PART B (Annexure) Details of Salary paid and any other income and tax deducted INR INR INR

1. Gross salary(a) Salary as per provisions contained in sec.17(1)(b) Value of perquisites u/s 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 ) (d) Total

2. Less: Allowance to the extent exempt u/s 10

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

8. Gross total income (6+7) 9. Deductions under Chapter VI-A

Gross Amount Deductible Amount A) sections 80C, 80CCC and 80CCD a) section 80C i) Employee Provident Fund

(b) section 80CCC(c) section 80CCD

B) Other sections (e.g. 80E, 80G, 80TTA, etc.) under chapter VI-A

Note: 1. Aggregate amount deductible under sections 80C, 80CCC and 80CCD(1) shall not exceed one lakh fifty thousand rupees.

Deductible amount

Qualifying amount

Gross amount

10. Aggregate of deductible amount under Chapter VI-A

11. Total Income (8-10)

12. Tax on total income

14. Tax payable (12+13)

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

16. Tax Payable (14-15)

15. Less: Relief under section 89 (attach details)

(Signature of person responsible for deduction of tax) Full Name:

Verification

I, BHUVANESHWARI K, son/daughter of KANNAPPA ARUMUGAM working in the capacity of HR SERVICE SR CONSULTANT (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, and other available records.

Designation:

Place

Date

FORM No.12BA {See Rule 26A(2)(b)}

Statement showing particulars of perquisities, other fringe benefits or amenities and profits in lieu of salary with value thereof

1) Name and address of employer :SAP India Private Limited Salarpuria Softzone, Bellandur post, Bangalore- 560103- Karnataka,

BLRS03271C2) TAN:3) TDS Assessment Range of the employer :

TDS Circle 18(2) , Bangalore, , , , 4) Name, designation and PAN of employee :

Mr Debanshu MukherjeeMr/Ms: Business Processes Consultant, Desig.: 01303114, Emp #: ALRPM2992D, PAN: 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 : 1678014.00 (other than from perquisites)

7) Financial year : 2014 2015-8) Valuation of Perquisites

S.No

(1)

Nature of perquisite (see rule 3) (2)

Value of perquisite as per rules(INR) (3)

Amount, if any recovered from the employee(INR) (4)

Amount of perquisite chargeable to tax(INR) Col(3)-Col(4) (5)

1 Accommodation

2 Cars/Other automotive

3 Sweeper , gardener , watchman or personal attendant

4 Gas , electricity , water5 Interest free or concessional loans6 Holiday expenses

7 Free or concessional Travel

8 Free meals

9 Free Education

10 Gifts,vouchers etc.11 Credit card expenses12 Club expenses

13 Use of movable assets by employees14 Transfer of assets to employees

15 Value of any other benefit /amenity/service/privilege

16 Stock options ( non-qualified options )17 Other benefits or amenities18 Total value of perquisites19 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

DECLARATION BY EMPLOYERI, BHUVANESHWARI K Son/daughter of KANNAPPA ARUMUGAM working as HR SERVICE SR CONSULTANT (designation ) do hereby declare on behalf of SAP India Private Limited ( name of the employer ) 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.

Signature of person responsible for deduction of tax

Place :Date :

Full Name:Designation:

Annexure to Form No.16

30.05.2015Date:BANGALOREPlace:

BHUVANESHWARI KFull Name:HR SERVICE SR CONSULTANTDesignation:

Name: Emp No.:

Particulars Amount(INR)

Emoluments paid

Perquisites

Gross emoluments

Income from other sources

Total income from other sources

Exemptions u/s 10

Total Exemption

data[0]: MASTER_PAGES[0]: F16PAGE5[0]: FLEXTXT[0]: ENAME[0]:

F16PAGE2[0]: EMPNO[0]: ENAME[0]:

Form12BA[0]: Cust_text[0]: ENAME[0]: HEADER_DETAILS[0]: #subform[3]: TextField13[0]:

ANNEXURE[0]: Cust_text[0]: ENAME[0]:

