"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
Name and address of the Name and Designation of the Employee
Employer
PAN of the TAN of the Deductor PAN of the Employee
Deductor
CIT(TDS) Assessment Year Period
Address___________________________________
City_______________Pin code__________ From To
Summary of tax deducted at source
Quarter Receipt Numbers of original Amount of tax deducted Amount of tax
statements of TDS under sub-section (3) in respect of the employee deposited/remitted in respect of
of section 200. the employee
Quarter 1
Quarter 2
Quarter 3
Quarter 4
Total
PART B (Refer Note 1)
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.12BB, Rs
wherever applicable)
(c) Profits in lieu of salary under section 17(3)(as per Rs.
Form No.12BB, wherever applicable)
(d) Total Rs
2 Less: Allowance to the extent exempt u/s 10
Allowance Rs.
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
7 Add: Any other income reported by the employee
Income Rs.
Rs
8 Gross total income (6+7) Rs
9 Deductions under Chapter VIA
(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.
(c) Section 80CCD
Note: 1. Aggregate amount deductible under section 80C
shall not exceed one lakh rupees.
2. Aggregate amount deductible under the three
sections, i.e., 80C, 80CCC and 80CCD shall not
exceed one lakh rupees.
(B) Other sections (e.g. 80E, 80G etc.) under Chapter VI-A.
Gross Qualifying Deductible
amount amount 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 VIA 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 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. 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 may be
issued by each of the employers or the last employer at the option of the assessee.
2. Government deductors to enclose AnnexureA if tax is paid without production of an
incometax challan and Annexure B if tax is paid accompanied by an income tax
challan.
3. Non Government deductors to enclose Annexure B.
4. The deductor shall furnish the address of the Commissioner of Incometax (TDS)
having jurisdiction as regards TDS statements of the assessee.
5. This Form shall be applicable only in respect of tax deducted on or after 1 st day of April,
2010.
ANNEXURE-A
DETAILS OF TAX DEDUCTED AND DEPOSITED IN THE CENTRAL GOVERNMENT ACCOUNT THROUGH
(The Employer to provide payment wise details of tax deducted and deposited with respect to the employee)
BOOK ENTRY
S. No. Tax Deposited in Book identification number (BIN)
respect of the
employee (Rs.) Receipt numbers of Form DDO Sequence Date on which tax
No.24G Number in the Book deposited
Adjustment Mini (dd/mm/yyyy)
Statement
Total
Note:
1. In the column for TDS, give total amount for TDS, Surcharge (if applicable) and education
cess.
ANNEXURE-B
DETAILS OF TAX DEDUCTED AND DEPOSITED IN THE CENTRAL GOVERNMENT ACCOUNT THROUGH
(The Employer to provide payment wise details of tax deducted and deposited with respect to the
employee) CHALLAN
S. No. Tax Deposited in Challan identification number (CIN)
respect of the
employee (Rs.) BSR Code of the Bank Date on which tax Challan Serial
Branch deposited Number
(dd/mm/yyyy)
Total
Note:
1. In the column for TDS, give total amount for TDS, Surcharge (if applicable) and education
cess.
