File Content - 
		 Request For New PAN Card Or/ And Changes Or Correction in PAN Data
Permanent Account Number (PAN)
1Full Name (Full expanded name to be mentioned as appearing in proof of identity/address documents: initials are not permitted)
Please select title,as applicableShriSmtKumariM/s
Last Name / SurnameFirst NameMiddle Name
Name you would like it printed on the PAN card
2Father's Name (Only 'Individual' applicants: Even married women should fill in father's name only)
Last Name / SurnameFirst NameMiddle Name
3Date of Birth/Incorporation/Agreement/Partnership/Trust Deed/ Formation of Body of individuals or Association of Persons 
4Gender (for 'Individual' applicant only)MaleFemale(Please tick as applicable)
5Photo Mismatch
6Signature Mismatch
7Address for Communication ResidenceOffice(Please tick as applicable)
Name of office (to be filled only in case of office address)
Flat/Room/ Door / Block No. 
Name of Premises/ Building/ Village
Road/Street/ Lane/Post Office
Area / Locality / Taluka/ Sub- Division
Town / City / DistrictState / Union TerritoryPincode / Zip codeCountry Name
8If you desire to update your other address also, give required details In additional sheet.
9Telephone Number & Email ID details Country codeArea/STD CodeTelephone / Mobile number
Email ID
10AADHAAR number (if allotted)
11Mention other Permanent Account Numbers (PANs) inadvertently allotted to you
PAN 1PAN 3
PAN 2PAN 4
12Verification
I/We, the applicant, in the capacity of
I/We have enclosed   (number of documents) in support of proposed changes/corrections. 
Place
DDMMYYYYDateSignature / Left Thumb Impression of Applicant (inside the box)
do  hereby declare that what is stated above is true to the best of my/our information and belief. 
DayMonthYear
Please read Instructions 'h' & 'i' for selecting boxes on left margin of this form.
Signature/ Left  thumb impression across this photo
INSTRUCTIONS FOR FILLING REQUEST FOR NEW PAN CARD OR/AND CHANGES OR CORRECTION IN PAN DATA 
 
(a) Form  to  be  filled  legibly  in BLOCK  LETTERS and  preferably  in BLACK  INK.   Form  should  be  filled  in  English 
only 
 
(b) Mention 10 digit PAN correctly. 
 
(c) Each box, wherever provided, should contain only one character (alphabet /number / punctuation sign) leaving a 
blank box after each word. 
 
(d) 'Individual'  applicants  should  affix  two  recent  colour  photographs with  white  background (size  3.5  cm  x  2.5  cm) 
in  the  space  provided on  the  form.  The  photographs  should  not  be  stapled  or  clipped  to  the  form.  The  clarity  of 
image on PAN card will depend on the quality and clarity of photograph affixed on the form. 
 
(e) Signature / Left hand thumb impression should be provided across the photo affixed on the left side of the form 
in such a manner that portion of signature/impression is on photo as well as on form.  
 
(f) Signature  /Left  hand  thumb  impression  should  be within  the  box provided  on  the  right  side  of  the  form.  The 
signature  should  not  be  on  the  photograph  affixed  on  right  side  of  the  form.  If  there  is  any  mark  on  this 
photograph such that it hinders the clear visibility of the face of the applicant, the application will not be accepted. 
 
(g) Thumb  impression,  if  used,  should  be  attested  by  a Magistrate  or  a  Notary  Public  or  a  Gazetted  Officer  under 
official seal and stamp. 
 
(h) For issue of new PAN card without any changes-  In case you have a PAN but no PAN card and wish to get a PAN 
card,  fill  all  column  of  the  form  but  do  not  tick  any  of  the  boxes  on the  left  margin.    In  case  of loss  of  PAN  card,  a 
copy of FIR may be submitted along with the form. 
 
(i) For  changes  or  correction  in  PAN  data,  fill  all  column  of  the  form  and  tick  box  on  the  left  margin  of  appropriate 
row where change/correction is required. 
 
