ABOUT YOURSELF

NameBalwant Pal Rawat SRI ATMA PRAKASH DIMRI Fathers Name Sri K.P.DIMRI
Designation ASSISTANT TEACHER GOVT
Name Of Institution INTER COLLEGE BAIRAGANA
FLATE/DOOR/BLOCK NO- BAIRAGANA Name Of Premises/Building/Village- BAIRAGANA
Road/ Street/Post Office- BAIRAGANA Area/Locality- BAIRAGANA
Town/City/District- CHAMOLI State- UTTARAKHAND
Designation Of Assessing Officer(Ward/Circle) SRINAGAR Email Address dimri_apr@yahoo.co.in
Emp. Code 4000 8020 G.P.F.No. KEDU 22174 Pin Code 2 4 6 4 0 1
Pan No. A G N P D 2 8 8 8 A Sex MALE
Bank Account No. 0 0 0 0 1 1 2 7 2 2 7 9 9 5 5
D.O.B. Enter D.O.B.as formate of SERVICE
7-Jul-1968 your computer BEFORE 1 OCT 2005
ABOUT DEDUCTOR
Tan No. Office M R T G 0 1 6 9 7 D Name of deductor KISHAN SINGH BADWAL
Pan No of Deductor A B W P B 9 6 5 9 F Fathers Name Sri P.S.BADWAL
ME OF INSTITUTIONGOVT INTER COLLEGE BAIRAGANADESIGNATION PRINCIPAL

ABOUT EMPLOYER
Name And Add of Employer STATE UTTARAKHAND
DIRECTOR OF EDUCATION
 SALARY
Basic Pay Of March 15 19240 Grade Pay 5400 D.A. ### % 26365 Personal Pay 460
HOUSE RENT
1 House
rent % 40 2160 HILL ALL 540 Travelling All BONUS 3454 C.P.A 0

Medical GROSS
Increment Month JULY All
ANY
ARREAR 1
ANY
ARREAR 2
SALARY 54165

DEDUCTIONS
Advance Income Tax
G.P.F. 18000 G.I.S. 200 Deduction 1000 H.R.A.Deduction

VEHICLE
R.D.A.Deduction 7000 G.P.F.ADVANCE MENTINENCE ANY OTHER

PAY IN HAND 27965 Per month House rent Paid

DEPOSITS
LIC PPF PLI NSC Tu.fee

80 C Suknya Samridhi Yojana

RPLI ELSS HOUSE LOAN PRINCIPAL 48000 TOTAL 80 C 279882
SECTION 80 CCC SECTION 80 CCD(1) 0 SECTION 80 CCD(1B)

TOTAL OF SEC. 80C, 80 CCC, 80 CCD 279882 REBATE SEC 80CCE(TOTAL OF SEC. 80C, 80 CCC, 80 CCD)+80ccd(1B) 150000

80 D(Health Premium) FAMILY 80DD Maintenance, Including medical

 80 U(DISABILITY) 80E(INTEREST OF LOAN FOR HIGHR EDUCATION)
Transport Allowance

DONATIONS (SECTION 80 G) HOUSE LOAN INTEREST 36000

DONATION AMOUNT REBATE % REBATE TOTAL REBATE SECTION 24 A →
DONATION 1 100 0
DONATION 2 100 0 0 BONDS 80 CCF
DONATION 3 0

INCOME TAX DETAIL

TOTAL INCOME TAX 27670 Assesment year Period (Financial Year)
Tax Payble
I.T.PAID BEFORE FEB 11000 FROM TO

I.T.PAID IN PAY OF FEB

2016-17 1-Apr-15 31-Mar-16
16670
I.T.PAID BY CHALAN

Summary Of TAX Deduted at source

Amount of tax deposited
Receipt Number Of Original Statements Of Amount of Tax deducted in respect of
Quarter TDS under sub-section(3) of section 200 the employee
remitted in respect of the
employee
Quarter 1
Quarter 2
Quarter 3
Quarter 4
Total
DETAILS OF TAX DEDUCTED AND DEPOSITED IN TO CENTRAL GOVERNMENT ACCOUNT
 Education
Cess
S.No. TDS Total Tax BSR Code DATE Vouchar No. /Chalan No.

