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To Be Filled in Case of Office Address

This document is a request form for obtaining a new PAN card or making changes/corrections to an existing PAN card for an individual. It requests information such as the applicant's name, father's name, date of birth, gender, photo, signature, address, telephone number, email, Aadhar number, and any other previously issued PAN numbers. The applicant needs to sign or provide a left thumb impression to verify the information provided on the form.

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70 views1 page

To Be Filled in Case of Office Address

This document is a request form for obtaining a new PAN card or making changes/corrections to an existing PAN card for an individual. It requests information such as the applicant's name, father's name, date of birth, gender, photo, signature, address, telephone number, email, Aadhar number, and any other previously issued PAN numbers. The applicant needs to sign or provide a left thumb impression to verify the information provided on the form.

Uploaded by

johnsamuel674
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as XLS, PDF, TXT or read online on Scribd
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Request For New PAN Card Or / And Changes Or Correction in PAN Data Only Individuals to affix recent photgraph

(3.5 cm x 2.5 cm)


Please read Instructions 'h' & 'I' for selecting boxes on left margin of this form.

Permanent Account Number [PAN]

Only Individuals to affix recent photgraph (3.5 cm x 2.5 cm)

Sign/left Thumb impression across this photo

Signature/Left Thumb impression

1 Full Name (Full expanded name to be mentioned as appearing in proof of identity/address documents: initials are not permitted) Please select title Last Name / Surname First Name Middle Name Name you would like it printed on the PAN card as applicable Shri Smt. Kumari M/s

2 Father's Name (Only 'Individual' applicants: Even married women should fill in father's name only) Last Name / Surname First Name Middle Name 3 Date of Birth / Incorporation / Agreement / Partnership / Trust / Deed / Formation of Body of individuals or Association of Persons Day Month Year Male Female (Please tick as applicable)

4 Gender for Individual applicant only 5 Photo Mismatch 6 Signature Mismatch 7 Address for Communication Name of Office (to be filled 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 / District State / UnionTerritory

Residence

Office

(Please tick as applicable)

Pin code / Zip code

CountryName

8 If you desire to update your other address also, give required details in additional sheet. 9 Telephone Number & Email ID details Country code Email Id 10 AADHAR number (if allotted) 11 Mention other Permanent Account Numbers (PANs) inadvertently allotted to you PAN 1 PAN 3 12 Verification I/We , the applicant, in the capacity of PAN 2 PAN 4 Area / STD Code Telephone / Mobile number

do hereby declare that what is stated above is true to the best of my /our information and belief. Place DD Date MM YYYY Signature / Left Thumb Impression of Applicant (inside the box)

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