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Accenture Services Private Limited Form 16

Assessment Year 2013-14 Employee Name Employee PAN Employee Code Employee Designation Period With The Employer Abir Roy AFDPA9480N 10288243 Level B From : 01-Apr-2012 To : 31-Jan-2013

(Digitally Signed Document)

Note on Digital Signature: This Form-16 document has been digitally signed with a Digital Signature Certicate as allowed under section 119 of the Income-Tax Act, 1961. Refer Circular No.2/2007, Dated 21-May-2007 for details. Axing of Digital Signature means that a secure cryptographic procedure has been applied to the entire contents of this document and a unique digital signature (equivalent to axing of hand written signature) has been embedded in this document.To view and validate the digital signature details, please click on the digital signature axed below.

Signature Details: Digitally Signed by : Bulusu S Murthy


Digitally signed by B S MURTHY Date: 2013.05.25 00:41:19 IST Reason: Security Reason Location: Mumbai

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. FQXJDTG Name and address of the Employer Accenture Services Private Limited Plant 3, Godrej & Boyce Complex, LBS Marg, Vikhroli (West), Mumbai - 400079 Maharashtra +(91)80-41062522 bulusu.murthy@accenture.com Last updated on Name and address of the Employee 18-May-2013

ABIR ROY 6, MOONLIGHT BLEG, DAULAT NAGAR RD NO.4, BORIVALI EAST, MUMBAI - 400066 Maharashtra

PAN of the Deductor

TAN of the Deductor

PAN of the Employee

Employee Reference No. provided by the Employer (If available)

AACCA8997K CIT (TDS) The Commissioner of Income Tax (TDS) Room No. 900A, 9th Floor, K.G. Mittal Ayurvedic Hospital Building, Charni Road , Mumbai - 400002

MUMA14563D Assessment Year

AFDPA9480N Period with the Employer From 2013-14 01-Apr-2012 To 31-Mar-2013

Summary of amount paid/credited and tax deducted at source thereon in respect of the employee Receipt Numbers of original quarterly statements of TDS under sub-section (3) of Section 200 CUTXXORG CUTXHTHG CUSXBSDB Amount of tax deposited / remitted (Rs.)

Quarter(s)

Amount paid/credited

Amount of tax deducted (Rs.)

Q1 Q2 Q3 Total (Rs.)

322305.00 470633.00 446474.00 1239412.00

51288.00 99390.00 71799.00 222477.00

51288.00 99390.00 71799.00 222477.00

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) 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) Challan Identification Number (CIN) BSR Code of the Bank Branch 6360218 6360218 6360218 6360218 6360218 Date on which Tax deposited Challan Serial Number (dd/mm/yyyy) 05-05-2012 07-06-2012 06-07-2012 04-08-2012 06-09-2012 31845 47967 36515 32646 34453 Status of matching with OLTAS* F F F F F

Sl. No.

Tax Deposited in respect of the deductee (Rs.) 18156.00 16430.00 16702.00 17004.00 17696.00

1 2 3 4 5

Page 1 of 2

Certificate Number: FQXJDTG

TAN of Employer: MUMA14563D

PAN of Employee: AFDPA9480N

Assessment Year: 2013-14

Sl. No.

Tax Deposited in respect of the deductee (Rs.) 64690.00 53918.00 8106.00 9775.00 222477.00

Challan Identification Number (CIN) BSR Code of the Bank Branch 6910333 6910333 6910333 6910333 Date on which Tax deposited Challan Serial Number (dd/mm/yyyy) 05-10-2012 07-11-2012 06-12-2012 05-01-2013 50208 50692 57410 52085 Status of matching with OLTAS* F F F F

6 7 8 9 Total (Rs.)

