Kotaka Form16 41970

FORM NO.
16
[See rule 31(1)(a)]
PART B (Annexure)
Certificate under section 203 of the Income-tax Act, 1961 for tax deducted at source on salary
Name and address of the Employer
Name and Designation of the Employee
KOTAK MAHINDRA BANK LIMITED

36-38 A NARIMAN BHAVAN
227, NARIMAN POINT, MUMBAI - 400021.
Miss. SRIPRIYA N T
SENIOR MANAGER
PAN of the Deductor
TAN of the Deductor
PAN of the Employee
Employee Reference No.
AAACK4409J
MUMK01323A
ADOPT8945J
41970
CIT (TDS)
Assessment Year
CIT (TDS) INCOME TAX - TDS

K. G. MITTAL HOSPITAL BUILDING, CHARNI ROAD, MUMBAI - 400002
Period With the Employer
2015-2016
From
To
01-Apr-2014
31-Mar-2015
Amount in Rs.
Amount in Rs.
Details of Salary paid and any other income and tax deducted
Amount in Rs.
1
Gross Salary
a. Salary as per provisions contained in sec.17(1)
903230.00
b. Value of perquisites U/S 17(2) (as per Form No.12BA)
1853.00
c. Profits in lieu of salary U/S 17(3) (as per Form No.12BA)
0.00
d. Total
2
905083.00
Less: Allowance to the extent exempt U/S 10

Allowance
Rs.
TRANSPORT EXEMPTION
9600.00
9600.00
Balance (1-2)
Deductions:
895483.00
a. Entertainment Allowance
0.00
a. Tax on Employment
2400.00
Aggregate of 4(a) and (b)
Income chargeable under the head 'salaries' (3-5)
Add: Any other income reported by the employee

Income
2400.00
893083.00
Rs.
Income / Loss from House Property (Sec 24)
0.00
Income from Other Sources
0.00
0.00
Gross total income (6+7)
Deductions under Chapter VI-A

(A) sections 80C, 80CCC and 80CCD
893083.00
Gross Amount
Deductible Amount
a. Section 80C
PROVIDENT FUND
39426.00
39426.00
39426.00
b. Section 80CCC
0.00
0.00
c. Section 80CCD(1)
0.00
0.00
Aggregate amount deductible under sections 80C, 80CCC and 80CCD(1)

shall not exceed one lakh fifty thousand rupees.
Page 1 of 4
TAN of Employer: MUMK01323A
PAN of Employee: ADOPT8945J
(B) Other sections (e.g. 80E, 80G, 80TTA, etc.) under Chapter VI-A.
Section 80CCD(2)
Section 80CCG
Assessment Year: 2015-2016
Gross Amount
Qualifying Amount
Deductible Amount
0.00
0.00
0.00
0.00
0.00
0.00
4800.00
4800.00
4800.00
Section 80DD
0.00
0.00
0.00
Section 80DDB
0.00
0.00
0.00
Section 80E
0.00
0.00
0.00
Section 80EE
0.00
0.00
0.00
Section 80G
0.00
0.00
0.00
Section 80GG
0.00
0.00
0.00
Section 80TTA
0.00
0.00
0.00
Section 80U
0.00
0.00
0.00
Section 80D
10
Aggregate of deductible amount under Chapter VI-A
11
Total Income (8-10)
848857.00
44226.00
12
Tax on total income
94772.00
13
Surcharge (on tax computed at S. No. 12)
14
Education cess @ 3% (on tax computed at S. No. 12 + S. No 13)
15
Tax Payable (12+13+14)
16
Less: Relief under section 89 (attach details)
17
Tax payable (15-16)
0.00
2843.00
97615.00
0.00
97615.00
Verification
I Mr. Nitin R. Vaidya, son / daughter of Mr. Ramesh Ramchandra Vaidya working in the capacity of Sr Vice President do hereby certify that a sum of Rs. 97615.00
(Rupees Ninety Seven Thousand Six Hundred And Fifteen 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 accounts, documents, TDS statements, TDS deposited and other available records.
Place : MUMBAI
Date : 31-May-2015
Signature of Person Responsible for Deduction of Tax
Designation : Sr Vice President
Full Name : Mr. Nitin R. Vaidya
NOTE : THIS FORM16 HAS BEEN DIGITALLY SIGNED IN ACCORDANCE WITH CIRCULAR NO. 2/2007 DATED 21-05-2007 ISSUED BY THE CENTRAL
BOARD OF DIRECT TAXES AND SHALL BE TREATED AS A CERTIFICATE ISSUED IN ACCORDANCE WITH RULE 31 OF THE INCOME TAX RULES,
1962.
Digitally Signed By VAIDYA NITIN (KOTAK

MAHINDRA BANK LIMITED)
Date : 31-May-2015
Page 2 of 4
ANNEXURE TO FORM 16
2014-2015
COM NAME : KOTAK MAHINDRA BANK LIMITED
EMP NAME : Miss. SRIPRIYA N T
SALARY AS PER PROVISIONS CONTAINED IN SECTION 17(1)
Amount in Rs.
ADVANCE AGAINST LTA
18000.00
BASIC
328540.00
HOUSE RENT ALLOW.
164270.00
MEDICAL TAXABLE
996.00
PROFESSIONAL ALLOWANCE
228521.00
SALES INCENTIVE
152103.00
TRANSPORT ALLOWANCE
10800.00
TOTAL
903230.00
Place : MUMBAI
Date : 31-May-2015
Designation : Sr Vice President
Full Name : Mr. Nitin R. Vaidya
Page 3 of 4
FORM NO. 12BA

