—— 4; ns | FORM No. 16 j INCOME TAX FOR THE FINANCIAL YEAR 2019-20 (Certficate under section 203 of the Inccme-tax Act, 1961 for Tax deducted at source from income ‘chargeatle under the head "Salaries WANE ENG RGGRESS OF THE EMPLOYER sae SME AND DESIGNATION OF THE EMPLOYEE | ‘SS POTHURAJU [Emp ID No. 0379603 TAHSILDAR Smt. G.Satya Veni : : Jr-Assistant Tahsildar Office, Mummidivaram ‘Tahsildar Office, Mummidivaram VPNMONITSE PAN oF Employee _| 0 eS SIGeTan GE af a quar stators oF TOS under ub secton 200 a oredr Te Fase Quarter Ackaowiodgernent No Period ‘Assessment 1 From Te Year 3 . 3 March.2019 | Feb,2020 | 2020-2021 z DETAILS OF SALARY PAID AND ANY OTHER INCOME AND TAX DEDUCTED Gross Salary Rs. 361,839 ey Saary2¢ gor provisions cotaned insection 17(1) Rs 5 >) Value of percuisites under section 17(2) Rs, (As Per Form No. 42BA, Wherever applicable) = |e). Profts in lieu of salary undet section 17(3) rs (es per Form No. 128A, Wherver applicable) ld) Total Rs. 361,839 Rs. (361,839 |Less :Standard Deduction for Salaried & Pensioner (Rs 50,000) IRs. 50,000, 2. |Lese: Allowance to the extent exempted Us 10 ja) House Rent Allowence ln. (18,638 i) Other Allowance i - lns.___—18,038, 3 Balance (1-2) ins 295,201 4 |Deductions a) Entertainment Alowence Rs. é 1b) Tax on Employment rs 2.400 5 |Aggreate of 4 (a)&(b) Rs. 2.400 6 |INCOME CHARGEABLE UNDER THE HEAD SALARIES: Rs. 290,801 Ade: Famiy Pension received during the year 2019-20 is. 5 IAdd: Income from House Property U's 24(v) is. 2 |Less:Interest on Housing Loan U/s 24(b) Rs. - 8 |Gross Total Income (6+7) IRs. 290,801 9 \Deductions Under Chapter VIA A) lUnderSection 80C,80CCC,80CCD. Gross Qualifying Deductbie a) Section 80C ‘Amount | Amount Amount i cps Rs. 29,359 |Rs. 29,359 |Rs. 29,359 i AP.GLI Rs. 4,200 |Rs. 4,200 |Rs. 4,200 lv cus fs 360 |r» 350s «360 iv LIC PremamDeducted mSSS Rs fre les = Ly Chiron Tuion Fee Re re «| Ni Repayemeat of Home Laan Premium Re Fe - lps. Nii LIC Anal Premiums Paid by Hand Rs - [re - |r it PUI Anna Prerin Rs = |r - les. ic 5 Years Fixed Deposits is - |e -|s. . y Unt Linkod Inurance Plan Rs rs = [es E Others) Rs -|rs. =e. 39.610 [Total Under Section 80C... Rs. 99,919 lb) Section 80CCC LIC TUT! ete Pension funds Rs Re as i. Z lc) Section 80CCD | Contibuion to Pension Fund is - |re - les as. lAggrigate Amount Deductible Under 3 Sections. 7 Rs. 33,919 Totes 7 gregate aroun dedicte unde secon BOE sna nor exceed 150,000.00 rupees, 2 egpegae amount deduce under section 806 80CCC, #000, shal net exceed 200 000-0,B) (Other Sections Under Chapter IA | Grose ‘Gusliyng] | Desuetbe ( Under Sections 80E,206,80DD etc ) Amount ‘Amount) | Amount EW Fi lage Day HFICMRF Re 41,150 4,150 4,150 Expondtre on medal treatment Rs. Medical Ineurance Premium Rs. 3 : 3 Donation of Chatable Insiiton Rs z Interest on Educatonal Loan RS zi : : Interest on Housing Loan Advance Rs = E = Medical treatment of Hanccapped/Depende RS - 4 - Maintaince for Below 80% disabled Employe RS. - : = investment made under Section 80 CCG :Rajiv Gandhi Equity Savings Rs 4 : q investment made in NPS up to Re $0,000- 00 under Section 80CCO(1B) Re i Total Under Sections 80CCG, 80GG, 80, 80EE, 80DD, 80U ete. TA50 10 |Aggregate of Deductible Amounts U/Chapter VIA (ASB)... Re. 35,060 256732 11 |TOTAL INCOME (8-10) 250000 Rs. 265,732 42 |TAX ON TOTAL INCOME Rs. 5732 Re. 287 Under section (87A) rebate of Rs 12500! for individual having Taxable Income not 43 [exceeding Rs 5.00,0001- R 415 |TAX PAYABLE (12-13) Re 16 |Education Cess @ 2% + 2% (On Tax at S.No.15) Rs 17 | TAX PAYABLE (15+16) Rs 1B |Less:(a) Tax deducted at source Us 192(1) Rs (b)Tax pad by the empioyer on behalf othe Rs Employee U/S 192 (1A) on perquisited UIS 17 (2) Rs 19 |TAX PAYABLE / REFUNDABLE (17-18) Rs DETAILS OF TAX DEDUCTED AND DEPOSITED INTO CENTRAL GOVERNMENT ACCOUNT (The employers to provide vanction- wae datais of tax deducted and depasited) si TOS Surcharge Total Tax Date on | Transtar No. Rs Rs Depostes iN No ncn Tax |vocne/enatana Rs Deposited _denincaten No 7 : z 3 z 5 6 7 3 3 70 = = i 2 |, Sri S POTHURAJU (DDO) working as TAHSILDAR do hereby certify that the sum] of Rs. 0-00 has been deducted Income Tax at source and paid to the credit of the central Government. 