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. PHLWDCL Last updated on 12-Jul-2018
Name and address of the Employer Name and address of the Employer
GOVERNMENT HOSPITAL MUTHU KANAGARAJAN SHENBAGAM
GOVERNMENT HOSPITAL,GOVT HOSPITAL ROAD,THENI, 117,FIRST STREET,CHINNAPPA NAGAR-622004 Tamil Nadu
THENI,THENI-625531
Tamil Nadu

deangtmc@gmail.com
PAN of the Deductor TAN of the Deductor PAN of the Employee Employee Reference number provided
by the Employer
(if available)
PANNOTREQD MRIG00250F DLCPS5119G
CIT (TDS) Assessment Year Period with the employer
The commissioner of Income Tax (TDS) From To
7th Floor,New Block,Aayakar Bhawan,121,M.G.Road, 2018-2019 01-apr-2017 31-mar-2018
Chennai-6000034
Summary of amount paid/Credited and tax deducted at source thereon in respect of the employee

Quarter(s) Receipt Number of Original

Quarterly statements of TDS Amount paid/Credited Amount of tax deducted Amount of tax
under sub-section (3) of (Rs.) deposited / remitted
Section 200 (Rs.)

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

I.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 deductee)
Book Identification Number (BIN)
SI.No Tax Deposited in respect of the
deductee Receipt number of Form DDO serial number in Form Date of transfer Status of matching
(Rs.) No.24G no. voucher with Form no.24G
24G (dd/mm/yyyy)