1 970.87 29.13 1000 9/4/2015 A22020128

2 970.87 29.13 1000 29/4/2015 A22020440
3 970.87 29.13 1000 28/5/2015 A22020156
4 970.87 29.13 1000 27/6/2015 A22020230
5 970.87 29.13 1000 28/7/2015 A22020214
6 970.87 29.13 1000 26/8/2015 A22020201
7 970.87 29.13 1000 28/9/2015 A22020195
8 970.87 29.13 1000 27/10/2015 A22020191
9 970.87 29.13 1000 28/11/2015 A22020391
10 970.87 29.13 1000 30/12/2015 A22020406
11 970.87 29.13 1000
12 0.00 0.00 0
13 0.00 0.00 0
14 0.00 0.00 0
15 0.00 0.00 0

Total 10680 320 11000

DETAIL OF PAY FOR FINANCIAL YEAR 20 15 - 16 Employee Category- 1 Whether Original or Revised Return- 1 ASSESMENT YEAR 20 16 - 17
Smt./Miss ATMA PRAKASH DIMRI FATHER'S NAME- SRI- K.P.DIMRI DESIGNATION- ASSISTANT TEACHER PAN NO. A G N P D 2 8 8 8 A
NAME OF INSTITUTION- GOVT INTER COLLEGE BAIRAGANA FLATE/DOOR/BLOCK NO- BAIRAGANA Mob. No. 9 4 1 2 9 6 1 9 8 6
Name Of Premises/Building/Village- BAIRAGANA Road/ Street/Post Office- BAIRAGANA Area/Locality- BAIRAGANA PIN CODE 2 4 6 4 0 1
Town/City/District- CHAMOLI State- UTTARAKHAND PIN CODE- 2 4 6 4 0 1 Email Address- dimri_apr@yahoo.co.in SEX- M D.O.B. 7-Jul-1968
Designation Of Assessing Officer(Ward/Circle) SRINAGAR 1 1 Residential Status -
Return Filled Under Section- 1 Bank A/C. 0 0 0 0 1 1 2 7 2 2 7 9 9 5 5
BASIC
40 DEDUCTIONS PAN / TAN NO.OF OFFICE M R T G 0 1 6 9 7 D

Travelling
PAY

Personal
PAY GROSS TOTAL

Pay
MONTH input grade D.A. H.R.A. HILL ALL C.P.A. Medical All IN

All
1 or 2 1
H.r.a. adv. tax
pay INCOME G.P.F. G.I.S. deduct dedction
R.D.A. OTHERS Deducti HAND Pay arrears of financial year 2015-16
on
Mar/15 19240 5400 26365 2160 540 0 0 460 0 54165 ### 200 0 1000 7000 0 26200 27965 GRADE
MONTH BASIC PAY PAY ARREAR TOTAL ARREAR
Apr/15 19240 5400 26365 2160 540 0 0 460 0 54165 ### 200 0 1000 7000 0 26200 27965 Jan/15 19240 5400 1478 if arrear
May/15 19240 5400 26365 2160 540 0 0 460 0 54165 ### 200 0 1000 7000 0 26200 27965 Feb/15 19240 5400 1478 change

