1. 4%1{
TRACES
TDS Re.Dnciliation Analysis and CorrErtion Enjbiir]g systlln
FORM NO. 16
PART A
Certilicrte urder Section 201 ofthe Income{ax Act, l96l for tax deductcd at source on satary
Name and address ofthe f,mptoyer
Name and address olthe Emptoyee
l--,"ilil;**,-..^,,r-d2 }d Ftoor AI-t atee, Torcr.. OrtntarrD Road,,
Unron Street. Bargalore - 5OO00l
KamaEka
+(9 r )-994508 8778
syed@ebreez.com
PA ofthe Deductor TAN ofthe Deduclor PA ofrhe LmDtovce :nrpluJL( ilif(rtn((:o.
protided bl thc Emptoyer
(Ifavailable)
AADCEO]288
lrLRE06t29E DIITPS3845G
TDS
C. rj.al d lt,x.r,,rqCrrl
Certificrte No. AJCSDAJ
Quarter(s)
Qr
Q2
Q3
Q4
'totat (Rs.)
Totrt(Rs.)
_ The Commr.sroner ol Income lax I IDS)
Room No 59 H.M I Bhawan.4rh F.oor. Belldry Road.
Gangdnagar. Bangalore _ 560032
MOULANA AZAD SHAIK
DOOR NO 2 I /12- I A.'t A DtpATRt ROAD. J AM4AI A ,.iADUGL p,
JA ,l VALAMADUCL l,1ANDAL. frA DA pA - i,64J4 Andhra pradesh
From
0l-ApF20l5
To
31-Mar21l6
Summary ofamount paid/creclited and tax dcducted at source thereon in respect of thc emptoyee
Receipt Numbers of oriqinat
quart€rly stat€ments of TDs
u nder su b-sectio n (3) of
Section 200
Amount oftax deposited / rcmitted
(Rs.)
172r00
r. D[rArLs oF r^x DED. c.r FD nxo ,rros,so rNi,o civ nn,.iouu*rv-1..r oico, .#h, uoo* or, a., ,an,(1he deductor to provide payment wise details oftax deducied and de;ited wiih respect to the deductee)
t 766.40
788 00
5867.00
St:r!u. cfmaiclirg
with Form no. 24c
Tax Deposited in respcct ofthe
deductee
(Rs.) Re.:cipt Numbcrs 0i Fi,rm
No. 24G
DDO seriat rumber in l.orm no.
24C
D3!e cf t!"snsfer !oucher
(dd/mm/ylyy)
I
II. Df,TATLS OF TAX DEDUCTED AD D[POSITED IN THE
(The deductor to provide payment wjse detajls of
CtrNTRAL COVERNMENT ACCOUNT THROUGH CHALLAN
ISee rule 3l(i)(a)l
Last updaled on I8-May-2016
clT (1DS)
Amount of lax dedrcted
(Rs.)
Book ldcntiffcarion Numbcr (BtN)
l-
Tax Depositcd in respect ot rhe
Sl. No,
I deductce
(Rs.)
I s:o oo
.-l". .. .-... .. .... -. _-
" 53t00
.-l_-J 53too
4 i 555.00
_ pa),u'EUr wrsc oera s ot tax deducled and deposited with respect to the deduclee)
Cha,.r Identifi cation Nr,,*r,"*
.-. -... -- ..... -. _-
-
BSR Code of lhe Bank ]ru,o o, ,"n,"n
---;,;;'
**
i*"
''l;r[})|;l;'ositcd r
charran seriar Number I sr'trs orm,tching with
0510308 ai-as-2ots
,_ ,_. 58e6,r ] ,0510308
Gdffi 08,06,2015
F
rlb a7-41-2015 1)6hA
05 rolq f7 ,5lt4r5 14558 F
XtoRej/

2. 7
Ce'lifi cat. Nuobefl AJCSDAJ TAli olEmoloyerBLRE06l29E PAN ol f, ontor* DHTPS33,I5C
Verification
t'ull Nflmc:SUNNY KUMAR
A$.smetrl Y.rr: ,016- r ,
Designation: SENIOR ACCOUNT EXECUTM
Notes:
]. Pjn B (Anie*ure) ofthe ce.rificare in Fom No.t6 sha be issued by rhe etnploy€!.
l.laiarleisempl6edunaermoreihaoreempto.erou.rngrheyea.eachofrheemntqe.ssna
i,sLepanAoi|necen,fi(,rc,nromNo.irpedarnjrJrorhepenodto,klrchslch
4 ro upda,c PA dciais In rncome.rar Dep,nrnenr d"rab*...pprr r* paN
"i-e",e*.; ;; ;"..ii,$, , . rrrsL.
