BRILLIANT BIO PHARMA PRIVATE LIMITED

Digitally signed document

Form 16

Details in Form 16:

Date: 25/06/2022

Employee Name: HIMADRI SEKHAR MONDAL

Employee PAN: BBAPM3103J

Financial Year: 2021-22

Assessment Year: 2022-23

Form 16 Control No: 2021-22/126/192/34

Details of signature:

Form 16 is a Certificate issued under section 203 of the Income-Tax Act, 1961 for Tax deducted at source. Please
refer, [See Rule 31(1)(a)]. This certificate is signed with a "Secure Digital Signature", as defined under
section 15 of Indian Information Technology Act, 2000.

Respective Digital Signature of the signatory has been affixed below. Please click on the box in order to see the
details and validate the signature (for your reference).

Issuer Organization: BRILLIANT BIO PHARMA PRIVATE LIMITED

Issuer (TAN): HYDB04468C
Document Name: Form 16

HARI NARAYANA REDDY GOLUGURI

Email : GHNR@BBPL.CO.IN
Issued by : Pantagon Sign Securities Pvt. Ltd.
Reason : Digitally signed TDS certificate as per Information Technology Act, 2000.
Date : 2022.06.25 10:47:45 +05:30

(This document is digitally signed and enclosed with Statutory format of Form 16.)

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 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.2021-22/126/192/34 Last updated on: 25/06/2022
Name and address of the Employer Name and address of the Employee
BRILLIANT BIO PHARMA PRIVATE LIMITED HIMADRI SEKHAR MONDAL
5TH FLOOR, 6-2-1012, TGV MANSION OFFICER PURCHASE
OPP.INSTITUTE OF ENGINEER
KHAIRATABAD
HYDERABAD - 500004
TELANGANA
PAN of the Deductor TAN of the Deductor PAN of the Employee Employee Reference No.
provided by the
Employer (If available)
AAECB1799G HYDB04468C BBAPM3103J
CIT (TDS) Assessment Year Period
Address: Room No. 411,,Income Tax Towers,,10-2-3 From To
A.C. Guard, 2022-23
City: Hyderabad Pincode: 500004 01/04/2021 31/03/2022
Summary of amount paid/credited and tax deducted at source thereon in respect of the employee

Quarter(s) Receipt Numbers Amount paid/ Amount of tax Amount of tax

of original credited deducted (Rs.) deposited/
quarterly remitted (Rs.)
statements of TDS
under sub-section
(3) of section 200

1
2
3
4

Total (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 the deductee)
Not Applicable
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)
Sl. Tax Deposited in Challan Identification Number (CIN)
No. respect of the
deductee (Rs.)
BSR Code of the Bank Date on which tax Challan Serial Status of
Branch deposited (dd/mm/ Number matching with
yyyy) OLTAS
Total 0.00

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 Certificate No.: 2021-22/126/192/34

Verification
I, G.HARI NARAYANA REDDY, son of G VENKATA REDDY working in the capacity of EXECUTIVE DIRECTOR
(designation) do hereby 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 HYDERABAD Form is digitally signed. Please refer Page 1 for details.

