pan form

7/28/2019 PAN Form

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Application for Allotment of Permanent Account Number

Under Section 139A of the Income Tax Act, 1961

(To avoid mistake(s), please follow the accompanying instructions and examples carefully before filling up the form) Only 'Individuals'

to affix recent

photograph (3.5

cm x 2.5 cm)

Sir,

I/We hereby request that a permanent account number be a llotted to me/us.

I/We give below necessary particulars :

Form No. ITS 49A

First Name

Middle Name

Last Name / Surname

Signature/ Left Thumb

Impression

If yes, please give that other name

(Full expanded name : initials are not permitted) Shri Smt. Kumari M/s

First Name

Middle Name

Last Name / Surname

3 Have you ever been known by any other name? Please Tick as applicable Yes No

4. Father's Name (Only 'Individual' applicants : Even married women should give father's name only)

Last Name / Surname First Name

Middle Name

5. Address

R. Residential AddressFlat/Door/Block No.

Name of Premises / Building / Village

Road / Street / Lane / Post Office

Area / Locality / Taluka / Sub - Division

Town / City / District State / Union Territory

(Indicating PIN is mandatory) O. Office Address (Name of Office)

Flat/Door/Block No.




Town / City / District State / Union Territory

Pin

Pin

(Indicating PIN is mandatory)

Ward/ Circle

Range

Commissioner

Are a

Code

AO

Type

Range

Code

AO

No.

To

The Assessing Officer

6. Address for communication Please Tick as applicable R or O

1. Full Name (Full expanded name : initials are not permitted)

Please Tick a s applicable Shri Smt. Kumari M/s

2 Name you would like printed on the card

Form No. 49A

7/28/2019 PAN Form

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13(a) Are you a salaried employee ? If yes, indicate Government Others

(b) If you are enganged in a business/ profession, indicate nature of business or profession and fill the relevant code

Name of the Organisation where working

(c) If you are not covered by (a) or (b) above, indicate sources of income, if any

Full Name(Full expanded name : initials are not permitted)Please tick as applicable Shri Smt. Kumari M/s

First Name

Middle Name

Last Name / Surname

Address


Flat/Door/Block No.



Town / City / District PinState / Union Territory

(Indicating PIN is mandatory)

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.

I/We , the applicant, do hereby declare that

what is stated above is true to the best of my/our information and belief.

Signature/ Left Thumb Impression of

Appl icant (ins ide the box)

Verified today, the

D D M M Y Y Y Y

7. Tel. No.

STD Code Tel. No.

email ID

8. Sex (For 'Individual' Applicants only) Please Tick as applicable Male Female

Individual P Firm F Body of Individuals

Hindu Undivided Family H Association of Person Local Authority

Company C Association of Persons (Trusts) Aritificial Juridical Person

10. Date of Birth / Incorporation / Agreement / Partnership or Trust Deed / Formation of Body

of Individuals/ Associastions of Persons

A

T

B

L

J

D D M M Y Y Y Y

12. Whether citizen of India ? Please Tick as applicable Yes No

11. Registration Number (In case of Firms, Companies etc.)

15. I/We have enclosed as proof of idenity and as

proof of address

9. Status of the Applicant Please Tick as applicable

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INSTRUCTIONS FOR FILLING FORM 49 A

a) Use BLACK INK for filling the FORM and SIGNATURE.

b) 'Individual' applicants shouldpaste one recent, coloured photograph (stamp size : 3.5cms x 2.5 ems). Thephotograph should

not be stapled or clipped. The clarity of image on PAN card will depend on the quality and clarity of photograph pasted on theform.

c) Thumb impression, if used, should beattestedby a Magistrate ora Notary Public or a Gazetted Officer, under official seal andstamp.

d) Each box, wherever provided, shouldcontain only onecharacter (alphabets/number/punctuationsign) leaving a boxblank aftereach word.

e) Area and AO code should be filled by the applicant, in consultation with IT PAN Service Center, if required.

ItemNo.

Item Details How to fill in the form

Individuals must statefull extended name. Do notuse abbreviations andinitials, Single and double characters in LastName andFirstName except OM, DE, UR,UL andAL aretreated as initials

For example SatyaPrakash Sharma shouldbe written as :LastName/Surname FirstName MiddleNameSHARMA SATYA PRAKASH

Applicants other than 'Individuals' i.e. Non-Individuals, must ignore above instructions.Non-Individuals will write their full name starting from the first block of Last Name/Surname. If the name is longer

1. Full name

than thespaceprovided forthelast name, itcanbe continuedin the spaceprovided forFirst andMiddleName. For example :LastName/Surname FirstName MiddleNameUTITECHNOLOGYSERVICES LIMITED

HUFs will mention (HUF) within brackets after their full name.For example:LastName/Surname FirstName MiddleName

SATYAPRAKASH SHARMA(HUF)In case of Company, the name should be provided without any abbreviation. For example, different variations of`Private Limited' viz Pvt. Ltd., Private Ltd., Pvt. Limited, P. Ltd., are not allowed. It should be 'Private Limited'only. In case of sole proprietorshipconcern, the sole proprietorshould use/apply PANin his/her personal name.Name should not be prefixed withtitles such as Shri,Smt.,Kumari, Dr., Major, M/s etc.

