Pan Card Application Form

To apply for a Pan Card one has to download the Form 49A and fill it completely and then submitted to the Pan Card office.
Text Version of the Form

 

FormNo.49A
ApplicationforAllotmentofPermanentAccountNumber
Only ‘Individuals’ [Inthe caseofIndianCitizens/IndianCompanies/EntitiesincorporatedinIndia/ Only ‘Individuals’
to affix recent to affix recent
photograph UnincorporatedentitiesformedinIndia] photograph
(3.5 cm x 2.5 cm) Undersection139AoftheIncomeTaxAct,1961 (3.5 cm x 2.5 cm)
avoidmistake(s),pleasefollowtheaccompanyinginstructionsandexamplesbeforefillinguptheform

Assessingofficer (AOcode)

Sign/leftTumbimpressionacross Areacode AOtype Rangecode AONo.
thisphoto Signature/Left Thumb Impression
I/Weherebyrequestthatapermanentaccountnumberbeallottedtome/us.
I/Wegivebelownecessaryparticulars:
1 FullName (Fullexpandednametobementionedasappearinginproofofidentity/addressdocuments:initialsarenotpermitted)

Pleaseselecttitle, L asapplicable Shri Smt. Kumari M/s
LastName/Surname
FirstName
MiddleName

2 Abbreviationoftheabovename,asyouwouldlikeit,tobeprintedonthePANcard
3 Have youeverbeenknownbyanyothername? Yes No (Pleasetickasapplicable)
Ifyes,pleasegivethatothername
L
Pleaseselecttitle, asapplicable Shri Smt. Kumari M/s
LastName/Surname
FirstName
MiddleName

4 Gender (forIndividualapplicantsonly) Male Female (Pleasetickasapplicable)
5 DateofBirth/Incorporation/Agreement/PartnershiporTrustDeed/FormationofBodyofindividualsorAssociationofPersons
Day Month Year
6 Father’sName (Only’Individual’applicants:Evenmarriedwomenshouldfillinfather’snameonly)
LastName/Surname
FirstName
MiddleName
7 Address
ResidenceAddress
Flat/Room/Door/BlockNo.
NameofPremises/Building/Village
Road/Street/Lane/PostOffice

Area/Locality/Taluka/Sub-Division
Town/City/District
State/UnionTerritory Pincode/Zipcode Country Name

OfficeAddress
Nameofoffice
Flat/Room/Door/BlockNo.

NameofPremises/Building/Village
Road/Street/Lane/PostOffice
Area/Locality/Taluka/Sub-Division
Town/City/District
State/UnionTerritory Pincode/Zipcode Country Name
8Address forCommunication Residence Office (Please tickasapplicable)

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9TelephoneNumber&EmailIDdetails
Countrycode Area/STDCode Telephone/Mobilenumber

 

EmailID
10Statusofapplicant
L
Pleaseselectstatus, D asapplicable Government

Individual Hinduundividedfamily Company PartnershipFirm AssociationofPersons
Trusts BodyofIndividuals LocalAuthority ArtificialJuridicalPersons LimitedLiabilityPartnership
11RegistrationNumber(forcompany,firms,LLPs,etc.)

 

12IncaseofacitizenofIndia,then

Please mentionyourAADHAARnumber(ifallotted)
13 Sourceof income Please select status, L asapplicable
Salary CapitalGains
IncomefromBusiness/Profession Business/Professioncode [ForCode:Referinstructions] IncomefromOthersources

IncomefromHouseproperty Noincome

14RepresentativeAssessee(RA)
Fullname,addressoftheRepresentativeAssessee,whoisassessableundertheIncomeTaxActinrespectoftheperson,whoseparticularshavebeengiveninthe
column1-13.
FullName (Fullexpandedname:initialsarenotpermitted)
Pleaseselecttitle, L asapplicable Shri Smt. Kumari M/s

LastName/Surname

FirstName
MiddleName
Address
Flat/Room/Door/BlockNo.

NameofPremises/Building/Village
Road/Street/Lane/PostOffice

Area/Locality/Taluka/Sub-Division
Town/City/District
State/UnionTerritory Pincode

 

15DocumentssubmittedasProofofIdentity(POI)andProofofAddress(POA)

I/Wehaveenclosed asproofofidentityand
asproofofaddress.
[Pleaserefertotheinstructions(asspecifiedinRule114ofI.T.Rules,1962)forlistofmandatorycertifieddocumentstobesubmittedasapplicable]
,theapplicant,inthecapacityof
16 I/We
do hereby declare that what is stated above is true to the best of my/our information and belief.

