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. UHMIYKA Last updated on 25-Jun-2020

Name and address of the Employer Name and address of the Employee
MICRON TECHNOLOGY OPERATIONS INDIA LIMITED LIABILITY
PARTNERSHIP
Unit 402,4th Floor, THE MILLENIA, TOWER B, No.1 & 2,MURPHY RAJASHEKAR KYAROLLA
ROAD, H NO 5-3 WARD NO 10, NANDIPET, ARMOOR, NIZAMABAD -
HALASUR U, BANGALORE - 560200 503212 Andhra Pradesh
Karnataka
+(91)80-7411571475
rgoureddy@micron.com
Employee Reference No.
PAN of the Employee
PAN of the Deductor TAN of the Deductor provided by the Employer
(If available)

ABJFM2468E BLRM30380A CZSPK1890F

CIT (TDS) Assessment Year Period with the Employer

From To
The Commissioner of Income Tax (TDS)
Room No. 59, H.M.T. Bhawan, 4th Floor, Bellary Road , 2020-21 01-Apr-2019 31-Mar-2020
Ganganagar, Bangalore - 560032

Summary of amount paid/credited and tax deducted at source thereon in respect of the employee

Receipt Numbers of original

Amount of tax deposited / remitted
quarterly statements of TDS Amount of tax deducted
Quarter(s) Amount paid/credited (Rs.)
under sub-section (3) of (Rs.)
Section 200

Q1 QTRTBZIA 365305.00 17532.00 17532.00

Q2 QTTEEPNG 674595.00 37550.00 37550.00
Q3 QTWNWHBC 456521.00 83133.00 83133.00
Q4 QTZKFMEA 525659.00 160956.00 160956.00
Total (Rs.) 2022080.00 299171.00 299171.00
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)

Tax Deposited in respect of the
Sl. No. deductee Date of transfer voucher Status of matching
Receipt Numbers of Form DDO serial number in Form no.
(Rs.) (dd/mm/yyyy) with Form no. 24G
No. 24G 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)

Challan Identification Number (CIN)

Tax Deposited in respect of the
Sl. No. deductee
(Rs.) BSR Code of the Bank Date on which Tax deposited Challan Serial Number Status of matching with
Branch (dd/mm/yyyy) OLTAS*

1 0.00 - 07-05-2019 - F
2 8766.00 6390340 06-06-2019 30240 F
3 8766.00 6390340 04-07-2019 13661 F
4 8827.00 6390340 05-08-2019 16695 F
Signature Not Verified
Signed By:MISHRA KUMAR
RAGENDRA Page 1 of 2
Signing Date:14.07.2020 18:15
 Certificate Number: UHMIYKA TAN of Employer: BLRM30380A PAN of Employee: CZSPK1890F Assessment Year: 2020-21

Challan Identification Number (CIN)

Tax Deposited in respect of the
Sl. No. deductee
(Rs.) BSR Code of the Bank Date on which Tax deposited Challan Serial Number Status of matching with
Branch (dd/mm/yyyy) OLTAS*

5 8827.00 6390340 06-09-2019 42831 F

6 19896.00 6390340 05-10-2019 20581 F
7 20267.00 6390340 06-11-2019 12997 F
8 37373.00 6390340 04-12-2019 06817 F
9 25493.00 6390340 04-01-2020 09035 F
10 43795.00 6390340 05-02-2020 14550 F
11 63261.00 6390340 05-03-2020 26163 F
12 53900.00 6390340 22-04-2020 01358 F
Total (Rs.) 299171.00

Verification

I, KUMAR RAGENDRA MISHRA, son / daughter of DEO SHYAM MISHRA working in the capacity of AUTHORISED SIGNATORY (designation) do hereby certify that a
sum of Rs. 299171.00 [Rs. Two Lakh Ninety Nine Thousand One Hundred and Seventy One Only (in words)] has been deducted and a sum of Rs. 299171.00 [Rs. Two
Lakh Ninety Nine Thousand One Hundred and Seventy 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 06-Jul-2020 (Signature of person responsible for deduction of Tax)

