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 paid to an employee
under section 192 or pension/interest income of specified senior citizen under section 194P
Certificate No. Last Updated On
Name and address of the Employer/Specified Bank Name and designation of the Employee/ Specified senior
citizen
CHILD DEVELOPMENT PROJECT OFFICER JALGAON RATNA GANGARAM CHAUDHARI
000, Central Admin Building, Near Akashwani Chowk, Jalgaon,
Jalgaon, MAHARASHTRA,425001
PAN No. of the Deductor TAN of the Deductor PAN No. of the Employee/ Employee Reference No./
specificed senior citizen Pension Payment order
no.provided by the
Employer (If available)
AAALC0242N NSKC01580F ANFPC0930P 11031
CIT (TDS) Assessment year Period with the Employer
Address:The Commissioner of Income Tax (TDS),4th Floor, A Wing, From To
PMT Commercial Complex,Shankar Sheth Road, Swargate, Pune
City:Akola Pin Code:400002 2022-2023 01/04/2021 31/03/2022
PART B (Annexure)
In relation to employees for tax deduction under section 192
A Whether opting for taxation u/s 115BAC? No
1. Gross Salary
(a) Salary as per provisions contained in section 17(1) 944158
(b) Value of perquisites under section 17(2) (as per Form No. 12BA, wherever 0
applicable)
(c) Profits in lieu of salary under section 17(3) (as per Form No. 12BA, 0
wherever applicable)
(d) Total 944158
(e) Reported total amount of salary received from other employer(s) 0
2. Less: Allowance to the extent exempt under section 10 0
Allowance Rs.
(a) Travel concession or assistance under section 0 0 0
10(5)
(b) Death-cum-retirement gratuity under section 0 0 0
10(10)
(c) Commuted value of pension under section 0 0 0
10(10A)
(d) Cash equivalent of leave salary encashment 0 0 0
under section 10(10AA)
(e) House rent allowance under section 10(13A) 0 0 0
(f) Amount of any other exemption under section
10
(g) Total amount of any other exemption under 0 0 0
section 10
(h) Total amount of exemption claimed under 0 0 0
section 10 [2(a)+2(b)+2(c)+2(d)+2(e)+2(g)]
3. Total amount of salary received from current employer [1(d)-2(h)] 944158
4. Less: Deductions under section 16
(a) Standard deduction under section 16(ia) 50000
(b) Entertainment allowance under section 16(ii) 0
(c) Tax on employment under section 16(iii) 2500
5. Total amount of deductions under section 16 [4(a)+4(b)+4(c)] 52500
6. Income chargeable under the head "Salaries" [(3+1(e)-5] 891658
7. Add: Any other income reported by the employee under as per section 192 (2B)

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 Income Rs
(a) Income (or admissible loss) from house property reported by 0
employee offered for TDS
(b) Income under the head Other Sources offered for TDS 0
8. Total amount of other income reported by the employee [7(a)+7(b)] 0
9. Gross total income(6+8) 891658
10. Deduction under Chapter VIA
Gross Deductible
Amount Amount
(a) Deduction in respect of life insurance premia, contributions to provident
fund etc. under section 80C
LIP 117061
PPF 42500
House Repayment 6016
gis 4320
169897
(b) Deduction in respect of contribution to certain pension funds under section 0
80CCC
(c) Deduction in respect of contribution by taxpayer to pension scheme under 24169
section 80CCD (1)
(d) Total deduction under section 80C, 80CCC and 80CCD(1) 150000
(e) Deductions in respect of amount paid/deposited to notified pension scheme 50000 50000
under section 80CCD (1B)
(f) Deduction in respect of contribution by Employer to pension scheme under 103840 103840
section 80CCD (2)
(g) Deduction in respect of health insurance premia under section 80D 0 0
(h) Deduction in respect of interest on loan taken for higher education under 0 0
section 80E
Gross Qualifying Deductible
amount amount amount
(i) Total Deduction in respect of donations to certain funds,charitable 1849 1849 1849
institutions, etc. under section 80G
(j) Deduction in respect of interest on deposits in savings account under section 0 0 0
80TTA
(k) Amount deductible under any other provision(s) of chapter VI-A 0 0 0
11. Aggregate of deductible amount under Chapter VI-A 305689
[10(d)+10(e)+10(f)+10(g)+10(h)+10(i)+10(j)+10(l)]
12. Total taxable income (9-11) 585969
13. Tax on Total Income 29694
14. Rebate under section 87A, if applicable 0
15. Surcharge, wherever applicable 0
16. Health and education cess 1188
17. Tax payable (13+15+16-14) 30882
18. Relief under section 89(attach details) 0
19. Net tax payable (17-18) 30882
Verification
I, VIJAYSING INDALSING PARDESHI, son/daughter of INDALSING PARDESHI working in the capacity of Project
Officer(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 16/01/2023 Signature of the person responsible for deduction of tax
Designation Project Officer Full Name:VIJAYSING INDALSING PARDESHI

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