1 further certify that tie Informtion givin above is true and correct based on the books of account, documents and other available records. fA Place Signature of the Maiopnion Re deduction of tax Date FullName- | MUMMIDIVARAM Designation Seles) a\Y ian Ww{ Vide rule 31{2)(@) of income Tax Rules,1962) FORM No. 16 Certificete under section 203 of the Income-tax Act, 1961 for Tax deducted at source from income chargeable under the head "salaries NAME AND ADDRESS OF THE EMPLOYER SRE SPOTHURATU TAHSILDAR TAHSTLDAR OFFICE. IAUM/ATDIVARAM NAME AND DESIGNATION OF EMPLOYEE GIDDI SATVA VENT JUNIOR ASSISTANT MUIUIAIDIVARAM , MUMMIDIVARAM, TAN No.of Deductor PAN Na_of Deductor PAN No, oT Employee VPNMOTI73E ELRPSS214L, Guarter ‘Acknowledgement No Amount Quarter-T Quarter-2 Quarter-3 Quarter -4 Period Assessment From To fear Apr-2a Mar-22 2022-23 DETAILS OF SALARY PAID AND ANY OTHER INCOME AND TAX DEDUCTED id (Gress Salary la) Salary 2s per provisions cotanec in section 17 (7) 'b) Value of percuisites under secton 17(2) (As Per Form No. 128A, Wherever applicable) le) Profits liu of salary under section 17(3) (#8 per Form No. 128A, Wherver applicable) Loss:Allowance to the extent exempted Ue 10(13A) la) Leastof (i)Actual amount of HRA received (inRlent Pakd 10% of Selary (ii}40% of Selary (BasicsDA) Not Salary (1-2) Deductions UIS 16 (a) | Starndard Deductions v/s 16(e) (©) Exemption rom Conveyance Allowance U's. 10(14) (i) (c) Tax onempleyment - (Prot Tax) u's) Ks) Other Allowance |Agrogate 4(a) To 4(4) Income chargeble under the Head "Salarios"(3-5) Income or Loss from House Property Sec.24, <2,00,000 (a) Rentfrom House Property (0) Municipal Tax Paid 30% as Maintenance (3) Interest on Hovsing Loan lo) Income chargoble under the House Property Income trom Otner Sources (a) Interest from Income Tax Refund fo) Interest rom Savings Accaount Income from Long Term Capita gains (6) Income from Other Source le) NPS Management Snare |Gross Total Income (647+8) [Deductions under section VIA lUnder Sections 89¢,80CCC,80CCD(1), focen(t) CPS joc AGLI loc © cs lace = Tuton Fee for Two Children 20c Postal Life Insurance 80c—=—(LIC Policies prenmum- Yearly 80C Principle Amcunt of Home Loan instalimen's soc ——Sukarya Samrudni Yojana lac HOF Life Insurance Jac SAIL fe Insurance Any athor enter here Total of Under Sections B0C,E0CCC. 485,002 | 456,892 30886 34.910 148.361 50,000 2400 52,400 y73.506 373.596 Gross Amt Dea Amt. 37.086 37004 7:200 7.200 380 360 4008 sage s.644[SOCCS Raj Gandh Equity Savings Scheme Jsocc0(2) Conioution te pension scneme of Central Govt by employer = Z ]80CCD(1) Contnbution te pension scheme of Central Goverment UIs ) = 7 S| £B}/Other Sections Under Chaptor VI A leos EWF&SWF&CMR cc ” JSe024 _ntorost of Housing Loan Sec-24 - : soo Health Insurance Promium for Se and Family (Non Sonior Cz 2,700 2,700 J60D0 ——_tedtcal expenciture for Selt and Family inclusing Parents (Sen - : soe Interest on Loan taken for hgher education z : eos Denation for Chartable instiution 50% 2 Any otner enter here q : 2770 11| Aggregate of Deductible Amounts UiChapter VIA (A+B) ara 12] Total Income (9-14) 326,180 13)Tax Payble on Total Income (on 42) 3,808 14{Tax Rebate vis 67a 16] Tax Aftor Rebate (13-14) : 16|Heath ard Education Cess @ 4% on (15) 17Tow' Tax & Ces 18)Loce: Rotef under secton 26(1) (atach details) F 19 Tax Payble aftor Relief 17-18) : 20)a)Tax ceducted at source 792(1) [b/Tax paid by employer en behalf of the employee uis 19214) on perquisted us 17 (2) 21/Tas Pay! No Tax DETAILS OF TAX DEDUCTED AND DEPOSITED INTO CENTRAL GOVERNMENT ACCOUNT (ine employers to provide tranction -wse deals of tax deducted and deposited) St 10S Surcharge Education Total Tax ChequeOD BER Code Dateon Transfer No Rs Fs. ess Deposited No. (itany) of Bank Which Tax vocher/chalana Rs Rs. Branch Deposited _Identiicaton No T 2 3 4 5 6 8 9 10 1 12 SRI S POTHURATU working in the capacity of TAHSILDAR do hereby certty that the sum of Rs. O/- Rupees in words IZero has been deducted at Source and paid to the credit of the contral Government. | further certify that the information given above is true, [complete and correct tased on the Books of account. documents ang other avaitable rocards Sor- TAHSILDAR MUMMIDIVARAM. ice uuanzorvanau Sigraiue of apenitle fer deacon fax bate. zer-2022 FulNome-°>' eet spoTeueary Designation: TAMSILDAR, TAHSTLDAR OFFICE. MUMMTDIVARAM