Designation: AUTHORISED SIGNATORY Full Name:KUMAR RAGENDRA MISHRA

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
Deductors have not deposited taxes or have furnished incorrect particulars of tax payment. Final credit will be reflected only when payment
U Unmatched
details in bank match with details of deposit in TDS / TCS statement
Provisional tax credit is effected only for TDS / TCS Statements filed by Government deductors."P" status will be changed to Final (F) on
P Provisional
verification of payment details submitted by Pay and Accounts Officer (PAO)
In case of non-government deductors, payment details of TDS / TCS deposited in bank by deductor have matched with the payment details
F Final 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)
Payment details of TDS / TCS deposited in bank by deductor have matched with details mentioned in the TDS / TCS statement but the
O Overbooked 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

Signed By:MISHRA KUMAR
RAGENDRA Page 2 of 2
Signing Date:14.07.2020 18:15
 FORM NO. 16
PART B
Certificate under Section 203 of the Income-tax Act, 1961 for tax deducted at source on salary

Certificate No. UHMIYKA Last updated on 25-Jun-2020

Name and address of the Employer Name and address of the Employee
MICRON TECHNOLOGY OPERATIONS INDIA LIMITED LIABILITY
PARTNERSHIP
Unit 402,4th Floor, THE MILLENIA, TOWER B, No.1 & 2,MURPHY RAJASHEKAR KYAROLLA
ROAD, H NO 5-3 WARD NO 10, NANDIPET, ARMOOR, NIZAMABAD -
HALASUR U, BANGALORE - 560200 503212 Andhra Pradesh
Karnataka
+(91)80-7411571475
rgoureddy@micron.com
PAN of the Deductor TAN of the Deductor PAN of the Employee

ABJFM2468E BLRM30380A CZSPK1890F

CIT (TDS) Assessment Year Period with the Employer

From To
The Commissioner of Income Tax (TDS)
Room No. 59, H.M.T. Bhawan, 4th Floor, Bellary Road , 2020-21 08-Apr-2019 31-Mar-2020
Ganganagar, Bangalore - 560032

Details of Salary Paid and any other income and tax deducted Rs. Rs.

1. Gross Salary

(a) Salary as per provisions contained in section 17(1) 2022079.00

Value of perquisites under section 17(2) (as per Form No. 12BA,
(b) 0.00
wherever applicable)
Profits in lieu of salary under section 17(3) (as per Form No.
(c) 0.00
12BA, wherever applicable)
(d) Total 2022079.00

(e) Reported total amount of salary received from other employer(s) 0.00

2. Less: Allowances to the extent exempt under section 10

(a) Travel concession or assistance under section 10(5) 0.00

(b) Death-cum-retirement gratuity under section 10(10) 0.00

(c) Commuted value of pension under section 10(10A) 0.00

Cash equivalent of leave salary encashment under section 10

(d) 0.00
(10AA)

(e) House rent allowance under section 10(13A) 293191.00

Page 1 of 4
Signature Not Verified
Signed By:MISHRA KUMAR
RAGENDRA

Signing Date:14.07.2020 18:15

Certificate Number: UHMIYKA TAN of Employer: BLRM30380A PAN of Employee: CZSPK1890F Assessment Year: 2020-21

Amount of any other exemption under section 10

(f) [Note: Break-up to be filled and signed by employer in the table
provide at the bottom of this form]

(g) Total amount of any other exemption under section 10 0.00

Total amount of exemption claimed under section 10

(h) 293191.00
[2(a)+2(b)+2(c)+2(d)+2(e)+2(g)]

Total amount of salary received from current employer

3. 1728888.00
[1(d)-2(h)]
4. Less: Deductions under section 16
(a) Standard deduction under section 16(ia) 50000.00

