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Abbreviation of the above name, as you would like it, to be printed on the pAN card:- SUNITA GODIYAL
Have been known by any other name? N
mother is a and you wish to aDoly for PAN the name of vour mother onlv?
7. Addressr
Residential Address:.
FlaUDoor/Block No.:- WARD NO 32
Name of Prcmises/Building/Village: - INDERPUR
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l3.Source of lncome
L saunteO n capital cains
L-.i lncome from BusinessrProfession [l lncome from other aources
[i lncome from House proporty No income
14. Full Name, address of the R6pr€sentativ€ Assassee, v{ho is asscasable under lhe lncome Tax Act in respect of tlle
po.son, whose particulars have been given in colmns'l to 13.
llLast Name:- Uiddle Name:- llFirst Name:-
FlaUDoorlBlock No.:-
Name of Premises/Buildinq,/Village:-
RoadlStreeuLane/Post Offi ca:.
ArealLocalityffaluka/Sub-Oivision: -
fown/City/District: - State/UnionTenttory:- llPlNCode:-
l,lwe have €nclosed A.ADHAAR Card issued by UIDAI (ln Copy) as Proof of ldentity , AADHAAR Card issued by
as Proof of Address and AADHAAR Card issued bv UIDAI (ln coov) as Proof of DoB,
l/We SUNITA GODIYAL ,the applicant,in the capacity of HIMSELF/HERSELF do hereby declare that what is stated
is true to the best of my/our information and belief.
DEHRADUN
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