(j) Having or using more than one PAN is illegal.  If you possess more than one PAN, kindly fill the details in Item No. 
11 of this form and surrender the same. 
 
Ite
m 
No.   
Item Details Guidelines for filling the form 
1 Full Name 
 
 
 
Please select appropriate title. 
Do not use abbreviations in the First and the Last name/Surname. 
For example RAVIKANT should be written as : 
Last 
Name/Surname R A V I K A N T                  
First Name                                         
Middle Name                          
 
For example SURESH SARDA should be written as : 
Last 
Name/Surname     S A R D A                     
First Name                S U R E S H                    
Middle Name                          
 
For example POONAM RAVI NARAYAN should be written as: 
Last 
Name/Surname     N A R A Y A N                   
First Name                P O O N A M                    
Middle Name R A V I                      
 
For example SATYAM VENKAT M. K. RAO should be written as : 
Last 
Name/Surname     R A O                       
First Name                S A T Y A M                    
Middle Name V E N K A T  M  K
For example M. S. KANDASWAMY(MADURAI SOMASUNDRAM KANDASWAMY) should be written as: 
Last 
Name/Surname     K A N D A S W A M Y                
First Name                M A D U R A I                   
Middle Name S O M A S U N D R A M               
 
Applicants other than 'Individuals' may ignore above instructions. 
 
Non-Individuals should write their full name starting from the first block of Last Name/Surname. If the 
name is longer than the space provided for the last name, it can be continued in the space provided for 
First and Middle Name. 
 
For example XYZ DATA CORPORATION (INDIA) PRIVATE LIMITED should be written as : 
Last 
Name/Surname     X Y Z  D A T A  C O R P O R A T I O N  ( I N D 
First Name               I A )  P R I V A T E  L I M I T E D       
Middle Name                          
 
For example MANOJ MAFATLAL DAVE (HUF) should be written as : 
Last 
Name/Surname   M A N O J  M A F A T L A L  D A V E  ( H U F ) 
First Name                                         
Middle Name                          
 
In  case  of  Company,  the  name  should  be  provided  without  any  abbreviations.  For  example,  different 
variations of 'Private Limited' viz. Pvt Ltd, Private Ltd, Pvt Limited, P Ltd, P. Ltd., P. Ltd are not allowed. 
It should be 'Private Limited' only. 
 
In case of sole proprietorship concern, the proprietor should apply for PAN in his/her own name. 
 
Name should not be prefixed with any title such as Shri, Smt, Kumari, Dr., Major, M/s etc. 
  
Abbreviation of the 
full  name  to  be 
printed on the PAN 
card 
 
Individual  applicants  should  provide  full/abbreviated  name  to  be  printed  on  the  PAN  card.  Name,  if 
abbreviated, should necessarily contain the last name. For example:  
 
SATYAM VENKAT M. K. RAO which is written in the Name field as: 
Last 
Name/Surname     R A O                       
First Name                S A T Y A M                    
Middle Name V E N K A T  M  K                
 
Can be written as in ‘Name to be printed on the PAN Card’ column as 
                                                      SATYAM VENKAT M. K. RAO or 
                                                      S. V. M. K. RAO                 or 
                                                      SATYAM V. M. K. RAO 
  
For non-individual applicants, this should be same as last name field in item no. 1 above. 
 
2 
 
Father’s Name 
 
Applicable  to  Individuals  only.  Instructions  in  Item  No.1  with  respect  to  name  apply  here.  Married 
woman applicant should give father's name and not husband's name. 
3 Date of 
Birth/Incorporatio
n/ Agreement 
/Partnership or 
Trust 
Deed/Formation of 
Body of 
Individuals/ 
Association of 
Date cannot be a future date. Date: 2nd August 1975 should be written as:  
 
D D M M Y Y Y Y 
0 2 0 8 1 9 7 5 
Relevant date for different categories of applicants is: 
 