2. Nametobeprinted on PAN Card

IndividualApplicant : sincethePAN Card cannotcarryname exceeding 25 characters, applicants with longernamesshould suitably abbreviatethe name but without using any nickname or aliases.

Forexample : SATYAM VENKATAIYAH M.K. REDDY,canbeabbreviatedas SATYAMV M KREDDY

Non-IndividualApplicant : Full applicant name will be printed on PAN Card

3. EarlierName Applicable toIndividualsonly and instructionsin itemno.1 for writingnameapply.

4. Father's Name Applicable to Individuals only and instructions in item no.1for writing name apply. Married women applicantsshouldalsogiveonly father'snameand not husband's name.

5. Address-Residential

& OfficeFor Status ofIndividual applicantresidenceaddress is compulsory. Ifthe status is non-individual thenoffice address iscompulsory.For Individual applicants havingsalary/business incomethen office name & address is also compulsory

Town/ City / District / State / Union TerritoryandPin for bothResidence and office (wherever available)address is mandetory

6. Address forcommunication

All futurecommunications will be sent at theaddress indicated inthis column. R means residence addressand0 means office address.

(I)IfTelephoneNumber ismentionedSTD Code ismandatory. (2)In case ofmobile number, Countrycodeshouldbementioned as STDCode.Forexample: STDCode TeL Number

9 1 9 8 2 0 1 1 1 1 1

7. TelephoneNumberand e-mail ID

Where '91' is the Country code of India(3) It is suggested that applicants mention their telephone number so that they can be contacted in case of anydiscrepancy in the applciation form. (4)Applicants may provide their valid e-mail id for faster Communication.

Date 21.9.1956 should be written as

2 11 0 9I 1 9 5

10. DateofBirth

Relevant date for different category of PAN applicants is:Individuals :Actual Date of Birth; Companies: Date of Incorporation; Association of Persons:Date of Formation/Creation; Association of Persons (Trusts) : Date of Creation or Trust Deed;Partnership Firms : Date of Partnership Deed; and HUFs: Date of Creation of HUF

11. Registration NO. Not applicable to Individual and HUF applicants. ' Company' applicants should mention registration numberissued by the Registrar of Companies. Other applicants may mention registration number issued by any State orCentral Govt. Authority.

13 (a) Salaried employee Write name of the Organisation where employed.

13 (b) Natureand codeof Business/Profession

Choose relevant code correspondingto your business / profession fromthe list mentioned at Point No.5Overleaf(General Information for PAN Applicants)

13 (c) Others Applicants other than those covered by column 13 (a) & 13 (b) must mention their source of income or give

reasons for applying for PAN.14 Name and addressof

RepresentativeAssessee

Section 160 of IT Act, 1961 provides that a non-resident, a minor, etc. can be represented through RepresentativeAssessee. This column will contain particulars of such Representative Assessee whereas column 1 to 13 willcontain details of person on whose behalf this application is submitted In such cases Representative Assessee

will sign the form.

15. Enclosures List of documentsthat will serve as proof of Identity and Address are available at Point No.4 overleaf (GeneralInformation for PANApplicants)

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G E N E R A L I N F O R M AT I O N F O R P A N A P P L I C A N T S

I. Applicants can obtain the application form for PAN (Form 49A) in the format prescribed by Income Tax Department, from any IT PANCenters, any other stationery vender providing such forms or freely downloaded from the UTITSL website.

(httpNvvww_paneard.utitslco.in). In case applicants obtain PAN application forms from IT PAN Service Center (managed by UTITSL),

PAN application forms may be issued at free of cost.

2.Before submission of form, a Processing Fee Coupon of Rs. 85/- (plus service tax, as applicable) should be obtained from IT FANService Center and affixed on the top of the form_

3.Those already allotted a ten digit alphanumeric PAN shall not apply again as having or using more than one PAN are illegal. Suchallottees may, however, request for the new tamper proof PAN card, with several security features, on payment of Rs.85/- (plus servicetax, as applicable) at 11' PAN Service Center by mentioning his her existing Permanent Account Number (PAN) underneath AO Code

blocks. Such applicant may also apply on CSF (form for new PAN card or / and change or correction in PAN Data) available separatelyat IT PAN Service Center.

