Rule Form XVI Form XVI
- Chapter
- Annexures · Forms and Appendices
- Text as on
- As notified 08 May 2026
FORM -- XVI [See rule 41 (2)(b)]
Format for Self-assessment of Cess for building or other construction work to be furnished by employer
1. Name and address (permanent) of the establishment.
2. Name of the employer and address details
3. Name and address or location of place where the
building or other construction work is proposed to be
carried on.
4. Name, designation and address of the authorised
Person along with contact details
5. Correspondence address for the proposed building or
other construction work
6. Nature of proposed construction work
7. Date of commencement of work(in case construction
has started)
8. Approximate duration of work
9. Total proposed area of construction work
10. Total estimated cost of the construction based on the
rates of (PWD or CPWD or RERA or some other
rates, as the case may be) along with documents
(original) as per Rule 41.
11 Total estimated cost of construction as certified by
chartered engineer
12 Amount of provisional cess %age of total estimated cost Total
of the construction as notified estimated
by the Central Government cess (in Rs.)
13 Advance cess paid, along with details (at the time of
approval of the Project or before the commencement
of the construction work) or deduction at source
14 Details of cess paid (when duration of the proposed
construction work is more than one year)
Sl Year Amount (in Rs.)
No
14.1 1st year
14.2 2nd Year
14.3 3rd Year
15 Total amount of the cess paid (Sl.No. 13 + 14)
Declaration
1. I/We hereby declare that the particulars given above are true to the best of my/our knowledge and belief and I/We hereby declare that nothing has been concealed or any fact has been mis-represented in the above calculation made by me/us.
2. I/We hereby declare that I/We am/are quite aware of the penal provisions of the Code on Social Security, 2020(36 of 2020) and if in future anything mentioned in the above self-assessment of cess amount, is found to be incorrect or inappropriate or any incidence of hiding the facts or under calculation of cess amount is found, punitive action may be taken against me/us.
Signature and seal of employer
Name: Date: Place: Mobile Number:
E-mail (if any):
Certified by Chartered Engineer Along with his registration number, duly stamped.