Top of FormForm No. 49AForm No. ITS 49A
Application for Allotment of Permanent Account NumberUnder
Section 139A of the Income Tax Act, 1961To avoid mistake(s), please
referguidelinesandinstructions.
Please verify the completed application form and confirm.
Area CodeAO TypeRange CodeAO Number
LKNW433
Sir, I/We hereby request that a permanent account number be
allotted to me/us. I/We give below necessary particulars:
1. Full Name(Initials are not permitted)
Title Shri Smt. Kumari M/s
Last Name/SurnameKUMARFirst NameASHOKMiddle Name
2. Name you would like printed on the card
ASHOK KUMAR
3. Have you ever been known by any other name?Yes No
4. GenderMale Female
5. Date of BirthDD01 -MM07 -YYYY1997
6. Father's Name(Even married women should give father's name
only)
Last Name/SurnamePRAKASHFirst NameOMMiddle Name
7. Address
(R)Residential Address(O)Office Address
Name of Office
Flat/Door/Block No.H.NO 116Flat/Door/Block No.
Name of Premises/Building/VillageKEDARIPURName of
Premises/Building/Village
Road/Street/Lane/Post OfficeBIRAMPURRoad/Street/Lane/Post
Office
Area/Locality/Taluka/Sub-DivisionLAKHIMPURArea/Locality/Taluka/Sub-Division
Town/City/DistrictLAKHIMPUR KHERITown/City/District
State/Union TerritoryUttar PradeshState/Union Territory
Pin(Indicating PIN is mandatory)262727Pin(Indicating PIN is
mandatory)
CountryCountry
ZipZip
8. Address for communicationResidential Office
9. Telephone No.Country code (ISD code)91
Mobile No.Telephone No.
Area/STD CodeTelephone No./Mobile No.8447058065
E-mail [email protected]
10. Status of the Applicant
Individual (P)Partnership Firm (F)Body of Individuals (B)
Hindu Undivided Family (H)Association of Persons (A)Local
Authority (L)
Company (C)Trust (T)Artificial Juridical Person (J)
Limited Liability Partnership (E)Government (G)
11. Registration Number(In case of Firms, companies etc.)
12. In case of a citizen of India, then
Please mention your AADHAAR number (if allotted)
369245850785
13.
(a)Are you a salaried employee?
(b)If you are engaged in a business/ profession, indicate nature
of business or profession and the relevant code
(c)If you are not covered by (a) or (b) above, indicate sources
of income, if any.No income
14. 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 column 1 to 13(Representative
Assessee details to be filled only in special cases like minor,
lunatic, idiot etc., as provided u/s 160 of Income-tax Act,
1961)
Appointing Representative Assessee ?Yes No
Title Shri Smt. Kumari M/s
Category Army Air Force Other Individual
Last Name/SurnamePRAKASHFirst NameOMMiddle Name
Flat/Door/Block No.H.NO 116
Name of Premises/Building/VillageKEDARIPUR
Road/Street/Lane/Post OfficeBIRAMPUR
Area/Locality/Taluka/Sub-DivisionLAKHIMPUR
Town/City/DistrictLAKHIMPUR KHERI
State/Union TerritoryUttar Pradesh
Pin(Indicating PIN is mandatory)262727
15. Documents enclosed
I/We have enclosed Copy of AADHAR Card issued by the Unique
Identification Authority of Indiaas proof of identity andCopy of
domicile certificate issued by the Governmentas proof of
AddressCopy of Matriculation certificateas proof of Date Of
Birth
Further,I/We have also enclosed Copy of Photo identity card
issued by the Central Government or a State Government or a Public
Sector Undertakingas proof of identity andCopy of AADHAR Card
issued by the Unique Identification Authority of Indiaas proof of
Address of representative assessee
16. I/We ASHOK KUMAR,the applicant,in the capacity of
Representative Assesse do hereby declare that what is stated above
is true to the best of my/our information and belief.
Place NEW DELHI
Verified today, theDD10 -MM03 -YYYY2015
Other Details
1. Depository Account Details
DP ID:Client ID:
2. Payment Details
Demand Draft/Cheque(in favour of 'NSDL - PAN' for105)
Demand Draftnumber dated - -for105 drawn on Bank,payable at
Mumbai.
Chequenumber dated - -for105 drawn on Bank, deposited at HDFC
Bank, branch at location (city/town)
Credit Card / Debit Card (105 plus applicable bank charges)
Net Banking (105)List of Banks available
*Verify Registration
Please enter alphabets and digits only and Characters are Case
Sensitive.
*Enter the code shown:
Bottom of Form
Payment through Net Banking
TRANSACTION NUMBER:400-1951510
NAME:Shri ASHOK KUMAR
TRANSACTION TYPE:ONLINE-PAN-NEW
AMOUNT:105.00
PAYMENT MODE:Net Banking
Please note the uniqueTransaction Numbermentioned above for your
reference and for tracking the status of your application in case
of loss of connectivity at any time from this screen onwards.
NOTE:
On agreeing to the contents of this page, the applicant will be
taken to the BillDesk payment gateway website. Applicant will
provide his login details there. NSDL respects the privacy and
security of applicants, hence login details are not collected at
TIN website. On successful Net Banking payment, an acknowledgment
screen will be displayed by NSDL. This acknowledgment screen will
contain a unique 15 digit acknowledgment number. The applicant
shall save and print this acknowledgment. Thereafter, affix
photograph (in case of 'individual' applicants), sign and attach
proof of identity and address and send the same to NSDL. Allotment
of PAN:Applications with payment through net banking will be
forwarded to Income Tax Department for allotment of PAN after
receipt of required documents. Despatch of PAN card:PAN card will
be despatched at the address for communication indicated in the
application only on receipt of relevant documents (proof of
identity and address along with duly signed acknowledgment). Please
note that forwarding of supporting documents is mandatory. In case
valid documents are not forwarded, PAN card will not be despatched
and may also attract penal action by the Income Tax Department.
Connectivity:If the applicant gets disconnected at any point
(either at the BillDesk payment gateway or the NSDL PAN application
site) aftertransaction numberis displayed, he can check status of
his application by entering the transaction number in the
transaction status link provided on the Online PAN application
page. Refund:The fee charged is for processing of the application.
It is non-refundable and irreversible.
TERMS AND CONDITIONS
The details displayed on this page are deemed to be read and
understood by the applicant.
Top of Form
Bottom of FormTop of FormBottom of Form
