TDS certificate salary details

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 CHARGEBLE UNDER THE HEAD "SALARIES"
Name and address of the employer Name and address of the employe
BAILANJINAPPA.P
BLOCK EDUCATION OFFICER
HOSAKOTE Tq
BENGALURU RURAL Dist
PAN of the Deducter PAN of the Deducter PAN of the Employe
AFNPB6610D
Period Assesment year

Acknoledgement No.s of all quarterly statements of
IDS under Sub section (3) of section 200 as provided
YEARLY
by Tin facilitation Centre or NSDL web-site
Quarter Acknoledgement No From To

Q-1
Q-2
Mar-13 Feb-14 2013-14
Q-3
Q-4
DETAILS OF SALARY PAID AND ANY OTHER INCOME AND TAX DEDUCTED
1. Gross Salary 500000
a) Salary as per Provisions contained in Sec. 17 (1) Rs
2. Less : Allowence to the exetent under section 10
HRA Rs 25000
3. Balance (1-2) 475000
4. Deductions :
a) Entertainment Allowence Rs 1200
b) Tax on Employment Rs 2400
5. Aggregrate of 4 (a) to (b) 3600
6. Income chargable under the head of "salaries"(3-5) 471400
7. Add: Any other income reported by the employee
1) Interest on NSC Rs
2) Interest on Housing Loan Rs
8. Gross total income (6+7)
9. Deductions under Chapter VI A
Section 80-C Amount
a) LIC 25000
b) FBF / Others 1440
c) PLI / PPF (GPF) 30000
d) HBA Principal
e) Tution Fee 10000
f) LIC (Personal)
g) PF (KGID) 20000
86440 384960
h) Interest on NSC
i) NSC
Total Deduction u/s 80C (Restricted to Rs. 1 Lakh only)
(b) Deductions u/s 80 DD physically handicapped dependent
10. Aggregate of deductible amount under Chapter VIA
11. Total income (8-10)
12. Tax on Total Income
13. Surcharge (on tax compound at S.No.12)
14. Education cess @ 3%
15. Tax payable (12+13+14)
16. Relief under section 89 ( attach details )
17. Tax payable (15-16)
18. Less : a) Tax deducted at source u/s 192 (1)
b) Tax paid by the employee on behalf of the
employee u/s 1932 (IA) on perquisites u/s 17 (2)
19. Tax payable / refundable ( 17-18 )
DETAILS OF TAX DEDUCTED AND DEPOSITED INTO CENTRAL GOVRNMENT ACCOUNT
Total Tax Date of tax
Sl.No TDS Surcharge Edu.Cess Cheque No. BSR Code
deposited deposited
1
2
3
4
5
6
7
8
9
10
11
12
I BAILANJINAPPA. P. B.E.O. HOSAKOTE Working in the capacity of
BLOCK EDUCATION OFFICER (designation) do hereby certify that a sum of Rs. .....................
(Rupees 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 book of accounts, documents and other
available records
Signature of the person responsible

Place : for deduction of tax
Date : Full Name ..............................................

Designation ............................................
FORM NO. 16
{ See Rule 31(1) (a) }
S.N.KANNAIAH MUNIRAJU
BLOCK EDUCATION OFFICER Second Division Assistant
HOSAKOTE Tq BLOCK EDUCATION OFFICE
BENGALURU RURAL Dist HOSAKOTE Tq
BBXPM7969M

YEARLY

Q-1
Q-2
Mar-15 Feb-16 2015-16
Q-3
Q-4
HRA Rs 28080
3. Balance (1-2) 371113
4. Deductions :
2) Interest on Housing Loan Rs 76000
8. Gross total income (6+7) 291513
Section 80-C Amount
a) LIC 17052
b) FBF / Others 1440
d) HBA Principal 35000
e) Tution Fee
f) LIC (Personal)
g) PF (KGID) 24000
107492 184021
h) Interest on NSC
i) NSC
12. Tax on Total Income NIL-
15. Tax payable (12+13+14)
17. Tax payable (15-16) NIL-
employee
19. Tax payable / refundable u/s )1932 (IA) on perquisites u/s 17 (2)
( 17-18
Date of
Total Tax
Sl.No TDS Surcharge Edu.Cess Cheque No. tax
deposited
deposited
1
2
3
4
5
6 NIL-
7
8
9
10
I S.N. KANNAIAH B.E.O. HOSAKOTE Working in the capacity of
BLOCK EDUCATION OFFICER (designation) do hereby certify that a sum of Rs. NIL-------------
(Rupees in words) ...................................NIL............................................................................)
available records.
Signature of the person

Place : Hosakote responsible for deduction of
tax
Date : 21.10.2017 Full Name ..............................................
Designation ............................................
FORM NO. 16
{ See Rule 31(1) (a) }
S.N.KANNAIAH MUNIRAJU
BLOCK EDUCATION OFFICER Second Division Assistant
HOSAKOTE Tq BLOCK EDUCATION OFFICE
BBXPM7969M

YEARLY

Q-1
Q-2
Mar-16 Feb-17 2016-17
Q-3
Q-4
HRA Rs 28860
3. Balance (1-2) 403008
4. Deductions :
Section 80-C Amount
a) LIC 18712
b) GIS/FBF / Others 1440
e) Tution Fee
f) LIC (Personal)
g) PF (KGID) 24000
109152 214256
h) Interest on NSC
i) NSC
15. Tax payable (12+13+14)
employee
19. Tax payable / refundable u/s )1932 (IA) on perquisites u/s 17 (2)
( 17-18
Date of
Total Tax
Sl.No TDS Surcharge Edu.Cess Cheque No. tax
deposited
deposited
1
2
3
4
5
6 NIL-
7
8
9
10
I S.N. KANNAIAH B.E.O. HOSAKOTE Working in the capacity of
available records.
Signature of the person responsible

Place : Hosakote for deduction of tax
Date : 21.10.2017 Full Name ...................................
Designation ..................................
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 CHARGEBLE UNDER THE HEAD
"SALARIES"
S.N.KANNAIAH SRINIVASA B.
BLOCK EDUCATION OFFICER Asst Teacher
HOSAKOTE Tq GHPS BETTAHALLI
CLKPS3571D
statements of IDS under Sub section (3) of

Assesment year
section 200 as provided by Tin facilitation YEARLY
Q-1
Q-2
Mar-17 Feb-18 2017-18
Q-3
Q-4
a) Salary as per Provisions contained in Sec.
17 (1) Rs
HRA Rs 29510
3. Balance (1-2) 435952
4. Deductions :
Section 80-C Amount
a) LIC 2508
c) PPF (GPF) 30000
d) HBA Principal 0
e) Tution Fee 85000
f) LIC (Personal)
g) PF (KGID) 30000
h) PLI 2952
i) Others 0
TOTAL DEDUCTIONS 151900 280452
Standard Deductiobn Permissible Upto 150000=00 Only
h) Interest on NSC
i) NSC
15. Tax payable (12+13+14)
19. Tax payableemployee u/s 1932
/ refundable (IA)
( 17-18 ) on perquisites u/s 17 (2)
Date of
Total Tax Cheque
Sl.No TDS Surcharge Edu.Cess BSR Code tax
deposited No.
deposited
1
2
3
4
5
6 NIL-
7
8
9
10
I.. S.N. KANNAIAH S/O Narayanappa B.E.O. HOSAKOTE Working in the capacity of
available records.
person responsible
Place : Hosakote
for deduction of
Date : 27.07.2018 Full Name ...................................
Designation ..................................
FORM NO. 16
{ See Rule 31(1) (a) }
"SALARIES"
S.N.KANNAIAH VENKATESHA S
BLOCK EDUCATION OFFICER Asst Teacher
HOSAKOTE Tq GLPS CHEEMASANDRA
AILPV5590K

