Ahspy8053e 2014-15

FORM NO.
16
[See rule 31(1)(a)]
PART A
Certificate under Section 203 of the Income-tax Act, 1961 for tax deducted at source on salary
Certificate No. AKOGDPH
Last updated on
Name and address of the Employer
14-Jun-2014
Name and address of the Employee
AMBOSELI PROFESSIONAL ASSOCIATES PRIVATE LIMITED

135 & 136, RAHEJA ARCADE,
KORAMANGALA, BANGALORE - 560095
Karnataka
+(91)-25505348
sari@amboselihr.com
AJAY REDDY YERRI

4-801-A-1, MAHATMA NAGAR, YERRAGUNTLA, KADAPA 516309 Andhra Pradesh
PAN of the Deductor
TAN of the Deductor
AAECA2762J
BLRA11117B
PAN of the Employee
Employee Reference No.

provided by the Employer
(If available)
AHSPY8053E
CIT (TDS)
Assessment Year
The Commissioner of Income Tax (TDS)

Room No. 59, H.M.T. Bhawan, 4th Floor, Bellary Road ,
Ganganagar, Bangalore - 560032
2014-15
Period with the Employer

From
To
01-Apr-2013
31-Mar-2014
Summary of amount paid/credited and tax deducted at source thereon in respect of the employee
Quarter(s)
Receipt Numbers of original

quarterly statements of TDS
under sub-section (3) of
Section 200
Q1
XQEXXEQE
32448.00
468.00
468.00
Q2
EIKXCSCE
122346.00
3055.00
3055.00
Q3
QARCKGDF
122346.00
3055.00
3055.00
Q4
QQQGGIDB
122346.00
7523.00
7523.00
399486.00
14101.00
14101.00
Total (Rs.)
Amount of tax deposited / remitted

(Rs.)
Amount of tax deducted

(Rs.)
Amount paid/credited
I. DETAILS OF TAX DEDUCTED AND DEPOSITED IN THE CENTRAL GOVERNMENT ACCOUNT THROUGH BOOK ADJUSTMENT
(The deductor to provide payment wise details of tax deducted and deposited with respect to the deductee)
Book Identification Number (BIN)
Sl. No.
Tax Deposited in respect of the

deductee
(Rs.)
Receipt Numbers of Form

No. 24G
DDO serial number in Form no.

24G
Date of transfer voucher Status of matching

(dd/mm/yyyy)
with Form no. 24G
Total (Rs.)
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)
Sl. No.

deductee
(Rs.)
Challan Identification Number (CIN)

BSR Code of the Bank
Branch
Date on which Tax deposited Challan Serial Number

(dd/mm/yyyy)
Status of matching with

OLTAS*
468.00
0510050
05-07-2013
05034
1018.00
0510050
02-08-2013
02009
1019.00
0510050
03-09-2013
03005
1018.00
0510050
01-10-2013
01003
Page 1 of 2
Certificate Number: AKOGDPH
Sl. No.
TAN of Employer: BLRA11117B

deductee
(Rs.)
PAN of Employee: AHSPY8053E
Assessment Year: 2014-15
Challan Identification Number (CIN)

BSR Code of the Bank
Branch
Date on which Tax deposited Challan Serial Number

(dd/mm/yyyy)
Status of matching with

OLTAS*
1018.00
0510050
05-11-2013
05048
1018.00
0510050
03-12-2013
03017
1019.00
0510050
03-01-2014
03008
2508.00
0510050
04-02-2014
04007
2508.00
0510050
04-03-2014
04014
10
2507.00
0510050
28-03-2014
28010
Total (Rs.)
14101.00
Verification
I, SARITHA UDAY KODIMANIYANDA, son / daughter of CHINNAPPA THAMMAIAH MULLENGADA working in the capacity of DIRECTOR (designation) do hereby
certify that a sum of Rs. 14101.00 [Rs. Fourteen Thousand One Hundred and One Only (in words)] has been deducted and a sum of Rs. 14101.00 [Rs. Fourteen
Thousand One Hundred and One 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
BANGALORE
Date
02-Jul-2014
Designation: DIRECTOR
(Signature of person responsible for deduction of Tax)

Full Name:SARITHA UDAY KODIMANIYANDA
Notes:
1. Part B (Annexure) of the certificate in Form No.16 shall be issued by the employer.
2. If an assessee is employed under one employer during the year, Part 'A' of the certificate in Form No.16 issued for the quarter ending on 31st March of the financial year shall contain the details
of tax deducted and deposited for all the quarters of the financial year.
3. If an assessee is employed under more than one employer during the year, each of the employers shall issue Part A of the certificate in Form No.16 pertaining to the period for which such
assessee was employed with each of the employers. Part B (Annexure) of the certificate in Form No. 16 may be issued by each of the employers or the last employer at the option of the assessee.
4. To update PAN details in Income Tax Department database, apply for 'PAN change request' through NSDL or UTITSL.
Legend used in Form 16

* Status of matching with OLTAS
Legend
Description
Definition
Unmatched
Deductors have not deposited taxes or have furnished incorrect particulars of tax payment. Final credit will be reflected only when payment
details in bank match with details of deposit in TDS / TCS statement
Provisional
Provisional tax credit is effected only for TDS / TCS Statements filed by Government deductors."P" status will be changed to Final (F) on
verification of payment details submitted by Pay and Accounts Officer (PAO)
Final
In case of non-government deductors, payment details of TDS / TCS deposited in bank by deductor have matched with the payment details
mentioned in the TDS / TCS statement filed by the deductors. In case of government deductors, details of TDS / TCS booked in Government
account have been verified by Pay & Accounts Officer (PAO)
Overbooked
Payment details of TDS / TCS deposited in bank by deductor have matched with details mentioned in the TDS / TCS statement but the
amount is over claimed in the statement. Final (F) credit will be reflected only when deductor reduces claimed amount in the statement or
makes new payment for excess amount claimed in the statement
Signature Not Verified

Digitally signed by
SARITHA UDAY
Date: 2014.07.02 17:08:58
IST
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FORM NO.

Name and address of the Employer

Name and address of the Employee

AMBOSELI PROFESSIONAL ASSOCIATES PRIVATE LIMITED

AJAY REDDY YERRI

PAN of the Deductor

TAN of the Deductor

PAN of the Employee

Employee Reference No.

The Commissioner of Income Tax (TDS)

Period with the Employer

Receipt Numbers of original

Amount of tax deposited / remitted

Amount of tax deducted

Tax Deposited in respect of the

Receipt Numbers of Form

DDO serial number in Form no.

Date of transfer voucher Status of matching

Tax Deposited in respect of the

Challan Identification Number (CIN)

Date on which Tax deposited Challan Serial Number

Status of matching with

Certificate Number: AKOGDPH

TAN of Employer: BLRA11117B

Tax Deposited in respect of the

PAN of Employee: AHSPY8053E

Assessment Year: 2014-15

Challan Identification Number (CIN)

Date on which Tax deposited Challan Serial Number

Status of matching with

(Signature of person responsible for deduction of Tax)

Legend used in Form 16

Signature Not Verified

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