7390
input here
Jun/15 19240 5400 27843 2160 540 0 0 460 0 55643 ### 200 0 1000 7000 0 26200 29443 Mar/15 19240 5400 1478
Jul/15 19980 5400 28679 2160 540 0 0 460 0 57219 ### 200 0 1000 7000 0 26200 31019 Apr/15 19240 5400 1478
Aug/15 19980 5400 28679 2160 540 0 0 460 0 57219 ### 200 0 1000 7000 0 26200 31019 May/15 19240 5400 1478
Sep/15 19980 5400 28679 2160 540 0 0 460 0 57219 ### 200 0 1000 7000 0 26200 31019 Jun/15 19240 5400 0
Oct/15 19980 5400 28679 2160 540 0 0 460 0 57219 ### 200 0 1000 7000 0 26200 31019 Jul/15 19980 5400 1523
Nov/15 19980 5400 30202 2160 540 0 0 460 0 58742 ### 200 0 1000 7000 0 26200 32542 Aug/15 19980 5400 1523
Dec/15 19980 5400 30202 2160 540 0 0 460 0 58742 ### 200 0 1000 7000 0 26200 32542 Sep/15 19980 5400 1523

6092
Jan/16 19980 5400 30202 2160 540 0 0 460 0 58742 ### 200 0 1000 7000 0 26200 32542 Oct/15 19980 5400 1523
Feb/16 19980 5400 30202 2160 540 0 0 460 0 58742 ### 200 0 7000 0 25200 33542 Nov/15 19980 5400 0
Rebate in HRA 0 D.A. Arrear JAN-15 TO MAY 15 7390 7390 7390 0 Dec/15 19980 5400 0
1-Actual Received HRA ### D.A. Arrear JUL-15 TO OCT 15 6092 6092 6092 0 Jan/16 19980 5400 0
2-Rent Paid Excess 10% of (Pay+G.P.) ### BONUS 3454 0 0 3454 Feb/16 19980 5400 0
3- 40 % of (Pay+Grade Pay) 120640 ANY ARREAR 1 0 0 0 0
Per Month House rent paid ANY ARREAR 2 0 0 0 0 0 www.govtteachersassociation.co.nr
TOTAL 236800 64800 3E+05 25920 6480 0 0 5520 0 698918 ### 2400 0 11000 84000 0 326882 4E+05 dimri_apr@yahoo.co.in Telphone No.- 01372252826

DEPOSITS &DONATIONS REBATE ON HILL ALL. 3600 INCOME FROM SALARY 695318 TAX CALCULATION
LIC DISABILITY SECTION 80U INCOME FROM HOUSE PROPERTY 0 UP TO 250000 0.00
PPF 80 CCC INCOME FROM AGRICULTURE and intt 0 250001 TO 500000 25000.00
www.prajjwaldimri.co.cc

RPLI 80 CCD(1B) 0 80 CCD(1) INCOME FROM FAMILY PENSION 0 500001 TO 509320 1864.00
pls visit the site

PLI 80CCE(TOTAL OF 80C,80CCC,80CCD-1) ### 0.00

695318
80 C

NSC 80CCF (LONG TERM INFRASTRUCTURE BOND)

GROSS TOTAL INCOME Less Tax if Taxble Income<500000 0
Tu.fee 80 D (HEALTH INSURANCE) REBATE UNDER SECTION80
CCE+80 ccd(1B) 150000 TAX PAYABLE ON TOTAL INCOME 26864.00
suknya yojna 80DD (MEDICAL TREATMENT) REBATE UNDER SECTION 81 CCF 0 Edu.Cess @ 2% 537.28
HOUSE LOAN 48000 80 E (INTT. OF LOAN FOR HEIGHER EDUCATION) REBATE UNDER SECTION 80 D 0 Sec.&Higher Edu Cess @ 1% 268.64
G.P.F. 229482 80 G (DONATIONS) REBATE UNDER SECTION 80 DD 0 Tax Payable with edu.cess 27670
GIS 2400 HOUSE LOAN INTREST SEC. 24A
36000 TOTAL DEDUCTION UNDER CHAPTER150000 Advance Tax Paid at Source 11000
TOTAL 80 C 279882 AMOUNT OF REBATE IN OTHER ALL
TAXABLE INCOME ### Tax Payable 16670
A.P.DIMRI G.I.C.BAIRAGANA
Mob. No.- 9412961986
Rebate in Travelling All TAXABLE INCOME ### Tax Payable 16670
If Assessee is PAN Card Holder input 1 for Yes or 2 for No 1 0