Assesment year
Q-1
Q-2
Mar-17 Feb-18 2017-18
Q-3
Q-4
1. Gross Salary
a) Salary as per Provisions contained in Sec. 336955
17 (1) Rs
HRA Rs 20440
3. Balance (1-2) 316515
4. Deductions :
Section 80-C Amount
a) LIC 40572
c) PPF (GPF) 0
d) HBA Principal 0
e) Tution Fee 0
f) LIC (Personal) 0
g) PF (KGID) 24000
h) PLI 0
i) Others (NPS) 29666
h) Interest on NSC
i) NSC
15. Tax payable (12+13+14)
/ refundable (IA)
Date of
Total Tax Cheque
deposited No.
deposited
1
2
3
4
5
6 NIL-
7
8
9
10
available records.
person responsible
Place : Hosakote
for deduction of
Date : 27.08.2018 Full Name ...................................
Designation ..................................
FORM NO. 16
{ See Rule 31(1) (a) }
"SALARIES"
S.N.KANNAIAH SURESHKUMAR M
BLOCK EDUCATION OFFICER FIRST DIVISION ASSISTANT
HOSAKOTE Tq GBHS HOSAKOTE
CIEPS1606J

Assesment year
Q-1
Q-2
Mar-17 Feb-18 2017-18
Q-3
Q-4
1. Gross Salary
17 (1) Rs
HRA Rs 24475
3. Balance (1-2) 354947
4. Deductions :
Section 80-C Amount
a) LIC 31416
c) PPF (GPF) 36000
d) HBA Principal 0
e) Tution Fee 0
f) LIC (Personal) 0
g) PF (KGID) 30000
h) PLI 0
i) Others (NPS) 0
h) Interest on NSC
i) NSC
10. Aggregate of deductible amount under Chapter VIA 252491
11. Total income (8-10) 2491
12. Tax on Total Income 125
13. Surcharge (on tax compound at S.No.12) 0
14. Education cess @ 3% 4
15. Tax payable (12+13+14)
16. Relief under section 89 ( attach details ) EXEMPTION UPTO 2500/-
/ refundable (IA)
Date of
Total Tax Cheque
deposited No.
deposited
1
2
3
4
5
6 NIL-
7
8
9
10
available records.
person responsible
Place : Hosakote
for deduction of
Date : 28.08.2018 Full Name ...................................
Designation ..................................
FORM NO. 16
{ See Rule 31(1) (a) }
"SALARIES"
S.N.KANNAIAH M. NARAYANAPPA
BLOCK EDUCATION OFFICER ASST TEACHER
HOSAKOTE Tq GLPS LINGAPURA
BTHPH3824K

Assesment year
Q-1
Q-2
Mar-17 Feb-18 2017-18
Q-3
Q-4
1. Gross Salary
17 (1) Rs
HRA Rs 24200
3. Balance (1-2) 365993
4. Deductions :
Section 80-C Amount
a) LIC 9672
c) PPF (GPF) 84000
d) HBA Principal 0
e) Tution Fee 0
f) LIC (Personal) 0
g) PF (KGID) 36000
h) PLI 0
i) Others (NPS) 0
h) Interest on NSC
i) NSC
15. Tax payable (12+13+14)
19. Tax payableemployee u/s (1932
/ refundable (IA)
17-18 ) on perquisites u/s 17 (2)
Date of
Total Tax Cheque
deposited No.
deposited
1
2
3
4
5
6 NIL-
7
8
9
10
available records.
person responsible
Place : Hosakote
for deduction of
Date : 28.08.2018 Full Name ...................................
Designation ..................................
FORM NO. 16
{ See Rule 31(1) (a) }
"SALARIES"
S.N.KANNAIAH M. NARAYANAPPA
HOSAKOTE Tq GLPS LINGAPURA
BTHPH3824K

Assesment year
Q-1
Q-2
Mar-16 Feb-17 2016-17
Q-3
Q-4
1. Gross Salary
17 (1) Rs
HRA Rs 23600
3. Balance (1-2) 347810
4. Deductions :
Section 80-C Amount
a) LIC 9672
c) PPF (GPF) 84000
d) HBA Principal 0
e) Tution Fee 0
f) LIC (Personal) 0
g) PF (KGID) 36000
h) PLI 0
i) Others (NPS) 0
h) Interest on NSC
i) NSC
15. Tax payable (12+13+14)
19. Tax payableemployee u/s (1932
/ refundable (IA)
17-18 ) on perquisites u/s 17 (2)
Date of
Total Tax Cheque
deposited No.
deposited
1
2
3
4
5
6 NIL-
7
8
9
10
person responsible
Place : Hosakote
for deduction of
Date : 28.08.2018 Full Name ...................................
Designation ..................................
FORM NO. 16
{ See Rule 31(1) (a) }
"SALARIES"
S.N.KANNAIAH VINODA
HOSAKOTE Tq GLPS CHOKKAHALLI
AIOPV9156J

Assesment year
Q-1
Q-2
Mar-17 Feb-18 2017-18
Q-3
Q-4
1. Gross Salary
17 (1) Rs
HRA Rs 24950
3. Balance (1-2) 369282
4. Deductions :
Section 80-C Amount
a) LIC 61788
c) PPF (GPF) 24000
d) HBA Principal 0
e) Tution Fee 38772
f) LIC (Personal) 0
g) PF (KGID) 24000
h) PLI 0
i) Others (NPS) 0
h) Interest on NSC
i) NSC
12. Tax on Total Income NIL
15. Tax payable (12+13+14)
/ refundable (IA)
Date of
Total Tax Cheque
deposited No.
deposited
1
2
3
4
5
6 NIL-
7
8
9
10
available records.
person responsible
Place : Hosakote
for deduction of
Date : 29.08.2018 Full Name ...................................
Designation ..................................
FORM NO. 16
{ See Rule 31(1) (a) }
"SALARIES"
S.N.KANNAIAH VIJAYA.N
HOSAKOTE Tq GHPS ITTASANDRA
AIMPV6159M

Assesment year
Q-1
Q-2
Mar-17 Feb-18 2017-18
Q-3
Q-4
1. Gross Salary
17 (1) Rs
HRA Rs 24950
3. Balance (1-2) 368441
4. Deductions :
Section 80-C Amount
a) LIC 4128
c) PPF (GPF) 60000
d) HBA Principal 0
e) Tution Fee 0
f) LIC (Personal) 0
g) PF (KGID) 24000
h) PLI 0
i) Others (NPS) 0
h) Interest on NSC
i) NSC
11. Total income (8-10) 25273
15. Tax payable (12+13+14) 1302
/ refundable (IA)
Date of
Total Tax Cheque
deposited No.
deposited
1
2
3
4
5
6 NIL-
7
8
9
10
available records.
person responsible
Place : Hosakote
for deduction of
Date : 29.08.2018 Full Name ...................................
Designation ..................................
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 CHARGEBLE UNDER THE HEAD "SALARIES"
S.N.KANNAIAH KAMALA JANARDHAN BHAT
HOSAKOTE Tq GHPS KOLATHURU
PAN of the Deducter PAN of the PAN of the Employe
ATTPB6381K
statements of IDS under Sub section

