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FORM 16 FOR ASSESSMENT YEAR 2010-2011,Prepared by Pranab Banerjee, Kalisthanpara, Jiaganj,Murshidabad, West

Working at Block Land & Land Reforms Office, Bhagwangola-I,under Lalbagh Sub-Div.in Murshidabad District.
For Contact :- pranabLr@yahoo.com or Call 9474316768.

FORM 16, PARTICULARS ONLY FOR


( HANDICAPPED- MALE EM
For Assessm
2011
FIRST NAME IN CAPITAL LETTERS
FORM 16 FOR MIDDLE NAME IN CAPITAL LETTERS
PH.HANDICAPPED
LAST NAME IN CAPITAL LETTERS
EMPLOYEE
DESIGNATION IN CAPITAL LETTERS
PAN NO OF EMPLOYEE
PARRICULARS REGARDING EMPLOYEE'S SALARY

Total Income from Salary Rs :(col.no 3 )of Salary Gross salary( including
0
Statement submitted by the Employee INT.From Bank/N.S.C./Ho

Income by interest from N.S.C./BANK 0


H.B.Loan Int.(Max-1,50,000/-) 0
DETUCTION OF THE EMPLOYEE U/S 80C,80CC,80CCC,80D,80DD,80E,80
G.P.F. 50000
Prepared by
Deduction U/S G.I.S. 20000
80C,80D,80DD,80E,80G
U/S- 80
(Max.limit 100000/-) C L.I.C./ NSC/
Tuition Fees Pranab Bandyo
HB Loan (Principal 0 Bhattapara,Jiaganj,Murshi
Pension Fund (Max.1,00,000/-) 80CCC 0
For Handicapped(Max.1,00,000/-) Bengal.
80 U 0
upto 70% Rs.75000/-
Prem. Health Insur(Max.15000/-) 80 D 0
Email.pranabLr@y
Educational Loan(Max.100,000/-) 80E 0 Gmail.pranabbanerjee
Donation (Max 100% of donation) 80G 0 Website;- www.prana
Double Click on this
Total Deduction 70000 Yellow Cell and put t
word "pranab" and e
ARREAR RELIEF OF U/S 89(1) 0 three Cell.

ADVANCE TAX PAID 0


NAME & ADDRESS OF THE EMPLOYER Note:- Please D
PAN NO OF OF THE DEDUCTOR
Yellow Cell an
Word pranab
TAN NO OF THE DEDUCTOR you like.
bad, West Bengal.

6768.

LE EMPLOYEE )
sessment Year 2010-

cluding HRA,BONUS,ANY
N.S.C./House property etc.

D,80E,80G

Bandyopadhyay,
nj,Murshidabad,

West

nabLr@yahoo.com,
banerjee83@gmail.com,
ww.pranab.jiaganj.com
k on this three
and put the pass
ab" and edit this

Please Double Click on the


w Cell and put the Pass
pranab and Edit the Cell as
ke.
FORM NO.16
[See rule 31(1)(a)]
Certificate under section 203 of the Income-tax Act, 1961 for Tax deducted at source
from Income chargable under the head on Salary
Name and address of the Employer Name and designation of the employee
0 0 0 0
PAN NO.of Deductor TAN No.of the Deductor PAN NO. of the Employee
0
Acknowledgement Nos. of all quarterly Period Assessment Year
statements of TDS under sub-section (3) of
section 200 as provided by TIN Facilitation
Centre or NSDLWebsite. 2009-2010 2010-2011
Quarter Acknowledgement No From To
Mar-09 Feb-10
DETAILS OF TAX DEDUCTED AND DEPOSITED INTO CERTRAL GOVERNMENT ACCOUNT

1 Gross Salary IN RUPEES IN RUPEES IN RUPEES


Salary as per provisions contained in section
(a) 17(1) 0
Value of perquisites under section 17(2)(as
(b) per Form No. 12BA,wherever applicable) 0

Profits in lieu of salary under section 17(3)


