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Certificate under section 203 of the Income-tax Act, 1961 for tax deducted at source on salary

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..... ACCOUNT THROUGH BOOK ADJUSTMENT (The deductor to provide payment wise details of tax deducted and deposited with respect to the deductee) Sl. No. Tax Deposited in respect of the deductee (Rs. ) Book Identification Number (BIN) Receipt numbers of Form No. 24G DDO serial number in Form No. 24G Date of transfer voucher dd/mm/yyyy Status of matching with Form No. 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) Sl. No. Tax Deposited in respect of the deductee (Rs. ) Challan Identification Number (CIN) BSR Code of the Bank Branch Date on which tax deposited (dd/mm/yyyy) Challan Serial Number Status of matching With OLTAS Total ( 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. .....

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..... by taxpayer to Rs.. Rs.. pension scheme under section 80CCD (1) (d) Total deduction under section 80C, 80CCC and 80CCD(1) Rs.. Rs.. (e) Deductions in respect of amount paid/deposited to notified Rs.. Rs.. pension scheme under section 80CCD (1B) (f) Deduction in respect of contribution by Employer to Rs.. Rs.. pension scheme under section 80CCD (2) (g) Deduction in respect of health insurance premia under Rs.. Rs.. section 80D (h) Deduction in respect of interest on loan taken for higher Rs.. Rs.. education under section 80E (i) Deduction in respect of contribution by the employee to Agnipath Scheme under section 80CCH Rs.. Rs.. (j) Deduction in respect of contribution by the Central Government to Agnipath Scheme under section 80CCH Rs.. Rs.. Gross Qualifying Deductible Amount Amount Amount (k) Total Deduction in respect of donations to certain funds, Rs.. Rs.. Rs.. charitable institutions, etc. under section 80G (l) Deduction in respect of interest on deposits in savings Rs.. Rs.. Rs.. account under section 80TTA (m) Amount deductible under any other provision(s) of Chapter VI‐A section Rs.. Rs.. Rs.. section Rs.. Rs.. Rs.. section Rs.. Rs.. Rs.. section Rs.. Rs.. Rs.. secti .....

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..... respect of health insurance premia under section 80D Rs.. Rs.. (g) Deduction in respect of interest on loan taken for higher education under section 80E Rs.. Rs.. Gross Amount Qualifying Amount Deductible Amount (h) Total Deduction in respect of donations to certain funds, charitable institutions, etc. under section 80G Rs.. Rs.. Rs.. (i) Deduction in respect of interest on deposits in savings account under section 80TTB Rs.. Rs.. Rs.. (j) Amount deductible under any other provision(s) of Chapter VI‐A section Rs.. Rs.. Rs.. section Rs.. Rs.. Rs.. section Rs.. Rs.. Rs.. section Rs.. Rs.. Rs.. section Rs.. Rs.. Rs.. section Rs.. Rs.. Rs.. Rs.. Rs.. Rs.. (k) Total of amount deductible under any other provision(s) of Chapter VI‐A Rs.. Rs.. Rs.. 9. Aggregate of deductible amount under Chapter VI-A [8(d)+8(e)+8(f)+8(g)+8(h)+8(i)+8(k)] Rs.. 10. Total taxable income (7-9) Rs.. 11. Tax on total income Rs.. 12. Rebate under section 87A, if applicable Rs.. 13. Surcharge, wherever applicable Rs.. 14. Health and education cess Rs.. 15. Tax payable (11+13+14-12) Rs.. 16. Less: Relief under section 89 (attach details) Rs.. 17. Net tax payable (16-17) Rs.. Verification I, .., son/daugh .....

