm/yyyy) OLTAS
1 0 30/06/2022
2 0 30/09/2022
3 0 31/12/2022
4 0 31/03/2023
TOTAL 0

Verification

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I, , son/daughter of working in the capacity ofDESIGNATED
PARTNER(designation) do hereby certify that a sum of Rs 0.00(Zero Only) has been deductedat 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.
Place BHOPAL
Date 20/03/2023 (Signature of person responsible for deduction of tax)
Designation Full Name
Notes:
1. Government deductors to fill information in item I if tax is paid without production of an income-tax challan and in item II if
tax is paid accompanied by an income-tax challan.
2. Non-Government deductors to fill information in item II.
3. The deductor shall furnish the address of the Commissioner of Income-tax (TDS) having jurisdiction as regards TDS
statements of the assessee.
4. If an assessee is employed under one employer only during the year, 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.
5. 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.
6. In items I and II, in column for tax deposited in respect of deductee, furnish total amount of TDS and education cess.
PART B (Annexure)
In relation to employees for tax deduction under section 192
A Whether opting for taxation u/s 115BAC? No
1. Gross Salary
(a) Salary as per provisions contained in section 17(1) 765923
(b) Value of perquisites under section 17(2) (as per Form No. 12BA, wherever 0
applicable)
(c) Profits in lieu of salary under section 17(3) (as per Form No. 12BA, 0
wherever applicable)
(d) Total 765923
(e) Reported total amount of salary received from other employer(s) 0
2. Less: Allowance to the extent exempt under section 10 0
Allowance Rs.
(a) Travel concession or assistance under section 0 0 0
10(5)
(b) Death-cum-retirement gratuity under section 0 0 0
10(10)
(c) Commuted value of pension under section 0 0 0
10(10A)
(d) Cash equivalent of leave salary encashment 0 0 0
under section 10(10AA)
(e) House rent allowance under section 10(13A) 12960 12960 12960
(f) Amount of any other exemption under section
10
(g) Total amount of any other exemption under 0 0 0
section 10
(h) Total amount of exemption claimed under 12960 12960 12960
section 10 [2(a)+2(b)+2(c)+2(d)+2(e)+2(g)]
3. Total amount of salary received from current employer [1(d)-2(h)] 752963
4. Less: Deductions under section 16
(a) Standard deduction under section 16(ia) 50000
(b) Entertainment allowance under section 16(ii) 0
(c) Tax on employment under section 16(iii) 2500
5. Total amount of deductions under section 16 [4(a)+4(b)+4(c)] 52500
6. Income chargeable under the head "Salaries" [(3+1(e)-5] 700463
7. Add: Any other income reported by the employee under as per section 192 (2B)

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 Income Rs
(a) Income (or admissible loss) from house property reported by 0
employee offered for TDS
(b) Income under the head Other Sources offered for TDS 42901
8. Total amount of other income reported by the employee [7(a)+7(b)] 42901
9. Gross total income(6+8) 743364
10. Deduction under Chapter VIA
Gross Deductible
Amount Amount
(a) Deduction in respect of life insurance premia, contributions to provident
fund etc. under section 80C
ULIP 4800
NPS 74809
LIC 30025
LIC 23074
SBI 34733
167441
(b) Deduction in respect of contribution to certain pension funds under section 0
80CCC
(c) Deduction in respect of contribution by taxpayer to pension scheme under
section 80CCD (1)
(d) Total deduction under section 80C, 80CCC and 80CCD(1) 150000
(e) Deductions in respect of amount paid/deposited to notified pension scheme 0 0
under section 80CCD (1B)
(f) Deduction in respect of contribution by Employer to pension scheme under 0 0
section 80CCD (2)
(g) Deduction in respect of health insurance premia under section 80D 0 0
(h) Deduction in respect of interest on loan taken for higher education under 0 0
section 80E
Gross Qualifying Deductible
amount amount amount
(i) Total Deduction in respect of donations to certain funds,charitable 0 0 0
institutions, etc. under section 80G
(j) Deduction in respect of interest on deposits in savings account under section 0 0 0
80TTA
(k) Amount deductible under any other provision(s) of chapter VI-A 0 0 0
11. Aggregate of deductible amount under Chapter VI-A 150000
[10(d)+10(e)+10(f)+10(g)+10(h)+10(i)+10(j)+10(l)]
12. Total taxable income (9-11) 593364
13. Tax on Total Income 31173
14. Rebate under section 87A, if applicable 0
15. Surcharge, wherever applicable 0
16. Health and education cess 1247
17. Tax payable (13+15+16-14) 33667
18. Relief under section 89(attach details) 0
19. Net tax payable (17-18) 33667
Verification
I, , son/daughter of working in the capacity of DESIGNATED
PARTNER(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 BHOPAL
Date 20/03/2023 Signature of the person responsible for deduction of tax
Designation Full Name

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