01805376/AJYPH0281M Hariharan Thalai Periyasamy
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
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 MUMBAI (Signature of person responsible for deduction of tax)
Date 10.04.2023 Full Name: CAWASI JOKHI
01805376/AJYPH0281M Hariharan Thalai Periyasamy
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
TATA CONSULTANCY SERVICES LTD.,9th Flr, Nirmal Bldg, Nariman Point,
1. Name and address of employer : Mumbai,400021,Maharashtra
2. TAN : MUMT11446B
3. TDS Assessment Range of the employer : ,,,,
4. Name, designation and Permanent Account Number or
Aadhaar Number of employee
: Hariharan Thalai Periyasamy,I.T. Analyst,01805376,AJYPH0281M
5. Is the employee a director or a person with substantial interest
in the company(where the employer is a company) :
6. Income under the head “Salaries” of the employee
(other than from perquisites)
: 922348.00
7. Financial year : 2022-2023
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 0.00 0.00 0.00
2. Cars/Other automotive 0.00 0.00 0.00
Sweeper, gardener, watchman or
3. 0.00 0.00 0.00
personal attendant
4. Gas, electricity, water 0.00 0.00 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 0.00 0.00 0.00
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 0.00 0.00 0.00
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) 82466.00
(b) Tax paid by employer on behalf of the employee under section 192(1A) 0.00
(c) Total tax paid 82466.00
(d) Date of payment into Government treasury
DECLARATION BY EMPLOYER
I, CAWASI JOKHI Son/daughter of BAHADUR JOKHI working as ASSISTANT GENERAL MANAGER (designation ) do hereby declare on behalf of
TATA CONSULTANCY SERVICES 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.
Signature Not Verified
Signature of person responsible for deduction of tax
Digitally signed by CAWASI
Place : MUMBAI Full Name:CAWASI JOKHI BAHADUR JOKHI
Date : 10.04.2023 Designation:ASSISTANT GENERAL MANAGER Date: 2023.04.13 03:36:43 IST
01805376/AJYPH0281M Hariharan Thalai Periyasamy
Annexure to Form No.16
Name: Hariharan Thalai Periyasamy Emp No.: 01805376
Particulars Amount(INR)
Emoluments paid
Basic Salary 379200.00
House Rent Allowance 209040.00
Leave Travel Allowance 30696.00
BoB Kitty Allowance 41784.00
Personal Allowance 262008.00
Variable Allowance 182100.00
City Allowance 21600.00
Perquisites
Gross emoluments 1126428.00
Income from other sources
Income
Total income from other sources 0.00
Exemptions u/s 10
Allowance
House rent allowance under section 10(13A) 151680.00
Total Exemption 151680.00
Date: 10.04.2023 Full Name: CAWASI JOKHI
Place:MUMBAI Designation: ASSISTANT GENERAL MANAGER