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‘OS Reconciliation Analysis and Correction Enabling System, Senet ne FORM NO. 16 PART B (Cerincate wader section 203 ofthe Incomm-ax Ac 196] for tax deducted at sure on slay paid to an employe under wean 10 or penlo/nert iacoe of pci seo lien vader ection 184P (Certcate Na, FORODXA Lastepdatedon _O7-Jon2022 | ™ adress ofthe Employer Specie Bank dress ofthe EnplayeoSpeifid venir czen ‘GOVr.iGH SCHOOL ‘GOVT HGH SCHOOK, VILLAGE, ‘BALBERA, PATIALA” 147001 ae ~~ HLNO203, QURU ARIAN DEV COLONY, BHOGLAN ROAD, RAJPURA, PATIALA. 10401 Pani (IS PATIALA.BALBERA@GMAIL.COM PAN ofthe Dest TAN tbe Delucter PANof he Bplyepeco wl cten panorseao FrLaieasin oo carers) I Amt Ye [__Petod wi he mphyer = Pm 7. sin of coe Te (TDS) CR. Building, Sector 17. E, Himalaya Marg Chandigarh - 460017 | te Ol-Ape2021 ‘MeMan-2022 me ‘Annexure = 1 Details of Salary Pad and anyother income nd ox deducted Whether oping for taxation ws 11SBAC No | Gross Satay Re Rs (@) | Salary pr provisions contained in section 171) 99079500) ‘Value of perquisites under section 17@) (as per Form No, 128A, ©) | wherever applicable) ae ©| Profits in lieu of salary under section 17(3) (as per Form No. 0.00) | 128A, wherever applicable) oy -@ | Tort =a 330795. 00| (©) | Reported otal amount of salary received from ott employe) 000 2. Les: Allowances tothe exent exempt under setion 10 (@) | Travel concession or assistance under setion 105) 0.00) |) | Deat-cumrotzenent graity under section 1010) 0.00) (©) | Commuted value of pension unde section 10(108) | 00° | 4 | Cash equivalent of eave salary encashment under section 10 @ (10AA) 0.00 (e) | House rent allowance under section 10(13A) 0.00 | Page 1 of 4it Ste EROOA relates Piatto ACORN Amount of any other exemption under section 10 (0 |[Note: Break-up to he filled and signed by employer in the table at the bottom of this form) (@) | Total amount of anyother exemption under seston 10 0.00) | Total amount of exemption claimed under section 10 o © | taca20acey216)+26)+2(0) on “ois amount of salary recived fom caren employer 5 | n@20 pee 4. | Less: Deductions under section 16 (@_| Standard deduetion vader seston 16(3) 0000.00 (0) | Enertainment allowance under sction 16(i) 09 (© _| Taxon employment under section 16(3) 2400.0] 5. | Tot amoun of deductions under section 16 ((a)+4(*4(0] 2400.00, 6. | tacome chargeable under the head "Salaries ((3+1(¢-5] 938395.00 7.__| Add: Any other income reported bythe employee under as per section 192 (2B) Income (or admissible loss) fom house property teported by : | (©) | cmployee offered for TDS eae | (©) | tncome under the head Other Sources offered for TDS. 0.00} | ss 1, | Total amount of oer income reporcdby the employes e. | paz ss s 9._| Gross total income (648) 156003,0 10, | Deductions under Chapter VEA Gross Amount Deductible Amount | | Deduction in respect of life insurance premia, contributions to | ©) provident and ete. under section 80C | ee ‘Deduction in respect of contribution to certain pension funds (©) | der section 80600 : 0.00 000 Deduction in respect of contribution by taxpayer to pension (©) | scheme under section 80CCD (1) 0.00 000 (@ | Total deduction under section 80C, 80CCC and SOCCD(1) 150000.00] 150000,00) Deductions in respect of amount pad/deposited o noid ma (q | Pesionscheme under stion 81CCD (18) cal aa Page 2of 42. (8) Break up for “Amount of any other exemption under section 10° to be filled in the table below Particulars of Amount for any other |, st] fenen wir ecion 0 GrusAncux | Quiiving Amomt | Dainite Ancun | ei Rs. + Rs. Rs. Rs. | 1 2 a ‘ S ‘ [i 10(k). Break up for ‘Amount deductible under any other provision(s) of Chapter VIA ‘to be filled in the table below | Particular’s of Amount deductible under | Si ayoerpovens)ofChaerVIA | Gres Amat | using noant | Delile Amun ®. Bs Rs Bs Rs ch 2 b 4 5. & I fie PATIALA (Signature of person espomsibi TOFdeducon of —_ tax) = ue res rat Jaxavoo neta Page of 4‘Deduction in respect of contribution by Employer to pension | (9 | scheme under section S0CCD (2) 0.00 0.00) g) | Deduction in respect of health insurance prema under section | ou 0.09 2.0) Deduction in respect of interest on loan taken for higher | (b) | edveaton under section 80E 00 000 5 Gross Qualifying | Deductible 4 Amount ‘Amount | Amount in respect of donations to certain finds, | | a charitable institutions, ete. under section 80G_ 1 oo ey eo | Deduction in respect of interest on deposits in Savings account © | under section SOTA, oe aa om | \Amount Deductible under any other provision (s) of Chapter VI-A| | (8) |[Note: Break-up tobe filed and signed. by employer in the table [provide atthe bottom of this form] ‘Total of amount deductible under any other provision(s) of ] | ieee 000 2.09 00 Aggregate of deductible amount under Chapter VA u (10(d}+10(e)+10(}+10(g)+10¢h)+10()+10)+100] | Hone [12 | ott taabte income 0-11) 706003.00 13, | Texontota income 3701.00 14. ] Rebate under section 87A, if applicable . 0.00| 1, | Surcharge, wherever applicable : 000 16, | Health nd education cess 2148.00 17, | Tax payable (3415416214) 5249.00 | 18, | Less: Retief under section 89 (attach details) | 3 09 eaah 119. | Net tox payable (7-18) 55849.00 | Verification | 1, SHALOO MEHRA, son/daughter of HIRA LAL MEHRA .Working in the capacity of PRINCIPAL (Designation) do hereby ctf tht the information given above iste, complete and core and is based on the books of account, documents, TDS statements, and othe available recor al ae 7 PATIALA | ignarre of person responsible for deduction aft) —_ at tymam at |suatoo nenita Page Sof 4