Assesment year
(3) of section 200 as provided by Tin YEARLY
Q-1
Q-2
Mar-17 Feb-18 2017-18
Q-3
Q-4
1.a)Gross
SalarySalary
as per Provisions contained 429737
in Sec. 17 (1) Rs
HRA Rs 27180
3. Balance (1-2) 402557
4. Deductions :
Section 80-C Amount
a) LIC 13764
c) PPF (GPF) 25000
d) HBA Principal 0
e) Tution Fee 9200
f) LIC (Personal) 3568
g) PF (KGID) 24120
h) PLI / NSC 24422
i) Others (NPS) 0
h) Interest on NSC
i) NSC
11. Total income (8-10) 47443
15. Tax payable (12+13+14) 2443
19. Tax payable / employee
refundableu/s 1932 )(IA) on perquisites u/s 17 (2)
( 17-18
Surcharg Total Tax BSR Date of tax
Sl.No TDS Edu.Cess Cheque No.
e deposited Code deposited
1
2
3
4
5
6 NIL-
7
8
9
10
I.. S.N. KANNAIAH S/O Narayanappa B.E.O. HOSAKOTE Working in the capacity of BLOCK
EDUCATION OFFICER (designation) do hereby certify that a sum of Rs. NIL------------- (Rupees in words)
NIL.......................................................................)
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 accounts, ocuments and other available
records.

Place : Hosakote responsible for deduction
of tax
Date : 29.08.2018 Full Name ...................................
Designation ..................................
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 CHARGEBLE UNDER THE HEAD "SALARIES"
S.N.KANNAIAH VINODA G S
HOSAKOTE Tq GLPS GANJARLAHALLI
PAN of the Deducter PAN of the PAN of the Employe
CFLPS6640Q
statements of IDS under Sub section

Assesment year
(3) of section 200 as provided by Tin YEARLY
Q-1
Q-2
Mar-17 Feb-18 2017-18
Q-3
Q-4
1.a)Gross
SalarySalary
as per Provisions contained 429622
in Sec. 17 (1) Rs
HRA Rs 27420
3. Balance (1-2) 402202
4. Deductions :
Section 80-C Amount
a) LIC 0
c) PPF (GPF) 36000
d) HBA Principal 0
e) Tution Fee 105775
f) LIC (Personal) 0
g) PF (KGID) 17400
h) PLI / NSC 22740
i) Others (NPS) 0
h) Interest on NSC
i) NSC
11. Total income (8-10) NIL
15. Tax payable (12+13+14)
19. Tax payable / employee
refundableu/s 1932 )(IA) on perquisites u/s 17 (2)
( 17-18
Surcharg Total Tax BSR Date of tax
Sl.No TDS Edu.Cess Cheque No.
e deposited Code deposited
1
2
3
4
5
6 NIL-
7
8
9
10
I.. S.N. KANNAIAH S/O Narayanappa B.E.O. HOSAKOTE Working in the capacity of BLOCK
EDUCATION OFFICER (designation) do hereby certify that a sum of Rs. NIL------------- (Rupees in words)
NIL.......................................................................)
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 accounts, ocuments and other available
records.

Place : Hosakote responsible for deduction
of tax
Date : 29.08.2018 Full Name ...................................
Designation ..................................
FORM NO. 16
{ See Rule 31(1) (a) }
S.N.KANNAIAH K MANJUNATHA
BLOCK EDUCATION OFFICER T.G.T.
HOSAKOTE Tq GHPS KURUBARAHALLI
AVCPM9083A
IDS under Sub section (3) of section 200 as

Assesment year
provided by Tin facilitation Centre or NSDL web- YEARLY
Q-1
Q-2
Mar-17 Feb-18 2017-18
Q-3
Q-4
1.a)Gross
SalarySalary
as per Provisions contained in Sec. 17 481664
(1) Rs
HRA Rs 29480
3. Balance (1-2) 452184
4. Deductions :
Section 80-C Amount
a) LIC 15712
c) PPF (GPF) 48000
d) HBA Principal 0
e) Tution Fee 0
f) LIC (Personal) 0
g) PF (KGID) 48000
h) PLI / NSC 12420
i) Others (NPS) 0
h) Interest on NSC
i) NSC
15. Tax payable (12+13+14)
employee
19. Tax payable / refundable u/s 1932
( 17-18 ) (IA) on perquisites u/s 17 (2)
Total Tax BSR
Sl.No TDS Surcharge Edu.Cess Cheque No.
deposited Code
1 1260 Deducted FEB-2018 SALARY
2
3
4
5
6
7
8
9
10
I.. S.N. KANNAIAH S/O Narayanappa B.E.O. HOSAKOTE Working in the capacity of BLOCK EDUCATION
OFFICER (designation) do hereby certify that a sum of Rs. 1260/- (Rupees in words) One Thousand Two Hundred
and Sixty 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 accounts, ocuments and other available records.

Place : Hosakote responsible for
deduction of tax
Date : 30.08.2018 Full Name ...................................
Designation ..................................
FORM NO. 16
{ See Rule 31(1) (a) }
S.N.KANNAIAH NAZMA NIKHATH
HOSAKOTE Tq GUHPS SULIBELE
AHAPN9644E

Assesment year
Q-1
Q-2
Mar-17 Feb-18 2017-18
Q-3
Q-4
1.a)Gross
SalarySalary
(1) Rs
HRA Rs 29480
3. Balance (1-2) 471968
4. Deductions :
Section 80-C Amount
a) LIC 44628
c) PPF (GPF) 36000
d) HBA Principal 0
e) Tution Fee 25000
f) LIC (Personal) 0
g) PF (KGID) 30000
h) PLI / NSC 0
i) Others (NPS) 0
h) Interest on NSC
i) NSC
15. Tax payable (12+13+14)
employee
Total Tax BSR
deposited Code
2
3
4
5
6
7
8
9
10
OFFICER (designation) do hereby certify that a sum of Rs. 1690/- (Rupees in words) One Thousand Six Hundred
and Ninghty 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 accounts, ocuments and other available records.

deduction of tax
Date : 30.08.2018 Full Name ...................................
Designation ..................................
FORM NO. 16
{ See Rule 31(1) (a) }
S.N.KANNAIAH SHAHEEN TAJ
HOSAKOTE Tq GUHPS B.N.PURA
CBPPS1601H

Assesment year
Q-1
Q-2
Mar-17 Feb-18 2017-18
Q-3
Q-4
1.a)Gross
SalarySalary
(1) Rs
HRA Rs 27360
3. Balance (1-2) 418422
4. Deductions :
Section 80-C Amount
a) LIC 14124
c) PPF (GPF) 0
d) HBA Principal 0
e) Tution Fee 26000
f) LIC (Personal) 0
g) PF (KGID) 12000
h) PLI / NSC 0
h) Interest on NSC
i) NSC
15. Tax payable (12+13+14)
employee
Total Tax BSR
deposited Code
2
3
4
5
6
7
8
9
10
OFFICER (designation) do hereby certify that a sum of Rs.420/- (Rupees in words) Four Hundred and Twenty 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 accounts, ocuments and other available records.

