DynPro India Private LimitedDigitally signed document Form 16 Details in Form 16: Date: Employee: Employee PAN: Financial Year: Assessment Year: Form 16 Control No: 10/05/2012 Kaushik Sarkar BORPS3963L 2011-12 2012-13 749/192/700 Details of signature: Form 16 is a Certificate issued under section 203 of the Income-Tax Act, 1961 for Tax deducted at source. Please refer, [See Rule 31(1)(a)] This certificate is signed with a "Secure Digital Signature", as defined under section 15 of Indian Information Technology Act, 2000. Respective Digital Signature of the signatory has been affixed below. Please click on the box in order to see the details and validate the signature (for your reference). Issuer Organization: DynPro India Private Limited Issuer (TAN): BLRD02399F Document Name: Form 16 Signer Info: Shefali Lall 1056958 Name : Shefali Lall 1056958 Certified Authority: India PKI Date: 10/05/2012 09:42:06 (This document is digitally signed and enclosed with Statutory format of Form 16.) Page 1 000.00 (A) Sections 80C and 80CCD (a)Deductions in respect of specified investments/savings 80C 1)Life Insurance Premium 2)Mutual Fund Sec 80CCE (B) Other Sections under Chapter VIA Page 2 Rs.00 Rs.06.T. 2. Rs. 2. Rs.228.52.846.16 [See Rule 31(1)(a)] PART A Certificate under section 203 of the Income-tax Act. DKCXBCYC DKCXCUZB EONXFGID EONXHMCF 1. 6.000. 1.Original 749/192/700 FORM NO.00 4. Bhawan.846. City: Bangalore Pincode: 560032 TAN of the Deductor BLRD02399F Assessment Year 2012-13 PAN of the Employee BORPS3963L Period From 31/10/2011 To 31/03/2012 Summary of tax deducted at source Quarter Receipt Numbers of original statements of TDS under sub-section (3) of section 200.560042 KARNATAKA PAN of the Deductor AAACD4498E CIT (TDS) Address: Room No. Ganganagar.51.00 Rs.00 2.228. 59.00 Rs.846. 1.228.00 PART B (Refer Note 1) Details of Salary paid and any other income and tax deducted 1..846. 2.00 1. Rs.06. THE ESTATE 121 Dickenson Road BANGALORE .00 Rs.272.000.00 .00 2. Rs.00 1.00 1. 1961 for Tax deducted at source on Salary Name and Address of the Employer Name and Designation of the Employee Kaushik Sarkar Sr.Bellary Road.51.56.00 Rs.00 1.000.00 Rs.272. First Floor.000.56. Rs. 4.00 Amount of tax deducted in respect of the employee Amount of tax deposited/remitted in respect of the employee 1 2 3 4 Total 1 Gross Salary a) Salary as per provisions contained in sec. Rs.846. Rs.228. 4th Floor.00.H. Rs. 1.M.000. Rs. Software Consultant DynPro India Private Limited # 101. 17(1) b) Value of perquisites u/s 17(2) c) Profits in lieu of salary under section 17(3) d) Total 2 Less :Allowance to the extent exempt u/s 10 Conveyance Exemption 3 Balance 1-2 4 Deductions : a) Entertainment Allowance b) Tax on Employment 5 Aggregate of 4 (a) and (b) 6 Income chargeable under the head 'salaries' (3-5) 7 Add: Any other income reported by the employee 8 Gross total income (6+7) 9 Deductions under chapter VI-A Gross Amount Deductible Amount Rs..000.00 6. 4.Gross Amount Qualifying Amount Deductible Amount 10 Aggregate of deductible amount under chapter VI-A 11 Total income (8-10) 12 Tax on total income 13 Education Cess @ 3% (on tax computed at S. Place BANGALORE Form is digitally signed. Rs.15) Verification Rs. Rs. Part B may be issued by each of the employers or the last employer at the option of the assessee.850.00 (1.00 Nil 1. Please refer Page 1 for details. documents. complete and correct and is based on the books of account. Rs. Rs. Rs.00 1. 3. TDS statements. Non-Government deductors to enclose Annexure-B.228. 2010. I further certify that the information given above is true. 1. S.228. 1 2 3 4 5 Tax payable as per Part-B (Sl No 16) Tax Deducted at Current Employment Tax Deducted at Previous Employment Total Tax Deducted (2+3) Net Tax Payable / (Refundable) (1-4) Particulars Amount Nil 1.Lall working in the capacity of Authorised Signatory (designation) do hereby certify that a sum of Rs.No.00 Nil Nil I.00) Page 3 .00 [Rupees One Thousand Two Hundred Twenty Eight Only] has been deducted at source and deposited to the credit of the Central Government. 2. The deductor shall furnish the address of the Commissioner of Income-tax (TDS) having jurisdiction as regards TDS statements of the assessee.B. 1. daughter of Mr. 5.51. 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. Tax Deducted Summary (Summary of Tax Payable and Tax Deducted Information) Sl.000.12) 14 Tax payable (12 + 13) 15 Less: Relief under section 89 (attach details) 16 Tax Payable (14 . TDS deposited and other available records.228. 16 pertaining to the period for which such assessee was employed with each of the employers. Rs.00. Date Designation 09/05/2012 Authorised Signatory Signature of person responsible for deduction of tax Full Name: Shefali Lall Notes: 1.No.228. If an assessee is employed under more than one employer during the year. This Form shall be applicable only in respect of tax deducted on or after 1st day of April. each of the employers shall issue Part A of the certificate in Form No. Shefali Lall. ANNEXURE-A DETAILS OF TAX DEDUCTED AND DEPOSITED IN THE CENTRAL GOVERNMENT ACCOUNT THROUGH BOOK ENTRY (The Employer to provide payment wise details of tax deducted and deposited with respect to the employee) Not Applicable Note: 1. give total amount for TDS. Surchage (if applicable) and education cess. In the column for TDS. Page 4 . 00 1.228.ANNEXURE-B DETAILS OF TAX DEDUCTED AND DEPOSITED IN THE CENTRAL GOVERNMENT ACCOUNT THROUGH CHALLAN (The Employer to provide payment wise details of tax deducted and deposited with respect to the employee) Sl. give total amount for TDS.No.00 Note: 0 3 0 2 2 7 5 1. Tax Deposited in respect of the employee (Rs. In the column for TDS. Page 5 .) Challan Identification Number (CIN) BSR Code of the Bank Branch 1 TOTAL Date on which tax deposited (dd/mm/yyyy) 0 6 1 2 2 0 1 1 0 Challan Serial Number 3 6 9 4 1. Surchage (if applicable) and education cess.228.