Form 16a - Tax Information Network Of Income Tax Department Page 2

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Tax Information Network of Income Tax Department
Certificate No.: FFFVWV
TAN of the Deductor
DELA01216E PAN of the Deductee
AAACR4445R Assessment Year
2011-12 Quarter
Q3
Last Updated 17/01/2011
II. DETAILS OF TAX DEDUCTED AND DEPOSITED IN THE CENTRAL GOVERNMENT ACCOUNT THROUGH CHALLAN (The deductor to
provide payment wise details of tax deducted and deposited with respect to the deductee
Challan Identification number (CIN)
S. No.
Tax Deposited in
respect of the
deductee
BSR Code of the Bank
Date on which tax
Challan Serial
Status of Booking
(
)
Branch
deposited
Number
(dd/mm/yyyy)
5
648.00
6910333
07/01/2011
57909
MATCHED
Total (
)
2,527.00
Verification
I, Baidyanath Sahoo, son/daughter of Bholanath Sahoo working in the capacity of Assistant Manager (designation) do hereby certify that a sum of (
) 2,527.00 [Rupees Two Thousand Five Hundred Twenty Seven only] has been deducted and a sum of (
) 2,527.00 [Rupees Two Thousand Five
Hundred Twenty Seven only] has been 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.
Place
Mumbai
Date
20/06/2011
Signature of person responsible for deduction of tax
Notes:
1. Government deductors to fill information in item I if tax is paid without production of an Income-tax challan and in item II if tax is paid accompanied by an
income-tax challan.
2. Non-Government deductors to fill information in item II.
3. In item I and II, in the column for TDS, give total amount for TDS, Surcharge (if applicable) and education cess.
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.
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