Form No.16 - Certificate Under Section 203 Of The Income-Tax Act, 1961 For Tax Deducted At Source On Salary Page 3

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(B)
Other sections (e.g. 80E, 80G, 80TTA, etc.) under Chapter VI-A.
Gross amount
Qualifying amount
Deductible amount
(i)
section………..
Rs.
Rs.
Rs.
(ii)
section………..
Rs.
Rs.
Rs.
(iii)
section………..
Rs.
Rs.
Rs.
(iv)
section………..
Rs.
Rs.
Rs.
(v)
section………..
Rs.
Rs.
Rs.
10
Aggregate of deductible amount under Chapter VI-A
Rs
11
Total Income (8-10)
Rs
12
Tax on total income
Rs
13
Education cess @ 3% (on tax computed at S. No. 12)
Rs.
14
Tax Payable (12+13)
Rs.
15
Less: Relief under section 89 (attach details)
Rs
16
Tax payable (14-15)
Rs.
Verification
I, …………………………….., son/daughter of ……………………………………….working in the capacity of .………………………......... (designation)
do hereby certify that the information given above is true, complete and correct and is based on the books of account, documents, TDS statements, and
other available records.
Place
Date
(Signature of person responsible for deduction of tax)
Designation:
Full Name: _______________________”;

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