pplication is dgtally signed using eSign/@KYC, there is no need to forward physical documents ‘eecntcomnrences woosrvostrs IML LITA FormNO. 498 ‘Application for Allotment of Permanent Account Number a [i the case of Indian Citizens/indian CompaniesEnttles Incorporated in India! Unincorporated ents formed in Ina] Under seston 1398 of he Income Tx e061 To vod mistake (plese follow the secompanyng instructions and examples bore Ming op Assessing oticer (AO code) Si [aneaGODE | AOTYPE | Range Gods [ AOWO a w = ds Not vor fee TCT STE TEST ‘Sk; We horaby request hat a permanent account number be alted to meus. Aca ree it {We give below necessary parulors: 1. Full Name (Fl expanded name o be mentioned Inala are not Pease select tte 88 applicable om Em El komen ws ym Last Nome'Sumame Fert Name Iida Name 2. Abbreviations ofthe above namo, 98 Yeu woul ke tobe printed onthe PAN card [Manu omar B ] ‘3. Have you ever been known by other name? tyes please give that ther name vs No S Please select tile, as applicable Osh OF sme 1 Kumars ws Laat Name'Surme Fist Nome ae tame A io SO Eee pce ara 8 mo Brenan AreementPotnerip Ts Ded Fomaion ty of milo aseciton of Fess Month Year S ee | || o 6. Deal ot Pant (epplicbi only forindvidl appa) eter moter singe parent ard you veh opp for PAN ching te ame of your mater ony? Yer Nol (plone ck a5 appl) Hf yesplease fin mother's name in the appropriate space prop below. Father's Name (Mandatory except where mothers a single print and PAN is aplied by furnishing the name of mother on Last NameSumame ‘singh S Fst Name ‘shankar SS | tres sine me nirenetac it ce pet ent Ps poly oki is eno ‘aime : rrattone — Sedna which you Mayo ba print on PAN car [oaec oe any) (neato reopen moos PAN ct ibe se ih ae rae wane O_ Motners Name (Please tek as apicabl then PAN card willbe issued wih father's name except where mather Is 2 single paren and you wish to apply {or PAN by furnish ‘aadrese Residence (eur Pecre( repay = | eS Ne fries Bing Vile RegaSveet/LanePost orice Canojpur Atom Toate [tyme Td Soucy ott ‘State / Union Tent Pine i oad ‘County Name ‘oz201 TWOIA ] ‘mother ony) Rete eer ee]oma Det SS satan Teron Preose 2p xt County Nae ] 8. Address tor Communieation Z| Residence Cotte Please tick as appicable ©. Telephone Number & Email 10 datas course Aea'STO Code Telaphne /Moblenunber (| | - 10, Status of applicant & Pease clot tats, a8 appcbla 0 Government a yl hee D1 Hindu uncivided farnily TD Company D Pannership Firm aq Assocagg Persons OF tse D1 ody of ncivcuais Cy Lexa urorty Arti src Persons] Uinta fay Parnerp 1. Rgletation Number tr company, ths, LLPs et) & s 12, Incase ofa person whol required quote Aadhaar number the Enrolment O of Aadhear application fn ax er eection 19044 Please mention your AADHAAR number (i allotted) & WAADHAAR number aloted, lees mann tho ercnen © of ashes epson xs Nam as er AAOHAAR iter ra phe Een 9 of Achar appnton x 0 KUMAR e = = Salary Businesa Profession Coy da meet Ci CantaCae rece tom anes 0 Cegetom rset) eae tom Otero 1. cone on Hoe opty Ss &h Nohcone “14, Representative Assessee (RA) Se Ful name adios fhe ReprecriaveAesesee, wo asesale und come Tax At eect fhe parson, wtose articular have boon given inthe column 1-13. & ul Name Fl xpanded name: nas ae not permite) Please sect ite at applicable Oo sg sm Kime os Last Name/Sumame ~ Frat Name ae Nae ‘esos at Poor oor Block No, Na of Premises lng. oad Stee! /LanePost fog. S NS. OO ————————— Town iy Diva Site / ion Teron = Conny Name [ x ] 16 omits Proot ot enty (Pl Pros of Arse PON) and Proto ste of Bh (008) We hayg closed [AADHAAR Card issued by the Unique Identification Authority of India 15 proo of entity [RROMAAR Card issued by the Unique Ideniication Authority of india "spol fsa ant TRDHAAR Cardosued bythe Unique Wenticaion Author onda os root ode of. Fosse spice [Annexure A, Annexure 8 & Anexue C are to be used wherever appcbie| 16 Uwe [MANU KUMAR te appar in the capscty ot [ Himsellerseit ry el Wn ws Hod ADO oo Boao VE TOA a at. ote. toe Place Brolpar See Larue ESOTT oo WW fea Toh heoctne (as epeatiod i Fe 174 1 LT: Rules, 1962) for Fao andaloy Cored Gocamaris To Bo God as