Age Of Assessee in years ON 31-Mar-2016 47.73 2000

 ER
IN
PU

2
PERIOD T If T.R.-1 input 1
FROM TO -1 if G.P.F. input 2 ®
4/1/2014 3/31/2015 IF
person responsible for deduction of tax AS
SE
NAME ß FATHERS NAME ß FOR HOUSE RENT HELP FOR BORDER
SE HELP
if Grade IS
pay
Change
put here
if 40% input 1
GE
TT M
IN O
G.P.F.
if 50% input 2
DESIGNATION Þ MONTH if 75% input 3 GN
PRINCIPAL
FOR ARREAR'S HELP
if don’t get H.R.A. input 4 HI T MONTH AMOUNT
LL H
First Arrear For arrear of Jan 15 input 1 if no arrear put 0 1 March-15 1 IN ###March-15 18000
Month For arrear of Feb15 input 1 if no arrear put 0 1 April-15 1 PU ###April-15 18000
For arrear of Mar 15 input 1 if no arrear put 0 1 1 T ###May-15 18000
April For arrear of Apr 15 input 1 if no arrear put 0 1
May-15
June-15 1 -2
###June-15 18000
For arrear of May 15 input 1 if no arrear put 0 1 July-15 1 ###July-15 18000
Second Arrear For arrear of June 15 input 1 if no arrear put 0 0 August-15 1 ###August-15 18000
Month For arrear of July 15 input 1 if no arrear put 0 1 September-15 1 ###September-15 18000
For arrear of August 15 input 1 if no arrear put 0 1 October-15 1 ###October-15 18000
October For arrear of september 15 input 1 if no arrear put 0 1 November-15 1 ###November-15 18000
For arrear of October 15 input 1 if no arrear put 0 1 December-15 1 ###December-15 18000
For arrear of November 15 input 1 if no arrear put 0 0 January-16 1 ###January-16 18000
For arrear of December 15 input 1 if no arrear put 0 0 February-16 1 ###February-16 18000

House rent received 0

Tax Paid to local authority 0
Annual value of Property 0 INCOME FROM HO
(a) Thirty percent of annual value 0
(b) Interest payble on borrowed capital 0

Total of a+b 0 0
TDS Circle where annual Return / Statement under section 206 is to be
40 filed
50
SRINAGAR

806.00
 prajjwal
0

0
 G.I.S.
MONTH AMOUNT FOR NEW PAY HELP #REF!
March-15 200 If New Pay Drawn in Sept Paid Oct 08 input 1 if not input 0 0
April-15 200 If New Pay Drawn in Oct Paid Nov 08 input 1 if not input 0 0 #REF!
May-15 200 If New Pay Drawn in Nov Paid Dec 08 input 1 if not input 0 0 #REF!
June-15 200 If New Pay Drawn in Dec Paid Jan 09 input 1 if not input 0 0
July-15 200 If New Pay Drawn in Jan Paid Feb 09 input 1 if not input 0 0
August-15 200 If New Pay Drawn in Feb Paid March 09 input 1 if not input 0 1
September-15 200
October-15 200 IF NEW PAY DOES NOT DRAWN
November-15 200 MONTH BASIC PAY IN OLD SCALE
December-15 200 Sep/08 19980 9990 12288 0 540 0
January-16 200 Oct/08 19980 9990 12288 0 540 0
February-16 200 Nov/08 19980 9990 14086 0 540 0
Dec/08 19980 9990 14086 0 540 0
Jan/09 19980 9990 14086 0 540 0
Feb/09 19980 9990 14086 0 540 0
COME FROM HOUSE PROPERTY
IF NEW PAY ARREAR 40% IS DIFFERENT T
ARREAR OF BONUS

