SFORMHR_INF16_2012_B HFORMHR_INF16_2012_B OLANE HEADFORM HR_INF16_2012_B SAP DEF EForm 16 for India 00023SAP 46C 20070416135715C5165446

HR_INF16_2012_B 701 2013061008501213200137 E0

000 LINE/:FORM CPI 10; LPI 6; TAB-STOP 0 CM; FONT HELVE; START-PAGE MAIN; LINE/:FORM PARAGRAPH P1; RDI; RDIDEV; LINE/:PARAGRAPH A1 ALIGN RIGHT; LINE-SPACE 1 LN; FONT HELVE; FONT-SIZE 8; BOLD ON; LINE/:PARAGRAPH A1 ITALIC OFF; ULINE OFF; LINE/:PARAGRAPH A2 ALIGN BLOCK; LINE-SPACE 1 LN; FONT HELVE; FONT-SIZE 8; LINE/:PARAGRAPH A2 LEFT-INDENT 0.50 CM; RIGHT-INDENT 0.50 CM; LINE/:PARAGRAPH H1 ALIGN CENTER; LINE-SPACE 1 LN; FONT HELVE; FONT-SIZE 10; LINE/:PARAGRAPH H1 BOLD ON; ITALIC OFF; ULINE OFF; LINE/:PARAGRAPH H2 ALIGN CENTER; LINE-SPACE 1 LN; FONT HELVE; FONT-SIZE 10; LINE/:PARAGRAPH H2 BOLD OFF; ITALIC OFF; ULINE OFF; LINE/:PARAGRAPH P0 LINE-SPACE 1 LN; FONT HELVE; FONT-SIZE 8; BOLD OFF; ITALIC O FF; LINE/:PARAGRAPH P0 ULINE OFF; LINE/:PARAGRAPH P1 LINE-SPACE 1 LN; FONT HELVE; FONT-SIZE 8; BOLD OFF; ITALIC O FF; LINE/:PARAGRAPH P1 ULINE OFF; LINE/:PARAGRAPH P2 LINE-SPACE 1 LN; FONT HELVE; FONT-SIZE 8; BOLD OFF; ITALIC O FF; LINE/:PARAGRAPH P2 ULINE OFF; LINE/:PARAGRAPH P3 LINE-SPACE 1 LN; FONT HELVE; FONT-SIZE 8; BOLD ON; ITALIC OF F; LINE/:PARAGRAPH P3 ULINE OFF; LINE/:PARAGRAPH P4 LINE-SPACE 1 LN; FONT HELVE; FONT-SIZE 8; BOLD ON; ITALIC OF F; LINE/:PARAGRAPH P4 ULINE OFF; LINE/:PARAGRAPH P5 LINE-SPACE 1 LN; FONT HELVE; FONT-SIZE 8; BOLD OFF; ITALIC O FF; LINE/:PARAGRAPH P5 ULINE OFF; LINE/:PARAGRAPH P6 LINE-SPACE 1 LN; FONT HELVE; FONT-SIZE 8; BOLD OFF; ITALIC O FF; LINE/:PARAGRAPH P6 ULINE OFF; LINE/:PARAGRAPH P7 LINE-SPACE 1 LN; FONT HELVE; FONT-SIZE 8; BOLD OFF; ITALIC O FF; LINE/:PARAGRAPH P7 ULINE OFF; LINE/:PARAGRAPH P8 LINE-SPACE 1 LN; FONT HELVE; FONT-SIZE 8; BOLD OFF; ITALIC O FF; LINE/:PARAGRAPH P8 ULINE OFF; LINE/:PARAGRAPH P9 LINE-SPACE 1 LN; FONT HELVE; FONT-SIZE 8; BOLD OFF; ITALIC O FF; LINE/:PARAGRAPH P9 ULINE OFF; LINE/:PARAGRAPH PA LINE-SPACE 0.60 LN; FONT HELVE; FONT-SIZE 8; BOLD OFF; LINE/:PARAGRAPH PA ITALIC OFF; ULINE OFF; LINE/:PARAGRAPH PG LINE-SPACE 1 LN; FONT HELVE; FONT-SIZE 8; BOLD OFF; ITALIC O FF; LINE/:PARAGRAPH PG ULINE OFF; LINE/:PARAGRAPH PP LINE-SPACE 1 LN; FONT HELVE; FONT-SIZE 8; BOLD OFF; ITALIC O FF; LINE/:PARAGRAPH PP ULINE OFF; LINE/:PARAGRAPH Q1 LINE-SPACE 1 LN; FONT HELVE; FONT-SIZE 9; BOLD OFF; ITALIC O FF; LINE/:PARAGRAPH Q1 ULINE OFF;