Individual:  Actual  Date  of Birth;  Company:  Date  of  Incorporation; Association  of  Persons:  Date  of 
formation/creation;  Trusts:  Date  of  creation  of  Trust Deed;  Partnership  Firms:  Date  of  Partnership 
Deed;  LLPs:  Date  of  Incorporation/Registration;  HUFs:  Date  of  creation  of  HUF  and  for ancestral  HUF
Persons date can be 01-01-0001 where the date of creation is not available. 
4 Gender This field is mandatory for Individuals. Field should be left blank in case of other applicants.  
5 
& 
6 
Photo/signature 
Mismatch 
Individuals issued a PAN card with incorrect/unclear photograph/signature should tick the box on the 
left margin. 
7 Address for 
Communication–  
Residence and 
office 
Indicate either Residence or Office address for communication as the case may be.  
 
(1) For Individuals, HUF, AOP, BOI or AJP, either of residential or office address is mandatory.  
(2)  In  case  of  Firm,  LLP,  Company,  Local  Authority  and Trust,  Name  of  office  and  complete  address  of 
office is mandatory. 
 
For  all  categories  of  applicants,  it  is necessary  to  mention  complete  address  and  the  details  of 
Town/City/District, State/Union Territory, and PINCODE are mandatory. 
 
In  case,  a  foreign  address  is  provided  then  it  is  mandatory  to  provide  Country  Name  along  with  ZIP 
Code of the country. 
 
8 
 
Update other 
address 
 
If  applicant  wishes  to  update  other  address,  besides  address  for  communication,  box  on  left  margin 
should  be  ticked  and  details  of  address  be  provided  on  an  additional  sheet  in  similar  format  as 
prescribed in Item No. 7. 
 
9 
 
Telephone Number 
and E-mail ID 
 
(1)  Telephone  number  should  include  country  code (ISD  code)  and  STD  code  or  Mobile  No.  should 
include Country code (ISD Code). 
 
For example :  
(i) Telephone number 23555705 of Delhi should be written as  
Country code STD Code  Telephone Number / Mobile number 
 9 1   1 1  2 3 5 5 5 7 0 5  
 
Where ‘91’ is the country code of India and 11 is the STD Code of Delhi. 
 
(ii) Mobile number 9102511111 of India should be written as 
Country code STD Code  Telephone Number / Mobile number  
 9 1      9 1 0 2 5 1 1 1 1 1 
 
Where '91' is the country code of India. 
 
(2) It is mandatory for the applicants to mention either their “Telephone number” or valid “e-mail id” so 
that  they  can  be  contacted  in  case  of  any  discrepancy  in  the  application  and/or  for  receiving PAN 
through e-mail. 
 
(3) Application status  updates  are sent using  the SMS facility  on the mobile numbers mentioned in the 
application form. 
10 AADHAAR number 
(in case of citizen 
of India) 
  
AADHAAR number, if allotted, has to be quoted (supported by copy of AADHAAR letter/card) 
11 Mention other 
Permanent 
Account Number 
(PANs) 
inadvertently 
allotted to you 
All PANs inadvertently allotted other than the one filled at the top of the form (the one currently used) 
should be mentioned and the copy of corresponding PAN card(s) to be submitted for cancellation with 
the form.   
12 Signature  /  Thumb 
impression 
Application  must  be  signed  by  (i)  the  applicant;  or  (ii)  Karta  in  case  of  HUF;  or  (iii)  Director  of  a 
Company;  or  (iv)  Authorised  Signaturee  in case  of  AOP,  Body  of  Individuals,  Local  Authority  and 
Artificial  Juridical  Person;  or  (v)  Partner  in  case  of  Firm/LLP;  or  (vi)  Trustee;  or  (vii)  Representative 
Assessee in case of Minor/deceased/idiot/lunatic/mentally retarded. 
Applications not signed in the given manner and in the space provided are liable to be rejected.
GENERAL INFORMATION FOR APPLICANTS 
 