4_ Documents to be submitted alongwith application for PAN (Column 1.5 of Form 49 A)

C a tego ry Documents Required

Individuals For proof of Identity : Copy of school leaving certificate or matriculation certificate or degree of a recognisededucational institution ar depository account or credit card or bank account or water bill or ration card or propertytax assessment order or passport or voter identity card or driving licence or certificate of identity signed by aMember of Parliament or Member of Legislative Assembly or Municipal Councilor or a Gazetted Officer, as thecase may be.For proof of Address : Copy of electricity bill or telephone bill or depository account or credit card or bankaccount or ration card or employer certificate or passport or voters identity card or property tax assessment order ordriving license or rent receipt or certificate of address signed by a Member of Parliament or Member o f LegislativeAssembly or Municipal Councilor or a Gazetted Officer, as the case may be.In case of a person being a minor, any of the above documents of any of the parents or guardian of such minorshall be deemed to be the proof of identity and address_

HUF For proof of identity and address, any document prescribed in the case of individuals in respect of Karta of the HUF

Company Copy of the Certificate of Registration issued by the Registrar of Companies.

Firms Copy of Certificate ofReg stration i ssued by the Registrar of Fi rrns or Copy a fPartnership Deed.

AOP (Trusts) Copy of the Trust deed or Copy of Certificate of Registration Number issued by Charity Commissioner.

AOPJ BOI ./Local Authority IArtificialJuridic al Person

Copy ofAgreement or Copy of Certificate of Registration Number issued by Charity Commissioner or Registrar of

Co-operative Society or any other Competent Authority or any other document originating from any Central orState Government Department establishing Identity and Address of such person.

5. Business / Professions along with codes (Column 13(b) of Form 49 A) :

01 Medical Profession and Business 11 Films, TV and such other entertainment

02 Engineering 12 Information Technology

03 Architecture 13 Bu ilders and Developers

04 Chartered Accountant / Accountancy 14 Members of Stock Exchange, Share Brokers and Sub - Brokers

05 Interior Decoration 15 Performing Arts and Yatra

06 Technical Consultancy 16 Operation of Ships, Hovercraft, Aircra fts or Helicopters

07 Company Secretary 17 Plying Taxis, Lorries, Trucks, Buses or other Commercial Vehicles

08 Legal Practitioner and Solicitors 18 Ownership of Horses or Jockeys

09 Government Contractors 19 Cinema Flails and other Theaters

10 Insurance Agency 20 Others

A C K N O W L E D G E M E N T

ReceivedRs.94:- (Inclusive ofapplicable Taxes)withthanks fromShri 1 Smt I Kum i Ws.

I. APPLICATION FORM 49ABEARING APPLICATION SR. NO.. FOR ISSUE OF PAN.2 . D A T E O F R E C E I P T

3 . P R O C E S SI N G F E E C O U P O N N U M B ER

4 . P R O O F O F ID E N T I TY

5 . P R O OF O F A D D RE S S

6 . O T H ER S ( p l e as e s p e c i fy )

PAN Service Center Code :Service-tax Rego Nu_

(ST/13AS1STUBEL'420/2004-2005) PAN Service Center Name :

AUTHORISED SIGNATORY(with date stamp)

(Note : THE PAN card will he issued within 15 working days from the dare of receipt at PAN Service Center)For knowing the PAN you may visit our Wetsite ! http:/Arrww_pancuritutitstemin

Any po es y r' co n-e sr ai nde nti n in th is co nn ect io n may be W h i t e SSL Y.1 by quoting the Application Number i Pro cessi ng Fee Coupon Nu m be r to th e addresses giv e n be low:TV RV3 NI ttll, titil

LITI T ec h n o l o gy S er v i c es Li mi ted ( G o v er n men t S er v i c e D ep o r tmen t)P.B. No. 20, Plot No.3. Sector 11, Cl3p - Beloinur, .

N o v i M u m h al - 4530614 T e le ph on e I: ( 0 2 2 ) 6 7 9 3 1 3 0 0 - 0 4 F a x : ( 0 2 2 ) 6 7 9 3 1 3 9 4 E m a i l I D i [email protected] ew D el h i

T I T I T ec h n o l o g y S er v i c es Li mi ted ( G o v er n men t S er v i c e D ep ar tmen t)1 7 4 - 1 7 5 , l et F l o o r , Raj en d r n B h aw an ( D D A B u i l d i n g ) , Raj en d r n P l ac e,

New Delhi - 11053 08 Telephone : (011) 2585 3115 -119 Fax : (Oil) 2385 0231 Email ID : eiewdelhi(kutitsLeminKiparatu

VI I t e c h n o l o g y S e r v i c e s L i m i t e d ( G o v e r n m e n t S e r v i c e D e p a r t m e n t )29, Netnji &Athos!" Road, Ground Floor, Kollenta - 700 0551

Telephone : (033)2242 4810/478314797, 2243 5425/5255 Fax t (033) 2243 5117 E-mail Ill : kulkalogutilal.cminChcninmi

I ; T i T ec h n o l o g y S er v i c es Li mi ted ( G o v er n men t S er v i c e D ep ar tmen t)4 5 , J u s ti c e Basheer A h med B u i l d i n g , S ec o n d Li n e B eac h ,

Chennal - 606 064 Telephone i (044) 2534 1224 f 1265 f 1356 Fa x : (044) 2534 1 3 4 6 E mai l I D : rhentiai(giutitsLeo.in

A A V K A R S A h l P A R K K E N D R A ( A S K )

'Telephone : 0124-24314000