LINE/:PARAGRAPH LINE/:PARAGRAPH LINE/:PARAGRAPH LINE/:PARAGRAPH LINE/:PARAGRAPH LINE/:PARAGRAPH LINE/:PARAGRAPH LINE/:PARAGRAPH LINE/:PARAGRAPH LINE/:PARAGRAPH LINE/:PARAGRAPH LINE/:PARAGRAPH LINE/:PARAGRAPH LINE/:PARAGRAPH LINE/:PARAGRAPH LINE/:PARAGRAPH LINE/:PARAGRAPH ; LINE/:PARAGRAPH LINE/:PARAGRAPH LINE/:PARAGRAPH LINE/:PARAGRAPH LINE/:PARAGRAPH L; LINE/:PARAGRAPH LINE/:PARAGRAPH LINE/:PARAGRAPH LINE/:PARAGRAPH LINE/:PARAGRAPH LINE/:PARAGRAPH LINE/:PARAGRAPH LINE/:PARAGRAPH LINE/:PARAGRAPH LINE/:PARAGRAPH LINE/:PARAGRAPH LINE/:PARAGRAPH T; LINE/:PARAGRAPH LINE/:PARAGRAPH ; LINE/:PARAGRAPH LINE/:PARAGRAPH LINE/:PARAGRAPH LINE/:PARAGRAPH LINE/:PARAGRAPH LINE/:PARAGRAPH LINE/:PARAGRAPH LINE/:PARAGRAPH LINE/:PARAGRAPH LINE/:PARAGRAPH LINE/:PARAGRAPH LINE/:PARAGRAPH LINE/:PARAGRAPH T; LINE/:PARAGRAPH LINE/:PARAGRAPH LINE/:PARAGRAPH ; LINE/:PARAGRAPH T;

S1 S1 S2 S3 S3 S4 S4 A1 A1 A1 A2 A2 H1 H2 P0 P0 P0 P0 P0 P0 P1 P1 P1 P1 P1 P1 P1 P1 P1 P2 P2 P3 P3 P3

LINE-SPACE 0.15 LN; FONT HELVE; FONT-SIZE 6; BOLD OFF; ITALIC OFF; ULINE OFF; LINE-SPACE 0.10 LN; BOLD OFF; ITALIC OFF; ULINE OFF; LINE-SPACE 0.35 LN; FONT HELVE; FONT-SIZE 6; BOLD OFF; ITALIC OFF; ULINE OFF; LINE-SPACE 0.55 LN; FONT HELVE; FONT-SIZE 6; BOLD OFF; ITALIC OFF; ULINE OFF; TAB 1 7.50 CM DECIMAL; TAB 2 9.50 CM DECIMAL; TAB 3 12.50 CM DECIMAL; TAB 4 15.50 CM DECIMAL; TAB 5 17.20 CM DECIMAL; TAB 6 18.40 CM DECIMAL; TAB 1 7.50 CM DECIMAL; TAB 2 9.50 CM DECIMAL; TAB 3 12.50 CM DECIMAL; TAB 1 9.50 CM CENTER; TAB 1 9.50 CM CENTER; TAB 1 0.30 CM LEFT; TAB 2 0.60 CM LEFT; TAB 3 1 CM LEFT; TAB 4 7.50 CM LEFT; TAB 5 9.95 CM RIGHT; TAB 6 10 CM RIGHT; TAB 7 12.90 CM RIGHT; TAB 8 12.90 CM RIGHT; TAB 9 13 CM LEFT TAB TAB TAB TAB TAB TAB TAB TAB TAB TAB TAB TAB TAB TAB TAB TAB TAB 10 13.50 CM LEFT; TAB 11 15.50 CM RIGHT; 12 15.90 CM RIGHT; TAB 13 16 CM RIGHT; 14 18.65 CM RIGHT; TAB 15 18.65 CM RIGHT; 1 0.30 CM LEFT; TAB 2 1.20 CM LEFT; TAB 3 2 CM LEFT; 4 2.20 CM LEFT; TAB 5 2.70 CM LEFT; TAB 6 6.60 CM DECIMA 7 7.60 CM LEFT; TAB 8 8 CM LEFT; TAB 9 8.80 CM LEFT; 10 9.36 CM LEFT; TAB 11 9.50 CM DECIMAL; 12 9.80 CM LEFT; TAB 13 10.60 CM LEFT; 14 10.60 CM RIGHT; TAB 15 12.40 CM RIGHT; 16 12.50 CM RIGHT; TAB 17 12.80 CM DECIMAL; 18 15.90 CM RIGHT; TAB 19 16.50 CM DECIMAL; 20 17.20 CM DECIMAL; TAB 21 18.70 CM RIGHT; 1 4.20 CM LEFT; TAB 2 8 CM LEFT; TAB 3 11.30 CM LEFT; 4 14.30 CM LEFT; TAB 5 17.20 CM LEFT; 1 1.20 CM LEFT; TAB 2 2.20 CM LEFT; TAB 3 7.60 CM LEFT; 4 8 CM LEFT; TAB 5 9.40 CM LEFT; TAB 6 10.60 CM LEFT; 7 11.20 CM LEFT; TAB 8 13.30 CM LEFT; TAB 9 16.30 CM LEF

