NEW PANCARD FROM-49A

Form No. 49A

Application for Allotment of Permanent Account Number

[In the case of Indian Citizens/Indian Companies/Entities incorporated in India

Only ‘Individuals’

Only ‘Individuals’

/Unincorporated entities formed in India]

To affix recent

to affix recent

Under section 139A of the Income Tax Act, 1961

photograph

photograph

(3.5 cm x 2.5 cm)

(3.5 cm x 2.5 cm)

To avoid mistake(s), please follow the accompanying instructions and examples before filling up the form

Assessing officer (AO code)

Sign/Left Thumb impression

Area Code

AO Type

Range Code

AO No.

across this photo

Signature/Left Thumb Impression

Sir,

I/We hereby request that a permanent account number be allotted to me/us.

I/We give below necessary particulars:

1

Full Name (Full expanded name to be mentioned as appearing in proof of identity/address documents: initials are not permitted)

Please select title,  þ 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 the PAN card

3

Have you ever been known by any other name?

Yes

No

(Please tick as applicable)

If yes, please give that other name

Please select title,  þ as applicable

Shri

Smt.

Kumari

M/s

Last Name / Surname

First Name

Middle Name

4

Gender (for Individual applicants only)

P

Male

Female

(Please tick as applicable)

5

Date of Birth/Incorporation/Agreement/Partnership or Trust Deed/ Formation of Body of individuals or Association of Persons

Day

Month

Year

6

Father's Name (Only 'Individual' applicants: Even married women should fill in father's name only)

Last Name / Surname

First Name

Middle Name

7

Address

Residence Address

Flat/Room/Door/Block No.

Name of Premises/Building/Village

Road/Street/Lane/Post Office

Area/Locality/Taluka/Sub‐Division

Town / City / District

State / Union Territory

Pincode / Zip code

Country Name

PUNJAB

INDIA

Office Address

Name of office

Flat/Room/Door/Block No.

Name of Premises/Building/Village

Road/Street/Lane/Post Office

Area/Locality/Taluka/Sub‐Division

Town / City / District

State / Union Territory

Pincode / Zip code

Country Name

INDIA

8

Address for Communication

P

Residence

Office

(Please tick as applicable)

9

Telephone Number & Email ID details

Country Code

Area/STD Code

Telephone / Mobile Number

Email ID

10

Status of applicant

Please select status, þ as applicable

Government

P

Individual

Hindu undivided family

Company

Partnership Firm

Association of Persons

Trusts

Body of Individuals

Local Authority

Artificial Juridical Person

Limited Liability Partnership

11

Registration Number (for company, firms, LLPs, etc.)

12

In case of a citizen of India, then

Please mention your AADHAAR number (if allotted)

13

Source of Income

Please select status, þ as applicable

Salary

Capital Gains

Income from Business/Profession

Business/Profession Code

[For Code: Refer instructions]

Income from Other sources

Income from House Property

No Income

14

Representative Assessee (RA)

Full name, address of the Representative Assessee, who is assessable under the Income Tax Act in respect of the person, whose particulars have been given in the column 1-13.

Full Name (Full expanded name: initials are not permitted)

Please select title,  þ as applicable

Shri

Smt.

Kumari

M/s

Last Name / Surname

First Name

Middle Name

Address

Flat/Room/Door/Block No.

Name of Premises/Building/Village

Road/Street/Lane/Post Office

Area/Locality/Taluka/Sub‐Division

Town / City / District

State / Union Territory

Pincode / Zip code

15

Documents submitted as Proof of Identity(POI) and Proof of Address (POA)and Proof of Date of Birth

I/We 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 114 of I.T. Rules, 1962) for list of mandatory certified documents to be submitted as applicable]

16

I/We

, the applicant, in the capacity of

do hereby declare that what is stated above is true to the best of my/our information and belief.

Place

D

D

M

M

Y

Y

Y

Y

Date

Signature / Left Thumb impression of

Applicant (inside the box)