Certificate under section 395 for tax deducted at source on salary paid to an employee under section 392 or pension or interest income of specified senior citizen under section 393(1) [Table: Sl. No. 8(iii)]

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....t of the employee Quarter (s) Receipt Numbers of original quarterly statements of TDS under section 397(3)(b) Amount paid/ credited Rate of deduction of tax Amount of tax deducted Amount of tax deposited/ adjusted                         Total         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) Sl. No. Tax deposited (refer Note 5) Book Identification Number (BIN) Receipt numbers of Form No. 137 DDO serial number in Form No. 137 Date of Transfer voucher (dd/mm/yyyy) Status of Matching with Form No. 137             Total           II. 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) Sl. No. Tax deposited (refer Note 5) Challan Identification Number (CIN) ....

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....-I) In relation to employees for tax deduction under section 392 Row No. Particulars   A Whether opting out of taxation under section 202(1)? (Yes/No)   1. Gross Salary     (a) Salary as per provisions contained in section 16     (b) Value of perquisites under section 17 (as per Form No. 123, wherever applicable)     (c) Profits in lieu of salary under section 18 (as per Form No. 123, wherever applicable)     (d) Total     (e) Reported total amount of salary received from other employer(s)     2. Allowances to the exempt under section 11     (a) Travel concession or assistance under section 11 being of the nature referred to in Schedule III [Table: Sl. No. 8]     (b) House rent allowance under section 11 being of the nature referred to in Schedule III [Table: Sl. No. 11]     (c) Other special allowances under section 11 being of the nature referred to in Schedule III [Table: Sl. No. 12 and 13]     (d) Amount of any other exemption under section 11 &n....

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....mployer to pension scheme under section 124(1)(a)         (d) Deduction in respect of health insurance premia under section 126         (e) Deduction in respect of interest on loan taken for higher education under section 129         (f) Deduction in respect of contribution by the employee to Agnipath Scheme under section 125 (1)         (g) Deduction in respect of contribution by the Central Government to Agnipath Scheme under section 125 (2)           Gross Amount Qualifying Amount Deductible Amount   (h) Total Deduction in respect of donations to certain funds, charitable institutions, etc. under section 133         (i) Deduction in respect of interest on deposits in savings account under section 153         (j) Amounts deductible under any other provisions of Chapter VIII of the Act   section ...         section ...         section .....

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.... Total amount of salary received       3. Deductions under section 19         (a) Tax on employment under section 19 [Table: Sl. No.1]         (b) Standard deduction under section 19 [Table: Sl. No.2]       4. Total amount of deductions under section 19 [3(a)+3(b)]       5. Income chargeable under the head "Salaries" [(2-4]       6. Interest Income under the head "Other Sources" paid by the specified bank       7. Gross total income (5+6)       8. Deductions under Chapter VIII of the Act   Gross Amount Deductible Amount   (a) Deduction in respect of life insurance premia, contributions to provident fund, certain pension funds, notified pension schemes etc. under section 123         (b) Deductions in respect of amount paid/deposited to notified pension scheme under section 124(3)         (c) Deduction in respect of health insurance premia unde....