0 PAY ARREAR SEPT.08 TO JAN 09

 C.P.D.
1300
1400 0 January
1650 0 February
1800 0 March
1900 0 April
2000 0 May
2400 0 June
2800 0 July
4200 0 August
ARREAR SEP TO NOV 08 FOR NEW PAY 4600 0 September
#REF! #REF! #REF! Sep/08 #REF! #REF! #REF! #REF! #REF! Sep/08 4800 0 October
#REF! #REF! #REF! Oct/08 #REF! #REF! #REF! #REF! #REF! Oct/08 5400 0 November
#REF! #REF! #REF! Nov/08 #REF! #REF! #REF! #REF! #REF! Nov/08 6600 0 December
#REF!
#REF! #REF! #REF! Dec/08 #REF! #REF! #REF! #REF! #REF! Dec/08 7600 January
#REF! #REF! #REF! Jan/09 #REF! #REF! #REF! #REF! #REF! Jan/09 8700 February
#REF! #REF! #REF! Feb/09 #REF! #REF! #REF! #REF! 0 Feb/09 8900
###
FFERENT THAN INPUT HERE ###
BONUS 0
0
IS DIFF. INPUT HERE
0
0
0
0
0
0
0
0
0
0
0
C.P.D.
0 0 540 1300
0 0 0 540 1300
739 0 0 540 1300
0 0 0 540 1300
0 0 0 540 1300
0 0 0 540 1300
0 0 0 540 1300
0 0 0 540 1300
609 0 0 540 1300
0 0 0 540 1300
0 0 0 540 1300
0 0 0 540 1300
0 0 15600
3600
 vk;dj x.kuk izi=
foRrh; o"kZ & 2015-16 Zj.k o"kZ& vof/k&01 Apr.2015 to 31 Mar.16
2016-17
uke vf/kdkjh@deZpkjh @fu/kkZfjrh&
ATMA PRAKASH DIMRI in& ASSISTANT TEACHER
irk & GOVT INTER COLLEGE BAIRAGANA PAN NO. AGNPD2888A
G.P.F. NO. KEDU22174 EMPLOYEE CODE 40008020 TAN NO. MRTG01697D
1- osru 236800
1&ldy osru@vk; 2- xzsM osru 64800
3- eagxkbZ HkRrk 342462
4- vkokl HkRrk 25920
5- HILL ALL 6480
6- C.P.A. 0
7- Medical All 0
8- Personal Pay 5520
12- Travelling All 0
11- BONUS 3454
9- D.A. Arrear JAN-15 TO MAY 7390
10-D.A. Arrear JUL-15 TO OCT 15 6092
13- Total Arrear 0
;ksx 698918 698918
2&/kkjk 10 ds varxZr NwV& 1&ioZrh; HkRrk 3600
2&edku fdjk;k HkRrk ,oa okgu 0
3- OTHERS 0
;ksx 3600
3&osru ls izkIr 'kq) vk; 695318
4&vU; Jksrksa ls vk; 1& fdjk;k 0
2&C;kt vkfn ls izkIr vk; 0
3&QSfeyh iSUlu ,oa vU; vk; 0
;ksx 0
5&leLr Jksrksa ls izkIr dqy vk; 695318
6&/kkjk 24 ds vUrxZr vkoklh; _.k ij O;kt esa NwV 36000
7&vo'ks"k vk; 659318
8&lSDlu 6 , dh dVkSfr;ka ¼/kkjk 80 lh ds vUrxZrLIC
½
PPF
RPLI
PLI
NSC
Tu.fee
suknya yojna
HOUSE LOAN 48000
G.P.F. 229482
GIS 2400
;ksx 279882
/kkjk 80 CCC ds vUrxZr
9&lSDlu 6 , dh vU; /kkjkvksa ds vUrxZr dVkSfr;ka 0
/kkjk 80 CCD(1ds vUrxZr 0
/kkjk 80 CCD(ds vUrxZr 0
/kkjk 80CCF ds vUrxZr 0
/kkjk 80 D ds vUrxZr 0
/kkjk 80 DD ds vUrxZr 0
/kkjk 80 E ds vUrxZr 0
/kkjk 80 G ds vUrxZr 0
/kkjk 80 U ds vUrxZr 0
10&lSDlu 6 , ds vUrxZr dVkSfr;ksa esa NwV dk ldy ;ksx 150000
11&dj ;ksX; vk; Under Section 288A income tax rounded off 509320
UP TO 250000 0.00
250001 TO 500000 25000.00
1864.00
12& vk;dj vkx.ku