deduction of tax
Date : 30.08.2018 Full Name ...................................
Designation ..................................
FORM NO. 16
{ See Rule 31(1) (a) }
S.N.KANNAIAH MURALI M
HOSAKOTE Tq GHPS OROHALLI
AYJPM5315P

Assesment year
Q-1
Q-2
Mar-17 Feb-18 2017-18
Q-3
Q-4
1.a)Gross
SalarySalary
(1) Rs
HRA Rs 28320
3. Balance (1-2) 432602
4. Deductions :
Section 80-C Amount
a) LIC 13728
c) PPF (GPF) 0
d) HBA Principal 0
e) Tution Fee 25000
g) PF (KGID) 24000
h) PLI / NSC 0
h) Interest on NSC
i) NSC
15. Tax payable (12+13+14)
employee
Total Tax BSR
deposited Code
2
3
4
5
6
7
8
9
10
OFFICER (designation) do hereby certify that a sum of Rs.30/- (Rupees in words) Thirty 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 accounts, ocuments and other available records.

deduction of tax
Date : 30.08.2018 Full Name ...................................
Designation ..................................
FORM NO. 16
{ See Rule 31(1) (a) }
S.N.KANNAIAH ANNAPURNA AS
HOSAKOTE Tq GHPS DEVANAGUNDI
ALAPA5136E

Assesment year
Q-1
Q-2
Mar-17 Feb-18 2017-18
Q-3
Q-4
1.a)Gross
SalarySalary
(1) Rs
HRA Rs 27300
3. Balance (1-2) 418024
4. Deductions :
Section 80-C Amount
a) LIC 15468
c) PPF (GPF) 0
d) HBA Principal 0
e) Tution Fee 7200
f) LIC (Personal) 0
g) PF (KGID) 25200
h) PLI / NSC 5700
i) (NPS) 44870
j) Others 12000
h) Interest on NSC
i) NSC
15. Tax payable (12+13+14)
employee
Total Tax BSR
deposited Code
2
3
4
5
6
7
8
9
10
OFFICER (designation) do hereby certify that a sum of Rs.210/- (Rupees in words) Two Hundred and Ten 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 accounts, ocuments and other available records.

deduction of tax
Date : 30.08.2018 Full Name ...................................
Designation ..................................
FORM NO. 16
{ See Rule 31(1) (a) }
S.N.KANNAIAH VARALAKSHMI R
HOSAKOTE Tq GHPS DASARAHALLI
AHETV3936B

Assesment year
Q-1
Q-2
Mar-17 Feb-18 2017-18
Q-3
Q-4
1.a)Gross
SalarySalary
(1) Rs
HRA Rs 0
3. Balance (1-2) 482264
4. Deductions :
Section 80-C Amount
a) LIC 5616
c) PPF (GPF) 24000
e) Tution Fee 0
f) LIC (Personal) 0
g) PF (KGID) 24000
h) PLI / NSC 0
i) (NPS) 0
j) Others 0
h) Interest on NSC
i) NSC
15. Tax payable (12+13+14)
employee
Total Tax BSR
deposited Code
2
3
4
5
6
7
8
9
10
OFFICER (designation) do hereby certify that a sum of Rs.1290/- (Rupees in words) One Thousand Two Hundred

deduction of tax
Date : 30.08.2018 Full Name ...................................
Designation ..................................
FORM NO. 16
{ See Rule 31(1) (a) }
S.N.KANNAIAH NAGEEN ANJUM
HOSAKOTE Tq GHPS HINDIGANALA
AJRPN4687S

Assesment year
Q-1
Q-2
Mar-17 Feb-18 2017-18
Q-3
Q-4
1.a)Gross
SalarySalary
(1) Rs
HRA Rs 29340
3. Balance (1-2) 471039
4. Deductions :
Section 80-C Amount
a) LIC 6696
c) PPF (GPF) 12000
d) HBA Principal 0
e) Tution Fee 49033
f) LIC (Personal) 0
g) PF (KGID) 20400
h) PLI / NSC 0
i) (NPS) 0
j) Others 0
h) Interest on NSC
i) NSC
15. Tax payable (12+13+14)
employee
Total Tax BSR
deposited Code
2
3
4
5
6
7
8
9
10
OFFICER (designation) do hereby certify that a sum of Rs.4090/- (Rupees in words) Four Thousand and Ninghty
Only) has been deducted at source and paid to the credit of the Central Government, I further certify that the

deduction of tax
Date : 30.08.2018 Full Name ...................................
Designation ..................................
FORM NO. 16
{ See Rule 31(1) (a) }
S.N.KANNAIAH MARY ALPHONSA D
HOSAKOTE Tq GHPS MUTHSANDRA
CKBPM4760J

Assesment year
Q-1
Q-2
Mar-17 Feb-18 2017-18
Q-3
Q-4
1.a)Gross
SalarySalary
(1) Rs
HRA Rs 29480
3. Balance (1-2) 455712
4. Deductions :
Section 80-C Amount
a) LIC 73916
c) PPF (GPF) 24000
d) HBA Principal 0
e) Tution Fee 16800
f) LIC (Personal) 0
g) PF (KGID) 30000
h) PLI / NSC 0
i) (NPS) 0
j) Others 0
h) Interest on NSC
i) NSC
15. Tax payable (12+13+14)
employee
Total Tax BSR
deposited Code
2
3
4
5
6
7
8
9
10
OFFICER (designation) do hereby certify that a sum of Rs.385/- (Rupees in words) Three Hundred and Eighty Five

deduction of tax
Date : 30.08.2018 Full Name ...................................
Designation ..................................
FORM NO. 16
{ See Rule 31(1) (a) }
CKBPM4760J

Assesment year
Q-1
Q-2
Mar-17 Feb-18 2017-18
Q-3
Q-4
1.a)Gross
SalarySalary
(1) Rs
HRA Rs 29480
3. Balance (1-2) 455712
4. Deductions :
Section 80-C Amount
a) LIC 73916
c) PPF (GPF) 24000
d) HBA Principal 0
e) Tution Fee 16800
f) LIC (Personal) 0
g) PF (KGID) 30000
h) PLI / NSC 0
i) (NPS) 0
j) Others 0
h) Interest on NSC
i) NSC
15. Tax payable (12+13+14)
employee
Total Tax BSR
deposited Code
2
3
4
5
6
7
8
9
10

deduction of tax
Date : 30.08.2018 Full Name ...................................
Designation ..................................
FORM NO. 16
{ See Rule 31(1) (a) }
S.N.KANNAIAH JAYASHREE L
HOSAKOTE Tq GHPS SULIBELE
ANJPJ2203J

Assesment year
Q-1
Q-2
Mar-17 Feb-18 2017-18
Q-3
Q-4
1.a)Gross
SalarySalary
(1) Rs
HRA Rs 29340
3. Balance (1-2) 452924
4. Deductions :
Section 80-C Amount
a) LIC 15120
c) PPF (GPF) 72000
d) HBA Principal 0
e) Tution Fee 37020
f) LIC (Personal) 0
g) PF (KGID) 24000
h) PLI / NSC 0
i) (NPS) 0
j) Others 0
h) Interest on NSC
i) NSC
15. Tax payable (12+13+14)
employee
Total Tax BSR
deposited Code
2
3
4
5
6
7
8
9
10
OFFICER (designation) do hereby certify that a sum of Rs.65/- (Rupees in words) Sixty Five 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 accounts, ocuments and other available records.