Date 25/06/2022 Signature of person responsible for deduction of tax

Designation EXECUTIVE DIRECTOR Full Name: G.HARI NARAYANA REDDY

PART B (Annexure)
Details of Salary paid and any other income and tax deducted
A. Whether opting for taxation u/s 115BAC? NO
1. Gross Salary
a) Salary as per provisions contained in sec. 17(1) Rs. 3,95,727.00
b) Value of perquisites u/s 17(2) Rs.
c) Profits in lieu of salary under section 17(3) Rs.
d) Total Rs. 3,95,727.00
e) Reported total amount of salary received from other employer(s) Rs.
2. Less: Allowances to the extent exempt under section 10
(a) Travel concession or assistance u/s 10(5) Rs. 10,800.00
(b) Death-cum-retirement gratuity u/s 10(10) Rs.
(c) Commuted value of pension u/s 10(10A) Rs.
(d) Cash equivalent of leave salary encashment u/s 10(10AA) Rs.
(e) House rent allowance u/s 10(13A) Rs.
(f) Amount of any other exemption under section 10
clause 10(14)(i)-1 Rs. 5,400.00
(g) Total amount of any other exemption under section 10 Rs. 5,400.00
(h) Total amount of exemption claimed under section 10 Rs. 16,200.00
3. Total amount of salary received from current employer [1(d)-2(h)] Rs. 3,79,527.00
4. Less: Deductions under section 16
(a) Standard deduction under section 16(ia) Rs. 50,000.00
(b) Entertainment allowance under section 16(ii) Rs.
(c) Tax on employment under section 16(iii) Rs. 2,400.00
5. Total amount of deductions under section 16 [4(a)+4(b)+4(c)] Rs. 52,400.00
6. Income chargeable under the head 'Salaries' [(3+1(e)-5] Rs. 3,27,127.00
7. Add: Any other income reported by the employee
(a) Income (or admissible loss) from house property Rs.
(b) Income under the head Other Sources Rs.
8. Total amount of other income reported by the employee [7(a)+7(b)] Rs.
9. Gross total income (6+8) Rs. 3,27,127.00
10. Deductions under Chapter VI-A
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 Certificate No.: 2021-22/126/192/34
Gross Amount Deductible Amount
(a) Deductions in respect of specified investments/savings - 80C Rs. 10,026.00 Rs. 10,026.00
(b) Contributions to Specified Pension Funds - 80CCC Rs. Rs.
(c) Contributions to Pension Funds 80CCD(1) Rs. Rs.
(d) Total deduction under section 80C, 80CCC and 80CCD(1) Rs. 10,026.00 Rs. 10,026.00
(e) Contribution to National Pension System 80CCD(1B) Rs. Rs.
(f) Contributions to Pension Funds 80CCD(2) Rs. Rs.
(g) Medical Insurance Premium Paid - 80D Rs. Rs.
(h) Repayment of Interest on Higher Education Loan - 80E Rs. Rs.
Gross Amount Qualifying Amount Deductible Amount
(i) Donations to Specified funds / Institutions - 80G Rs. Rs. Rs.
(j) Interest on Savings Account - 80TTA Rs. Rs. Rs.
(k) Amount deductible under any other provision(s) of Chapter VI-A
(l) Total of amount deductible under any other provision(s) Rs. Rs. Rs.
11. Aggregate of deductible amount under Chapter VI-A Rs. 10,026.00
[10(d)+10(e)+10(f)+10(g)+10(h)+10(i)+10(j)+10(l)]
12. Total taxable income (9-11) Rs. 3,17,101.00
13. Tax on total income Rs. 3,355.00
14. Rebate under section 87A, if applicable Rs. 3,355.00
15. Surcharge, wherever applicable Rs.
16. Health and education cess (@ 4%) Rs.
17. Tax payable (13+15+16-14) Rs. Nil
18. Less: Relief under section 89 (attach details) Rs.
19. Net tax payable (17-18) Rs.
Verification
I, G.HARI NARAYANA REDDY, son of G VENKATA REDDY working in the capacity of EXECUTIVE DIRECTOR
(designation) do hereby certify that a sum of Rs. Nil [Rs. Zero] has been deducted at source 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 account, documents, TDS statements, TDS deposited and other available records.

Place HYDERABAD Form is digitally signed. Please refer Page 1 for details.

Date 25/06/2022 Signature of person responsible for deduction of tax

Designation EXECUTIVE DIRECTOR Full Name: G.HARI NARAYANA REDDY

Notes:

1. Government deductors to fill information in item I of Part A if tax is paid without production of an income-
tax challan and in item II of Part A if tax is paid accompanied by an income-tax challan.
2. Non-Government deductors to fill information in item II.
3. The deductor shall furnish the address of the Commissioner of Income-tax (TDS) having jurisdiction as
regards TDS statements of the assessee.
4. If an assessee is employed under one employer only during the year, 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.
5. 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.
6. In items I and II, in column for tax deposited in respect of deductee, furnish total amount of TDS and
education cess Page 4
 Certificate No.: 2021-22/126/192/34
Tax Deducted Summary
(Summary of Tax Payable and Tax Deducted Information)
Sl.No. Particulars Amount
1 Tax payable as per Part-B Nil
2 Tax Deducted at Current Employment Nil
3 Tax Deducted at Previous Employment Nil
4 Total Tax Deducted (2+3) Nil
5 Net Tax Payable / (Refundable) (1-4) Nil

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