I/We hereby request that a permanent account number be allotted to me/us. I/We give below ... Telephone / Mobile number
FormNo.49A ApplicationforAllotmentofPermanentAccountNumber [InthecaseofIndianCitizens/IndianCompanies/EntitiesincorporatedinIndia/ UnincorporatedentitiesformedinIndia] Undersection139AoftheIncomeTaxAct,1961 Toavoidmistake(s),pleasefollowtheaccompanyinginstructionsandexamplesbeforefillinguptheform
Assessingofficer(AOcode) Areacode
Sign/leftTumbimpressionacross thisphoto
AOtype
Rangecode
AONo.
Sir, I/Weherebyrequestthatapermanentaccountnumberbeallottedtome/us. I/Wegivebelownecessaryparticulars:
1 FullName(Fullexpandednametobementionedasappearinginproofofidentity/addressdocuments:initialsarenotpermitted)
D asapplicable
Pleaseselecttitle,
Shri
Smt.
Kumari
M/s
LastName/Surname FirstName MiddleName
2 Abbreviationoftheabovename,asyouwouldlikeit,tobeprintedonthePANcard
3 Haveyoueverbeenknownbyanyothername?
Yes
No
Smt.
Kumari
Male
Female
(Pleasetickasapplicable)
Ifyes,pleasegivethatothername
D asapplicable
Pleaseselecttitle,
Shri
M/s
LastName/Surname FirstName MiddleName
4 Gender(forIndividualapplicantsonly)
(Pleasetickasapplicable)
5 DateofBirth/Incorporation/Agreement/PartnershiporTrustDeed/FormationofBodyofindividualsorAssociationofPersons Day
Month
Year
6 Father'sName(Only'Individual'applicants:Evenmarriedwomenshouldfillinfather'snameonly) LastName/Surname FirstName MiddleName
7 Address ResidenceAddress Flat/Room/Door/BlockNo. NameofPremises/Building/Village Road/Street/Lane/PostOffice Area/Locality/Taluka/SubDivision Town/City/District State/UnionTerritory
OfficeAddress Nameofoffice Flat/Room/Door/BlockNo. NameofPremises/Building/Village Road/Street/Lane/PostOffice Area/Locality/Taluka/SubDivision Town/City/District
Pincode/Zipcode
CountryName
State/UnionTerritory
Pincode/Zipcode
8 AddressforCommunication
CountryName
Residence
(Pleasetickasapplicable)
Office
9 TelephoneNumber&EmailIDdetails Countrycode
Area/STDCode
Telephone/Mobilenumber
EmailID
10 Statusofapplicant Pleaseselectstatus,
D asapplicable
Government
Individual
Hinduundividedfamily
Company
PartnershipFirm
AssociationofPersons
Trusts
BodyofIndividuals
LocalAuthority
ArtificialJuridicalPersons
LimitedLiabilityPartnership
11 RegistrationNumber(forcompany,firms,LLPs,etc.)
12 IncaseofacitizenofIndia,then PleasementionyourAADHAARnumber(ifallotted) Pleaseselectstatus,
13 SourceofIncome Salary
D asapplicable
CapitalGains
IncomefromBusiness/Profession
Business/Professioncode
[ForCode:Referinstructions]
IncomefromHouseproperty
IncomefromOthersources Noincome
14 RepresentativeAssessee(RA) Fullname,addressoftheRepresentativeAssessee,whoisassessableundertheIncomeTaxActinrespectoftheperson,whoseparticularshavebeengiveninthe column113.
FullName(Fullexpandedname:initialsarenotpermitted) Pleaseselecttitle,
D asapplicable
Shri
Smt.
Kumari
M/s
LastName/Surname FirstName MiddleName Address Flat/Room/Door/BlockNo. NameofPremises/Building/Village Road/Street/Lane/PostOffice Area/Locality/Taluka/SubDivision Town/City/District State/UnionTerritory
Pincode
15 DocumentssubmittedasProofofIdentity(POI)andProofofAddress(POA) I/Wehaveenclosed
asproofofidentityand
asproofofaddress. [Pleaserefertotheinstructions(asspecifiedinRule114ofI.T.Rules,1962)forlistofmandatorycertifieddocumentstobesubmittedasapplicable]
16 I/We doherebydeclarethatwhatisstatedaboveis
,theapplicant,inthecapacityof truetothebestofmy/ourinformationandbelief.
Place D Date
D M M
Y
Y
Y
Y
Signature/LeftThumbImpressionof Signature / Left Thumb Impression of Applicant(insidethebox)