deduction of tax
Date : 30.08.2018 Full Name ...................................
Designation ..................................
FORM NO. 16
{ See Rule 31(1) (a) }
S.N.KANNAIAH
CKBPM4760J

Assesment year
Q-1
Q-2
Mar-17 Feb-18 2017-18
Q-3
Q-4
1.a)Gross
SalarySalary
(1) Rs
HRA Rs 29480
3. Balance (1-2) 455712
4. Deductions :
Section 80-C Amount
a) LIC 73916
c) PPF (GPF) 24000
d) HBA Principal 0
e) Tution Fee 16800
f) LIC (Personal) 0
g) PF (KGID) 30000
h) PLI / NSC 0
i) (NPS) 0
j) Others 0
h) Interest on NSC
i) NSC
15. Tax payable (12+13+14)
employee
Total Tax BSR
deposited Code
2
3
4
5
6
7
8
9
10
OFFICER (designation) do hereby certify that a sum of Rs.385/- (Rupees in words)
Signature Three Hundred and Eighty Five
of the person
deduction of tax
Date : 30.08.2018 Full Name ...................................
Designation ..................................
73012
3651
0
109
3760
PTION UPTO 2500/-
1260
NT ACCOUNT
Date of tax
deposited
EB-2018 SALARY
f BLOCK EDUCATION
Thousand Two Hundred
t, I further certify that the
r available records.
81300
4065
0
122
4187
PTION UPTO 2500/-
1687
1690/-
NT ACCOUNT
Date of tax
deposited
EB-2018 SALARY
f BLOCK EDUCATION
Thousand Six Hundred
ent, I further certify that
other available records.
56698
2835
0
85
2920
PTION UPTO 2500/-
420
420
NT ACCOUNT
Date of tax
deposited
EB-2018 SALARY
BLOCK EDUCATION
undred and Twenty Only)
that the information
ecords.
49096
2455
0
73
2528
PTION UPTO 2500/-
28
30
NT ACCOUNT
Date of tax
deposited
EB-2018 SALARY
f BLOCK EDUCATION
nly) has been deducted
given above is true and
52546
2627
0
79
2706
PTION UPTO 2500/-
206
210
NT ACCOUNT
Date of tax
deposited
EB-2018 SALARY
f BLOCK EDUCATION
ndred and Ten Only) has
the information given
s.
73608
3680
0
110
3790
PTION UPTO 2500/-
1290
1290
NT ACCOUNT
Date of tax
deposited
EB-2018 SALARY
f BLOCK EDUCATION
housand Two Hundred
127870
6394
0
192
6586
PTION UPTO 2500/-
4086
4090
NT ACCOUNT
Date of tax
deposited
EB-2018 SALARY
f BLOCK EDUCATION
housand and Ninghty
certify that the
55956
2798
0
84
2882
PTION UPTO 2500/-
382
385
NT ACCOUNT
Date of tax
deposited
EB-2018 SALARY
f BLOCK EDUCATION
undred and Eighty Five
certify that the
55956
2798
0
84
2882
PTION UPTO 2500/-
382
385
NT ACCOUNT
Date of tax
deposited
EB-2018 SALARY
f BLOCK EDUCATION
certify that the
49744
2487
0
75
2562
PTION UPTO 2500/-
62
65
NT ACCOUNT
Date of tax
deposited
EB-2018 SALARY
f BLOCK EDUCATION
e Only) has been
formation given above is
55956
2798
0
84
2882
PTION UPTO 2500/-
382
385
NT ACCOUNT
Date of tax
deposited
EB-2018 SALARY
f BLOCK EDUCATION
FORM NO. 16
{ See Rule 31(1) (a) }
AVCPM9083A

Assesment year
Q-1
Q-2
Mar-17 Feb-18 2017-18
Q-3
Q-4
1.a)Gross
SalarySalary
(1) Rs
HRA Rs 29480
3. Balance (1-2) 452184
4. Deductions :
Section 80-C Amount
a) LIC 15712
c) PPF (GPF) 48000
d) HBA Principal 0
e) Tution Fee 0
f) LIC (Personal) 0
g) PF (KGID) 48000
h) PLI / NSC 12420
i) Others (NPS) 0
h) Interest on NSC
i) NSC
15. Tax payable (12+13+14)
employee
Total Tax BSR
deposited Code
2
3
4
5
6
7
8
9
10

deduction of tax
Date : 30.08.2018 Full Name ...................................
Designation ..................................
FORM NO. 16
{ See Rule 31(1) (a) }
AHAPN9644E

Assesment year
Q-1
Q-2
Mar-17 Feb-18 2017-18
Q-3
Q-4
1.a)Gross
SalarySalary
(1) Rs
HRA Rs 29480
3. Balance (1-2) 471968
4. Deductions :
Section 80-C Amount
a) LIC 44628
c) PPF (GPF) 36000
d) HBA Principal 0
e) Tution Fee 25000
f) LIC (Personal) 0
g) PF (KGID) 30000
h) PLI / NSC 0
i) Others (NPS) 0
h) Interest on NSC
i) NSC
15. Tax payable (12+13+14)
employee
Total Tax BSR
deposited Code
2
3
4
5
6
7
8
9
10

deduction of tax
Date : 30.08.2018 Full Name ...................................
Designation ..................................
FORM NO. 16
{ See Rule 31(1) (a) }
CBPPS1601H

Assesment year
Q-1
Q-2
Mar-17 Feb-18 2017-18
Q-3
Q-4
1.a)Gross
SalarySalary
(1) Rs
HRA Rs 27360
3. Balance (1-2) 418422
4. Deductions :
Section 80-C Amount
a) LIC 14124
c) PPF (GPF) 0
d) HBA Principal 0
e) Tution Fee 26000
f) LIC (Personal) 0
g) PF (KGID) 12000
h) PLI / NSC 0
h) Interest on NSC
i) NSC
15. Tax payable (12+13+14)
employee
Total Tax BSR
deposited Code
2
3
4
5
6
7
8
9
10

deduction of tax
Date : 30.08.2018 Full Name ...................................
Designation ..................................
FORM NO. 16
{ See Rule 31(1) (a) }
AYJPM5315P

Assesment year
Q-1
Q-2
Mar-17 Feb-18 2017-18
Q-3
Q-4
1.a)Gross
SalarySalary
(1) Rs
HRA Rs 28320
3. Balance (1-2) 432602
4. Deductions :
Section 80-C Amount
a) LIC 13728
c) PPF (GPF) 0
d) HBA Principal 0
e) Tution Fee 25000
g) PF (KGID) 24000
h) PLI / NSC 0
h) Interest on NSC
i) NSC
15. Tax payable (12+13+14)
employee
Total Tax BSR
deposited Code
2
3
4
5
6
7
8
9
10

deduction of tax
Date : 30.08.2018 Full Name ...................................
Designation ..................................
FORM NO. 16
{ See Rule 31(1) (a) }
ALAPA5136E

Assesment year
Q-1
Q-2
Mar-17 Feb-18 2017-18
Q-3
Q-4
1.a)Gross
SalarySalary
(1) Rs
HRA Rs 27300
3. Balance (1-2) 418024
4. Deductions :
Section 80-C Amount
a) LIC 15468
c) PPF (GPF) 0
d) HBA Principal 0
e) Tution Fee 7200
f) LIC (Personal) 0
g) PF (KGID) 25200
h) PLI / NSC 5700
i) (NPS) 44870
j) Others 12000
h) Interest on NSC
i) NSC
15. Tax payable (12+13+14)
employee
Total Tax BSR
deposited Code
2
3
4
5
6
7
8
9
10

deduction of tax
Date : 30.08.2018 Full Name ...................................
Designation ..................................
FORM NO. 16
{ See Rule 31(1) (a) }
AHETV3936B