Place
D D M M Y Y Y Y Signature/Left Thumb Impression of
Date Applicant(insidethebox)

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a) Form to be filled legibly in BLOCK LETTERS and preferably in BLACK INK. Form should be filled in English only.
b) Each box, wherever provided, should contain only one character (alphabet /number / punctuation sign) leaving a blank box after each word.
c) ‘Individual’ applicants should affix two recent colour photographs with white backgrounds (size 3.5 cm x 2.5 cm) in the space provided on the form. The photographs should
not be stapled or clipped to the form. The clarity of image on PAN card will depend on the quality and clarity of photograph affixed on the form.
d) Signature / Left hand thumb impression should be provided across the photo affixed on the left side of the form in such a manner that portion of signature/impression is on
photo as well as on form
e) Signature /Left hand thumb impression should be within the box provided on the right side of the form. The signature should not be on the photograph affixed on right side
of the form. If there is any mark on this photograph such that it hinders the clear visibility of the face of the applicant, the application will not be accepted.
f) Thumb impression, if used, should be attested by a Magistrate or a Notary Public or a Gazetted Officer under official seal and stamp.
g) AO code (Area Code, AO Type, Range Code and AO Number) of the Jurisdictional Assessing Officer must be filled up by the applicant. These details can be obtained from
the Income Tax Office Or IT PAN Service Centers may (managed by UTIITSL) Or UTIITSL website www.utiitsl.com
h) Guidelines for filling the Form49A:

R A V I K A N T

 

S A R D A
S U R E S H

N A R A Y A N
P O O N A M
R A V I
R A O
S A T Y A M
V E N K A T M K
K A N D A S W A M Y
M A D U R A I
S O M A S U N D R A M

 

X Y Z D A T A C O R P O R A T I O N ( I N D
I A ) P R I V A T E L I M I T E D

M A N O J M A F A T L A L D A V E ( H U F )

 

Pvt. P. P. Ltd., P Ltd

 

 

R A O
S A T Y A M
V E N K A T M K

 

 

 
D D M M Y Y Y Y
0 2 0 8 1 9 7 5

 

 

 

 

 

 

 

 

 

 

9 1 1 1 2 2 5 5 5 7 0 5
9 1 9 1 0 2 5 1 1 1 1 1

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AADHAAR number if allotted has to be quoted (Supported by copy of AADHAAR Letter/Card)
Code Business/Profession Code Business/Profession
1 Medical Profession and Business 11 Films, TV and such other entertainment
2 Engineering 12 Information Technology
3 Architecture 13 Builders and Developers
4 Chartered Accountant/Accountancy 14 Members of Stock Exchange, Share Brokers and Sub-Brokers
5 Interior Decoration 15 Performing Arts and Yatra
6 Technical Consultancy 16 Operation of Ships, Hovercraft, Aircrafts or Helicopters
7 Company Secretary 17 Plying Taxis, Lorries, Trucks, Buses or other Commercial Vehicles
8 Legal Practitioner and Solicitors 18 Ownership of Horses or Jockeys
9 Government Contractors 19 Cinema Halls and Other Theatres
10 Insurance Agency 20 Others

 

 

 

 

 

 

 

 

1. In case of Minor, any of the above mentioned documents as
proof of Identity and Address of any of parents/guardians of such 1. Proof of Address is required for residential address
minor shall be deemed to be the proof of identity and address for
the minor applicant. mentioned in item no. 7
2. In case of an Indian Citizen residing outside India, copy of
2. For HUF an affidavit made by the Karta of Hindu Undivided
Family stating name, father’s name and address of all the Bank Account statement in country of residence or copy of

coparceners on the date of application and copy of any of the Non-resident External ( NRE ) bank account statement
above documents in the name of Karta of Huf is required.
or State

 
a.

b.
c.

d.

 

 

 
Authorized Signatory

 

Navi Mumbai
UTI Infrastructure Technology & Services Ltd. P. B NO 20, Plot no 3, Sector-11 CBD- Belapur, Navi Mumbai- 400614 Telephone: (022) 67931300
Fax : (022) 67931399 Email ID : [email protected]
New Delhi
UTI Infrastructure Technology & Services Ltd. Ground Floor, Jeevan Tara Building Opp Patel Chowk Metro Station 5, Parliament Street, New Delhi- 110001
Telephone : (011) 23741282-86 Fax: (011 ) 23741280 Email ID :- [email protected]
Kolkata
UTI Infrastructure Technology & Services Ltd 29,Netaji Subhash Road, Ground Floor, Opp Gilander House & Standard Chartered Bank,
Kolkata- 700001 Telephone: (033) 22108959, 2242 – 4774/4810/4783 Fax: ( 033) 22435217 Email ID : [email protected],[email protected]

Chennai
UTI Infrastructure Technology & Service Ltd 45, Justice Basheer Ahmed Building, Second Floor Second Line Beach, Chennai- 600001
Telephone:-(044) 25341224/ 1265/ 1356 Fax : ( 044)- 25341346 Email ID:- [email protected]/[email protected]
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