P4 TAB 1 0.50 CM LEFT; TAB 2 2.40 CM LEFT; TAB 3 6.70 CM LEFT; P4 TAB 4 8.30 CM LEFT; TAB 5 10.50 CM LEFT; TAB 6 14.70 CM LEFT P4 P5 P5 P5 P5 P5 P6 P6 P7 P8 P9 P9 P9 TAB TAB TAB TAB TAB TAB TAB TAB TAB TAB TAB TAB TAB 7 16.20 CM LEFT; TAB 8 17.70 CM LEFT; TAB 9 18 CM LEFT; 1 0.30 CM LEFT; TAB 2 0.60 CM LEFT; TAB 3 1 CM LEFT; 4 7.50 CM LEFT; TAB 5 8 CM LEFT; TAB 6 10.50 CM LEFT; 7 11 CM LEFT; TAB 8 12.50 CM LEFT; TAB 9 13 CM LEFT; 10 13.50 CM LEFT; TAB 11 14 CM LEFT; TAB 12 17 CM RIGHT; 13 17.55 CM RIGHT; 1 0.50 CM LEFT; TAB 2 4.50 CM LEFT; TAB 3 10 CM LEFT; 4 13 CM CENTER; TAB 5 13.50 CM LEFT; TAB 6 17 CM LEFT; 1 9.50 CM CENTER; TAB 2 15 CM RIGHT; 1 1.50 CM LEFT; 1 0.30 CM LEFT; TAB 2 2.16 CM LEFT; TAB 3 4.10 CM LEFT; 4 5.80 CM LEFT; TAB 5 8.10 CM LEFT; TAB 6 10.10 CM LEFT; 7 12.45 CM LEFT; TAB 8 14.54 CM LEFT; TAB 9 16.55 CM LEF

PA TAB 1 0.50 CM LEFT; TAB 2 4.10 CM LEFT; TAB 3 10 CM LEFT; PA TAB 4 13 CM CENTER; TAB 5 13.50 CM LEFT; TAB 6 17 CM LEFT; PG TAB 1 0.30 CM LEFT; TAB 2 3.50 CM RIGHT; TAB 3 5.50 CM RIGHT PG TAB 4 7.20 CM RIGHT; TAB 5 9.90 CM RIGHT; TAB 6 10.10 CM LEF

