FORM NO. 16 A

[See Rule 31 (1) (b) ]

 Certificate of deduction of tax at source under section 203 of the Income Tax Act, 1961
 "[For interest of securities, dividents, interest on time deposits referred to in clause (vii) and (viia) of sub-section(3) of section 194A, insurance commission; payments in respect of deposits under National Saving Scheme; payments on account of repurchase of units by Mutual Fund or Unit Trust of India; commission, remuneration or price on sale of lottery tickets.
Name and address of the person deducting tax TDS circle where Annual Return under section 206 is to be delivered Name and address of the person to whom payment made or in whose account it is credited
     
     
Tax Deduction A/c No. of the deductor Name of payment PAN/GIR No. of the payee
PAN/GIR No. of the Deductor   For the period

..................... .20    to ...................... 20

Details of payment tax deduction and deposit of tax central government account

Date of Payment/ Credit Amount paid / Credited (Rs.) Amount of Income Tax deducted (Rs.) Rate at which deducted Date & Challan No. of deposit of Tax into central Government Account Name of bank and branch where tax deposited
           
           

Certified that a sum of Rs. (in words)

.........................................has been deducted at source and paid to the credit of the Central Government as per details given above.

 

                                                                                                                 Signature of person responsible for deduction of tax

Place.........................                                                                             Name.....................................

Date.........................                                                                               Designation............................