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. AMJCLUA Last updated on 01-Jun-2023

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

HDFC BANK LIMITED

1, HDFC BANK HOUSE, SENAPATI BAPAT MARG, MOHAN LAL CHOUDHARY
LOWER PAREL, MUMBAI - 400013 S/O SHIV LAL CHOUDHARY, JODHPUR ROAD, NR AKRIYIA
Maharashtra MAHADEV MANDIR, WARD NO 34,PACHPADRA, BARMER -
+(91)22-30752816 344026 Rajasthan
[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)

AAACH2702H MUMH03189E ALNPC8555C

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 01-Apr-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

Q1 QUZCYLZE 181610.00 0.00 0.00

Q2 QVCCMZYE 128430.00 0.00 0.00
Q3 QVGHLTBE 147065.00 6400.00 6400.00
Q4 QVISUQSF 133022.00 9430.00 9430.00
Total (Rs.) 590127.00 15830.00 15830.00
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 0.00 - 06-05-2022 - F
2 0.00 - 07-06-2022 - F
3 0.00 - 07-07-2022 - F
4 0.00 - 05-08-2022 - F

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 Certificate Number: AMJCLUA TAN of Employer: MUMH03189E PAN of Employee: ALNPC8555C 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*

5 0.00 - 07-09-2022 - F
6 0.00 - 07-10-2022 - F
7 0.00 - 07-11-2022 - F
8 3200.00 0510080 07-12-2022 63489 F
9 3200.00 0510080 06-01-2023 42455 F
10 3200.00 0510080 07-02-2023 26908 F
11 3200.00 0510011 06-03-2023 32384 F
12 0.00 - 06-04-2023 - F
13 3030.00 0510403 06-04-2023 03999 F
Total (Rs.) 15830.00

Verification

I, ARUN ARJUN PAWAR, son / daughter of ARJUN GOPAL PAWAR working in the capacity of DEPUTY V P (designation) do hereby certify that a sum of
Rs. 15830.00 [Rs. Fifteen Thousand Eight Hundred and Thirty Only (in words)] has been deducted and a sum of Rs. 15830.00 [Rs. Fifteen Thousand Eight Hundred
and Thirty 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 MUMBAI

Date 04-Jun-2023 (Signature of person responsible for deduction of Tax)

Designation: DEPUTY V P Full Name:ARUN ARJUN PAWAR

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

Signed by : ARUN ARJUN PAWAR
Date : 10-Jun-2023 00:09:34
Location : Mumbai
Reason : Form16 FY 2022-23

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 FORM NO. 16
PART B
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. AMJCLUA Last updated on 01-Jun-2023

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

HDFC BANK LIMITED

1, HDFC BANK HOUSE, SENAPATI BAPAT MARG, MOHAN LAL CHOUDHARY
LOWER PAREL, MUMBAI - 400013 S/O SHIV LAL CHOUDHARY, JODHPUR ROAD, NR AKRIYIA
Maharashtra MAHADEV MANDIR, WARD NO 34,PACHPADRA, BARMER -
+(91)22-30752816 344026 Rajasthan
[email protected]

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

AAACH2702H MUMH03189E ALNPC8555C

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 01-Apr-2022 31-Mar-2023
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) 585535.00

Value of perquisites under section 17(2) (as per Form No. 12BA,
(b) 4592.00
wherever applicable)
Profits in lieu of salary under section 17(3) (as per Form No.
(c) 0.00
12BA, wherever applicable)
(d) Total 590127.00

(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) 0.00

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Certificate Number: AMJCLUA TAN of Employer: MUMH03189E PAN of Employee: ALNPC8555C Assessment Year: 2023-24

Amount of any other exemption under section 10

[Note: Break-up to be prepared by employer and issued to the
(f)
employee, where applicable, before furnishing of Part B to the
employee]

(g) Total amount of any other exemption under section 10 0.00

Total amount of exemption claimed under section 10

(h) 0.00
[2(a)+2(b)+2(c)+2(d)+2(e)+2(g)]

Total amount of salary received from current employer

3. 590127.00
[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] 540127.00

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) 540127.00

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

Deduction in respect of life insurance premia, contributions to

(a) 26540.00 26540.00
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) 26540.00 26540.00

Deductions in respect of amount paid/deposited to notified

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

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 Certificate Number: AMJCLUA TAN of Employer: MUMH03189E PAN of Employee: ALNPC8555C Assessment Year: 2023-24

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 account
(j) 0.00 0.00 0.00
under section 80TTA

Amount Deductible under any other provision (s) of Chapter VI-A

[Note: Break-up to be prepared by employer and issued to the
(k)
employee, where applicable , before furnishing of Part B to the
employee]

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. 26540.00
[10(d)+10(e)+10(f)+10(g)+10(h)+10(i)+10(j)+10(l)]

12. Total taxable income (9-11) 513587.00

13. Tax on total income 15218.00

14. Rebate under section 87A, if applicable 0.00

15. Surcharge, wherever applicable 0.00

16. Health and education cess 609.00

17. Tax payable (13+15+16-14) 15827.00

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

19. Net tax payable (17-18) 15827.00

Verification
I, ARUN ARJUN PAWAR, son/daughter of ARJUN GOPAL PAWAR .Working in the capacity of DEPUTY V P (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 MUMBAI (Signature of person responsible for deduction of tax)

Full
Date 06-Jun-2023
Name:
ARUN ARJUN PAWAR Signature Not Verified
Signed by : ARUN ARJUN PAWAR
Date : 10-Jun-2023 00:09:34
Location : Mumbai
Reason : Form16 FY 2022-23
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 Employee Code: M16279

2. (f) Break up for ‘Amount of any other exemption under Section 10’ to be filled in the table below

Sl. Particular's of Amount for any other Gross Qualifying Deductible

No. exemption under section 10 Amount Amount Amount

(Rs.) (Rs.) (Rs.)

