Form 16 21-22

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FORM NO.

16
PART B
Certificate under section 203 of the Income-tax Act, 1961 f or tax deducted at source on salary paid to an employee un der section 192 or pension/interest income
of specified senior citizen under section 194P
Certificate No. Last updated on 18-July-2021

Name and address of the Employer/Specified Bank Name and address of the Employee/Specified senior citizen

HCL Technologies Limited Sunil


806 Siddarth, 96, Nehri Place H. No. 379 VPO. Popran, Karnal , INDIA
New Delhi 110019 Haryana- Pin : 132039
Delhi
Delhi

[email protected]

PAN of the Deductor TAN of the Deductor PAN of the Employee/Specified senior citizen

AACH1645P DELH01586E HVJPS1752L

CIT (TDS) Assessment Year Period with the Employer

From To
The Commissioner of Income Tax (TDS)
Room No. 900A, 9th Floor, K.G. Mittal Ayurvedic Hospital 2021- 22 01-Apr-2020 31-Mar-2021
Building, Charni Road , Mumbai – 400002

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) 873180.00

Value of perquisites under section 17(2) (as per Form No. 12BA,
(b) 0 .00
wherever applicable)
Profits in lieu of salary under section 17(3) (as per Form No.
(c) 0.00
12BA, wherever applicable)
(d) Total 873180.00

(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) 48900. 00

Page 1 of 4

Signature Not Verified


Signed By:AMIT GOYAL Signing
Date:18/07/2021
Certificate Number: TAN of Employer:DELH01586E PAN of Employee:HVJPS1752L Assessment Year: 2020-21

Amoun t 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 43200.00

Total amount of exemption claimed under section 10


(h) 92100.00
[2(a)+2(b)+2(c)+2(d)+2(e)+2(g)]

Total amount of salary received from current employer


3. 781080.00
[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) 0.00

5. Total amount of deductions under section 16 [4(a)+4(b)+4(c)] 50000.00

6. Income chargeable under the head "Salaries" [(3+1(e)-5] 731080.00

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 0.00

Total amount of other income reported by the employee


8. 0.00
[7(a)+7(b)]
9. Gross total income (6+8) 731080 .00

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

Deduction in respect of life insurance premia, contributions


to
(a) 73354.00 73354.00
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) 73354.00 73354.00

Deductions in respect of amount paid/deposited to notified


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

Page 2 of 4

Signature Not Verified


Signed By:AMIT GOYAL Signing
Date:18/07/2021
Certificate Number: AYORYOA TAN of Employer:DELH01586E PAN of Employee:HVJPS1752L Assessment Year: 2020-21

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 nt
accou
(j) 0.00 0.00 0.00
under section 80TTA

Amount Deductible under any other provision (s) of Chapter


(k) VI-A [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. 73354.00
[10(d)+10(e)+10(f)+10(g)+10(h)+10(i)+10(j)+10(l)]

12. Total taxable income (9-11) 657730.00

13. Tax on total income 45808.00

14. Rebate under section 87A, if applicable 0 .00

15. Surcharge, wherever applicable 0.00

16. Health and education cess 6431.00

17. Tax payable (13+15+16-14) 52239.00

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

19. Net tax payable (17-18) 52239.00

Verification
I, AMIT GOYAL ,son/daughter of PREM GOYAL Working in the capacity of XEN (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 Delhi (Signature of person responsible for deduction of tax)


Full
Date 18-July-2021 A MIT GOYAL
Name:

Page 3 of 4
Signature Not Verified
Signed By:AMIT GOYAL Signing
Date:18/07/2021
Certificate Number: AYORYOA TAN of Employer:DELH01586E PAN of Employee:HVJPS1752L Assessment Year: 2020-21

2. (f) Break up for‘Amount of any other exemption under section10’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
any other provision(s) of Chapter VIA Gross Amount Qualifying Amount Deductible Amount
Sl.
No. Rs. Rs. Rs. Rs.
1.
2.
3.
4.
5.
6.

Delhi (Signature of person responsible for deduction of


Place
tax)
Full
Date 18-July-2021 AMIT GOYAL
Name:

Page 4 of 4
Signature Not Verified
Signed By:AMIT GOYAL Signing
Date:18/07/2021

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