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. FCAWNGG Name and address of the Employer HSBC Software Development (India) Pvt Ltd HSBC Center Riverside,, West Avenue,, 25 B,Kalyani Nagar,, Pune - 411006 Maharashtra +(91)20-66045008 shisheerpanse@hsbc.co.in Last updated on Name and address of the Employee 21-May-2013

PRAFULLA PADMAKAR KALE MILE POST -4, PUNE-NAGAR RD, PUNE - 411014 Maharashtra

PAN of the Deductor

TAN of the Deductor

PAN of the Employee

Employee Reference No. provided by the Employer (If available)

AABCH0517M CIT (TDS) The Commissioner of Income Tax (TDS) 4th Floor, .A. Wing, PMT Commercial Complex, Shankar Sheth Road , Swargate, Pune - 411037

PNEH04197E Assessment Year

AKEPK4726H Period with the Employer From 2013-14 01-Apr-2012 To 31-Mar-2013

Summary of amount paid/credited and tax deducted at source thereon in respect of the employee Receipt Numbers of original quarterly statements of TDS under sub-section (3) of Section 200 GDIXXLEB GDIXDODE GDIXFRPA GDIXIPDD Amount of tax deposited / remitted (Rs.)

Quarter(s)

Amount paid/credited

Amount of tax deducted (Rs.)

Q1 Q2 Q3 Q4 Total (Rs.)

465776.00 347726.00 358926.00 190004.00 1362432.00

55583.00 31785.00 35247.00 18695.00 141310.00

55583.00 31785.00 35247.00 18695.00 141310.00

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

Total (Rs.) 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 with respect to the deductee) Challan Identification Number (CIN) BSR Code of the Bank Branch 0004329 0004329 0004329 0004329 Date on which Tax deposited Challan Serial Number (dd/mm/yyyy) 07-05-2012 07-06-2012 06-07-2012 07-08-2012 56676 42668 59958 35700 Status of matching with OLTAS* F F F F

Sl. No.

Tax Deposited in respect of the deductee (Rs.) 33724.00 10759.00 11100.00 11749.00

1 2 3 4

Digitally signed by SHISHEER DATTATRAYA PANSE Date: 2013.05.26 14:43:11 +05'30'

Page 1 of 2

Certificate Number: FCAWNGG

TAN of Employer: PNEH04197E

PAN of Employee: AKEPK4726H

Assessment Year: 2013-14

Sl. No.

Tax Deposited in respect of the deductee (Rs.) 10991.00 9045.00 13588.00 10667.00 10992.00 18695.00 141310.00

Challan Identification Number (CIN) BSR Code of the Bank Branch 0004329 0004329 0004329 0004329 0004329 0004329 Date on which Tax deposited Challan Serial Number (dd/mm/yyyy) 07-09-2012 05-10-2012 06-11-2012 06-12-2012 04-01-2013 06-03-2013 35951 27725 32326 35148 16406 40290 Status of matching with OLTAS* F F F F F F

5 6 7 8 9 10 Total (Rs.)

Verification
I, SHISHEER DATTATRAYA PANSE, son / daughter of DATTATRAYA DAMODAR PANSE working in the capacity of HEAD FINANCE (designation) do hereby certify that a sum of Rs. 141310.00 [Rs. One Lakh Fourty One Thousand Three Hundred and Ten Only (in words)] has been deducted and a sum of Rs. 141310.00 [Rs. One Lakh Fourty One Thousand Three Hundred and Ten Only] has been 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 account, documents, TDS statements, TDS deposited and other available records.

Place Date Designation: HEAD FINANCE Notes:

Pune 24-May-2013 (Signature of person responsible for deduction of Tax) Full Name: SHISHEER DATTATRAYA PANSE

1. Part B (Annexure) of the certificate in Form No.16 shall be issued by the employer. 2. If an assessee is employed under one employer during the year, Part 'A' of the certificate in Form No.16 issued for the quarter ending on 31st March of the financial year shall contain the details of tax deducted and deposited for all the quarters of the financial year. 3. If an assessee is employed under more than one employer during the year, each of the employers shall issue Part A of the certificate in Form No.16 pertaining to the period for which such assessee was employed with each of the employers. Part B (Annexure) of the certificate in Form No. 16 may be issued by each of the employers or the last employer at the option of the assessee. 4. To update PAN details in Income Tax Department database, apply for 'PAN change request' through NSDL or UTITSL.

Legend used in Form 16 * Status of matching with OLTAS

Legend U P Description Unmatched Provisional Definition Deductors have not deposited taxes or have furnished incorrect particulars of tax payment. Final credit will be reflected only when payment details in bank match with details of deposit in TDS / TCS statement Provisional tax credit is effected only for TDS / TCS Statements filed by Government deductors."P" status will be changed to Final (F) on verification of payment details submitted by Pay and Accounts Officer (PAO) In case of non-government deductors, payment details of TDS / TCS deposited in bank by deductor have matched with the payment details mentioned in the TDS / TCS statement filed by the deductors. In case of government deductors, details of TDS / TCS booked in Government account have been verified by Pay & Accounts Officer (PAO) Payment details of TDS / TCS deposited in bank by deductor have matched with details mentioned in the TDS / TCS statement but the amount is over claimed in the statement. Final (F) credit will be reflected only when deductor reduces claimed amount in the statement or makes new payment for excess amount claimed in the statement

Final

Overbooked

Page 2 of 2

PART B
DETAILS OF SALARY PAID AND ANY OTHER INCOME AND TAX DEDUCTED
1. Gross Salary a. Salary as per provisions contained in section 17(1) b. Value of perquisites under section 17(2) (as per Form No. 12BA, wherever applicable) c. Profits in lieu of salary under section 17(3) (as per Form No.12BA, wherever applicable) (Rs.) (Rs.) 1,538,710 0 0 1,538,710 (Rs.) (Rs.)

d. Total
2. Less: Allowance to the extent exempt under section 10 a. House Rent Allowance b. Conveyance c. Medical Reimbursement d. Leave Travel Assistance e. Leave Encashment f. Gratuity g. Other Allowances 0 8,514 13,304 31,929 3,274 176,278 0

i.

