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. AXHMAVA Last updated on 08-Jun-2023

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

CITCO GROUP SERVICES (INDIA) LLP

2ND FLR, SURVEY NO.72,, TOWER B, KHARADI,,
ANUDEEP KUMAR
EKIPL-SEZ, PHASE II, PUNE - 411014
1-5-104, JAHIRABAD, BLACK 4 5, MEDAK - 500060 Andhra Pradesh
Maharashtra
+(91)20-66380800
[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)

AANFC8880B MUMC25837A COQPK9094E

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 2023-24 12-Sep-2022 31-Mar-2023
Building, Charni Road , Mumbai - 400002

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

Q2 QVCIHMIE 62805.00 2696.00 2696.00

Q3 QVFKCQIB 301626.00 13628.00 13628.00
Q4 QVJROKIE 300861.00 13467.00 13467.00
Total (Rs.) 665292.00 29791.00 29791.00
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 2696.00 6394517 07-10-2022 03814 F

2 5115.00 6390031 07-11-2022 27951 F
3 4257.00 6390009 07-12-2022 65232 F
4 4256.00 6390009 06-01-2023 56463 F
5 4256.00 6390009 07-02-2023 57164 F

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 Certificate Number: AXHMAVA TAN of Employer: MUMC25837A PAN of Employee: COQPK9094E Assessment Year: 2023-24

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*

6 4955.00 6390009 06-03-2023 79301 F

7 4256.00 6390009 27-04-2023 27108 F
Total (Rs.) 29791.00

Verification

I, PRASAD MADHUSUDAN KULKARNI, son / daughter of MADHUSUDAN VASUDEO KULKARNI working in the capacity of EVP (designation) do hereby certify that a
sum of Rs. 29791.00 [Rs. Twenty Nine Thousand Seven Hundred and Ninety One Only (in words)] has been deducted and a sum of Rs. 29791.00 [Rs. Twenty Nine
Thousand Seven Hundred and Ninety One 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 PUNE

Date 11-Jun-2023 (Signature of person responsible for deduction of Tax)

Designation: EVP Full Name:PRASAD MADHUSUDAN KULKARNI

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

Signature Not Verified

Digitally signed by PRASAD
MADHUSUDAN KULKARNI
Date: 2023.06.12 15:02:26 +05:30
Reason: Form 16 Digital Signature

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