(a) Applicants  may  obtain  the ‘Request  for  New  PAN  Card  or/and  Changes  or  Correction  in  PAN  Data’  Form  in  the  format 
prescribed  by  Income  Tax  Department from any  IT  PAN  Service  Centres (managed  by  UTIITSL)  or TIN-Facilitation 
Centres (TIN-FCs)/PAN  Centres (managed  by  NSDL), or any  other  stationery  vendor  providing  such  forms  or  download 
from the Income Tax Department website (www.incometaxindia.gov.in) / UTIITSL website (www.utiitsl.com) / NSDL 
website (www.tin-nsdl.com). 
 
(b) The fee for processing PAN application is ` 105/- (including service tax).  In case, the PAN card is to be dispatched outside 
India then additional dispatch charge of ` 866/- will have to be paid by applicant.  
 
(c) It  is  mandatory  to attach proof  of  identity,  proof  of address and  proof  of date  of  birth with  PAN  application.    Changes  or 
corrections  desired  in  PAN  particulars  should  be  supported  by  any  one  or  combination  of  the  relevant  documents 
mentioned below : 
 
Document acceptable as proof of identity, address and date of birth as per Rule 114 of Income Tax Rules, 1962 
Proof of Identity Proof of Address Proof of date of birth  
Indian Citizens (including those located outside India)  
Individuals & HUF  
(i) Copy of  
a. Aadhaar  Card  issued  by  the Unique 
Identification Authority of India; or 
b. Elector’s photo identity card; or 
c. Driving License; or 
d. Passport; or 
e. Ration  card  having  photograph  of  the 
applicant; or 
f. Arm’s license; or 
g. Photo  identity  card  issued  by  the  Central 
Government  or  State  Government  or 
Public Sector Undertaking; or 
h. Pensioner  card  having  photograph  of  the 
applicant; or 
i. Central  Government  Health  Service 
Scheme  Card  or  Ex-Servicemen 
Contributory Health Scheme photo card 
 
(ii) Certificate  of  identity in  Original signed 
by  a  Member  of  Parliament or  Member  of 
Legislative  Assembly  or  Municipal 
Councilor or a Gazetted officer, as the case 
may be; or 
 
(iii) Bank  certificate in  Original on 
letter  head  from  the  branch (alongwith 
name  and  stamp  of  the  issuing  officer) 
containing  duly  attested  photograph  and 
bank account number of the applicant 
 
(i) Copy of 
a. Aadhaar  Card  issued  by  the  Unique 
Identification Authority of India; or 
b. Elector’s photo identity card; or 
c. Driving License; or 
d. Passport; or 
e. Passport of the spouse; or 
f. Post  office  passbook  having  address  of 
the applicant; or 
g. Latest property tax assessment order; or 
h. Domicile  certificate  issued  by  the 
Government; or 
i. Allotment  letter  of  accommodation 
issued  by  Central  or  State Government  of 
not more than three years old; or 
j. Property Registration Document; or 
 
(ii) Copy  of  following  documents  of  not 
more than three months old 
(a) Electricity Bill; or 
(b) Landline  Telephone  or  Broadband 
connection bill; or 
(c) Water Bill; or 
(d) Consumer gas connection card or book or 
piped gas bill; or 
(e) Bank account statement or as per Note 2; 
or 
(f) Depository account statement; or 
(g) Credit card statement; or 
 
(iii) Certificate of identity in Original signed 
by  a  Member  of  Parliament  or  Member 
of  Legislative  Assembly  or  Municipal 
Councilor  or  a  Gazetted  officer,  as  the 
case may be; or 
 
(iv) Employer certificate in original. 
 