LINE/:PARAGRAPH PG TAB 7 12.70 CM LEFT; TAB 8 14.68 CM LEFT; TAB 9 16.80 CM LEF T; LINE/:PARAGRAPH PP TAB 1 1 CM LEFT; TAB 2 1.75 CM LEFT; TAB 3 2 CM LEFT; LINE/:PARAGRAPH PP TAB 4 2.20 CM LEFT; TAB 5 2.70 CM LEFT; TAB 6 6.60 CM DECIMA L; LINE/:PARAGRAPH PP TAB 7 7.60 CM LEFT; TAB 8 8 CM LEFT; TAB 9 8.80 CM LEFT; LINE/:PARAGRAPH PP TAB 10 9.40 CM LEFT; TAB 11 9.50 CM DECIMAL; LINE/:PARAGRAPH PP TAB 12 9.80 CM LEFT; TAB 13 10.60 CM LEFT; LINE/:PARAGRAPH PP TAB 14 11.20 CM LEFT; TAB 15 12.50 CM DECIMAL; LINE/:PARAGRAPH PP TAB 16 13.30 CM LEFT; TAB 17 14 CM LEFT; LINE/:PARAGRAPH PP TAB 18 15.50 CM DECIMAL; TAB 19 16.30 CM LEFT; LINE/:PARAGRAPH PP TAB 20 17.20 CM DECIMAL; TAB 21 18.30 CM DECIMAL; LINE/:PARAGRAPH Q1 TAB 1 0.30 CM LEFT; TAB 2 0.60 CM LEFT; TAB 3 1 CM LEFT; LINE/:PARAGRAPH Q1 TAB 4 7.50 CM LEFT; TAB 5 8 CM LEFT; TAB 6 10.50 CM LEFT; LINE/:PARAGRAPH Q1 TAB 7 11 CM LEFT; TAB 8 12.50 CM LEFT; TAB 9 13 CM LEFT; LINE/:PARAGRAPH Q1 TAB 10 13.50 CM LEFT; TAB 11 14 CM LEFT; TAB 12 17 CM RIGHT; LINE/:PARAGRAPH Q1 TAB 13 17.55 CM RIGHT; LINE/:PARAGRAPH S1 TAB 1 0.10 CM LEFT; LINE/:PARAGRAPH S2 TAB 1 1 CM LEFT; LINE/:PARAGRAPH S3 TAB 1 0.10 CM LEFT; LINE/:PARAGRAPH S4 TAB 1 0.10 CM LEFT; TAB 2 4.10 CM LEFT; LINE/:STRING A1 FONT HELVE; FONT-SIZE 7.50; BOLD OFF; ITALIC OFF; ULINE OFF; LINE/:STRING A1 SUBSCRIPT OFF; SUPERSCRIPT OFF; HIDDEN OFF; PROTECT OFF; MARK O FF; LINE/:STRING B1 FONT HELVE; FONT-SIZE 8; BOLD ON; ITALIC OFF; ULINE OFF; LINE/:STRING B1 SUBSCRIPT OFF; SUPERSCRIPT OFF; HIDDEN OFF; PROTECT OFF; MARK O FF; LINE/:STRING B2 FONT HELVE; FONT-SIZE 8; BOLD ON; ITALIC OFF; ULINE ON; LINE/:STRING B2 SUBSCRIPT OFF; SUPERSCRIPT OFF; HIDDEN OFF; PROTECT OFF; MARK O FF; LINE/:STRING B3 FONT HELVE; FONT-SIZE 10; BOLD ON; ITALIC OFF; ULINE OFF; LINE/:STRING B3 SUBSCRIPT OFF; SUPERSCRIPT OFF; HIDDEN OFF; PROTECT OFF; MARK O FF; LINE/:STRING B4 FONT HELVE; FONT-SIZE 9; BOLD ON; ITALIC OFF; ULINE OFF; LINE/:STRING B4 SUBSCRIPT OFF; SUPERSCRIPT OFF; HIDDEN OFF; PROTECT OFF; MARK O FF; LINE/:STRING B5 FONT HELVE; FONT-SIZE 8; BOLD OFF; ITALIC OFF; LINE/:STRING B5 ULINE ON 0 LN 0.01 LN 0; SUBSCRIPT OFF; SUPERSCRIPT OFF; LINE/:STRING B5 HIDDEN OFF; PROTECT OFF; MARK OFF; LINE/:STRING V1 FONT HELVE; FONT-SIZE 14; BOLD OFF; ITALIC OFF; ULINE OFF; LINE/:WINDOW BOXES2 TYPE VAR; LINE/:WINDOW BOXES3 TYPE VAR; LINE/:WINDOW EMPNAME TYPE CONST; LINE/:WINDOW MAIN LINE/:WINDOW PAGENO TYPE CONST; LINE/:WINDOW TEXT3 TYPE VAR; LINE/:WINDOW VAR2 TYPE VAR; LINE/:WINDOW VAR3 TYPE VAR; LINE/:WINDOW VERIF TYPE CONST; LINE/:PAGE MAIN NEXT MAIN; LINE/:PAGE MAIN MAIN 0 0.80 CM 1.60 CM 19 CM 24.90 CM; LINE/:PAGE MAIN WINDOW EMPNAME 0.80 CM 0.60 CM 19 CM 1 CM; LINE/:PAGE MAIN WINDOW VERIF 0.80 CM 23.60 CM 18.80 CM 5.50 CM; END HEADFORM HR_INF16_2012_B SAP TXT EForm 16 for India HR_INF16_2012_B 00023SAP 46A 20000308163406C5165446 701 2013061008501213200415 E0 000 LINE/:FORM TEXT 'Form 16 for India';

