File Content -
5. Date of Birth / Incorporation/Agreement/Partnership or T
rust Deed / Formation of Body of individuals or Association of Persons (DD / MM /
YYYY) 3. Have you ever been known by any other name ?
Yes No (Please tick as applicable)7.
Address (Residence Address)
Flat/Room/Door/Block No.
Name of Premises/Building/V illage
Road/S treet/Lane/Post Of fice
Area/Locality/T aluka/Sub-Division
T own/City/District
St ate/Union Territory 6. Father
’s Name (Only Individual applicant s: Even married women should fill in father ’s name only)
Last Name / Surname
First Name
Middle Name 4. Gender (for Individual applicant
s only) Male Female(Please tick as applicable)Last Name / Surname
First Name
Middle Name1. Full Name (Full exp
anded name to be mentioned as appearing in proof of identity/address doc\
ument s:initials are not permitted)
Please select title as applicable Shri Smt. \
Kumari M/s Last Name / Surname
First Name
Middle Name
2.
Abbreviation of the above name, as you would like it, to be printed on t\
he P AN cardForm No. 49A
Application for Allotment of Permanent Account Number
( In case of Indian Citizens/Indian Comp anies/ Entities incorparated in
India/Unincorporated entities formed in India )
Under section 139A of the Income Tax Act, 1961
T o avoid mist ake(s), please follow the accomp anying instructions and
examples before filling up the form. Assessing Officer (AO Code)
Sir
,
I/W e hereby request that a permanent account number be alloted to me/us.
I/W e give below necessary p articulars. Area Code
AO Type Range Code AO No.Signature/Left Thumb Impression across this photo Signature/Lef
t Thumb Impression Flat/Room/Door/Block No.
Name of Premises/Building/V
illage
Road/S treet/Lane/Post Of fice
Area/Locality/T aluka/Sub-Division
T own/City/District
St ate/Union Territory (Office
Address) P
U N J A B PIN
Code
I N D I A Country
P
U N J A B PIN
Code
I N D I A CountryOnly ‘Individuals’
to af fix recent
photograph
(3.5 cm X 2.5 cm) Only ‘Individuals’
to af fix recent
photograph
(3.5 cm X 2.5 cm) TIN FC - CODE - 02565
Branch ID : 2565
Please select title as applicable Shri Smt. \
Kumari M/s
Address (Residence
Address)
Flat/Room/Door/Block No.
Name of Premises/Building/V illage
Road/S treet/Lane/Post Of fice
Area/Locality/T aluka/Sub-Division
T own/City/District
St ate/Union Territory P
U N J A B PIN
Code
I N D I A Country Full Name (Full exp
anded name: initials are not permitted)
Last Name / Surname
First Name
Middle Name 13. Source of Income
Please select status; as applicable Income from Business/Profession
Income from House property
Business/Profession code(For code : Refer Instruction) Income from other
sources
No IncomeCapit
al Gains 10. S
tatus of applicant
Hindu undivided family
Body of Individuals Comp
any
Local Authority Partnership Firm
Artificial Juidical PersonsPlease select st
atus, as applicable12. In case of a citizen of India, then
Please mention your AADHAAR number (if allotted) 8.
Address for Communication Residence Office (Please tick as applicable)9. T
elephone Number & email ID det ailsCountry Code Area/STD Code T
elephone / Mobile Number e-mail id
1 1. Registration Number (for comp any, firms, LLPs, etc.) Salary
14. Represent
ative Assessee (RA)
Full Name, address of the Represent ative Assessee, who is assessable under the Income Tax Act in respect of the person,
whose p articulars have been given in the column 1-13.
15. Document s submitted as Proof of Identity (POI) and Proof of Address (POA)
I/W e have enclosed as proof of identity and
as proof of address as proof of date of birth.
[ Please refer to the instructions (as specified in Rule 1 14 of I.T . Rules, 1962) for list of mandatory certified document s to be submitted as applicable.] +
9 1 16.
I/W e \
the applicant, in the cap acity of
fo hereby declare that what is st ated above is true to the best of my/our information and belief. Signature/Lef
t Thumb Impression of Applicant (inside the box) Apply for P
AN, TAN, FILE e-TDS/
TCS/24 G Returns at TIN-FC :
TIN F ACILIT ATION CENTRE
Moti Bhuru Bazar , (Main Bazar) Near Dhodha Chowk, Kotkapura.
Ph. : 01635-220579, Mb. 946 304 0808, 981 510 1878 email : sahujag@gmail\
.com Place :
Date :
2 0
1
(06/08/2015)Please select title as applicable Shri Smt. \
Kumari M/s Association of PersonsGovernment
T
rust s Individual
Limited Liability Partnership