Copy of  
a. Birth  Certificate  issued  by 
the  Municipal  Authority  or 
any  office  authorized  to 
issue  Birth  and  Death 
Certificate  by  the  Registrar 
of  Birth  and  Death  or the 
Indian Consulate as defined 
in  clause  (d)  of  sub-section 
(1)  of  session  2  of  the 
Citizenship Act, 1955 (57 of 
1955); or 
b. Pension payment order; or 
c. Marriage  certificate  issued 
by  Registrar  of  Marriages; 
or 
d. Matriculation Certificate; or 
e. Passport; or 
f. Driving License; or 
g. Domicile  Certificate  issued 
by the Government; or 
h. Affidavit  sworn before  a 
magistrate  stating  the  date 
of birth
Note: 
1. In  case  of  Minor,  any  of  the  above 
mentioned  documents  as  proof  of 
identity  and  address  of  any  of 
parents/guardians of such minor shall be 
deemed  to  be  the  proof  of  identity  and 
address for the minor applicant.  
 
2. For  HUF,  an  affidavit  made  by  the  Karta 
of Hindu  Undivided  Family  stating  name, 
father’s name  and  address  of  all  the 
coparceners  on  the  date  of  application 
and  copy  of  any  of  the  above  documents 
in the name of Karta of HUF is required is 
required as proof of identity, address and  
date of birth.. 
Note: 
1. Proof  of  Address  is  required  for 
residence  address  mentioned  in  item 
no. 7. 
 
2. In  case  of  an  Indian  citizen  residing 
outside  India,  copy  of  Bank  Account 
Statement  in  country  of  residence  or 
copy  of  Non-resident  External  (NRE) 
bank  account  statements  (not  more 
than  three  months  old)  shall  be  the 
proof of address. 
  
Other than Individuals and HUF 
1 Company Copy of Certificate of Registration issued by the Registrar of Companies. 
2 Partnership Firm Copy of Certificate of Registration issued by the Registrar of Firms or Copy 
of partnership deed. 
3 Limited Liability Partnership Copy of Certificate of Registration issued by the Registrar of LLPs 
4 Association of Persons (Trust) Copy  of  trust  deed  or  copy  of  certificate  of  registration  number  issued by 
Charity Commissioner. 
5 Association  of  Person,  Body  of 
Individuals,  Local  Authority,  or 
Artificial Juridical Person 
Copy  of  Agreement  or  copy  of  certificate  of  registration  number  issued  by 
charity  commissioner  or  registrar  of  cooperative  society  or  any  other 
competent  authority  or  any  other  document  originating  from  any  Central 
or State Government Department establishing identity and address of such 
person. 
 
Foreign Citizens  
Individuals not being a Citizen of India 
Proof of Identity Proof of Address 
(a) Copy of passport, or  
(b) Copy of Person of Indian Origin (PIO) card issued by 
Government of India, or 
(c) Copy of Overseas Citizen of India (OCI) card issued by 
Government of India, Or 
(d) Copy  of  other  national  or  citizenship  Identification 
Number or Taxpayer Identification Number duly attested 
by  “Apostille”  (in  respect  of  countries  which  are 
signatories  to  the  Hague  Convention  of  1961)  or  by  the 
Indian  Embassy  or  High  Commission  or  Consulate  in  the 
country  where  the  applicant  is  located  or  authorised  
officials    of    overseas    branches    of  Scheduled  Banks 
registered in India. 
 