Verification
I, SAMBA MURTHY RAOBU BULUSU, son / daughter of RAOBU working in the capacity of MANAGER (designation) do hereby certify that a sum of Rs. 222477.00 [Rs. Two Lakh Twenty Two Thousand Four Hundred and Seventy Seven Only (in words)] has been deducted and a sum of Rs. 222477.00 [Rs. Two Lakh Twenty Two Thousand Four Hundred and Seventy 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 Date Designation: MANAGER Notes:

MUMBAI 24-May-2013 (Signature of person responsible for deduction of Tax) Full Name: SAMBA MURTHY RAOBU BULUSU

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 U P Description Unmatched Provisional Definition 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 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) 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) 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

Final

Overbooked

Page 2 of 2

PART B DETAILS OF SALARY PAID AND ANY OTHER INCOME AND TAX DEDUCTED

Particulars
1.GROSS SALARY (As per enclosed annexure) (a) Salary as per provisions contained in section 17(1) (b) Value of perquisites under section 17(2) (as per Form No.12BA, wherever applicable) (c) Prots in lieu of salary under section 17(3) (as per Form No.12BA, wherever applicable) (d) Total 2.Less: Allowance to the extent exempt u/s 10 (As per enclosed annexure) 3.Balance(1-2) 4.DEDUCTIONS: (a) Entertainment Allowance (b) Tax on Employment 5.Aggregate of 4 (a) and (b) 6.INCOME CHARGEABLE UNDER THE HEAD SALARIES(3-5) 7.Add: Any other income reported by the employee (a) Income under the Head Income from House Property (b) Income under the Head Income from Other Sources 8.GROSS TOTAL INCOME ( 6+7 ) 9.DEDUCTIONS UNDER CHAPTER VI-A (A) Sections 80C,80CCC and 80CCD (a) Section 80C Life Insurance Premium Public Provident Fund Employee Provident Fund (b) Section 80CCC (c) Section 80CCD Total of (a)+(b)+(c) (B) Other Sections under Chapter VI-A (a) 80CCG (b) 80D (c) 80DD (d) 80DDB (e) 80E (f) 80G (g) 80TTA (h) 80U Rajiv Gandhi Equity Savings Scheme Medical Claim Handicapped Dependents Medical Expenses, Chronic Diseases Education loan repayment Donation Interest on Savings Bank Account Permanent Physical disability
Gross Amount

Rs.

Rs.

Rs.

14,48,605.00 1,27,711.00 0.00 15,76,316.00

2,84,859.00 12,91,457.00

0.00 2,000.00 2,000.00 12,89,457.00

0.00 0.00 12,89,457.00

Gross Amount

Deductible Amount

10,000.00 70,000.00 7,800.00 0.00 0.00

10,000.00 70,000.00 7,800.00 0.00 0.00 87,800.00


Deductible Amount

Qualifying Amount

0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

Abir Roy/10288243/1

10.Aggregate of deductible amounts under Chapter VI-A 11.Total Income (8-10) 12.Tax On Total Income 13.Education cess @ 3% (on tax computed at S. No. 12) 14.Tax Payable(12+13) 15.Less: Relief under section 89 16.Tax Payable (14-15)

87,800.00 12,01,660.00 1,90,498.00 5,715.00 1,96,213.00 0.00 1,96,213.00

Verication
I, Bulusu S Murthy, son of Late B Venkata Rao working in the capacity of Manager, do hereby certify that a sum of Rs 2,22,477.00 [ Rupees Two Lakh Twenty Two Thousand Four Hundred Seventy Seven Only ]has been deducted and 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 statement, TDS deposited and other available records,which includes the declaration given by the employee.