(c) (as per Form No. 12BA, wherever applicable) 0
(d) TOTAL 0
2 Less: Allowance to the extent exempt u/s 10
Allowance Rs.
0 0
3 Balance(1-2) 0
4 Deductions : Rs.
H.B.Loan Int.(Max-1,50,000/-) U/S
(a)
24(B) 0 0
Tax on employment U/S 16(iii)(Exemped for
(b)
hddcpd)
5 Aggregate of 4(a) to (b) 0
6 Income chargeable under the head 'salaries' (3-5) 0
7 Add: Any other income reported by the employee
a)Income form N.S.C./Bank int.etc. 0
8 Gross total income (6+7a) 0
9 Deductions under Chapter VIA
U/s 80C,80CCC& 80CCD,80DD,80E,80G
Gross Deductible Amount
A (Aggregate amount Maximum Rs.1,60,000/-)
Amount Rs.
(a)(i)Sec.80C-G.P.F. Rs. 50000
(ii) G.I.S. Rs. 20000
(iii) L.I.C./P,L.I./U.LIP/Tuition
Fees/NSC
Rs. 0
(iv) H.B.LOAN(PRINCIPAL) Rs. 0
(v) Deduction U/S 80 U Rs. 0
(b) Section U/S 80CCC Rs. 0
(c) Section 80 D Rs. 0 70000 70000
Qulfy Deductible Amount
B Other sections e.g.,80E,80G,etc under chapter VI Gross Amount
amount Rs.
(a) Section 80 E Rs. 0
(b) Section 80 G Rs. 0
© Section Rs. 0
(d) Section Rs. 0
3/8
(e) Section Rs. 0
Aggregate of deductible amount under Chapter
10
VIA
70000 70000
11 Total Income (8-10) -70000
12 Tax on total income 0
13 Surcharge on col.12 0
14 Education & cess @3% on col.no.12 0
15 Tax payable (12+13+14) 0
16 Relief U/s 89(1) 0
17 Tax payable/refundable (15-16) 0
18 Less (a) Tax deducted at source 0
19 Net Tax payable /Refundable(col.17-18) 0
DETAILS OF TAX DEDUCTED AND DEPOSITED INTO CERTRAL GOVERNMENT ACCOUNT
(The employer is to provide transaction-wise details of tax deducted and
deposited)
Transfer
voucher
Total Tax Dt.of which
Sl. Surcharge Education Cess Cheque No/DD BSR Code of No/Challa
No
TDS Rs.
Rs. Rs.
Deposited
No (if any) Bank Branch
tax deposited
Rs.
n
(dd/mm/yy
Identificati
on No.
1 0 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0 0
3 0 0 0 0 0 0 0 0
4 0 0 0 0 0 0 0 0
5 0 0 0 0 0 0 0 0
6 0 0 0 0 0 0 0 0
7 0 0 0 0 0 0 0 0
8 0 0 0 0 0 0 0 0
9 0 0 0 0 0 0 0 0
10 0 0 0 0 0 0 0 0

I, 0 son/daughter of 0
working in the capacity of 0 (designation)do hereby certify that a sum of Rs 0

Rupees 0 (In words)

has been deducted at source and paid to the credit of the Central Government. I further certify that the
information
given above is true and correct based on the books of account, documents and other available records.

0
Place
Signature of the person responsible
12/30/1899 for deduction of tax
Date

Full Name with desitgnation

4/8
5/8
DETAILS OF TAX DEDUCTED AND DEPOSITED INTO CERTRAL GOVERNMENT ACCOUNT
(The employer is to provide transaction-wise details of tax deducted and deposited)

BSR
Total Tax
Sl. TDS Surcharge Education
Deposited
Cheque No/DD Code of Dt.on which
No Rs. Rs. Cess Rs. No (if any) Bank tax deposited
Rs.
Branch (dd/mm/yy

9
(Rupees
10

I, son/daughter of
working in the capacity of (designation) do hereby certify that a sum of Rs
)
has been deducted at source and paid to the credit of the Central Government. I further certify that the information
given above is true and correct based on the books of account, documents and other available records.

Place
Signature of the person responsible
for deduction of tax
Date

Full Name with desitgnation


T
and deposited)

Transfer voucher
No/Challan
Identification No.

(In words)
the information
ords.

n responsible

nation
hgf

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