(b) Entertainment allowance under section 16(ii) 0.00

(c) Tax on employment under section 16(iii) 2400.00

5. Total amount of deductions under section 16 [4(a)+4(b)+4(c)] 52400.00

6. Income chargeable under the head "Salaries" [(3+1(e)-5] 1676488.00

7. Add: Any other income reported by the employee under as per section 192 (2B)

Income (or admissible loss) from house property reported by

(a) 0.00
employee offered for TDS

(b) Income under the head Other Sources offered for TDS 0.00

Total amount of other income reported by the employee

8. 0.00
[7(a)+7(b)]
9. Gross total income (6+8) 1676488.00

10. Deductions under Chapter VI-A Gross Amount Deductible Amount

Deduction in respect of life insurance premia, contributions to

(a) 92613.00 92613.00
provident fund etc. under section 80C

Deduction in respect of contribution to certain pension funds

(b) under section 80CCC 0.00 0.00

Deduction in respect of contribution by taxpayer to pension

(c) scheme under section 80CCD (1) 0.00 0.00

(d) Total deduction under section 80C, 80CCC and 80CCD(1) 92613.00 92613.00

Deductions in respect of amount paid/deposited to notified

pension scheme under section 80CCD (1B)
(e) 0.00 0.00

Page 2 of 4
Signature Not Verified
Signed By:MISHRA KUMAR
RAGENDRA

Signing Date:14.07.2020 18:15

 Certificate Number: UHMIYKA TAN of Employer: BLRM30380A PAN of Employee: CZSPK1890F Assessment Year: 2020-21

Deduction in respect of contribution by Employer to pension

(f) scheme under section 80CCD (2) 0.00 0.00

Deduction in respect of health insurance premia under section

(g) 0.00 0.00
80D

Deduction in respect of interest on loan taken for higher

(h) education under section 80E 0.00 0.00

Gross Qualifying Deductible

Amount Amount Amount
Total Deduction in respect of donations to certain funds,
(i) 0.00 0.00 0.00
charitable institutions, etc. under section 80G
Deduction in respect of interest on deposits in savings account
(j) 0.00 0.00 0.00
under section 80TTA

Amount Deductible under any other provision (s) of Chapter VI-A

(k) [Note: Break-up to be filled and signed by employer in the table
provide at the bottom of this form]

Total of amount deductible under any other provision(s) of

(l) 0.00 0.00 0.00
Chapter VI-A

Aggregate of deductible amount under Chapter VI-A

11. 92613.00
[10(d)+10(e)+10(f)+10(g)+10(h)+10(i)+10(j)+10(l)]

12. Total taxable income (9-11) 1583875.00

13. Tax on total income 287664.00

14. Rebate under section 87A, if applicable 0.00

15. Surcharge, wherever applicable 0.00

16. Health and education cess 11507.00

17. Tax payable (13+15+16-14) 299171.00

18. Less: Relief under section 89 (attach details) 0.00

19. Net tax payable (17-18) 299171.00

Verification
I, KUMAR RAGENDRA MISHRA, son/daughter of DEO SHYAM MISHRA .Working in the capacity of AUTHORISED
SIGNATORY (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 BANGALORE (Signature of person responsible for deduction of tax)

Full
Date 06-Jul-2020 KUMAR RAGENDRA MISHRA
Name:

Page 3 of 4
Signature Not Verified
Signed By:MISHRA KUMAR
RAGENDRA

Signing Date:14.07.2020 18:15

 Certificate Number: UHMIYKA TAN of Employer: BLRM30380A PAN of Employee: CZSPK1890F Assessment Year: 2020-21

2. (f) Break up for ‘Amount of any other exemption under section 10’ to be filled in the table below
Particular's of Amount for any other
Sl. exemption under section 10 Gross Amount Qualifying Amount Deductible Amount
No.
Rs. Rs. Rs. Rs.
1.
2..
3.
4.
5.
6.

10(k). Break up for ‘Amount deductible under any other provision(s) of Chapter VIA ‘to be filled in the table below
Particular's of Amount deductible under
Sl. any other provision(s) of Chapter VIA Gross Amount Qualifying Amount Deductible Amount
No.
Rs. Rs. Rs. Rs.
1.
2.
3.
4.
5.
6.

BANGALORE (Signature of person responsible for deduction of

Place
tax)
Full
Date 06-Jul-2020 KUMAR RAGENDRA MISHRA
Name:

Page 4 of 4
Signature Not Verified
Signed By:MISHRA KUMAR
RAGENDRA

Signing Date:14.07.2020 18:15

Certificate No. UHMIYKA EMPID:1227400

Form No.12BA
{See Rule 26A(2)(b)}
Statement showing particulars of perquisites,other fringe benefits or amenities and profits in lieu of salary with value thereof