Assesment year
Q-1
Q-2
Mar-17 Feb-18 2017-18
Q-3
Q-4
1.a)Gross
SalarySalary
(1) Rs
HRA Rs 0
3. Balance (1-2) 482264
4. Deductions :
Section 80-C Amount
a) LIC 5616
c) PPF (GPF) 24000
e) Tution Fee 0
f) LIC (Personal) 0
g) PF (KGID) 24000
h) PLI / NSC 0
i) (NPS) 0
j) Others 0
h) Interest on NSC
i) NSC
15. Tax payable (12+13+14)
employee
Total Tax BSR
deposited Code
2
3
4
5
6
7
8
9
10

deduction of tax
Date : 30.08.2018 Full Name ...................................
Designation ..................................
FORM NO. 16
{ See Rule 31(1) (a) }
AJRPN4687S

Assesment year
Q-1
Q-2
Mar-17 Feb-18 2017-18
Q-3
Q-4
1.a)Gross
SalarySalary
(1) Rs
HRA Rs 29340
3. Balance (1-2) 471039
4. Deductions :
Section 80-C Amount
a) LIC 6696
c) PPF (GPF) 12000
d) HBA Principal 0
e) Tution Fee 49033
f) LIC (Personal) 0
g) PF (KGID) 20400
h) PLI / NSC 0
i) (NPS) 0
j) Others 0
h) Interest on NSC
i) NSC
15. Tax payable (12+13+14)
employee
Total Tax BSR
deposited Code
2
3
4
5
6
7
8
9
10

deduction of tax
Date : 30.08.2018 Full Name ...................................
Designation ..................................
FORM NO. 16
{ See Rule 31(1) (a) }
S.N.KANNAIAH SRIDEVI GANESHA SATAPATHI
BLOCK EDUCATION OFFICER ASSISTANT TEACHER
DJMPS2748B

Assesment year
Q-1
Q-2
Mar-18 Feb-19 2019-20
Q-3
Q-4
1.a)Gross
SalarySalary
(1) Rs
HRA Rs 27972
3. Balance (1-2) 385999
4. Deductions :
a) Standard Deductions Rs 40000
Section 80-C Amount
a) LIC 18240
c) PPF (GPF) 36770
d) HBA Principal 0
e) Tution Fee 0
f) LIC (Personal) 0
g) PF (KGID) 21300
h) PLI / NSC 0
i) (NPS) 0
j) Others 1169
h) Interest on NSC
i) NSC
15. Tax payable (12+13+14)
employee
Total Tax BSR
deposited Code
1 NILL
2
3
4
5
6
7
8
9
10
NILL
OFFICER (designation) do hereby certify that a sum of Rs. 0/- (Rupees in words: NILL) 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

deduction of tax
Date : 8/31/2019 Full Name ...................................
Designation ..................................
FORM NO. 16
{ See Rule 31(1) (a) }
CKBPM4760J

Assesment year
Q-1
Q-2
Mar-17 Feb-18 2017-18
Q-3
Q-4
1.a)Gross
SalarySalary
(1) Rs
HRA Rs 29480
3. Balance (1-2) 455712
4. Deductions :
Section 80-C Amount
a) LIC 73916
c) PPF (GPF) 24000
d) HBA Principal 0
e) Tution Fee 16800
f) LIC (Personal) 0
g) PF (KGID) 30000
h) PLI / NSC 0
i) (NPS) 0
j) Others 0
h) Interest on NSC
i) NSC
15. Tax payable (12+13+14)
employee
Total Tax BSR
deposited Code
2
3
4
5
6
7
8
9
10

deduction of tax
Date : 30.08.2018 Full Name ...................................
Designation ..................................
FORM NO. 16
{ See Rule 31(1) (a) }
ANJPJ2203J

Assesment year
Q-1
Q-2
Mar-17 Feb-18 2017-18
Q-3
Q-4
1.a)Gross
SalarySalary
(1) Rs
HRA Rs 29340
3. Balance (1-2) 452924
4. Deductions :
Section 80-C Amount
a) LIC 15120
c) PPF (GPF) 72000
d) HBA Principal 0
e) Tution Fee 37020
f) LIC (Personal) 0
g) PF (KGID) 24000
h) PLI / NSC 0
i) (NPS) 0
j) Others 0
h) Interest on NSC
i) NSC
15. Tax payable (12+13+14)
employee
Total Tax BSR
deposited Code
2
3
4
5
6
7
8
9
10

deduction of tax
Date : 30.08.2018 Full Name ...................................
Designation ..................................
FORM NO. 16
{ See Rule 31(1) (a) }
S.N.KANNAIAH
CKBPM4760J

Assesment year
Q-1
Q-2
Mar-17 Feb-18 2017-18
Q-3
Q-4
1.a)Gross
SalarySalary
(1) Rs
HRA Rs 29480
3. Balance (1-2) 455712
4. Deductions :
Section 80-C Amount
a) LIC 73916
c) PPF (GPF) 24000
d) HBA Principal 0
e) Tution Fee 16800
f) LIC (Personal) 0
g) PF (KGID) 30000
h) PLI / NSC 0
i) (NPS) 0
j) Others 0
h) Interest on NSC
i) NSC
15. Tax payable (12+13+14)
employee
Total Tax BSR
deposited Code
2
3
4
5
6
7
8
9
10
of the person
deduction of tax
Date : 30.08.2018 Full Name ...................................
Designation ..................................
73012
3651
0
109
3760
PTION UPTO 2500/-
1260
NT ACCOUNT
Date of tax
deposited
EB-2018 SALARY
f BLOCK EDUCATION
81300
4065
0
122
4187
PTION UPTO 2500/-
1687
1690/-
NT ACCOUNT
Date of tax
deposited
EB-2018 SALARY
f BLOCK EDUCATION
56698
2835
0
85
2920
PTION UPTO 2500/-
420
420
NT ACCOUNT
Date of tax
deposited
EB-2018 SALARY
BLOCK EDUCATION
ecords.
49096
2455
0
73
2528
PTION UPTO 2500/-
28
30
NT ACCOUNT
Date of tax
deposited
EB-2018 SALARY
f BLOCK EDUCATION
52546
2627
0
79
2706
PTION UPTO 2500/-
206
210
NT ACCOUNT
Date of tax
deposited
EB-2018 SALARY
f BLOCK EDUCATION
s.
73608
3680
0
110
3790
PTION UPTO 2500/-
1290
1290
NT ACCOUNT
Date of tax
deposited
EB-2018 SALARY
f BLOCK EDUCATION
housand Two Hundred
127870
6394
0
192
6586
PTION UPTO 2500/-
4086
4090
NT ACCOUNT
Date of tax
deposited
EB-2018 SALARY
f BLOCK EDUCATION
housand and Ninghty
certify that the
14320
716
0
29
745
PTION UPTO 2500/-
NILL
NILL
NT ACCOUNT
Date of tax
deposited
f BLOCK EDUCATION
s been deducted at
ven above is true and
55956
2798
0
84
2882
PTION UPTO 2500/-
382
385
NT ACCOUNT
Date of tax
deposited
EB-2018 SALARY
f BLOCK EDUCATION
certify that the
49744
2487
0
75
2562
PTION UPTO 2500/-
62
65
NT ACCOUNT
Date of tax
deposited
EB-2018 SALARY
f BLOCK EDUCATION
e Only) has been
55956
2798
0
84
2882
PTION UPTO 2500/-
382
385
NT ACCOUNT
Date of tax
deposited
EB-2018 SALARY
f BLOCK EDUCATION
FORM NO. 16
{ See Rule 31(1) (a) }
AVCPM9083A