500001 TO 509320
0.00
If Taxble Income is less than 500000 than less tax(-) 0.00
TAX PAYBLE ON TOTAL INCOME 26864.00
Edu.Cess @ 2% 537.28
Sec.&Higher Edu Cess @ 1% 268.64
Additional Rebate:: Finance Act, 2013 section 87A 0.00
Tax Payble with edu.cess 27670.00
Advance Tax Deducted at Source 11000.00
Tax Payable 16670.00
13&osru ls dVkSrh¼vk;dj $ Edu Cess @ 2%+Higher Edu Cess @ 1% ½ Under Section 288B ### Or say 16670
fnukad&
gLrk{kj vf/kdkjh@deZpkjh®
A.P.DIMRI G.I.C.BAIRAGANA uke& ATMA PRAKASH DIMRI
Mob. No.- 9412961986 in uke& ASSISTANT TEACHER
1667.00
 FORM NO 16
Name and address of the Employer Name and designation of the Employee

ATMA PRAKASH DIMRI

DIRECTOR OF EDUCATION ASSISTANT TEACHER
UTTARAKHAND GOVT INTER COLLEGE BAIRAGANA
PAN OF Deductor TAN Of The Deductor PAN Of Employee
ABWPB9659F MRTG01697D AGNPD2888A
CIT (TDS) ASSESMENT YEAR Period (Financial Year)
Address- Income Tax Officer FROM TO
Srinagar (Garhwal) 2016-17 1-Apr-15 31-Mar-16
CITY- Srinagar Pin Code- 246174
Summary Of TAX Deduted at source
Receipt Number Of Original Statements Of TDS Amount of Tax deducted in Amount of tax deposited remitted in
Quarter under sub-section(3) of section 200 respect of the employee respect of the employee
#NAME? 0 0 0
#NAME? 0 0 0
#NAME? 0 0 0
#NAME? 0 0 0
Total 0 0 0
DETAILS OF SALARY PAID AND ANY OTHER INCOME AND TAX DEDUCTED
1. Gross (a) Salary as per provision contained in section 17 (1) Rs. 698918
Salary (b) Value of perquisites under section 17 (2)
( as per Form no. 12 BA, wherever applicable) Rs.
(c) Profits in lieu of salary under section 17 (3)
( as per Form no. 12 BA, wherever applicable) Rs.

(d) Total Rs. 698918

2. Less : Allowance to the extent exempt under 1-H.R.A. & Travel all Rs. 0
section 10
2-HILL ALL. Rs. 3600
3- OTHERS Rs. 0 Rs. 3600
3. Balance (1-2) Rs. 695318
4(i). Deduction under section 16 : (a) Entertainment Allowance Rs. 0
(b) Tax on Employment Rs. 0
4(ii). Aggregate of 4 (a) and (b) Rs. 0
5. Deduction under section 24A(House loan intt) Rs. 36000
6. Income chargeble under the head "Salaries" Rs. 659318
7. Add: Any other income reported by the employee
(a) Income under the head 'Income from House Property' Rs. 0
(b) Income under the head 'Income from Other Sources' Rs. 0
(c) Total of (a) + (b) above Rs. 0
8. GROSS TOTAL INCOME (6+7) Rs. 659318
9. DEDUCTION UNDER CHAPTER VI-A
(A) Section 80C, 80CCC, 80 CCD GROSS AMOUNT QUALIFYING AMOUNT DEDUCTIBLE AMOUNT
(i) LIC Rs. 0
(ii) PPF Rs. 0
(a) SECTION 80 C

