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Affix recent
photograph
(3.5cm x 2.5cm)
Affix recent
photograph
(3.5cm x 2.5cm)
Signature/ Left Thumb
Impression across this
photo
ACKNOWLEDGEMENT NUMBER:
Category
Permanent
Account No.
Name to be
printed on card
Father's Name
Name
Other Address
Address for
Communication
Date of Birth
Telephone No.
AADHAAR No.
Email ID
BXVPS8815C
Smt. SUPRIYA ABHISHEK DUDWADKAR
SUPRIYA ABHISHEK DUDWADKAR
Shri SADANAND SHRIPAT SAKPAL
19-04-1988
SAI CHHAYA CHSL
NEAR BEST QUATERS
GORAI (I), BORIVALI (WEST
MUMBAI - 400092
Maharashtra
[email protected]
633764622579
91 9833585057
Payment Mode
Credit Card:Your Payment of 105 against transaction number
401-1061289 has been successfully processed.
The following documents are enclosed as:
Proof of Identity:
Proof of Address:
Proof of PAN:
Proof of PAN to be cancelled:
Any other document:
Date:
Copy of AADHAR Card issued by the Unique Identification
Authority of India
Copy of landline telephone bill
Copy of PAN card
09-09-2014
Signature/ Left Thumb Impression of Applicant
(inside the box without touching the sides and in BLACK INK
ONLY)
Service Tax Code (Registration Number): AAACN2082NST001
Service Tax Registration Category: BUSINESS AUXILIARY
SERVICES
Individual
Photo Mismatch Signature Mismatch Sex
Request for cancellation of PAN(s)
PAN1: PAN2: PAN3: PAN4:
ROOM NO.B/7, PLOT NO.86
I/We, MRS.SUPRIYA ABHISHEK DUDWADKAR the applicant, do hereby
declare that what is stated above is true to the best of my/our
information and belief.
(PLEASE READ INSTRUCTIONS GIVEN ON NEXT PAGE)
CIN U72900MH1995PLC095642
Proof of Date of birth: Copy of Marriage certificate issued by
Registrar of Marriages
881020214808053
Acknowledgement for Request for New PAN Card or/and Changes or
Correction in PAN Data
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nstructions:
The above-mentioned 15-digit acknowledgement number is a unique
reference number for your application for 'Request for New
PAN Card or/and Changes or Correction in PAN Data'. Kindly quote
this number for tracking the status of your application on
https://tin-nsdl.com or any queries relating thereto.
Save and print this acknowledgement.
Application fee and mode of payment: Payment favouring
'NSDL-PAN'can be made as follows:
Sr. No. Address forCommunication
Amount payable( )
Mode of payment
1 Indian 105Credit card / Debit card/ Net Banking / Demand Draft
(DD) payable at
Mumbai/Cheque to be deposited in any HDFC bank branch across the
country
2 Foreign 971 Credit card / Debit card / DD payable at
Mumbai
Please mention name of applicant and acknowledgement number on
the reverse of cheque/DD.
Individual applicants affix your recent colourphotograph (3.5 cm
x 2.5 cm), sign the acknowledgement (inside the box provided
without touching the sides and in BLACK INKonly) and enclose a
Demand Draft (DD), if any, alongwith Proof of Identity, Proof
of
Address and (Proof of Date of Birth - Indian citizens only) as
specified in the application form.
Superscribe the envelope with 'APPLICATION FOR PAN -
Acknowledgement Number' (e.g. 'APPLICATION FOR PAN -
881010100000973').
Send the documents as specified in point no. 4 above to Income
Tax PAN Services Unit, NSDL e-Governance Infrastructure
Limited, 5th floor, Mantri Sterling, Plot No. 341, Survey No.
997/8, Model Colony, Near Deep Bungalow Chowk, Pune -411016Tel:
020-27218080; Fax: 020-27218081.
Your acknowledgement, Demand Draft if any, and proofs, should
reach NSDL within 15 days from the date of online application.
Application will be processed only on receipt of relevant proofs
and realisation of payment.
Applications without proof of PAN will be processed on a good
effort basis - (as mentioned in guidelines).
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