Legend used in Form 16
* Slatus ofmatching with OLTAS
Patn1dehlsoiTDSTCSd.posiled$bankbJ.c,.'-l..ffi
dn!m,,! o*'.h med,n rne s,a,(m., i i,nai(F) c,rrtr*iir beleire.,ed oniy si,cn iec,.;", ;.,;;; :;",;, ",",,r in dte !.re,henr o!manes new paromr for ectsmoLn, !tdmed 11re jdremenr
Sl. No.
Trx Deposited ir respect ofthe
deductee
(Rs.)
583.00
Chaltan Identiff cBtion h-umber (CIN)
BSR Code oflbe Bank
Branch
Dat€ on which Tax deposiled
(dd/nm/yyyy)
Cha llan Seria I r'u m b€r Slatus olmatching witfi
oLIAS*
0510308 07,09-2015 307r 8 F
6 583 00 0510108 06-10-2015 15420
06, -2015 t3415
07-12-2A15 28873
07,0 t-20t6 99286
F
F
7 583 00 0510308
8
9
582.00
601.00
05r0t08
05t0075
F
l0 263 00 0510308 05.02-2016 114t0 F
tl 263 00 0510108 03-03-2016 11447 F
t2 262 00 0510:t08 t9-01-2016 05885 F
Total (Rs.) 5867,00
Deducto6hsvenordcpositedtaxesorha!efum^hedircor"@
deiaik in bank malch with details ofdeposil in TDS /TCS slalcmenl
Plovisiona]lscreditiseffec,"oon,',o,,o,,,.,.'u
verificalion of palmenr details submined by pay a.d Accouts OtticcriPAOJ
Incaseofnon.govemmentdedUdou,paymmrdetaihofTos,rcsa"po,;,"@
::::::i1ll SI":,".:: s,arc,mr rled by rhe dcd*o*. rn.u." oigo"".-",, a.ou",..i i""lr,
"iius
rrcs tooked in cov€mmeiraccount have been lcdfiedby pay & Accounts Officer(pAO)
Paee2 of2

3. SHAIK MOULANA AZAD
Total
3. Balance (1-2)
4 DEduciions:
PAN - DHTPS 3845 G
FORM '16 - PART B (Annexure)
4.Y.2018-17
b) Value of perquisites u/s .17(2)(as
per Form No 128A,
wherever applicable)
c) Profits in lieu of salary under section 17(3) (as per Form No
128A, wherever applicable)
d) Total
Less: Allowance to the extent exempt u/s 1O
House Rent Allowance
lvledical Reimbursement
Conveyance Allowance
58,688
15,000
19,200
a) Entertainmentallowance
b) Tax on employment
Aggregate of4(a) and (b)
lncome chargeable under the head ,,Salaries,,
(3_5)
Add: Any other income reported by the employee
BANGALORE
18-May-2016
NIL
2,400
5.
6.
7.
Place
Date
3,91,079
3,9'r,079
8. Gross total income (6+7)
9. Deductions under chapter VIA
(A)Sections 80C, 8OCCC and SOCCD
a) Section 80C
pF contribution
Life insurance premium
PpF contribution
b) Section 8oCCC
c) Section 80CCD
Eligible Deduction
(B) Other sections (e.g., 8OE, BOG, SOTTA etc.) under Ch VIA
Gross
Amount
Gross Amount
20,605
13,518
30,000
NIL
NIL
Deductible
Amounl
Qualifying
Amount
Deductible
Amount
84,'t23
5,867
NIL
NIL
10. Aggregate of deductible amount under chapter Vl_A
1'l Total income (8-1O)
12. Tax on totai tncome
13. Education cess @ 3%
a tax payable
i5 Less: Reitef Jnoer sect,on gg(atiach oetailsl
ro Tax payable
17. Less: Tax deducted at source u/s i92(1)
I Tax paid on behatf of emptoyee u/s192 (1A)
Tax deducted by others
18. Balance tax payable
64,123
3,26,960
5,696
17'l
s,867
NIL
5,867
5,867
NIL
I SUNNY KUMAR, son of
Verlfication
!1?g::,:"f *^f^r"lyrertify thar.the information siven above t. tr*, iiipr"tl
working in the capacity of SR.ACCOU
account, documents, TDS statements, anO otner avaiaOte recoiOs.
)3
o'r/
9a-io-eej
Designatjon : SR.ACCOUNTSEXECUTTVE
and is