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    Request For New PAN Card Or/And Changes or Correction in PAN Data

    Uploaded by

    Karthik
    This document is a request form for an individual to get a new PAN card or make changes/corrections to their existing PAN data. It requests information such as the applicant's name, date of birth, gender, address, phone number, email, Aadhaar number, and details of any other PAN numbers held. The applicant verifies the information provided and declares it is true to the best of their knowledge, enclosing supporting documents for the requested changes.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Request For New PAN Card Or/And Changes or Correction in PAN Data

    Uploaded by

    Karthik
    1K views1 page
    This document is a request form for an individual to get a new PAN card or make changes/corrections to their existing PAN data. It requests information such as the applicant's name, date of birth, gender, address, phone number, email, Aadhaar number, and details of any other PAN numbers held. The applicant verifies the information provided and declares it is true to the best of their knowledge, enclosing supporting documents for the requested changes.

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    This document is a request form for an individual to get a new PAN card or make changes/corrections to their existing PAN data. It requests information such as the applicant's name, date of birth, gender, address, phone number, email, Aadhaar number, and details of any other PAN numbers held. The applicant verifies the information provided and declares it is true to the best of their knowledge, enclosing supporting documents for the requested changes.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    1K views1 page

    Request For New PAN Card Or/And Changes or Correction in PAN Data

    Uploaded by

    Karthik
    This document is a request form for an individual to get a new PAN card or make changes/corrections to their existing PAN data. It requests information such as the applicant's name, date of birth, gender, address, phone number, email, Aadhaar number, and details of any other PAN numbers held. The applicant verifies the information provided and declares it is true to the best of their knowledge, enclosing supporting documents for the requested changes.

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    © All Rights Reserved
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    Request For New PAN Card Or/And Changes Or Correction in

    PAN Data
    Only 'Individuals' Only 'Individuals'
    to affix recent to affix recent
    colour colour
    photograph photograph
    (3.5 cm x 2.5 cm) (3.5 cm x 2.5 cm)
    Permanent Account Number (PAN)
    E D R P K 9 0 7 5 H
    Please read Instructions 'h' & 'i' for selecting boxes on left margin of this form.
    Signature of applicant across
    this photo

    1 Full Name (Full expanded name to be mentioned as appearing in proof of


    identity/address documents: initials are not permitted)
    Please select title, as applicable Shri Smt. Kumari M/s Signature of applicant (inside the box)
    Last Name / Surname K O T H A
    First Name S U J A T H A
    Middle Name
    Name you would like it printed on the PAN card
    S U J A T H A K O T H A

    2 Details of Parents (Applicable only for Individual Applicants)


    Father's Name (Mandatory : Even married women should fill in father's name only)
    Last Name / Surname S A M M E T A
    First Name V E E R A
    Middle Name S W A M Y
    Mother's Name (Optional)
    Last Name / Surname S A M M E T A
    First Name S U D H A R S H A N A D E V I
    Middle Name
    Select the name of either father or mother which you may like to be printed on PAN card (Select one only)
    (In case no option is provided then PAN card will be issued with Father's name) Father's Name Mother's Name
    3 Date of Birth 2 3 0 5 1 9 7 6 4 Gender Male Female
    5 Photo Mismatch 6 Signature Mismatch
    7 Address for Communication Residence Office (Please tick as applicable)
    Name of office
    Flat/Door/Block No. P L O T N O 7 9 6
    Name of Premises/Building/Village H S N R R E S I D E N C Y
    Road/Street/Lane/Post Office V E N K A T A R A M A N A C O L O N Y
    Area/Locality/Taluka/Sub-Division K P H B P H A S E 9
    Town/City/District H Y D E R A B A D
    State/Union Territory Pincode/Zipcode Country Name
    TELANGANA 5 0 0 0 8 5 INDIA
    8 If you desire to update your other address also, give required details in additional sheet
    9 Telephone Number & Email ID details
    Country Code Telephone/Mobile Number Email ID
    9 1 6 3 0 0 5 3 7 3 9 3 KARTHIK.KOTHA777@GMAIL.COM
    10 AADHAAR number (if allotted) 8 2 9 1 4 1 7 0 0 0 0 2
    Name as per AADHAAR letter/card
    K O T H A S U J A T H A

    11 Mention other Permanent Account Numbers (PANs) inadvertently allotted to you


    PAN 1 PAN 2 PAN 3
    12 Verification
    I/We SUJATHA KOTHA , the applicant, in the capacity of HERSELF
    do hereby declare that what is stated above is true to the best of my/our information and belief.
    I/We enclosed 3 (number of documents) in support of proposed changes/corrections.
    Place HYDERABAD
    Date 2 4 0 4 2 0 2 1

    Signature of applicant (inside the box)

    A3725571

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