1. Name and address of the employer: Micron Technology Operations India LLP
The Sky View 20, Sy. No. 83/1
Plot No. 22, 23, 24, 7 Level, Raidurgam
Madhapur, Hyderabad, Telangana-500081
TELANGANA
INDIA
2. TAN BLRM30380A
3. TDS Assessment Range of the employer:
4. Name,designation and PAN of the employee: RAJASHEKAR KYAROLLA
ENGINEER, SCRIBE DESIGN
CZSPK1890F
5. Is the employee a director or a person with No
substantial interest in the company (where the
employer is a company):
6. Income under the head 'Salaries' of the employee 1,676,488.00
(other than from perquisites):
7. Financial Year: 2019-2020
8. Valuation of Perquisites:

SL. Nature of perquisites(see rule 3) Value of perquisite Amount,if any Amount of

No. as per rules (Rs.) recovered from perquisite
employee (Rs.) chargeable to tax
Col(3)-Col(4) (Rs.)
(1) (2) (3) (4) (5)
1 Accommodation 0.00 0.00 0.00
2 Cars/Other automotive 0.00 0.00 0.00
3 Sweeper, gardener, watchman or personal Attendant 0.00 0.00 0.00
4 Gas, electricity, water 0.00 0.00 0.00
5 Interest free or concessional loans 0.00 0.00 0.00
6 Holiday Expenses 0.00 0.00 0.00
7 Free or Concessional Travel 0.00 0.00 0.00
8 Free Meals 0.00 0.00 0.00
9 Free Education 0.00 0.00 0.00
10 Gifts, vouchers, etc. 0.00 0.00 0.00
11 Credit card expenses 0.00 0.00 0.00
12 Club expenses 0.00 0.00 0.00
13 Use of movable assets by employees 0.00 0.00 0.00
14 Transfer of assets to Employees 0.00 0.00 0.00
15 Value of any other benefit/amenity/service/privilege 0.00 0.00 0.00
16 Stock options (non-qualified options) 0.00 0.00 0.00
17 Other benefits or amenities 0.00 0.00 0.00
18 Total value of perquisites 0.00 0.00 0.00
19 Total value of Profits in lieu of salary as per section 17(3) 0.00 0.00 0.00

9. Details of Tax.
a)Tax deducted from salary of the employee u/s 192(1) 299,171.00
b)Tax paid by employer on behalf of the employee u/s 192(1A) 0.00
c)Total Tax Paid 299,171.00
d)Date of payment into Government treasury Various dates as mentioned on Part A of the Form 16

DECLARATION BY THE EMPLOYER

I, KUMAR RAGENDRA MISHRA, S/O DEO SHYAM MISHRA working as AUTHORISED SIGNATORY do hereby
declare on behalf of Micron Technology Operations India LLP that the information given above is based on the books of
account,documents and other relevant records or information available with us and the details of value of each such perquisite
are in accordance with section 17 and rules framed thereunder and that such information is true and correct.

Place BANGALORE

Date 06-Jul-2020 (Signature of person responsible for deduction of tax)

Designation : AUTHORISED SIGNATORY Full Name : KUMAR RAGENDRA MISHRA

Signature Not Verified

Signed By:MISHRA KUMAR
RAGENDRA

Signing Date:14.07.2020 18:15 Page 1 of 1(Form 12BA)

 FORM NO. 12BB
(See rule 26C)
Statement showing particulars of claims by an employee for deduction of tax under section 192

1. Name and address of the employee : RAJASHEKAR KYAROLLA

2. Permanent Account Number of the employee : CZSPK1890F
3. Financial year : 2019-2020

Details of claims and evidence thereof

Sl. No. Nature of claim Amount(Rs.) Evidence / particulars
(1) (2) (3) (4)
House Rent Allowance:
(i) Rent paid to the landlord : Rs.370650
(ii) Name of the landlord
MANGALARAM SUMAN
1. (iii) Address of the landlord Rs.370650 House Rent Receipts
H N0-1-23/11 VILL Nandipet MDL NANDIPET DIST NIZAMABAD
TELANGANA 503212
(iv) Permanent Account Number of the landlord
DDJPM3016H

2. Leave travel concessions or assistance Rs.0 Travel Receipts/Tickets

Deduction of interest on borrowing:

(i) Interest payable/paid to the lender

Self Occupied Interest :

Let-OutInterest :
(ii) Name of the lender
Self Occupied :
Let-Out :
(iii) Address of the lender Provisional Certificate from
3. Rs.0.0 Bank/Financial
Self Occupied : Institution/Lender
Let-Out :
(iv) Permanent Account Number of the lender
Self Occupied :
Let-Out :