Total 0.00

10. (k) Break up for ‘Amount deductible under any other provision(s) of Chapter VIA’ to be filled in the
table below
Sl. Particular's of Amount deductible under Gross Qualifying Deductible
No. any other provision(s) of chapter VIA Amount Amount Amount
(Rs.) (Rs.) (Rs.)

Total 0.00

Verification
I, Arun Arjun Pawar, Son of Arjun Pawar working in the capacity of Deputy Vice President 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: Mumbai
Date: 10-Jun-2023 Signature of person responsible for deduction of tax
Designation : Deputy Vice President Full Name: Arun Arjun Pawar

Signature Not Verified

Signed by : ARUN ARJUN PAWAR
Date : 10-Jun-2023 00:09:34
Location : Mumbai
Reason : Form16 FY 2022-23

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 Employee Code: M16279

FORM NO. 12BA

{See rule 26 A(2)(b)}
Statement showing particulars of perquisites, other fringe or Amenities and profits in lieu of salary with value thereof
1. Name and address of the Employer : HDFC BANK LIMITED
HDFC Bank House, Senapati Bapat Marg,
Lower Parel, Mumbai - 400 013.
2. TAN : MUMH03189E
3. TDS Assessment Range of the employer :
4. Name, designation and PAN of the Employee: Mohan Choudhary
Deputy Manager
ALNPC8555C
5. Is the Employee a director or a person : No
with substantial interest in the company
(where the employer is a company)
6. Income under the head salaries of the 585535.00
employee (other than from perquisites) :
7. Financial Year : 2022-2023
8. Valuation of Perquisites : 4591.09
Sr Nature Of Perquisite (See Rule 3) Value Of Amount if any, Amount of
No. Perquisite recovered from Taxable
as per rule employee Perquisites
(Rs.) (Rs.) (Rs.)
1. Accommodation 0.00 0.00 0.00
2. Cars/Other Automotive 0.00 0.00 0.00
3. Sweeper, Gardner, Watchman or Attendant 0.00 0.00 0.00
4. Gas, Electricity, Water 0.00 0.00 0.00
5. Interest free or concessional loans 4591.09 0.00 4591.09
6. Holiday Expenses 0.00 0.00 0.00
7. Free or Concessional Travels 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
Stock options allotted or transferred by employer being an
16. 0.00 0.00 0.00
eligible start-up referred to in section 80-IAC
17. Stock options (non-qualified options) other than col 16 above 0.00 0.00 0.00
Contribution by employer to funds and scheme taxable under
18. 0.00 0.00 0.00
section 17(2)(vii)
Annual accretion by way of interest, dividend etc. to the
19. 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 4591.09 0.00 4591.09
22. Profits in lieu of salary as per section 17(3) 0.00
9.Details Of Tax :-
(a) Tax Deducted from salary of the employee under section 192(1): 15830.00
(b) Tax by employer on behalf of the employee under section 192(1A): NIL
(c) Total Tax Paid : 15830.00
(d) Date Of Payment into Government treasury : As per Form 16
DECLARATION BY EMPLOYER
I, Arun Arjun Pawar, Son of Arjun Pawar working in the capacity of Deputy Vice President do hereby declare on behalf of HDFC
BANK LIMITED that the information given above is based on the books of accounts, documents and other relevant records or
information available with us and details of value of such perquisite are in accordance with section 17 and rules framed there under
and that such information is true and correct.
HDFC BANK LIMITED

Signature of the person responsible for deduction of tax

Place: Mumbai Full Name: Arun Arjun Pawar
Signature Not Verified
Signed by : ARUN ARJUN PAWAR
Date: 10-Jun-2023 Designation: Deputy Vice PresidentDate : 10-Jun-2023 00:09:34
Location : Mumbai
Reason : Form16 FY 2022-23

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 Employee Code: M16279

Gross Salary Breakup

Allowance Name Allowance Value
Basic 221180.00
Conveyance Allowance 19200.00
House Rent Allowance 40500.00
Medical Reimbursement 15000.00
Other Allowance 118290.00
Personal Pay 83020.00
Bonus / Ex-Gratia 58790.00
Food Allowance 10920.00
Leave Travel Allowance Reimbursement 18635.00
Perquisite - Interest Free or Concessional Loan 4591.09
Gross Salary 590127.00

Less : Exemptions Amount

Total of Exemptions 0.00

Total (Gross Salary - Exemptions) 590127.00

Staff Loan Outstanding Balance as on 31st March 2023

Loan Type Outstanding Amount

STAFF PERSONAL LOAN 68298.27

Signature Not Verified

Signed by : ARUN ARJUN PAWAR
Date : 10-Jun-2023 00:09:34
Location : Mumbai
Reason : Form16 FY 2022-23

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