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ITS 49A
Range
Commissioner
Sir,
I/We hereby request that a permanent account number be allotted to me/us.
I/We give below necessary particulars :
1. Full Name (Full expanded name : initials are not permitted) Signature/Left Thumb
Please Tick as applicable Shri Smt. Kumari M/s Impression
Last Name / Surname First Name
Middle Name
3. Have you ever been known by any other name ? Please Tick as applicable Yes No
If yes, please give that other name
(Full expanded name : initials are not permitted) Shri Smt. Kumari M/s
Last Name / Surname First Name
Middle Name
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 Address
Flat/Door/Block No.
Flat/Door/Block No.
email ID
8. Sex (For ‘Individual’ Applicants only) Please Tick as applicable Male Female
9. Status of the Applicant Please Tick as applicable
10. Date of Birth / Incorporation / Agreement / Partnership or Trust Deed / Formation of Body
of Individuals / Association of Persons
D D M M Y Y Y Y
13. (a) Are you a salaried employee? If yes, indicate Government Others
Name of the Organisation where working
(b) If you are engaged in a business / profession, indicate nature of business or profession and fill the relevant code
(c) If you are not covered by (a) or (b) above, indicate sources of income, if any
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.
Full Name (Full expanded name : initials are not permitted) Please tick as applicable Shri Smt. Kumari M/s
Middle Name
Address
Flat/Door/Block No.
Deed; Partnership Firms: Date of Partnership Deed; HUFs: Date of Creation of HUF and for ancestral HUF date
can be 01010001 where the date of creation is not available.
11. Registration Number Not applicable to Individuals and HUFs. Mandatory for 'Company'. Company should mention registration number
issued by the Registrar of Companies. Other applicants may mention registration number issued by any State or
Central Government Authority.
12. Citizen of India This field is mandatory for all categories of applicants.
13. (a) Salaried Employee In case of salaried employee this is a mandatory field and Name of Organiation should be mentioned.
13 (b) Nature and Code of This field should be specified if applicant is not covered under 13 (a) or 13 (c). Corresponding Business/Profession
Business/Profession Code should be mentioned from the list given in Point No. (e) below (General Information for PAN Applicants).
13 (c) Others Applicants not covered by column 13(a) and 13(b) must mention any one or combination of (i) income from house
property (ii) income from capital gains (iii) income from other sources, as their source of income.
14. Name and address of Section 160 of Income Tax Act, 1961 provides that any assessee can be represented through Representative Assessee.
Representative Assessee This column will contain particulars of such Representative Assessee. Column 1 to 13 will contain details of assessee
on whose behalf this application is submitted. Proof of Identity & Proof of address is also required for representative assessee.
15. Proof of Identity and It is mandatory to attach proof of identity and address with PAN application. List of documents which will
Address serve as proof of identity and address for each category of applicant is given in point (f) below (General
Information for PAN Applicants). Documents should be in the name of applicant.
Trusts) or Body of Individuals or Local registrar of cooperative society or any other competent authority or any other document originating
authority or Artificial Juridical Person from any Central or State Government Department establishing identity and address of such person.
(g) For more information
Visit us at http://www.tin-nsdl.com
Call TIN Call Centre at 022-2499 4650
e-mail us at tininfo@nsdl.co.in
Write to: National Securities Depository Limited, A Wing, 4th Floor, Trade World, Kamala Mills Compound, Senapati Bapat Marg, Lower Parel
(W), Mumbai - 400 013.