FORM NO.16
[See rule 31(1)(a)]
Certificate under section 203 of the Income-tax Act, 1961 for tax deducted at source on salary
PART A
Certificate No. Last updated on
Name and address of the Employer
Name and address of the Employee
PAN of the Deductor
TAN of the Deductor
PAN of the
Employee
Employee Reference No.
provided by the Employer
(If available)
Assessment Year Period with the Employer
From To
CIT (TDS)
Address………………………………………………………
……………………………………………………………….
City…………………………….Pin code…………………..,
Summary of amount paid/credited and tax deducted at source thereon in respect of the employee
Quarter(s) Receipt Numbers of original
quarterly statements of TDS
under sub-section (3) of
section 200
Amount
paid/credited
Amount of tax deducted
( Rs. )
Amount of
tax deposited/ remitted
(Rs. )
Total (Rs.)
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)
Sl. No. Tax Deposited in respect Book Identification Number (BIN)
of the deductee
( Rs. ) Receipt numbers of
Form No. 24G
DDO serial number in Form No.
24G
Date of transfer
voucher
(dd/mm/yyyy)
Status of matching
with Form No.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)
Sl. No. Tax Deposited in respect Challan Identification Number (CIN)
of the deductee
( Rs. )
BSR Code of the Bank
Branch
Date on which tax deposited
(dd/mm/yyyy)
Challan Serial
Number
Status of
matching with
OLTAS
Total ( Rs. )
Verification
I,…………….., son/daughter of ………….working in the capacity of ……. (designation) do hereby certify that a sum of Rs. ………….. [Rs. ………….(in words)] has been deducted and 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
Date
(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)
Details of Salary paid and any other income and tax deducted
1 Gross Salary Rs .
(a) Salary as per provisions contained in sec.17(1) Rs.
(b) Value of perquisites u/s 17(2) (as per Form No.12BA, wherever
applicable)
Rs.
(c) Profits in lieu of salary under section 17(3)(as per Form No.12BA,
wherever applicable)
Rs.
(d) Total Rs.
Less: Allowance to the extent exempt u/s 10
Allowance Rs.
2
Rs.
Rs.
3 Balance(1-2) Rs.
4 Deductions :
(a) Entertainment allowance Rs.
(b) Tax on employment Rs.
5 Aggregate of 4(a) and (b) Rs.
6 Income chargeable under the head 'salaries' (3-5) Rs.
Add: Any other income reported by the employee
Income Rs.
7
Rs.
8 Gross total income (6+7) Rs.
Deductions under Chapter VI-A
(A) sections 80C, 80CCC and 80CCD
(a) section 80C Gross Amount Deductible amount
(i) ………….…… Rs.
(ii) ………………. Rs.
(iii) ………………. Rs.
(iv) ………………. Rs.
(v) ………….……
(vi) ………….……
(vii) ………….…… Rs. Rs.
(b) section 80CCC Rs. Rs.
9
(c) section 80CCD
Note: 1. Aggregate amount deductible under sections 80C, 80CCC and
80CCD(1) shall not exceed one lakh rupees.
(B) Other sections (e.g. 80E, 80G, 80TTA, etc.) under Chapter VI-A.
Gross amount Qualifying amount Deductible amount
(i) section……….. Rs. Rs. Rs.
(ii) section……….. Rs. Rs. Rs.
(iii) section……….. Rs. Rs. Rs.
(iv) section……….. Rs. Rs. Rs.
(v) section……….. Rs. Rs. Rs.
10 Aggregate of deductible amount under Chapter VI-A Rs
11 Total Income (8-10) Rs
12 Tax on total income Rs
13 Education cess @ 3% (on tax computed at S. No. 12) Rs.
14 Tax Payable (12+13) Rs.
15 Less: Relief under section 89 (attach details) Rs
16 Tax payable (14-15) Rs.
Verification
I, …………………………….., son/daughter of ……………………………………….working in the capacity of .………………………......... (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
Date
(Signature of person responsible for deduction of tax)
Designation: Full Name: _______________________”;