For Accenture Services Private Limited

Place :Mumbai Date :24-May-2013

Signature of the person responsible for deduction of tax (Digitally Signed Document) Full Name : Bulusu S Murthy Designation : Manager

Abir Roy/10288243/2

FORM No.12BA
{See Rule 26A(2)(b)} Statement showing particulars of perquisites, other fringe benets or amenities and prots in lieu of salary with value thereof 1) Name and Address of the Employer : Accenture Services Private Limited Plant 3, Godrej & Boyce Complex, LBS Marg, Vikhroli(West), Mumbai, Maharashtra -400079 2) TAN: 3) TDS Assesment Range of the Employer : 4) Name of Employee: Designation: PAN: 5) Is the employee a director or a person with substantial interest in the company (Where the employer is a company): 6) Income under the Head Salaries of the Employee : (Other than from perquisites) 7) Financial Year : 8) Valuation of Perquisites
Sr No. Nature of perquisite

MUMA14563D DCIT (TDS), Circle 1(1), Mumbai Abir Roy Level B AFDPA9480N No 14,48,605.00 2012-13

Value of perquisite as per rules(Rs.)

Amount, if any paid by employee(Rs.)

Amount of Taxable perquisite(Rs.)

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19

Accommodation Cars/Other automotive Sweeper,gardener,watchman or personal attendant Gas,electricity,water Interest free or concessional loans Holiday expenses Free or concessional travel Free meals Free Education Gifts,vouchers etc. Credit card Club expenses Use of movable assets by employee Transfer of assets to employee Value of any other benet/amenity/service/privilege Stock options Other benets or amenities * Total Value of Perquisites Value of prots in lieu of salary as per section 17 (3)

0.00 1,09,745.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 17,966.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 1,27,711.00 0.00

0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

0.00 1,09,745.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 17,966.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 1,27,711.00 0.00

* Other benets or amenities includes medical reimbursement exceeding Rs.15,000/-.

9) Details of tax (a) Tax Deducted from Salary of Employee u/s 192(1) (b) Tax Paid by Employer on behalf of Employee u/s 192(1A) (c) Total tax paid (d) Date of payment into Government treasury
DECLARATION BY EMPLOYER

2,22,477.00 0.00 2,22,477.00 Refer Form16

I, Bulusu S Murthy, son of Late B Venkata Rao working in the capacity of Manager, do hereby declare on behalf of Accenture Services Private Limited , 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.

For Accenture Services Private Limited

Place :Mumbai Date :24-May-2013

Signature of the person responsible for deduction of tax (Digitally Signed Document) Full Name : Bulusu S Murthy Designation : Manager

Abir Roy/10288243/3

ANNEXURE TO FORM NO.16


Details of Salary Paid and Allowance Exempted u/s 10 and 17(2) of Income-tax Act,1961 1) Name and Address of the Employer: Accenture Services Private Limited Plant 3, Godrej & Boyce Complex, LBS Marg, Vikhroli(West), Mumbai, Maharashtra -400079 2) Name of Employee: Designation: PAN: Employee Code: Salary Details for the period: 01-Apr-2012 to 31-Jan-2013 1. Salary as per provisions contained in Sec 17(1) Basic HRA Special Allowance Variable Pay Exgratia Leave Encashment Uncollected Food Coupon Abir Roy Level B AFDPA9480N 10288243

5,82,175.00 2,59,180.00 2,60,000.00 2,48,693.00 13,280.00 83,077.00 2,200.00

Total Salary (A) Value of perquisites u/s 17(2) (as per Form No.12BA,wherever applicable) Prots in lieu of Salary u/s 17(3) (as per Form No.12BA,wherever applicable) Total Perquisites (B) Gross Salary (A+B) 2. Details of Allowance exempted under section 10 and 17(2) HRA Leave Encashment 1,27,711.00

14,48,605.00

0.00

1,27,711.00 15,76,316.00 2,01,782.00 83,077.00

Total (C) 3. Balance : (A+B-C)

2,84,859.00

2,84,859.00 12,91,457.00

For Accenture Services Private Limited

Place :Mumbai Date :24-May-2013

Signature of the person responsible for deduction of tax (Digitally Signed Document) Full Name : Bulusu S Murthy Designation : Manager

Abir Roy/10288243/4

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Abir Roy/10288243/5

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