[See rule 26A(2)(b)]
Statement Showing particular of perquisities, other fringe benefits or amenities and profits in lieu of salary with value thereof
(1)
Name of the Employer
KOTAK MAHINDRA BANK LIMITED

36-38 A NARIMAN BHAVAN
227, NARIMAN POINT, MUMBAI - 400021
(2)
TAN
MUMK01323A
(3)
TDS Assessment Range of the employer
COMMISSIONER OF INCOME TAX(TDS) MUMBAI
(4)
Name, designation and PAN of employee
Miss. SRIPRIYA N T
SENIOR MANAGER
ADOPT8945J
(5)
Is the employee a director or a person with substantial interest in No

the company (Where the employer is a company)
(6)
Income under the head Salaries of the employee (Other than

from Perquisities)
903230.00
(7)
Financial Year
2014-2015
(8)
Valuation of Perquisities
S No
Nature of Perquisite
(See rule 3)
Value of Perquisite
as per rules (Rs.)
Amount, if any
Recovered from the
employee (Rs.)
Amount of perquisite
chargeable to tax
col.(3)- col.(4) (Rs.)
(1)
(2)
(3)
(4)
(5)
Accomodation
0.00
0.00
0.00
Cars / Other automotive
0.00
0.00
0.00
Sweeper, gardener, watchman or personal attendant
0.00
0.00
0.00
Gas, electricity, water
Interest free or concessional Loans
0.00
0.00
0.00
1853.00
0.00
1853.00
Holiday expenses
0.00
0.00
0.00
Free or concessional travel
0.00
0.00
0.00
Free Meals
0.00
0.00
0.00
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
18
Total value of perquisites
19
Total value of profits in lieu of salary as per 17(3)
(9)
Details of Tax
0.00
0.00
0.00
1853.00
0.00
1853.00
0.00
0.00
0.00
(a) Tax Deducted from salary of the employee under section 192(1)
97615.00
(b) Tax paid by the employer on behalf of the employee under section 192(1A)
(c) Total Tax paid
0.00
97615.00
(d) Date of payment into Government Treasury :
(See Form No 16)

DECLARATION BY EMPLOYER
I Mr. Nitin R. Vaidya, son / daughter of Mr. Ramesh Ramchandra Vaidya working as Sr Vice President do hereby declare on behalf of KOTAK MAHINDRA
BANK LIMITED that the information given above is based on the books of accounts, 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 : MUMBAI
Date : 31-May-2015
Designation: Sr Vice President
Full Name:Mr. Nitin R. Vaidya
Page 4 of 4

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FORM NO.

Name and Designation of the Employee

KOTAK MAHINDRA BANK LIMITED

PAN of the Deductor

TAN of the Deductor

PAN of the Employee

Employee Reference No.

CIT (TDS) INCOME TAX - TDS

Period With the Employer

b. Value of perquisites U/S 17(2) (as per Form No.12BA)

c. Profits in lieu of salary U/S 17(3) (as per Form No.12BA)

Less: Allowance to the extent exempt U/S 10

Aggregate of 4(a) and (b)

Income chargeable under the head 'salaries' (3-5)

Add: Any other income reported by the employee

Income / Loss from House Property (Sec 24)

Income from Other Sources

Gross total income (6+7)

Deductions under Chapter VI-A

Aggregate amount deductible under sections 80C, 80CCC and 80CCD(1)

TAN of Employer: MUMK01323A

PAN of Employee: ADOPT8945J

Assessment Year: 2015-2016

Aggregate of deductible amount under Chapter VI-A

Total Income (8-10)

Tax on total income

Surcharge (on tax computed at S. No. 12)

Education cess @ 3% (on tax computed at S. No. 12 + S. No 13)

Tax Payable (12+13+14)

Less: Relief under section 89 (attach details)

Tax payable (15-16)

Signature of Person Responsible for Deduction of Tax

Designation : Sr Vice President

Full Name : Mr. Nitin R. Vaidya

Digitally Signed By VAIDYA NITIN (KOTAK

TAN of Employer: MUMK01323A

PAN of Employee: ADOPT8945J

Assessment Year: 2015-2016

ADVANCE AGAINST LTA

HOUSE RENT ALLOW.

Signature of Person Responsible for Deduction of Tax

Designation : Sr Vice President

Full Name : Mr. Nitin R. Vaidya

TAN of Employer: MUMK01323A

PAN of Employee: ADOPT8945J

Assessment Year: 2015-2016

FORM NO. 12BA

Name of the Employer

KOTAK MAHINDRA BANK LIMITED

TDS Assessment Range of the employer

COMMISSIONER OF INCOME TAX(TDS) MUMBAI

Name, designation and PAN of employee

Is the employee a director or a person with substantial interest in No

Income under the head Salaries of the employee (Other than

Cars / Other automotive

Sweeper, gardener, watchman or personal attendant

Gas, electricity, water

Interest free or concessional Loans

Free or concessional travel

Gifts, Vouchers etc

Credit Card Expenses

Use of movable assets by employees

Transfer of assets to employees