Assesment year
Q-1
Q-2
Mar-17 Feb-18 2017-18
Q-3
Q-4
1.a)Gross
SalarySalary
(1) Rs
HRA Rs 29480
3. Balance (1-2) 452184
4. Deductions :
Section 80-C Amount
a) LIC 15712
c) PPF (GPF) 48000
d) HBA Principal 0
e) Tution Fee 0
f) LIC (Personal) 0
g) PF (KGID) 48000
h) PLI / NSC 12420
i) Others (NPS) 0
h) Interest on NSC
i) NSC
15. Tax payable (12+13+14)
employee
Total Tax BSR
deposited Code
2
3
4
5
6
7
8
9
10

deduction of tax
Date : 30.08.2018 Full Name ...................................
Designation ..................................
FORM NO. 16
{ See Rule 31(1) (a) }
AHAPN9644E

Assesment year
Q-1
Q-2
Mar-17 Feb-18 2017-18
Q-3
Q-4
1.a)Gross
SalarySalary
(1) Rs
HRA Rs 29480
3. Balance (1-2) 471968
4. Deductions :
Section 80-C Amount
a) LIC 44628
c) PPF (GPF) 36000
d) HBA Principal 0
e) Tution Fee 25000
f) LIC (Personal) 0
g) PF (KGID) 30000
h) PLI / NSC 0
i) Others (NPS) 0
h) Interest on NSC
i) NSC
15. Tax payable (12+13+14)
employee
Total Tax BSR
deposited Code
2
3
4
5
6
7
8
9
10

deduction of tax
Date : 30.08.2018 Full Name ...................................
Designation ..................................
FORM NO. 16
{ See Rule 31(1) (a) }
CBPPS1601H

Assesment year
Q-1
Q-2
Mar-17 Feb-18 2017-18
Q-3
Q-4
1.a)Gross
SalarySalary
(1) Rs
HRA Rs 27360
3. Balance (1-2) 418422
4. Deductions :
Section 80-C Amount
a) LIC 14124
c) PPF (GPF) 0
d) HBA Principal 0
e) Tution Fee 26000
f) LIC (Personal) 0
g) PF (KGID) 12000
h) PLI / NSC 0
h) Interest on NSC
i) NSC
15. Tax payable (12+13+14)
employee
Total Tax BSR
deposited Code
2
3
4
5
6
7
8
9
10

deduction of tax
Date : 30.08.2018 Full Name ...................................
Designation ..................................
FORM NO. 16
{ See Rule 31(1) (a) }
AYJPM5315P

Assesment year
Q-1
Q-2
Mar-17 Feb-18 2017-18
Q-3
Q-4
1.a)Gross
SalarySalary
(1) Rs
HRA Rs 28320
3. Balance (1-2) 432602
4. Deductions :
Section 80-C Amount
a) LIC 13728
c) PPF (GPF) 0
d) HBA Principal 0
e) Tution Fee 25000
g) PF (KGID) 24000
h) PLI / NSC 0
h) Interest on NSC
i) NSC
15. Tax payable (12+13+14)
employee
Total Tax BSR
deposited Code
2
3
4
5
6
7
8
9
10

deduction of tax
Date : 30.08.2018 Full Name ...................................
Designation ..................................
FORM NO. 16
{ See Rule 31(1) (a) }
ALAPA5136E

Assesment year
Q-1
Q-2
Mar-17 Feb-18 2017-18
Q-3
Q-4
1.a)Gross
SalarySalary
(1) Rs
HRA Rs 27300
3. Balance (1-2) 418024
4. Deductions :
Section 80-C Amount
a) LIC 15468
c) PPF (GPF) 0
d) HBA Principal 0
e) Tution Fee 7200
f) LIC (Personal) 0
g) PF (KGID) 25200
h) PLI / NSC 5700
i) (NPS) 44870
j) Others 12000
h) Interest on NSC
i) NSC
15. Tax payable (12+13+14)
employee
Total Tax BSR
deposited Code
2
3
4
5
6
7
8
9
10

deduction of tax
Date : 30.08.2018 Full Name ...................................
Designation ..................................
FORM NO. 16
{ See Rule 31(1) (a) }
AHETV3936B

Assesment year
Q-1
Q-2
Mar-17 Feb-18 2017-18
Q-3
Q-4
1.a)Gross
SalarySalary
(1) Rs
HRA Rs 0
3. Balance (1-2) 482264
4. Deductions :
Section 80-C Amount
a) LIC 5616
c) PPF (GPF) 24000
e) Tution Fee 0
f) LIC (Personal) 0
g) PF (KGID) 24000
h) PLI / NSC 0
i) (NPS) 0
j) Others 0
h) Interest on NSC
i) NSC
15. Tax payable (12+13+14)
employee
Total Tax BSR
deposited Code
2
3
4
5
6
7
8
9
10

deduction of tax
Date : 30.08.2018 Full Name ...................................
Designation ..................................
FORM NO. 16
{ See Rule 31(1) (a) }
AJRPN4687S

Assesment year
Q-1
Q-2
Mar-17 Feb-18 2017-18
Q-3
Q-4
1.a)Gross
SalarySalary
(1) Rs
HRA Rs 29340
3. Balance (1-2) 471039
4. Deductions :
Section 80-C Amount
a) LIC 6696
c) PPF (GPF) 12000
d) HBA Principal 0
e) Tution Fee 49033
f) LIC (Personal) 0
g) PF (KGID) 20400
h) PLI / NSC 0
i) (NPS) 0
j) Others 0
h) Interest on NSC
i) NSC
15. Tax payable (12+13+14)
employee
Total Tax BSR
deposited Code
2
3
4
5
6
7
8
9
10

deduction of tax
Date : 30.08.2018 Full Name ...................................
Designation ..................................
FORM NO. 16
{ See Rule 31(1) (a) }
S.N.KANNAIAH N R NAGARATHNAMMA
BLOCK EDUCATION OFFICER ASSISTANT TEACHER
ASEPN0446P

Assesment year
Q-1
Q-2
Mar-18 Feb-19 2019-20
Q-3
Q-4
1.a)Gross
SalarySalary
(1) Rs
HRA Rs 0
3. Balance (1-2) 575609
4. Deductions :
a) Standard Deductions Rs 40000
Section 80-C Amount
a) LIC 7728
c) PPF (GPF) 15600
e) Tution Fee 25000
f) LIC (Personal) 0
g) PF (KGID) 15600
h) PLI / NSC 0
i) (NPS) 0
j) Others 1783
h) Interest on NSC
i) NSC
15. Tax payable (12+13+14)
employee
Total Tax BSR
deposited Code
1 1280 DEDUCTED IN FEB-2019 SALARY
2
3
4
5
6
7
8
9
10
1280
OFFICER (designation) do hereby certify that a sum of Rs. 1280/- (Rupees in words: ONE THOUSAND TWO
HUNDRED AND EIGHTY 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 accounts, ocuments and other
available records.
deduction of tax
Date : 8/31/2019 Full Name ...................................
Designation ..................................
FORM NO. 16
{ See Rule 31(1) (a) }
CKBPM4760J

