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PAN Application Form (Correction) 49AC PDF Fillable #pdf
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8. If you desire to up date your other address also, give required det ails in additional sheet.7. Address for Communication Resident Office (Please tick as applicable)5. Photo Mismatch 6. Signature Mismatch4. Gender (for Individual applicant s only) Male Female (Please tick as applicable)3. Date of Birth / Incorporation/Agreement/Partnership or T rust Deed / Formation of Body of individuals or Association of Persons (DD / MM / YYYY) 1. Full Name (Full expanded name to be mentioned as appearing in proof of identity/address doc\ ument s:initials are not permitted) Please Select Title as applicable Shri Smt. Kumari M/s Last Name / Surname First Name Middle Name Name you would like it printed on the P AN cardName of Of fice (to be filled only in case of of fice address) Flat/Room/Door/Block No. Name of Premises/Building/V illage Road/S treet/Lane/Post Of fice Area/Locality/T aluka/Sub-Division T own/City/District St ate/Union Territory P U N J A B PIN Code I N D I A CountryLast Name / Surname First Name Middle Name 2. Father ’s Name (only ‘Individual’ applicants : Even married women should fill in father ’s name only) 9. T elephone Number & Email ID det ailsCountry Code Area/STD Code T elephone / Mobile Number + 9 1 Email ID 10. AADHAAR number (if allotted)1 1. Mention other Permanent Account Numbers (PANs) inadvetently alloted to youP AN 1 PAN 2 I/W e \ the applicant, in the cap acity of fo hereby declare that what is st ated above is true to the best of my/our information and belief. I/W e have enclosed (number of document s) in support of proposed changes/corrections. Signature/Lef t Thumb Impression of Applicant (inside the box)Place : Date : 2 0 1 12. V erification Branch ID : 02565 (07/08/2015) Request for New P AN Card or / And Changes or Correction in P AN Data Permanent Account Number (P AN) Signature/Left Thumb Impression across this photo Signature/Lef t Thumb Impression Only ‘Individuals’ to af fix recent photograph (3.5 cm X 2.5 cm) Only ‘Individuals’ to af fix recent photograph (3.5 cm X 2.5 cm) Please read Instructions ‘h’ & ‘i’ for selection boxes on left margin of this form. TIN FC - CODE - 02565




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