Total [a to g]

233,299 1,305,411

3. Balance (1 - 2) 4. Deductions a. Entertainment allowance b. Tax on Employment 5. Aggregate of 4 (a) and (b) 6. Income chargeable under the head 'salaries' (3 - 5) 7. Add: Any other income reported by the employee a. Income under the head 'Income from House Property' b. Income under the head 'Income from Other Sources' c. Total of (a+b) above 8. Gross total income (6 + 7) 9. Deductions under Chapter VI-A (A) sections 80C, 80CCC and 80CCD (a) section 80C (i) (ii) Provident Fund Life Insurance Premium 41,806 20,073 0 0 189,570 0 0 0 251,449 0 0
Gross Amount

0 2,100 2,100 1,303,311

-179,330 0 -179,330 1,123,981

Deductible Amount

(iii) Public Provident Fund (vi) N.S.C. & Interest (v) Housing Loan Principal (vi) Children Education (vii) Infra.Bonds/ULIP/MFs (viii) Fixed Deposite (b) section 80 CCC (c) section 80 CCD

100,000 0 0

(B) other sections ( e.g., 80E, 80G, 80TTA etc.) under Chapter VI-A a. Section 80 G b. Section 80 CCF c. Section 80 D (Mediclaim) d. Section 80 U (Handicapped) e. Section 80 DD (Hand.Depnt.) f. Section 80 E (Education Loan) g. Section 80 DDB h. Section 80 DDB ( Sr Ctzn) 10. Aggregate of deductible amount under Chapter VI-A 11. Total Income (8 - 10) 12. Tax on total income 13. Education cess @3.00% (on tax computed at S.No.12) 14. Tax payable (12+13) 15. Less: Relief under section 89 (attach details) 16. Tax payable (14-15)

Gross Amount

Qualifying Amount

Deductible Amount

0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 100,000 1,023,980 137,194 4,116 141,310 0 141,310

Verification
I, Mr. Shisheer Panse, son of Mr. Dattatraya Panse working in the capacity of Head - Finance do hereby certify that the information given above is true, complete and correct and is based on the books of account, documents, TDS statements, and other available records.

Digitally Signed By SHISHEER DATTATRAYA PANSE Signature of the person responsible for deduction of tax Place: Date: Pune 26-May-2013 Full Name: Mr. Shisheer Panse Designation: Head - Finance

Prafulla Padmakar Kale

Gross Salary Basic Salary House Rent Allowance Conveyance Allowance Medical Allowance Leave Travel Allowance Special Allowance Variable Pay 2011 Shift Allowance Gratuity Exempt Leave Encashment

Annexure to Form No. 16

Total (Rs.) 348,415 174,213 8,514 13,304 31,929 603,833 110,000 68,950 176,278 3,274 Gross Salary 1,538,710

FORM NO. 12BA

[{See Rule 26A(2)(b)}] Statement showing particulars of perquisites, other fringe benefits or amenities and profits in lieu of salary with value thereof 1. Name and address of employer :

HSBC Software Development (India) Pvt Ltd

HSBC Center Riverside, West Avenue, 25 B,Kalyani Nagar, Pune 411006 PNEH04197E TDS-1 PUNE MAHARASHTRA

2. TAN 3. TDS Assessment Range of employer: 4. Name,designation and PAN of employee: 5. Is the employee a director or a person with substantial interest in the company (where the employer is a company): 6. Income under the head 'Salaries' of the employee: (other than from perquisites) 7. Financial Year 8. Valuation of Perquisites S.No. Nature of perquisites (see rule 3)

Prafulla Padmakar Kale - Team Leader

AKEPK4726H NO 1,538,710 2012-2013 Value of perquisite as per rules (Rs.) Amount, if any, Amount of perquisite recovered from the chargeable to tax employee (Rs.) (Rs.) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 141,310 0 141,310 as per Form-16

1. Accommodation 2. Perquisites-Cars/Other automotive 3. Sweeper,gardner,watchman,P.A. 4. Gas,electricity,water 5. Int.free/concessional loans 6. Holiday expenses 7. Free or concessional travel 8. Free meals 9. Free education 10. Gifts, vouchers, etc. 11. Credit card expenses 12. Club expenses 13. Use of movable assets by employees 14. Transfer of assets to employees 15. Stock options (non-qualified options) 16. Other benefits or amenities 17. Profits in lieu of salary 18. Total value of perquisites 19. Total value of profits in lieu of salary as per section 17(3) 9. Details of tax: (a) Tax deducted from salary of the employee under section 192(1) (b) Tax paid by employer on behalf of the employee under section 192(1A) (c) Total tax paid (d) Date of payment into Government treasury

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

DECLARATION BY EMPLOYER I, Mr. Shisheer Panse, son of Mr. Dattatraya Panse working as Head - Finance do hereby declare on behalf of HSBC Software Development (India) Pvt Ltd that the information given above is based on the books of account, 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.

Digitally Signed By SHISHEER DATTATRAYA PANSE Signature of the person responsible for deduction of tax Place: Date: Pune 26-May-2013 Full Name: Mr. Shisheer Panse Designation: Head - Finance