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Annexure to Form No.

16

Name and address of the employer : Reliance Industries Limited 222, Maker Chambers-IV, 3rd Floor, Nariman Point, Mumbai Maharashtra PAN/GIR NO. :AAACR5055K Assessment Year :2011-2012 Name: Mr. Santo Abraham Emp No.: 10027907

Particulars Exemptions u/s 10

Amount(Rs.)

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U/s. 10(14)(i) Office Wear Exemption Conveyance Exemption Total Exemption

18000 9600 27600

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Full Name: R SANTHANAM Place: Mumbai Designation: AUTHORISED SIGNATORY Annexure to Digitally Signed Certificate.

FORM No.12BA See Rule 26A(2)


Statement showing particulars of perquisites , other fringe benefits or amenities and profits in lieu of salary with value thereof 1) Name and address of employer : Reliance Industries Limited , 222, Maker Chambers-IV, 3rd Floor, Nariman Point, Mumbai - 400021 , Maharashtra 2) TAN: RKTR00980A 3) TDS Assesment Range of the employer : CIT(TDS), AHMEDABAD, 201. 2nd Floor, Navjivan Bldg., Nea, Ashram Road, AHMEDABAD, 380014, Gujarat 4) Name, designation and PAN of employee : Mr/Ms: Mr. Santo Abraham , Desig.: , Emp #: 10027907 , PAN: AXMPP2117N 5) Is the employee a director or a person with substantial interest in the company (where the employer is a company): No 6) Income under the head "Salaries" of the employee : (other than from perquisites) 7) Financial year : 8) Valuation of Perquisites S.No (1) 1 2 3 Nature of perquisite (see rule 3) (2) Accommodation Cars/Other automotive Sweeper , gardener , watchman or personal attendant 4 5 6 7 8 9 10 11 12 13 14 15 Gas , electricity , water Interest free or concessional loans Holiday expenses Free or concessional travel Free meals Free Education Gifts,vouchers etc. Credit card expenses Club expenses Use of movable assets by employees Transfer of assets to employees Value of any other benefit /amenity/service/privilege 16 17 18 19 Stock options ( non-qualified options ) Other benefits or amenities Total value of perquisites Total value of Profits in lieu of salary as per 17 (3) 0 35594 0 0 0 35594 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Value of perquisite as per rules(Rs.) (3) 35594 0 0 Amount, if any recovered from the employee(Rs.) (4) 0 0 0 Amount of perquisite chargeable to tax(Rs.) (5) Col(3)-Col(4) 35594 0 0 2010-2011 532474

0 31484 0 0 31484 *

9. Details of tax, - (a) Tax deducted from salary of the employee u/s192(1) (b) Tax paid by employer on behalf of the employee u/s 192(1A) (bb) Tax paid by previous employer/or on other income (c) Total tax paid (d) Date of payment into Government treasury * Refer to page 3 of form 16 under Details of tax deducted and depositedinto Central Government Account.

DECLARATION BY EMPLOYER
I R SANTHANAM S/o S RAJAGOPAL working as AUTHORISED SIGNATORY ( designation ) do hereby declare on behalf of Reliance Industries Limited ( name of the employer ) that the information given above is based on the books of account , documents and other relevant records or information available with us and the details of value of each such perquisite are in accordance with section 17 and rules framed thereunder and that such information is true and correct. Signature of the person responsible for deduction of tax Place: Mumbai Full Name : R SANTHANAM Designation : AUTHORISED SIGNATORY Annexure to Digitally Signed Certificate.

ANNEXURE - A DETAILS OF TAX DEDUCTED AND DEPOSITED IN THE CENTRAL GOVERNMENT ACCOUNT THROUGH BOOK ENTRY S.No. (The Employer to provide payment-wise details of tax deducted and deposited with respect to the employee) Tax Deposited in respect on Book identification number (BIN) of the employee(Rs.) Receipt numbers of form No. 24G DDO Sequence Number in the Book Adjustment Mini Statement NOT APPLICABLE Date on which tax deposited (dd/mm/yyyy)

ANNEXURE - B DETAILS OF TAX DEDUCTED AND DEPOSITED IN THE CENTRAL GOVERNMENT ACCOUNT THROUGH CHALLAN S.No. (The Employer to provide payment-wise details of tax deducted and deposited with respect to the employee) Tax Deposited in respect on Challan identification number (CIN) of the employee (Rs.) BSR Code of the Bank Branch 1 2 3 4 5 6 7 8 9 10 11 12 Total 1,031.00 2,300.00 984.00 8,863.00 2,131.00 2,004.00 2,152.00 2,152.00 2,291.00 2,290.00 2,278.00 3,008.00 31,484.00 0510308 0510308 0510308 0510308 0510308 0510308 0510308 0510308 0510308 0510308 0510308 0510308 Date on which tax Deposited Challan Serial (dd/mm/yyyy) 07.05.2010 07.06.2010 07.07.2010 07.08.2010 07.09.2010 07.10.2010 06.11.2010 07.12.2010 07.01.2011 07.02.2011 07.03.2011 30.04.2011 Number 12149 15035 15357 04515 09042 06075 03412 06945 17568 18062 21840 08383

Full Name: R SANTHANAM Designation: AUTHORISED SIGNATORY Annexure to Digitally Signed Certificate.

