Form 49AA

Application for Allotment of Permanent Account Number

[Individuals not being a Citizen of India/Entities incorporated outside India/
Unincorporated entities formed outside India]
Under section 139A of the Income Tax Act, 1961

Date: 23/04/2020
Print

Payment Status: Success

Your Payment of Rs.72.00/- for one PAN Application has been accepted subject to realization
and final settlement confirmation from your Banker.
Please quote Reference No. SHMP8733484673 for any future correspondence.

Application Number:U-F001036735
Coupon Number:U-F001036735

PAN Card e-PAN only, No physical PAN

Mode Card
Application PAPER APPLICATION (physical
Mode submission by applicant)

Assessing Officer(AO Code)

Area Code AO Type Range Code AO No

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

First Name:-
Title:- SHRI Last Name:- SUREDA MORA Middle Name:-
JOAN
2. Abbreviation of the above name, as you would like it, to be printed on the PAN card:- JOAN SUREDA
MORA
3. Have you been known by any other name? N
Last Name:- Middle Name:- First Name:-
4. Gender:- MALE
5.Date of Birth / Incorporation/Agreement/Partnership or Trust Deed/Formation of Body of
30/05/1975
Individuals/Association of Persons:-
6. Father's Name : Last Name / Surname :- SUREDA MORA First Name:- MARTIN Middle Name:-
First Name:-
Mother's Name : Last Name / Surname :- SUREDA MORA Middle Name:-
CATALINA
The name of either father or mother which you may like to be printed on PAN
MOTHER'S NAME
card :
7. Address:-
Residential Address:-
Flat/Door/Block No.:- C/ MARINETA TASCO
Name of Premises/Building/Village:-
Road/Street/Lane/Post Office:- S/N, PORTO CRISTO
Area/Locality/Taluka/Sub-Division:- MANACOR
Town/City/District:- ISLAS State/Union Territory:- PIN Code:-
Country:- SPAIN ZIP Code:- 07500
BALEARES OTHER 999999
Official Address:-
SHAURYA AERONAUTICS PRIVATE
Office Name:-
LIMITED
Flat/Door/Block No.:- T-15, 2ND FLOOR
Name of Premises/Building/Village:-
Road/Street/Lane/Post Office:- GREEN PARK MAIN
Area/Locality/Taluka/Sub-Division:-
State/Union Territory:- PIN Code:-
Town/City/District:- NEW DELHI Country:- INDIA ZIP Code:-
DELHI 110016
8. Address for Communication:- OFFICE

9. Telephone Number & Email ID Details :-

Country Area/STD Telephone/Mobile
91 91 9841744033 Email Address:- hrishikesh.narasimhan@gmail.com
Code:- Code:- Number:-
10. Status of the Applicant:- Individual
11. Registration Number(for
Company,firms,LLP's etc):-
ISD Code of
12. Country Of Citizenship :- SPAIN country of 34
citizenship

13.Source of Income

SALARIED Capital Gains

Income from Business/Profession Business/Profession code:- Income from Other sources

Income from House property No income

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 colmns 1 to 13.
Last Name:- Middle Name:- First Name:-
Flat/Door/Block No.:-
Name of Premises/Building/Village:-
Road/Street/Lane/Post Office:-
Area/Locality/Taluka/Sub-Division:-
Town/City/District:- State/Union Territory:- PIN Code:- ZIP Code:-

15. I/We have enclosed Passport (In Copy) as Proof of Identity and Registration certificate issued by Foreigners
Registration offices showing indian address (In Copy) as Proof of Address
16. I/We JOAN SUREDA MORA ,the applicant,in the capacity of do hereby declare that what is stated above is true to the
best of my/our information and belief.

INDIA

Place Date Signature/Left thumb impression of the

applicant