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PAN Correction New

The document is a request form for changes or corrections to PAN data or reprinting of a new PAN card. It requests information such as name, date of birth, address, photo, signature, and other PAN numbers. The applicant declares the information is true and may enclose supporting documents.

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nkpalamuru
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104 views1 page

PAN Correction New

The document is a request form for changes or corrections to PAN data or reprinting of a new PAN card. It requests information such as name, date of birth, address, photo, signature, and other PAN numbers. The applicant declares the information is true and may enclose supporting documents.

Uploaded by

nkpalamuru
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Request For Changes Or Correction in PAN Data Or/

And reprint of New PAN Card

recent photograph recent photograph


Permanent Account Number (PAN)

Please read Instructions ‘h’ & ‘i’ for selecting boxes on left margin of this form.

Signature / Left thumb


impression 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 / Left thumb impression
Last Name / Surname
First Name
Middle Name
Name you would like it printed on the PAN card

2 Details of Parents (applicable only for Individual applicants)

Last Name / Surname


First Name
Middle Name
Mother’s Name (optional)
Last Name / Surname
First Name
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 (Please tick as applicable)

3 Date of Birth/Incorporation/Agreement/Partnership/Trust Deed/ Formation of Body of individuals or Association of Persons


Day Month Year

4 Gender (for ‘Individual’ applicant only) Male Female Transgender (Please tick as applicable)
5 Photo Mismatch
6 Signature Mismatch
7 Address for Communication Residence (Please tick as applicable)

Flat/Room/ Door / Block No.


Name of Premises/ Building/Village

Pincode / Zip code

8 If you desire to update your other address also, give required details In additional sheet.
9 Telephone Number & Email ID details
Country code Area/STD Code Telephone / Mobile number

Email ID
10 AADHAAR number (if allotted)
Name as per AADHAAR letter/card

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


PAN 1 PAN 2 PAN 3 PAN 4
12 Verification
I/We , 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.
I/We have enclosed (number of documents) in support of proposed changes / corrections.
Place
D D M M Y Y Y Y
Date

Note: As per provisions of Section 272B of the Income Tax Act., 1961, a penalty of 10,000 can be levied on possession of more than one PAN.

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