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Quarterly Statement of deduction of tax under sub-section (3) of section 200 of the Income-tax Act in respect of salary for the quarter ended .............. (June/September/December/March) ................. (Financial Year)

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..... s Yes , then token No. of original statement (f) Type of Deductor [See Note 2] 2. Particulars of the Deductor (employer) (a) Name of the employer (b) If Central/State Government Name (See Note 3) AIN Code of PAO/TO/CDDO (c) TAN Registration No. (d) Address Flat No.. Name of the premises/building Road/Street/Lane Area/Location Town/City/District State PIN Code Telephone No. Alternate telephone No. (See Note 4) Email Alternate email (See Note 4) 3. Particulars of the .....

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..... 5. Details of salary paid and tax deducted thereon from the employees- (i) enclose Annexure I along with each statement having details of the relevant quarter; (ii) enclose Annexure II along with the last statement, i.e., for the quarter ending 31st March having details for the whole financial year. (iii) enclose Annexure III along with the last statement, i.e., for the quarter ending 31st Ma .....

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..... Total Interest to be allocated among deductees below Name of the Employer TAN Sl. No. Employee reference number provided by employer/ PPO number, if available PAN of the employee/ specified senior citizen Name of the employee/ specified senior citizen Section Code [See Note 4] Date of payment/ credit (dd/mm/yyyy) Date of Deduction (dd/mm/yyyy) Amount Paid or Credited [314] [315] [316] [31A] [318] [319] [320] [321] 1 2 3 .....

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..... tion of the person responsible for deducting tax at source Notes: 1 Write A if certificate has been given by the Assessing Officer for deduction of tax at lower rate under section 197. PAN of employee is mandatory in such cases. 2 Write B if certificate has been given by the Assessing Officer for no deduction of tax under section 197. PAN of employee is mandatory in such cases. 3 Write C if deduction is on higher rate on account of non-furnishing of PAN by the deductee. 4 List of section codes is as under: Section Nature of Payment Section Code 192 Payment to Government employees other than Inion Government employees 92A 192 Payment to employees other than Government employees 92B 192 Payment to Indian Government employees 92C 194P Payment to Specified Senior Citizen 94P 7 [Annexure II Details of salary paid or credited during th .....

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..... other exemption under section 10. Total amount of exemption claimed under section 10 (340 +341 +342 +343 +344+ 346A +346B). Total deduction under section 16(ia). (339) (340) (341) (342) (343) (344) (345) (346A) (346B) (347) (348) Total deduction under section 16(ii). Total deduction under section 16(iii). Income chargeable under the head Salaries [338+339- (347+348+ 349+350)]. Income (or admissible loss) from house property reported by employee offered for TDS as per section 192 (2B). .....

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..... 0TTA. Amount deductible under any other provision (s) of Chapter VI‐A. Total amount deductible under Chapter VI‐A [357+ 359+ 361 (limited to Rs. 1,50,000) +363 +364B + 365B +366B + 367B +369 + 372 +375 +378]. Gross amount Deducti ble amount Gross amount Deduc tible amount Gross amount Deducti ble amount Gross amount Deducti ble amount Gross amount Deducti ble amount Gross amount Deductibl e amount Gross amount Qualify ing amount Deducti ble amount Gross amount Qualify ing amount Deducti ble amount Gross amount Qualify ing amount Deducti ble amount (362) (363) (364A) (364B) (365A) (365B) (366A) (36 .....

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..... Notes: 1. Salary includes wages, annuity, pension, gratuity (other than exempted under section 10(10), fees, commission, bonus, repayment of amount deposited under the Additional Emoluments (Compulsory Deposit) Act, 1974 (37 of 1974), perquisites, profits in lieu of or in addition to any salary or wages including payments made at or in connection with termination of employment, advance of salary, any payment received in respect of any period of leave not availed (other than exempted under section 10 (10AA), any annual accretion to the balance of the account in a recognised provident fund chargeable to tax in accordance with rule 6 of Part A of the Fourth Schedule of the Income-tax Act, 1961, any sums deemed to be income received by the employee in accordance with sub‐rule (4) of rule 11 of Part A of the Fourth Schedule of the Income-tax Act, 1961, any contribution made by the Central Government to the account of the employee under a pension scheme referred to in section 80CCD or any other sums chargeable to income .....

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..... ibution to certain pension funds u/s 80CCC Deduction in respect of contribution by taxpayer to pension scheme u/s 80CCD(1) Total Deduction u/s 80C, 80CCC and 80CCD(1) [does not exceed ₹ 1,50,000] Deductions in respect of amount paid/deposited to notified pension scheme u/s 80CCD (1B) Deduction in respect of health insurance premia u/s 80D Deduction in respect of loan taken for higher education u/s 80E Gross amount Deductible amount Gross amount Deductible amount Gross amount Deductible amount Gross amount Deductible amount Gross amount Deductible amount Gross amount Deductible amount (403) (404) (405) (406) (407) (408) (409) (410) (411) (412) (413) (414) (415) .....

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..... Notes: 2.Section codes: Sl. No. Section Particulars Section code 1 80DD Deduction in respect of maintenance including medical treatment of a dependent who is a person with disability DD 2 80EE Deduction in respect of interest on loan taken for residential house property EE 3 80EEA Deduction in respect of interest on loan taken for certain house property (not covered u/s 80EE) EEA 4 80GG Deduction in respect of rents paid GG 5 80GGC Deduction in respect of contributions given by any person to political parties. GGC 6 80 .....

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..... le) Total amount of gross salary received from current employer (see Note 1 for definition of Salary). (330) (331) (332A) (332B) (333) (334) (335) (336) (337) (338) Reported total amount of salary received from other employer(s) (see Note 1 for definition of Salary) Travel concession or assistance under section 10(5) Death-cum-retirement gratuity under section 10(10) Commuted value of pension under section 10(10A) Cash equivalent of leave salary encashment under section 10(10AA) House rent Allowance under section 10(13A) PAN of landlord .....

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..... on in respect of amount paid or deposited under notified pension scheme under section 80CCD(1B). Deduction in respect of contribution by employer to notified pension scheme under section 80CCD(2). Deduction in respect of health insurance premia under section 80D. Gross amount Deductible amount Gross amount Deductible amount Gross amount Deductible amount Gross amount Deductible amount Gross amount Deductible amount (358) (359) (360) (361) (362) (363) (364) (365) (366) (367) .....

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..... 339). Total amount of tax deducted at source for the whole year (387 +388). Shortfall in tax deduction (+) or excess tax deduction (‐) (386 - 389). (380) (381) (382) (383) (384) (385) (386) (387) (388) (389) (390) Notes: 1. Salary includes wages, annuity, pension, gratuity (other than exempted under section 10(10), fees, commission, bonus, repayment of amount deposited under the Additional Emoluments (Compulsory Deposit) Act, 1974 (37 of 1974), perquisites, profits in lieu of or in addition to any salary or wages including payments made at or in connection with terminatio .....

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