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..... ucted at source from income chargeable under the head Salaries ************ NOTES:- 1. Omitted vide NOTIFICATION NO. 36/2019 dated 12-04-2019 before it was read as, Notes: 1. Government deductors to fill information in item I if tax is paid without production of an income-tax challan and in item 11 if tax is paid accompanied by an income-tax challan 2. Non-Government deductors to fill information in item II. 3. The deductor shall furnish the address of the Commissioner of Income-tax (TDS) having jurisdiction as regards TDS statements of the assessee. 4. If an assessee is employed under one employer only during the year, certificate in Form No. 16 issued for the quarter ending on 31 March of the financial year shall contain the details of tax deducted and deposited for all the quarters of the financial year. 5. If an assessee is employed under more than one employer during the year, each ofthe 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. .....

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..... e and tax deducted 1. Gross Salary (a) Salary as per provisions contained in section 17(1) Rs.. (b) Value of perquisites under section 17(2) (as per Form No. 12BA, wherever applicable) Rs.. (c) Profits in lieu of salary under section 17(3) (as per Form No. 12BA, wherever applicable) Rs.. (d) Total Rs.. (e) Reported total amount of salary received from other employer(s) Rs.. 2. Less: Allowances to the extent exempt under section 10 (a) Travel concession or assistance under section 10(5) Rs.. (b) Death-cum-retirement gratuity under section 10(10) Rs.. (c) Commuted value of pension under section 10(10A) Rs.. (d) Cash equivalent of leave salary encashment under section 10(10AA) Rs.. (e) House rent allowance under section 10(13A) Rs.. (f) Amount of any other exemption under section 10 clause Rs.. clause Rs.. clause Rs.. clause Rs.. clause Rs.. Rs.. (g) Total amount of any other exemption under section 10 Rs.. (h) Total amount of exemption claimed under section 10 [2(a)+2(b)+2(c)+2(d)+2(e)+2(g)] Rs.. 3. Total amount of salary received from current employer [1(d)-2(h)] Rs.. 4. Less: Deductions under section 16 (a) Standard deduction under section 16(ia) Rs.. (b) Entertainment allowance un .....

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..... Rs.. Verification I, .., son/daughter of .working in the capacity of . ......... (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 ...... (Signature of person responsible for deduction of tax) Date ....... Full Name : Notes: 1. Government deductors to fill information in item I of Part A if tax is paid without production of an income-tax challan and in item II of Part A if tax is paid accompanied by an income-tax challan. 2 . Non-Government deductors to fill information in item II of Part A. 3. The deductor shall furnish the address of the Commissioner of Income-tax (TDS) having jurisdiction as regards TDS statements of the assessee. 4. If an assessee is employed under one employer only during the year, 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. 5 . (i) 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 .....

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..... do hereby certify that a sum of Rs .. IRs .. (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 (Signature of person responsible for deduction of tax) Date Designation: Full Name: 1 [****] 4 [PART B (Annexure) Details of Salary Paid and any other income and tax deducted A Whether opting for taxation u/s 115BAC? [YES/NO] 1. Gross Salary (a) Salary as per provisions contained in section 17(1) Rs.. (b) Value of perquisites under section 17(2) (as per Form No. 12BA, wherever applicable) Rs.. (c) Profits in lieu of salary under section 17(3) (as per Form No. 12BA, wherever applicable) Rs.. (d) Total Rs.. (e) Reported total amount of salary received from other employer(s) Rs.. 2. Less: Allowances to the extent exempt under section 10 (a) Travel concession or assistance under section 10(5) Rs.. (b) Death-cum-retirement gratuity under section 10(10) Rs.. (c) Commuted value of pension under section 10(10A) Rs.. (d) Cash equivalent of leave salary encashment under se .....