LINE/:PARAGRAPH A1 TEXT 'Main paragraph'; LINE/:PARAGRAPH A2 TEXT 'Text with margin'; LINE/:PARAGRAPH H1 TEXT 'Main heading'; LINE/:PARAGRAPH H2 TEXT 'Sub Heading1'; LINE/:PARAGRAPH P0 TEXT 'Main window 1'; LINE/:PARAGRAPH P1 TEXT 'Main paragraph'; LINE/:PARAGRAPH P2 TEXT 'Main paragraph'; LINE/:PARAGRAPH P3 TEXT 'Main paragraph'; LINE/:PARAGRAPH P4 TEXT 'Main paragraph'; LINE/:PARAGRAPH P5 TEXT 'Main window 1'; LINE/:PARAGRAPH P6 TEXT 'Main Table'; LINE/:PARAGRAPH P7 TEXT 'Heading'; LINE/:PARAGRAPH P8 TEXT 'for setting of point'; LINE/:PARAGRAPH P9 TEXT 'third page'; LINE/:PARAGRAPH PA TEXT 'Main Table'; LINE/:PARAGRAPH PG TEXT 'third page'; LINE/:PARAGRAPH PP TEXT 'Main paragraph'; LINE/:PARAGRAPH Q1 TEXT 'Main window 1'; LINE/:PARAGRAPH S1 TEXT 'Space 1.5'; LINE/:PARAGRAPH S2 TEXT 'Space 1.5'; LINE/:PARAGRAPH S3 TEXT 'Space 1.5'; LINE/:PARAGRAPH S4 TEXT 'Space 1.5'; LINE/:STRING A1 TEXT 'Character format for ACKNO'; LINE/:STRING B1 TEXT 'Bold'; LINE/:STRING B2 TEXT ' Character format for line'; LINE/:STRING B3 TEXT 'Heading'; LINE/:STRING B4 TEXT 'Heading'; LINE/:STRING B5 TEXT 'underline'; LINE/:STRING V1 TEXT 'Character format for vline'; LINE/:WINDOW BOXES2 TEXT 'Boxes window(page 2)'; LINE/:WINDOW BOXES3 TEXT 'Boxes(page 3)'; LINE/:WINDOW EMPNAME TEXT 'Employee Name'; LINE/:WINDOW MAIN TEXT 'Main window'; LINE/:WINDOW PAGENO TEXT 'Page number'; LINE/:WINDOW TEXT3 TEXT 'Text Window(page3)'; LINE/:WINDOW VAR2 TEXT 'Variables(page 2)'; LINE/:WINDOW VAR3 TEXT 'variables(page 3)'; LINE/:WINDOW VERIF TEXT 'Verification'; LINE/:PAGE MAIN TEXT 'Main page'; LINE/WVAR2 LINEA1,,,,,,,,,,&tax_payable& LINES1 LINES1 LINEA1,,,,,,,,,,&tax_deducted& LINES1 LINES1 LINEA1,,,,,,,,,,&net_tax_payable& LINE/WVAR3 LINEH1 LINEH1 LINEH1 LINEH1 LINES1 LINEP3,,,,&name1& LINEP3,,,,&stras& LINEH1 LINEH1 LINEP3,,,,&ename&,,,,,,,,&empno& LINEP1 LINES1

LINES1 LINEP4 LINEP4 LINES1 LINES1 LINEP4 LINEP4 LINEA1,,&basic& LINEA1,,&fixed_da& LINEA1,,&hra& LINEA1,,&conv& LINEA1,,&med_reim& LINEA1,,&lta& LINEA1,,&ch_ed_all& LINEA1 LINEA1 LINEA1 LINEA1 LINEA1 LINEA1 LINEA1 LINEA1 LINEA1 LINEA1,,&gross_sal& LINEA1 LINEA1,,&ptax& LINEA1 LINEA1 LINEA1 LINEA1 LINEA1 LINEA1 LINEA1 LINEA1 LINEA1 LINEA1 LINEA1 LINEA1 LINEA1 LINEA1 LINEA1 LINEA1 LINEA1 LINEA1 LINEA1 LINES1 LINES1 LINES1 LINEP3,, &sy-datum& LINE/WTEXT3 LINEH1Annexure to Form No.16 LINEH1 LINEH1 LINEH1 LINEH1 LINEH1 LINEH1 LINEH1 LINES1 LINEP4,,Name:,,,,,,Emp No.:

LINEP1 LINES1 LINEP4,,Details of emoluments paid for the period to ,,Allowances LINE exempted under Section 10. LINEP4 LINES1 LINES1 LINEP4,,,,Particulars,,,,,,,,Amount LINEP4,,,,,,,,,,,,,, Rs. LINES1 LINEP4,,1. Basic LINEP4,,2. DA,,,,,, Leave Travel Allowance LINEP4,,3. House Rent Allowance,,,,,,II. Under Section 10(13A) r.w. Rule 2A LINEP4,,4. Conveyance Reimbursement,,,,,, House Rent Allowance LINEP4,,5. Medical Reimbursement,,,,,, a) Actual HRA Paid LINEP4,,6. Leave Travel Allowance,,,,,, b) 40% of Basic & DA(Metro 50%) LINEP4,,7. Children Education Allowance,,,,,, c) Actual Rent paid LINEP4,,8. Performance Incentive,,,,,, Less: 10% of Basic Salary LINEP4,,9. Bonus/Ex-gratia,,,,,, d) Least of (a),(b)&(c) is exempted LINEP4,,10. Payment under Medical Scheme,,,,,,III.Under Section 10(14) LINEP4,,11. Vehicle Maintenance,,,,,, a) Conveyance reimbursement LINEP4,,12. Leave Encashment,,,,,, b) Vehicle Maintenance LINEP4,,13. Miscellaneous Salary,,,,,, c) Children Education Allowance LINEP4,,14. Additional contribution to PF &,,,,,, Total of a) to c) LINEP4,, Superannuation Fund LINEP4,,,,,,,,IV. Under section 17(2) LINEP4,,Gross Emoluments,,,,,, Medical Reim.[17(2) (v) proviso v] LINEP4,,,,,,,, Medical Scheme[17(2) (v) proviso ii] LINEP4,,Profession Tax LINEP4,,,,,,,,V. Under Section 10(10AA) LINEP4,,,,,,,, Leave Encashment LINEP4,,,,,,,, a) Statutory limit as per IT act LINEP4,,,,,,,, b) 8 months salary LINEP4,,,,,,,, c) Actual Leave Encashment paid LINEP4,,,,,,,, d) Least of a),b) & c) is exempted LINES1 LINES1 LINES1 LINEP4,,,,,,,, Total Exempted Allowances LINEP4 LINEP4 LINEP4 LINEP4 LINEP4 LINEP4 LINEP4 LINEP4 LINEP4 LINEP4 LINEP4 LINEP4 LINEP4,,Date: LINEP4,,Place: LINE/WPAGENO LINE* &PAGE& of &SAPSCRIPT-JOBPAGES(CR)& LINE/:PERFORM WRITEFORM1 IN PROGRAM HINCF160 LINE/:USING &PAGE& LINE/:ENDPERFORM LINE/WBOXES3 LINE/*Main box 1

LINE/:BOX XPOS '0.2' CM YPOS '0.2' CM WIDTH '18.6' CM HEIGHT '3.0' CM FRAME 10 TW LINE/*Main box 2 LINE/:BOX XPOS '0.2' CM YPOS '3.5' CM WIDTH '18.6' CM HEIGHT '13.2' CM FRAME 10 TW LINE/*Horizontal line 1 LINE/:BOX XPOS '0.2' CM YPOS '2.5' CM WIDTH '18.6' CM HEIGHT '0' CM FRAME 10 TW LINE/*Vertical line 1 LINE/:BOX XPOS '6.0' CM YPOS '4.4' CM WIDTH '0' CM HEIGHT '12.3' CM FRAME 10 TW LINE/*Vertical line 2 LINE/:BOX XPOS '8' CM YPOS '3.5' CM WIDTH '0' CM HEIGHT '13.2' CM FRAME 10 TW LINE/*Vertical line 3 LINE/:BOX XPOS '14.3' CM YPOS '4.4' CM WIDTH '0' CM HEIGHT '12.3' CM FRAME 10 T W LINE/*Vertical line 4 LINE/:BOX XPOS '15.8' CM YPOS '4.4' CM WIDTH '0' CM HEIGHT '12.3' CM FRAME 10 T W LINE/*Vertical line 5 LINE/:BOX XPOS '17.3' CM YPOS '4.4' CM WIDTH '0' CM HEIGHT '12.3' CM FRAME 10 T W LINE/*Sub-box 1 LINE/:BOX XPOS '0.2' CM YPOS '4.4' CM WIDTH '18.6' CM HEIGHT '0.9' CM FRAME 10 TW LINE/*Sub-box 2 LINE/:BOX XPOS '0.2' CM YPOS '12' CM WIDTH '7.8' CM HEIGHT '0.7' CM FRAME 10 TW LINE/*Horizontal Line 2 LINE/:BOX XPOS '8' CM YPOS '16' CM WIDTH '10.8' CM HEIGHT '0' CM FRAME 10 TW LINE/WEMPNAME LINE/EEMP LINE* &emp_no&,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,&ENAME(40CR)& LINE* LINE/WBOXES2 LINE/:BOX XPOS '10.1' CM YPOS '0.2' CM WIDTH '0' CM HEIGHT '18.0' CM FRAME 10 LINE TW LINE/WVERIF LINE/:IF &PRINT_VERIF& = 'X' LINE/:NEW-PAGE LINEP7,,<B1>Verification</> LINE/:BOX XPOS '0.1' CM YPOS '0.0' CM WIDTH '18.8' CM HEIGHT '2.49' CM FRAME 10 TW LINES2 LINES3 LINEA2 I, <B1>&rp_name&</><B1>, </>son/daughter of <B1>&rp_sof&</> working LINE in the capacity of <B1>&rp_dsg&</> (designation) do hereby certify that LINE the information given above is true, complete and correct and is based LINE on the books of account, documents, TDS statements, and other available LINE records. LINES2 LINES3 LINES4 LINES4 LINES4 LINEA2Place &rplace& LINES4 LINE/* LINEA2Date &repodate&,,,, ,, LINE= (Signature of person responsible for deduction of tax) LINES3 LINES3 LINES2