(a) Financial Institutions

(b) Employer
(c) Others

Signature Not Verified

Signed By:MISHRA KUMAR
RAGENDRA

Signing Date:14.07.2020 18:15 Page 1(Form 12BB)

 Deduction under Chapter VI-A

(A) Section 80C,80CCC and 80CCD

(i) Section 80C

Provident Fund 92613

Rs. 92613.0 Photocopy of the investment
4.
(ii) Section 80CCC : proofs
(iii) Section 80CCD :

(B) Other sections (e.g. 80E, 80G, 80TTA, etc.) under Chapter VI-A.

Verification
I, RAJASHEKAR KYAROLLA son/daughter of . do hereby certify that the information given above is complete and correct.
Place : Hyderabad

Date: 06-Jul-2020

(Signature of the employee)

Designation : ENGINEER, SCRIBE DESIGN Full Name: RAJASHEKAR KYAROLLA

Note: The information/details above, as required for deduction of tax u/s 192 of the Income Tax Act, has been entered by the employee through an authorized
login on the portal.

Signature Not Verified

Signed By:MISHRA KUMAR
RAGENDRA

Signing Date:14.07.2020 18:15 Page 2(Form 12BB)

 Annexure to Form No.16 Part B

Details of Salary Paid and Allowance Exempted u/s 10, Chapter VI-A and 17(2) Income-tax Act, 1961

Company Name : Micron Technology Operations India LLP TAN : BLRM30380A PAN : ABJFM2468E

Fin Year : 2019-2020 Asst. Year : 2020-2021

Name : RAJASHEKAR KYAROLLA Employee ID : 1227400 PAN : CZSPK1890F

Particulars Amount (INR)

Basic 771,783.00
House Rent Allowance 308,712.00
Salary u/s 17(1)
Special Allowance 463,067.00
Medical Allowance 14,708.00
Leave Travel Allowance 40,207.00
Referral Bonus 60,000.00
Irr Award Points 13,653.00
Irr Tax Assistance 6,725.00
Leave Encashment 36,406.00
Relocation Assistance Pay 261,000.00
Incentive Pay Plan 45,818.00
Perquisites u/s 17(2), as 0.00
per Form No. 12BA
Gross Salary 2,022,079.00

Income from Other

Sources
Total Income from Other Sources 0.00

If the House Property is Let Out, then furnish the following details:

i Gross rent received/ receivable/ letable value during the year 0.00
ii Tax paid to local authorities 0.00
iii Annual Value (i – ii) 0.00
iv 30% of Annual Value 0.00
v Interest payable on borrowed capital 0.00
vi Previous Year Carried Forward Loss claimed against Income from Let Out Property (to 0.00
be applicable & adjusted only in case of Income from Let Out Property)
Gross Amount Qualifying Deductible
Amount Amount
Exemptions u/s 10 [details
of 2 (a) to 2(f) of Part B]
House Rent Allowance 293,191.00 293,191.00 293,191.00
Total of Exemptions u/s 10 293,191.00 293,191.00 293,191.00

Deduction u/s VI-A Sec 80C, Sec 80CCC, Sec 80CCD(1)

[details of 10 (a),(b),(c) of
Part B]
Provident Fund 92,613.00 92,613.00 92,613.00
Deduction u/s VI-A Other Sections (e.g. 80E, 80G, 80TTA, etc.) under
[details of 10 (e) to (j), (k) Chapter VI-A
of Part B]
Total of Deductible Amount under Chapter VI-A 92,613.00 92,613.00 92,613.00

Aggregate of Deductible Amount under Chapter VI-A 92,613.00

DECLARATION BY EMPLOYER
I, KUMAR RAGENDRA MISHRA, S/O DEO SHYAM MISHRA working in the capacity of AUTHORISED SIGNATORY 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 : BANGALORE
Date : 06-Jul-2020 (Signature of Person Responsible for Deduction of Tax)
Designation : AUTHORISED SIGNATORY Full Name :KUMAR RAGENDRA MISHRA

Signature Not Verified

Signed By:MISHRA KUMAR
RAGENDRA

Signing Date:14.07.2020 18:15 Page 1 of 1 (Annexure to Form No. 16)