FORM NO. 16
[ See rule 31(1) (a) ] PART A ""

Certificate under section 203 of the Income-tax Act, 1961,for tax deducted at source on Salary
Name and address of the Employer Reliance Industries Limited 222, Maker Chambers-IV, 3rd Floor, Nariman Point, Mumbai 400021 Maharashtra PAN of the Deductor AAACR5055K TAN of the Deductor RKTR00980A CIT(TDS) Address1: CIT(TDS), AHMEDABAD Address2: City: Ashram Road, AHMEDABAD Pin Code 380014 2011-2012 01.04.2010 31.03.2011 PAN of the Employee AXMPP2117N Assessment Year Period From To Name and designation of theEmployee Mr/Ms: Mr. Santo Abraham Desig.: Emp #:10027907

Summary of tax deducted at source


Quarter Receipt Numbers of original statements of TDS under sub-section(3) of section 200 Quarter1 Quarter2 Quarter3 Quarter4 Total JPDFPTRG HQOXXKUB ETGXBIWG ETGXFGWB Amount of tax deducted in respect of the employee 4,315.00 12,998.00 6,595.00 7,576.00 31,484.00 Amount of tax deposited remitted in respect of the employee 4,315.00 12,998.00 6,595.00 7,576.00 31,484.00

PART B (Refer Note 1) DETAILS OF SALARY PAID AND ANY OTHER INCOME AND TAX DEDUCTED
Particulars 1. Gross salary a) Salary as per provisions contained in sec.17(1) b) Value of perquisites under section 17(2) ( as per Form No.12BA wherever applicable ) c) Profits in lieu of salary under section 17(3) ( as per Form No.12BA wherever applicable ) d) Total 2. Less: Allowance to the extent exempt under section 10 3. Balance(1-2) 3.A Salary from previous employer * 3.B Total (3 + 3A) 4. DEDUCTIONS: (a) Entertainment allowance (b) Tax on Employment 5. Aggregate of 4(a) and (b) 6. INCOME CHARGEABLE UNDER THE HEAD "SALARIES"(3B-5) 7. Add: Any other Income reported by the employee ** 8. GROSS TOTAL INCOME(6+7) 9. DEDUCTIONS UNDER CHAPTER VI-A (A) sections 80C, 80CCC and 80CCD (a) Section 80C i) Employeee Provident Fund ia) previous employment PF ii) Payment towards Life Insurance Policy iii) Contribution to ULIP (b) section 80CCC (c) section 80CCD Note: 1. aggregate amount deductible under section 80C shall not exceed one lakh rupees 21383 0 55122 55000 131505 0 0 100000 0 0 Gross Amount Deductible Amount 0 2400 2400 565668 0 565668 0 595668 27600 568068 0 568068 560074 35594 Rs. Rs. Rs.

2. aggregate amount deductible under the three sections i.e. 80C, 80CCC and 80CCD shall not exceed one lakh rupees (B) other sections (for e.g. 80CCF,80E, 80G etc.) under Chapter VIA 10. Aggregate of deductible amounts under Chapter VI-A 11. Total Income(8-10) 12. Tax on total income 13. Education cess @ 3% (on tax computed at S.No.12) 14. Tax payable (12+13) 15. Relief u/s 89 (Attach details) 16. Tax payable (14-15) 17. Less: a) Tax deducted at source u/s 192 (1) b) Tax paid by the employer on behalf of the employee u/s 192(1A) on perquisites u/s 17(2) c) Tax deducted by previous employer/or on other income d) Total tax deducted 18. Tax payable/refundable [16-17(d)] 100000 465670 30567 917 31484 0 31484 31484 0 0 31484 0

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Verification _______________________________________________________________ _______________________________________________________________ _________________________________ I R SANTHANAM son of S RAJAGOPAL working in the capacity of AUTHORISED SIGNATORY do hereby certify that a sum of Rs 31,484.00 [ Rupees THIRTY ONE THOUSAND FOUR HUNDRED EIGHTY FOUR Rupees ( 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. * : As per the information provided by the employee through Form 12B **: As per the information provided by the employee through Form 12C Signature of the person responsible for deduction of tax for Reliance Industries Limited Full Name: R SANTHANAM Place: Mumbai Designation: AUTHORISED SIGNATORY

Notes : 1.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 No.16 pertaining to the period for which such assessee was employed with each of the employers.Part B may be issued by each of the employers or the last employer at the option of the assessee. 2.Government deductors to enclose Annexure-A if tax is paid without production of an income-tax challan and Annexure-B if tax is paid accompanied by an income-tax challan. 3.Non-Government deductors to enlcose Annexure-B. 4.The deductor shall furnish the address of the Commissioner of Income-tax(TDS) having jurisdiction as regards TDS statements of the assessee. 5.This Form shall be applicable only in respect of tax deducted on or after 1st day of April,2010.

Signature valid
Digitally signed by RAJAGOPAL SANTHANAM Date: May 21, 2011 12:46:30 PM IST Reason: Form 16 Location: Mumbai