Assesment year
Q-1
Q-2
Mar-17 Feb-18 2017-18
Q-3
Q-4
1.a)Gross
SalarySalary
(1) Rs
HRA Rs 29480
3. Balance (1-2) 455712
4. Deductions :
Section 80-C Amount
a) LIC 73916
c) PPF (GPF) 24000
d) HBA Principal 0
e) Tution Fee 16800
f) LIC (Personal) 0
g) PF (KGID) 30000
h) PLI / NSC 0
i) (NPS) 0
j) Others 0
h) Interest on NSC
i) NSC
15. Tax payable (12+13+14)
employee
Total Tax BSR
deposited Code
2
3
4
5
6
7
8
9
10

deduction of tax
Date : 30.08.2018 Full Name ...................................
Designation ..................................
FORM NO. 16
{ See Rule 31(1) (a) }
ANJPJ2203J

Assesment year
Q-1
Q-2
Mar-17 Feb-18 2017-18
Q-3
Q-4
1.a)Gross
SalarySalary
(1) Rs
HRA Rs 29340
3. Balance (1-2) 452924
4. Deductions :
Section 80-C Amount
a) LIC 15120
c) PPF (GPF) 72000
d) HBA Principal 0
e) Tution Fee 37020
f) LIC (Personal) 0
g) PF (KGID) 24000
h) PLI / NSC 0
i) (NPS) 0
j) Others 0
h) Interest on NSC
i) NSC
15. Tax payable (12+13+14)
employee
Total Tax BSR
deposited Code
2
3
4
5
6
7
8
9
10

deduction of tax
Date : 30.08.2018 Full Name ...................................
Designation ..................................
FORM NO. 16
{ See Rule 31(1) (a) }
S.N.KANNAIAH
CKBPM4760J

Assesment year
Q-1
Q-2
Mar-17 Feb-18 2017-18
Q-3
Q-4
1.a)Gross
SalarySalary
(1) Rs
HRA Rs 29480
3. Balance (1-2) 455712
4. Deductions :
Section 80-C Amount
a) LIC 73916
c) PPF (GPF) 24000
d) HBA Principal 0
e) Tution Fee 16800
f) LIC (Personal) 0
g) PF (KGID) 30000
h) PLI / NSC 0
i) (NPS) 0
j) Others 0
h) Interest on NSC
i) NSC
15. Tax payable (12+13+14)
employee
Total Tax BSR
deposited Code
2
3
4
5
6
7
8
9
10
of the person
deduction of tax
Date : 30.08.2018 Full Name ...................................
Designation ..................................
73012
3651
0
109
3760
PTION UPTO 2500/-
1260
NT ACCOUNT
Date of tax
deposited
EB-2018 SALARY
f BLOCK EDUCATION
er available records.
81300
4065
0
122
4187
PTION UPTO 2500/-
1687
1690/-
NT ACCOUNT
Date of tax
deposited
EB-2018 SALARY
f BLOCK EDUCATION
56698
2835
0
85
2920
PTION UPTO 2500/-
420
420
NT ACCOUNT
Date of tax
deposited
EB-2018 SALARY
BLOCK EDUCATION
ecords.
49096
2455
0
73
2528
PTION UPTO 2500/-
28
30
NT ACCOUNT
Date of tax
deposited
EB-2018 SALARY
f BLOCK EDUCATION
52546
2627
0
79
2706
PTION UPTO 2500/-
206
210
NT ACCOUNT
Date of tax
deposited
EB-2018 SALARY
f BLOCK EDUCATION
s.
73608
3680
0
110
3790
PTION UPTO 2500/-
1290
1290
NT ACCOUNT
Date of tax
deposited
EB-2018 SALARY
f BLOCK EDUCATION
housand Two Hundred
127870
6394
0
192
6586
PTION UPTO 2500/-
4086
4090
NT ACCOUNT
Date of tax
deposited
EB-2018 SALARY
f BLOCK EDUCATION
housand and Ninghty
certify that the
72670
3634
0
146
3780
PTION UPTO 2500/-
1280
1280
NT ACCOUNT
Date of tax
deposited
D IN FEB-2019 SALARY
y of BLOCK EDUCATION
THOUSAND TWO
entral Government, I
ts, ocuments and other
55956
2798
0
84
2882
PTION UPTO 2500/-
382
385
NT ACCOUNT
Date of tax
deposited
EB-2018 SALARY
f BLOCK EDUCATION
certify that the
49744
2487
0
75
2562
PTION UPTO 2500/-
62
65
NT ACCOUNT
Date of tax
deposited
EB-2018 SALARY
f BLOCK EDUCATION
e Only) has been
55956
2798
0
84
2882
PTION UPTO 2500/-
382
385
NT ACCOUNT
Date of tax
deposited
EB-2018 SALARY
f BLOCK EDUCATION

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FORM NO.

Period Assesment year

Quarter Acknoledgement No From To

I BAILANJINAPPA. P. B.E.O. HOSAKOTE Working in the capacity of

(Rupees in words) ...................................................................................................................)

Signature of the person responsible

Date : Full Name ..............................................

Period Assesment year

Quarter Acknoledgement No From To

I S.N. KANNAIAH B.E.O. HOSAKOTE Working in the capacity of

(Rupees in words) ...................................NIL............................................................................)

Signature of the person

Period Assesment year

Quarter Acknoledgement No From To

I S.N. KANNAIAH B.E.O. HOSAKOTE Working in the capacity of

(Rupees in words) ...................................NIL............................................................................)

Signature of the person responsible

Date : 21.10.2017 Full Name ...................................

statements of IDS under Sub section (3) of

(Rupees in words) ...................................NIL............................................................................)

statements of IDS under Sub section (3) of

(Rupees in words) ...................................NIL............................................................................)

statements of IDS under Sub section (3) of

(Rupees in words) ...................................NIL............................................................................)

statements of IDS under Sub section (3) of

(Rupees in words) ...................................NIL............................................................................)

statements of IDS under Sub section (3) of

statements of IDS under Sub section (3) of

(Rupees in words) ...................................NIL............................................................................)

statements of IDS under Sub section (3) of

(Rupees in words) ...................................NIL............................................................................)

statements of IDS under Sub section

Signature of the person

statements of IDS under Sub section

Signature of the person

IDS under Sub section (3) of section 200 as

Signature of the person

IDS under Sub section (3) of section 200 as

Signature of the person

IDS under Sub section (3) of section 200 as

Signature of the person

IDS under Sub section (3) of section 200 as

Signature of the person

IDS under Sub section (3) of section 200 as

Signature of the person

IDS under Sub section (3) of section 200 as

Signature of the person

IDS under Sub section (3) of section 200 as

Signature of the person

IDS under Sub section (3) of section 200 as

Signature of the person

IDS under Sub section (3) of section 200 as

Signature of the person

IDS under Sub section (3) of section 200 as

Signature of the person

IDS under Sub section (3) of section 200 as

IDS under Sub section (3) of section 200 as

Signature of the person

IDS under Sub section (3) of section 200 as

Signature of the person

IDS under Sub section (3) of section 200 as

Signature of the person