Form No. 49A Applicaton for Allotment of Permanent Account Number ony Inthe case of indian Ciizensndian Companies/Enttes incorporated in India ow nibs Unincorporated entties formed in india wnt ‘oatresst sera gce Rule 114 7 ‘oat cant coal ‘end nie) se lx he sempre nal bi ing po eet ny Assessing officer (AO code) , ‘rea code | AOwpe | _ Range code | _AONo. se Ahan liWe hereby request that a permanent account number be alloted to metus. liWe give below necessary particulars Sas Le as a 1. Full Name (Full expanded name to be mentioned as appearing in proof of idontty/dato of brth/address documents: initials are not permitted) Please select tte, [Jas applicable sh sm kama [Jus Last Name / Sumame First Neme Middle Name 2. Abbreviations of the above name, as you would like it, to be printed on the PAN card 3 Have you ever been known by any other name’ Yes No (please tick as applicable) Please eolect ttle, [V ]as applicable Shei sm Kuma [] is Last Name / Sumame First Name Middle Name 4 Gender (for individual applicants only) Male Female (please tick as applicable) 5 Date of Birth/incorporation/AgreementPartnership or Trust Deed/ Formation of Body of individuals or Association of Persons 6 Detail ‘of Parents (applicable only for individual applicants) Father's Name (Mandatory. Even married women should fil n father's name only) Last Name / Sumame. Fist Name Middle Name Mother's Name (optional) Last Name / Suame Fist Name Middle Name Select the name of ether father or mother which you may lke tobe printed on PAN card (Select one only) {tn case no option s provided then PAN card wil be issued with father's name) Father's name Mother'sname (Please ck as applicable) 7 Address Residence Address Flat Room / Door Sock No, "Name of Promises /Buléing / Vilage Road | Steet / LaneiPost Office ‘rea Locally Talal Sub- Division ‘oun {City Distiet State Union Tertory Pincods / Zip code Country Name10 " 2 2 Office Address Name of ofce Flat/ Room / Door! Block No Name of Promiges/ Buling Vilage Road / Steet /Lana/Post Office ‘Area | Locally! Taluka! Sub- Division Town {City District State Union Tetitory Pincode !Zip cos County Nar ‘Address for Communication Residence Office (Please tick as applicable) Telephone Number & Email ID de Country code Area/STO Code Telephone / Mobile number mai 1D Status of applicant Please eolect status, 3s applicablo [1 covernment Individual Hindu undivided family JCompany ries Fim [Ey Associaton of Persons Trusts Body of individuals Local Authority Atif! Jriical Persons [F] Lite Laity Partnership Registration Number (for company, firms, LLF Incase of aeltizen of India, then Please mention your ARDHAAR number (f alloted) ‘Source of income Salary v7] Capital Gains Please select, [Vas applicable Income from Business / Profession Business!Profession code Income from Other sources [For Code: Refer instructions} Income from House property 4 6 16 Representative Assessee (RA) Full name, address of the Representative Assessee, who is assessib been given inthe column 1-13, Full Name (Full expanded name : initials are net permitted) Noincome funder the Income Tax Act in respect ofthe person, whose particulars have Please eolect tite, [Jas applicable she [sm Kuma [7 ]ws Last Name / Sumame Fist Name Middle Name Address Flat / Room / Door / Block No, Name of Premises / Building! Vilage Road / Stroet/LanesPost Office ‘Asoa / Local! Talukal Sub- Division Town / City / District State / Union Tetitary Pincods Documents submitted as Proof of kdentity (PON), Proof of Address (POA) and Proof of Date of Birth (DOB) LiWe have encloses a8 proof of identi, as proof of addrass and as proof of date of bith [Please rote to the instructions (as specified in Rulo 114 of LT. Rules, 1962) for lis of mandatory cored documents to be submitted 2s applicable] owe| de hereby declare thal what i slated above is true to the best of mylour information ang bli Place MY yyy Date |, the applicant, in the capacty of Dor soon ‘ostcanl sie the Don)INSTRUCTIONS FOR FILLING FORM 498 (a) Form to be filed legibly in BLOCK LETTERS and preferably in BLACK INK. Form should be filled (b) Each box, wherever provided, should contain only one character (alphabet /number / punctuation sign) leaving a blank box after each word English only (c) ‘Individual’ applicants should affix two recent colour photographs with white background (size 3.5 cm x 2.5 em) in the space provided on the form. The photographs should not be stapled or clipped to the form. The clarity of mage on PAN card will depend fon the quality and clarity of photograph affixed on the form. (@) 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. (©) 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 ofthe form. Ifthere 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 (Thumb impression, if used, should be attested by a Magistrate or a Notary Public or a Gazetted Officer under official seal and stamp. (@) AO code (Area Code, AO Type, Range Code and AO Number) of the Jurisdictional Assessing Officer must be filed up by the applicant. These details can be obtained from the Income Tax Office or PAN Centre or websites of PAN Service Providers on www.utitsl.com or www-tin-nsdl.com (b) Guidelines for filing the Form 490 Tem Ne tem Details, Guidelines for filling the form 1 [Full Name Please select appropriate title. Do not use abbreviations in the First and the Last name/Surmame, For example RAVIKANT should be written as Last Name/Surname First Name Middle Name For example SURESH SARDA should be written as Last Nameisumame_|°|*)®]°|& First Name slufre|s|H Middle Name For example POONAM RAVI NARAYAN should be written as: Last Name/surname |‘ |*|®|4|¥|A/N First Namo Plolo|n|als MiddleName |r| A|v| 1 For example SATYAM VENKAT M. K. RAO should be written as Last Name/surname _|"||° FirstName || A|T|y| A] MiddieName |v|e|n|K|Alt| Ju] |i