(a) Copy of Passport, or  
(b) Copy  of  Person  of  Indian  Origin  (PIO)  card  issued  by 
Government of India, or 
(c) Copy  of  Overseas  Citizen  of  India  (OCI)  card  issued  by 
Government of India, or 
(d) Copy  of  other  national  or  citizenship  Identification  Number 
or  Taxpayer  Identification  Number  duly  attested  by 
“Apostille” (in respect of the countries which are signatories 
to the Hague Convention of 1961) or by the Indian Embassy 
or  High  Commission  or  Consulate  in  the  country  where  the 
applicant  is  located, or authorised    officials    of    overseas  
branches  of Scheduled Banks registered in India or  
(e) Copy of Bank account statement in the country of residence, 
or  
(f) Copy  of  Non-resident  External  (NRE)  bank  account 
statement in India, or 
(g) Copy  of  Certificate  of  Residence  in  India  or  Residential 
permit issued by the State Police Authorities, or  
(h) Copy  of  Registration  certificate  issued  by  the  Foreigner's 
Registration Office showing Indian address, or 
(i) Copy  of  Visa  granted & Copy  of  appointment  letter  or 
contract  from  Indian  Company & Certificate  (in  original)  of 
Indian address issued by the employer.
For  other  than  Individuals  (Foreign  companies/Entities  incorporated  outside  India/Unincorporated  entities formed 
outside India) 
(a) Copy  of  Certificate  of  Registration  issued  in  the  country 
where  the  applicant  is  located,  duly  attested  by 
“Apostille”  (in  respect  of  the  countries  which  are 
signatories  to  the  Hague  Convention  of  1961)  or  by  the 
Indian Embassy or High Commission or Consulate in the 
country  where  the  applicant  is  located, or authorised 
officials  of  overseas  branches  of  Scheduled  Banks 
registered in India. 
 
(b) Copy  of  registration  certificate  issued  in  India  or  of 
approval  granted  to  set  up  office  in India  by  Indian 
Authorities. 
(a) Copy of Certificate of Registration issued in the country where 
the applicant is located, duly attested by “Apostille” (in respect 
of  the  countries  which  are  signatories  to  the  Hague 
Convention  of  1961)  or  by  the  Indian  Embassy or  High 
Commission  or  Consulate  in  the  country  where  the  applicant 
is  located, or authorised  officials  of  overseas  branches  of 
Scheduled Banks registered in India. 
 
(b) Copy  of  registration  certificate  issued  in  India  or  of  approval 
granted to set up office in India by Indian Authorities. 
Proof of PAN 
(a) Copy of PAN Card; or 
(b) Copy of PAN Allotment Letter 
 
Note:  No  other  document  shall  be  accepted  as  Proof  of  PAN. If proof  is  not  provided  then application  shall  be  accepted  on  a ‘good 
effort basis’. 
Supporting document required for changes in PAN data 
Case/Applicant type Document acceptable for change of name/father’s name 
Married ladies – change of name on account of marriage - Marriage certificate or 
- Marriage invitation card or  
- Copy of passport showing husband’s name 
- Publication of name change in official gazette or 
- Certificate  issued  by  a  Gazetted  officer  (only  for  change  in 
applicant’s name) 
Individual applicants other than married ladies - Publication of name change in official gazette or 
- Certificate  issued  by  a  Gazetted  officer  (only  for  change  in 
applicant’s name) 
Companies - ROC’s certificate for name change 
Firms / Limited Liability Partnerships - Revised partnership deed 
- Registrar of Firm/LLP’s certificate for name change 
AOP/Trust/BOI/AJP/LOCAL authority - Revised Deed/ Agreement 
- Revised registration certificate 
(d) Applicant  will  receive  an  acknowledgement  containing  a  unique  number  on  acceptance  of  this  form.  This 
acknowledgement number can be used for tracking the status of the application. 
 
(e) For more information / Application status enquiry contact: 
 
Mode Income-tax Department NSDL 
 
Website  
 
 
www.incometaxindia.gov.in 
 
www.tin-nsdl.com 
 
CallCenter  
 
 
1800-180-1961 
 
020‐27218080 
 
Email ID 
 
 
 
 
tininfo@nsdl.co.in 
SMS 
 
 SMS NSDLPAN  Acknowledgement No. & send to 57575 to obtain 
application status.  
For example  Type ‘NSDLPAN 881010101010100’ and send to 57575 
Address   INCOME  TAX  PAN  SERVICES  UNIT (Managed  by  NSDL  e-Governance 
Infrastructure  Limited),  5th  Floor,  Mantri  Sterling,  Plot  No.  341,  Survey 
No. 997/8, Model Colony, Near Deep Bunglow Chowk, Pune ‐ 411 016.