FORM16_BODY_PAGE2[0]: #subform[0]: #subform[1]: SAL_SEC17[0]: 1680414.00VAL_F12BA[0]: 0.00PROF_F12BA[0]: 0.00GROSS_SAL[0]: 1680414.00

Sec10Details[0]: SEC10_ALL[0]: 0.00

Exemption[0]: Table1[0]: Row1[0]: SPEC_TEXT[0]: AllowanceAMOUNT[0]:

Balance[0]: BALANCE[0]: 1680414.00ETALL[0]: 0.00PTAX[0]: 2400.00AGGR_DED[0]: 2400.00SALARIES[0]: 1678014.00

Addtionalincome[0]: OTH_INCOME[0]: 0.00

AddIncome[0]: Table2[0]: Row1[0]: SPEC_TEXT[0]: IncomeAMOUNT[0]:

GrossAmount[0]: GROSS_TOT_INCOME[0]: 1678014.00

DEDUCTIONS[0]: True[0]: deduction_header[1]: TOT_EPF[0]: TOT_EPF[1]: 67452.00DEDMT_PF[0]:

DEDUCTIONSDATA[0]: TextField[0]: ii) Payment towards Life Insurance Policy#field[1]: QLAMT[0]: QLAMT[1]: 33783.00DEDMT[0]:

DEDUCTIONSDATA[1]: TextField[0]: iii) 80CCD(1)#field[1]: QLAMT[0]: QLAMT[1]: 0.00DEDMT[0]: 101235.00

#subform[2]: TextField7[0]: TextField7[1]: TextField7[2]: 0.00TextField7[3]: 0.00TextField7[4]: 0.00SEC80_CCC_CONMT[0]: 0.00

AGGRDEDAMT[0]: SEC80_ded[0]: 101235.00TOT_INCOME[0]: 1576780.00TAX_TOT_INCOME[0]: 298034.00

TEXTS[0]: TAX_BEF_RELIEF[0]: 306980.00TAX_PAYABLE[0]: 306980.00SEC89_RELIEF[0]: 0.00Education_cess[1]: 8941.00

TOT_AMT_DEDUC[0]: RP_NAME[0]: BHUVANESHWARI K2015-06-17T08:32:04+0200BHUVANESHWARI KI attest to the accuracy and integrity of this document

RP_DSG[1]: HR SERVICE SR CONSULTANTRPLACE[0]: BANGALOREREPODATE[0]: 30.05.2015FTEXT2[0]: FTEXT1[0]:

F12BA_BODY_PAGE[0]: F12BA[0]: F12BA_ACCOMODATION[0]: VAL_PERK1[0]: 0.00EERECVR1[0]: 0.00TAX_PERK1[0]: 0.00

F12BA_CARS[0]: VAL_PERK2[0]: 0.00EERECVR2[0]: 0.00TAX_PERK2[0]: 0.00

F12BA_PERSONAL[0]: VAL_PERK3[0]: 0.00EERECVR3[0]: 0.00TAX_PERK3[0]: 0.00

F12BA_GAS[0]: VAL_PERK4[0]: 0.00EERECVR4[0]: 0.00TAX_PERK4[0]: 0.00

F12BA_CONCESS[0]: VAL_PERK5[0]: 0.00EERECVR5[0]: 0.00TAX_PERK5[0]: 0.00

F12BA_HOLIDAY[0]: VAL_PERK6[0]: 0.00EERECVR6[0]: 0.00TAX_PERK6[0]: 0.00

F12BA_LOANS[0]: VAL_PERK7[0]: 0.00EERECVR7[0]: 0.00TAX_PERK7[0]: 0.00

F12BA_FREEMEALS[0]: VAL_PERK8[0]: 0.00EERECVR8[0]: 0.00TAX_PERK8[0]: 0.00

F12BA_FREEEDU[0]: VAL_PERK9[0]: 0.00EERECVR9[0]: 0.00TAX_PERK9[0]: 0.00

F12BA_GIFTS[0]: VAL_PERK10[0]: 0.00EERECVR10[0]: 0.00TAX_PERK10[0]: 0.00

F12BA_CREDITCARD[0]: VAL_PERK11[0]: 0.00EERECVR11[0]: 0.00TAX_PERK11[0]: 0.00

F12BA_CLUB_EXPENSE[0]: VAL_PERK12[0]: 0.00EERECVR12[0]: 0.00TAX_PERK12[0]: 0.00

F12BA_MOVABLE[0]: VAL_PERK13[0]: 0.00EERECVR13[0]: 0.00TAX_PERK13[0]: 0.00

F12BA_ASSETS[0]: VAL_PERK14[0]: 0.00EERECVR14[0]: 0.00TAX_PERK14[0]: 0.00

F12BA_ANYOTHER[0]: VAL_PERK15[0]: 0.00EERECVR15[0]: 0.00TAX_PERK15[0]: 0.00

F12BA_STOCK_OPTIONS[0]: VAL_PERK16[0]: 0.00EERECVR16[0]: 0.00TAX_PERK16[0]: 0.00

F12BA_AMENITIES[0]: VAL_PERK17[0]: 0.00EERECVR17[0]: 0.00TAX_PERK17[0]: 0.00

F12BA_TOTAL[0]: VAL_PERK18[0]: 0.00EERECVR18[0]: 0.00TAX_PERK18[0]: 0.00

F12BA_PROFITS_SALARY[0]: VAL_PERK19[0]: 0.00EERECVR19[0]: 0.00TAX_PERK19[0]: 0.00

FOOTER[0]: DETAILS[0]: TAX[0]: TAX_DEDUCT[0]: 306980.00EMPLOYER_TAX[0]: 0.00TOT_TAX_DEDUCTED[0]: 306980.00

2015-06-17T08:32:05+0200BHUVANESHWARI KI attest to the accuracy and integrity of this document

place[0]: RPLACE[0]: BANGALOREREPODATE[0]: 30.05.2015

DESIGNATION[0]: RP_NAME[0]: BHUVANESHWARI KRP_DSG[0]: HR SERVICE SR CONSULTANT

F16_ANNEXURE_BODY[0]: F16ANNEXURE[0]: EMP_DETAILS[0]: ENAME[0]: Mr Debanshu MukherjeeEMPNO[0]: 01303114

ANNEXURE_GROSS[0]: Subform2[0]: DATA[0]: SPEC_TEXT[0]: Basic SalaryANX_GROSS[0]: AMOUNT[0]: 562092.00SIGN[0]:

DATA[1]: SPEC_TEXT[0]: House Rent AllowanceANX_GROSS[0]: AMOUNT[0]: 224832.00SIGN[0]:

DATA[2]: SPEC_TEXT[0]: Leave Travel AllowanceANX_GROSS[0]: AMOUNT[0]: 50000.00SIGN[0]:

DATA[3]: SPEC_TEXT[0]: Medical ReimbursementANX_GROSS[0]: AMOUNT[0]: 15000.00SIGN[0]:

DATA[4]: SPEC_TEXT[0]: Other AllowancesANX_GROSS[0]: AMOUNT[0]: 843490.00SIGN[0]:

DATA[5]: SPEC_TEXT[0]: Exm.under proviso to sec.17(2)ANX_GROSS[0]: AMOUNT[0]: - 15000.00SIGN[0]:

ANNEXURE_PERKS[0]: SPEC_TEXT[0]: AMOUNT[0]:

GROSS_EMOLUMENTS[0]: GROSS_SAL[0]: 1680414.00

ANNEXURE_IFOS[0]: SPEC_TEXT[0]: IncomeAMOUNT[0]:

TOT_INCOME_OTH[0]: OTH_INCOME[0]: 0.00

ANNEXURE_EXEMPS[0]: SPEC_TEXT[0]: AllowanceAMOUNT[0]: SIGN[0]:

TOTAL_EXEMP[0]: SEC10_ALL[0]: 0.00