LINEA2Designation: &rp_dsg&,, ,, Full Name: &rp_name& LINE/* LINE/:BOX XPOS '0.1' CM YPOS '2.50' CM WIDTH '18.8' CM HEIGHT '1.4' CM FRAME 10 TW LINE/:BOX XPOS '0.1' CM YPOS '3.20' CM WIDTH '8.90' CM HEIGHT '0.0' CM FRAME 10 TW LINE/:BOX XPOS '3.0' CM YPOS '2.50' CM WIDTH '0.0' CM HEIGHT '1.40' CM FRAME 10 TW LINE/:BOX XPOS '9.0' CM YPOS '2.50' CM WIDTH '0.0' CM HEIGHT '2.3' CM FRAME 10 TW LINE/:BOX XPOS '0.1' CM YPOS '3.91' CM WIDTH '18.8' CM HEIGHT '0.0' CM FRAME 10 TW LINE/:PERFORM CLEARVERIF IN PROGRAM &SY-REPID& LINE/:ENDPERFORM LINES3 LINES3 LINES3 LINEP1,,&ftext1& LINEP1,,&ftext2& LINE/:PERFORM CLEARVERIF IN PROGRAM &SY-REPID& LINE/:ENDPERFORM LINE/:ENDIF LINE/WMAIN LINE/EDETAILS2 LINE/*Salary details(main box) [ the static box for page1 of Part B ] LINE/*Is is commom for all cases X,Y and Z for 1st page LINE/:BOX XPOS '.1' CM YPOS '1.4' CM WIDTH '18.8' CM HEIGHT '25.40' CM FRAME 10 TW LINE/*Header boxes ( PART B etc) LINE/:BOX XPOS '.1' CM YPOS '0' CM WIDTH '18.8' CM HEIGHT '1.4' CM FRAME 10 TW LINE/:BOX XPOS '.1' CM YPOS '.7' CM WIDTH '18.8' CM HEIGHT '0' CM FRAME 10 TW LINE/*Used for printing 2nd page in Case'Z' LINE/:IF &PAGE3_FLG2& = 'Z' LINE/:BOX XPOS '10.1' CM YPOS '1.41' CM WIDTH '0' CM HEIGHT '25.4' CM FRAME 10 TW LINE/:BOX XPOS '13.1' CM YPOS '1.41' CM WIDTH '0' CM HEIGHT '25.4' CM FRAME 10 TW LINE/:BOX XPOS '16.1' CM YPOS '1.41' CM WIDTH '0' CM HEIGHT '25.4' CM FRAME 10 TW LINE/:ENDIF LINEP7<B4> ,,PART B (Annexure)</> LINES3 LINES3 LINEP7<B4> Details of Salary paid and any other income and tax deducted,, LINE &currc&,,&currc&,, ,, &currc&</> LINES2 LINES3 LINES3 LINES1 LINEP5,,1. Gross Salary LINEP0,,,,(a) Salary as per provisions contained in sec.17(1),,,,,,,,,,,,<B1> LINE= &sal_sec17&</> LINEP0,,,,(b) Value of perquisites u/s 17(2) LINEP0,,,,,, (as per Form No.12BA, wherever applicable),,,,,,,,<B1>&val_f12ba& LINE= </> LINEP0,,,,(c) Profits in lieu of salary under section 17(3) LINEP0,,,,,, (as per Form No.12BA, wherever applicable),,,,,,,,<B1> LINE= &prof_f12ba&</> LINES1 LINEP0,,,,(d) Total,,,,,,,,,,,,,,,,,,,,<B1>&gross_sal&</>