(iii) RPLI Rs. 0

(iv) PLI Rs. 0
(v) NSC Rs. 0
(vi) Tu.fee Rs. 0
(vii) suknya yo Rs. 0
(viii) HOUSE L Rs. 48000
(ix) G.P.F. Rs. 229482
(x) GIS Rs. 2400
Section #NAME? Rs. 0
Section #NAME? Rs. 0
Section 80CCD(1B Rs. 0
Total of section 80C,80CCC,80CCD Rs. 279882 Rs. 150000 Rs. 150000
Section 80CCF Rs. 0 Rs. 0 Rs. 0
Section 80 D Rs. 0 Rs. 0 Rs. 0
Sections
Other

Section 80 DD Rs. 0 Rs. 0 Rs. 0

Section 80 E Rs. 0 Rs. 0 Rs. 0
Section 80 G Rs. 0 Rs. 0 Rs. 0

Page 16 Form 16
 Sect
Ot
Section 80 U Rs. 0 Rs. 0 Rs. 0
10.Aggregate of deductible amounts under Chepter VI-A Rs. 150000
11. TOTAL INCOME (8-10) Rs. 509318
12. TAX ON TOTAL INCOME Rs. 26864.00
13. Rebate Under Section 87 A Rs. 0.00
14. Education cess @ 3% (On tax computation at S.No. 12) Rs. 806
15. Tax payable on total income and edu.cess Rs. 27670
16. Less : Relief under section 89 (attach details) Rs.

17. Tax payable (14-15) Rs. 27670

18. Less: (a) tax deducted at source under section 192 (1) Rs. 11000
(b) tax paid by the employer on behalf of the employee under
section 192 (1A) on perquisites under section 17 (2) Rs. Rs. 11000

19. Tax Payble Rs. 16670 or say Rs. 16670

DETAILS OF TAX DEDUCTED AND DEPOSITED IN TO CENTRAL GOVERNMENT ACCOUNT
THROUGH CHALLAN
Tax Deposited in respect on of the
Challan identification number (CIN)
employee (Rs.)
S.No.
Education Vouchar No.
TDS Total Tax BSR Code DATE
Cess /Chalan No.
1 970.87 29.13 1000 4-Sep-15 A22020128

2 970.87 29.13 1000 29/4/2015 A22020440

3 970.87 29.13 1000 28/5/2015 A22020156

4 970.87 29.13 1000 27/6/2015 A22020230

5 970.87 29.13 1000 28/7/2015 A22020214

6 970.87 29.13 1000 26/8/2015 A22020201

7 970.87 29.13 1000 28/9/2015 A22020195

8 970.87 29.13 1000 27/10/2015 A22020191

9 970.87 29.13 1000 28/11/2015 A22020391

10 970.87 29.13 1000 30/12/2015 A22020406

11 970.87 29.13 1000 30-Dec-99

12 30-Dec-99

13 30-Dec-99

14 30-Dec-99

15 30-Dec-99

Total 10680 320 11000

I, KISHAN SINGH BADWAL son of Shri P.S.BADWAL
working in the capacity of PRINCIPAL do hereby certify that a sum of Rs.11000
(in words Rs. Rupees Eleven Thousand Only ) 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 book of account, documents and other available records.

Place -

Signature of the person responsible for deduction of tax

Date -
Full Name - KISHAN SINGH BADWAL
Page 17 Form 16
 Designation- PRINCIPAL
A.P.DIMRI G.I.C.BAIRAGANA
Name Of Institute GOVT INTER COLLEGE BAIRAGANA
MOB.-9412961986

Page 18 Form 16
Page 19 Form 16