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..... Rs.. Rs.. Rs.. Rs.. Rs.. Rs.. (l) Total of amount deductible under any other provision(s) of Chapter VI‐A Rs.. Rs.. Rs.. 11. Aggregate of deductible amount under Chapter VI-A [10(a)+10(b)+10(c)+10(d)+10(e)+10(f)+10(g)+10(h)+10(i) 10(j)+10(l)] Rs.. 12. Total taxable income (9-11) Rs.. 13. Tax on total income Rs.. 14. Rebate under section 87A, if applicable Rs.. 15. Surcharge, wherever applicable Rs.. 16. Health and education cess @ 4% Rs.. 17. Tax payable (13+15+16-14) Rs.. 18. Less: Relief under section 89 (attach details) Rs.. 19. Net tax payable (17-18) Rs.. Verification I, .., son/daughter of .working in the capacity of . ......... (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 ...... (Signature of person responsible for deduction of tax) Date ....... Full Name : Notes: 1. Government deductors to fill information in item I of Part A if tax is paid without production of an income-tax challan and in item II of Part A if tax is paid accompanied by an income-tax challan. 2. Non-Government deductors to fill information in item II of .....

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..... tax deducted and deposited with respect to the deductee) Sl. No. Tax Deposited in respect of the deductee (Rs. ) Book Identification Number (BIN) Receipt numbers of Form No. 24G DDO serial number in Form No. 24G Date of transfer voucher dd/mm/yyyy Status of matching with Form No. 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) Sl. No. Tax Deposited in respect of the deductee (Rs. ) Challan Identification Number (CIN) BSR Code of the Bank Branch Date on which tax deposited (dd/mm/yyyy) Challan Serial Number Status of matching with OLTAS Total 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. ................................................................................ .....

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..... nder section 80CCD (1) Rs.. Rs.. (d) Total deduction under section 80C, 80CCC and 80CCD(1) Rs.. Rs.. (e) Deductions in respect of amount paid/deposited to notified pension scheme under section 80CCD (1B) Rs.. Rs.. (f) Deduction in respect of contribution by Employer to pension scheme under section 80CCCD (2) Rs.. Rs.. (g) Deduction in respect of health insurance premia under section 80D Rs.. Rs.. (h) Deduction in respect of interest on loan taken for higher education under section 80E Rs.. Rs.. Gross Amount Qualifying Amount Deductible Amount (i) Total Deduction in respect of donations to certain funds, charitable institutions, etc. under section 80G Rs.. Rs.. Rs.. (j) Deduction in respect of interest on deposits in savings account under section 80TTA Rs.. Rs.. Rs.. (k) Amount deductible under any other provision(s) of Chapter VI‐A section Rs.. Rs.. Rs.. section Rs.. Rs.. Rs.. section Rs.. Rs.. Rs.. section Rs.. Rs.. Rs.. section Rs.. Rs.. Rs.. section Rs.. Rs.. Rs.. Rs.. Rs.. Rs.. (l) Total of amount deductible under any other provision(s) of Chaper VI-A Rs.. Rs.. Rs.. 11. Aggregate of deductible amount under Chapter VI-A [10(a) +10(b) +10(c)+ 10(d)+ 10(e)+ 10(f)+ 10(g)+ 10( .....

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..... rovision(s) of Chapter VI‐A section Rs.. Rs.. Rs.. section Rs.. Rs.. Rs.. section Rs.. Rs.. Rs.. section Rs.. Rs.. Rs.. section Rs.. Rs.. Rs.. section Rs.. Rs.. Rs.. (i) Total of amount deductible under any other provision(s) of Chapter VI‐A Rs.. Rs.. Rs.. 9. Aggregate of deductible amount under Chapter VI-A [8(a)+8(b)+8(c)+8(d)+8(e)+8(f)+8(g)+8(h)+8(i)] Rs.. 10. Total taxable income (7-9) Rs.. 11. Tax on total income Rs.. 12. Rebate under section 87A, if applicable Rs.. 13. Surcharge, wherever applicable Rs.. 14. Health and education cess Rs.. 15. Tax payable (11+13+14-12) Rs.. 16. Less: Relief under section 89 (attach details) Rs.. 17. Net tax payable (16-17) Rs.. Verification I, .., son/daughter of .working in the capacity of . .. (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 (Signature of person responsible for deduction of tax) Date.................. Full Name : Notes: 1. Government deductors to fill information in item I of Part A if tax is paid without production of an income-tax challan and in item II of Part A if t .....

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