LINES3 LINEP1,,2. Less: Allowance to the extent exempt u/s 10 ,,,,,,,,,,,,,,,,,,,,,, LINE= ,,,,,,,,,,,,<B1>&sec10_all&</> LINES1 LINES1 LINES1 LINE/*Section 10 Exemptions LINE/ESEC10_COMPONENTS LINEP0,,,,&SEC10_TAB-SPEC_TXT&,,,,,,,,<B1>&sign&</><B1>&amount&</>,,,,,,,,,,,, LINE/EDETAILS13 LINES1 LINEP1,,3. Balance(1-2),,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,<B1>&balance&</> LINES2 LINEP5,,4. Deductions : LINEP0,,,,(a) Entertainment allowance,,,,,,,,,,<B1>&etall&</> LINES1 LINEP0,,,,(b) Tax on employment,,,,,,,,,,<B1>&ptax&</> LINES1 LINEP0,,5. Aggregate of 4(a) and (b),,,,,,,,,,,,,,,,,,,,,,<B1>&aggr_ded&</> LINES1 LINES1 LINEP0,,6. Income chargeable under the head 'salaries' (3-5),,,,,,,,,,,,,,,,,, LINE= ,,,,,,,,<B1>&salaries&</> LINES1 LINES1 LINEP0,,7. Add: Any other income reported by the employee ,,,,,,,,,,,,,,,,,, LINE ,,,, <B1>&oth_income&</> LINES1 LINES1 LINES1 LINE/EIFOS_COMPONENTS LINEP0,,,,&IFOS_TAB-SPEC_TXT&,,,,,,,,<B1>&sign&</><B1>&amount&</> LINE/EDETAILS14 LINEP0,,8. Gross total income (6+7),,,,,,,,,,,,,,,,,,,,,,,,,, <B1> LINE= &gross_tot_income&</> LINES1 LINES1 LINEP5,,9. Deductions under chapter VI-A,,,,,,,,,,,,,,,, Gross amount ,, LINE= ,,,, Deductible amount LINES3 ,, LINEP5,, (A) sections 80C, 80CCC and 80CCD LINES1 LINEP5,,,,(a) section 80C LINEP0,,,,,,i) Employee Provident Fund,, ,,,,,,,,,,,,,,,, LINE= <B1>&epf&</>,,,,,, <B1>&dedmt_epf&</> LINE/* <B1>&epf&</>,,,,,, <B1>&dedmt_epf&</> LINE/ESEC88_DED LINEP0,,,,,,&int_S88-ITEXT&,,,,,,,,,,,,,,,,,,<B1>&INVMT&</>,,,,<B1>&dedmt&</> LINE/*,,,,,, ,,,,,,,,,,,,,,,,,,<B1>&conmt&</>,,,,<B1>&dedmt&</> LINE/EDETAILS10 LINEP0,,,,(b) section 80CCC,,,,,,,,,, ,,,,,,,,,, <B1>&conmt&</>,, ,,,, LINE <B1>&dedmt&</> LINE/EDETAILS11 LINEP0,,,,(c) section 80CCD,,,,,,,,,, ,,,,,,,,,, <B1>&80ccda&</>,, ,,,, LINE <B1>&80ccdd&</> LINEP5,,,,Note: 1. Aggregate amount deductible under sections 80C, 80CCC and LINEP5,,,,,, 80CCD(1) shall not exceed one lakh rupees. LINEP5,, (B) Other sections (e.g. 80E, 80G, 80TTA, etc.) under Chapter VI-A.,, LINE= ,,,,,,,,Gross amount,,,,,, Qualifying amount,,,,,, Deductible a mount

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LINE/* LINE/:IF &PAGE3_FLG2& = 'Z' LINE/:DEFINE &ENDPAGE2& = 'X' LINE/:PERFORM WRITEVERIF IN PROGRAM &SY-REPID& LINE/:USING &ENDPAGE2& LINE/:ENDPERFORM LINE/:ENDIF LINE/* LINE/:IF &PAGE3_FLG& = 'X' LINE/:ELSE LINE/:POSITION LINE/*Only used for 2nd page outline border for case Y and Z LINE/:BOX XPOS '0.1' CM YPOS '0' CM WIDTH '18.8' CM HEIGHT '26.8' CM FRAME 10 T W LINE/:BOX XPOS LINE/:BOX XPOS LINE/:BOX XPOS LINE/:ENDIF LINE/:POSITION END ACTVSAP E '10.1' CM YPOS '0' CM WIDTH '0' CM HEIGHT '22.0' CM FRAME 10 TW '13.1' CM YPOS '0' CM WIDTH '0' CM HEIGHT '22.0' CM FRAME 10 TW '16.1' CM YPOS '0' CM WIDTH '0' CM HEIGHT '22.0' CM FRAME 10 TW WINDOW