ny eat! poorer bene acm ‘weeres sin Wie hereby request thata permanent acount number be alloted to melus, We give below necessary particular: FORM No. 49AA [APPLICATION FOR ALLOTMENT OF PERMANENT ACCOUNT NUMBER [INDIVIDUALS NOT BEING A CITIZEN OF INDIA/ENTITIES INCORPORATED OUTSIDE INDIA/ ‘UNINCORPORATED ENTITIES FORMED OUTSIDE INDIA] ny dt Se Rule 114 Siac ‘To avoid mistake (please follow the accompanying instructions and examples before filling up the form Sma Sem) Assessing officer (AO code) ‘rea code ‘AD type Range code AON, 1 Full Name (Full expanded name to be mentioned as appearing in proof of Identity/address documents: Intialsare not permitted) Pease select tte Lastname Surname Fst Name Mile Nome 2 Abbreviation oft fs oppiable shine smets Kumars ws the above name, as you would like it tobe printed on the PAN card 3 Have you ever been known by any other name? Yes No (Preasetckas applicable) yes please ave that other name Pease select fos applicable shauna smetis Kumars ws LastName/sumame [] FirstName Mile Name 4 Gender for individual applicants only) Male Female (Please tckas applicable) 5 Date of Birth/Incorporation/Agreement/Partnership or Trust Deed/Formation of Body of Individuals or Association of persons Day Month Yeat 6 Detals of Patents (applicable only for Individual applicants) Fathers Name (Mandatory, Even maried women shoud filin father's name ony) LastName / Surname Fst Name Middle Name Mothers Name (optional LastName/ Sumame Fst Name Mile Nome Select the name of incase noaption 7 Address Residence Address FatRoom/Deor/ Name of Premises/Buing Village Road/SueetLane/PostOffce ‘Area/Localty/Teluka/Sub Division TonriCiy/isriet, StateUnion Trt ether ater or mother which you may The tobe printed on PAN card (elecronecony) is provided then PAN card wil betssued wth fathers name) rathers name [Mothers name (leasetickas applicable lock No 7 Pincode /Zip code ‘County Name 8 Adres for Communication [residence [_Jotice easenckasenpa) 9 Telephone Number &EmalD details EmalID CCountrycade Area/STD Code “Telephone / Mobile number CLO) CLIT) CEE) (ew C C Jraremersiap etre: [__Jaseocsation of persone [ tetanus peencatraccimnom —E]ume tes rrertie 7 ettraton Number (or company ts tse) ee ee | Cl ae o = fe cere income from House property ) womcome site) ater ( orataner owernt [1] wits widowe [LE rereon orinaan onan [el oversnasenzen of nts a ou [Clrnvate sxctor service [Clruntc sector/cove. service Coma (Claereuiurist [JRetred []Housewite [Cstucent others [lrretessionst [Le pevate company 7 Wwe Jpntic company [Booey corsorate LE pnancit intuition [elven covermentorponnaton _[E]enerais onsen ros Ant come — | oO Cn |- the apptcant in ae eapacty at [d a ppm my yyyINSTRUCTIONS FOR FILLING FORM 494A 2 topet testy mocic errand ty AK mene Men aig Se ee ee EE a meter 2 Sec te cna etc ye fm Te har Sere tran none sree stereo nh no tte ee on 0 Epi Ss mn npn i rv hi nc ey arte fe Tip peso, chul be ssid ys Nott Pub oro unis ome a tapece une) at rsenee ter oficial seated sg pe heen te XR he rom ary = _Forcanpie WES.RANDASWAMY (TADURAT SOMASUNDRAM KANDASWAMY) oi = Forexample MANOJ MAFATLAL DAVE (HUF) shou 2. _Abbrevintion of full name to be printed on the PAN card Tfapplicant sclects "Yes, then it mandatory to provide dotalla ofthe other name, Instructions in Rem No.1 with Feo name aPPIT Soy Geet {re a | [OS a | ‘Sear crepancy into ai siting PAN oh ema Capponi nse etn heTI. Registration number Not applicable o Individuals and HUFS. Mandatory for ‘Company Company should mention registration number issued by the Registrar of companies or the concemed Government Authority of Country of residence 12. Country of Citsmships This Field is mandatory forall ealegories of appivcanis * Fn Haines profeaion we selected by the appear then wn appronrate bustnoosprofenion Sade shouldbe mentioned. Pleats | Malka Poftmbn md sine | 2 | Easing 3 | aehieme 4+ [ Cored Account Accomney 9” | ever Gon 10 [sane Ao TW [Piss TVasdch ir eneraien!| 12 lfrmton Tesi 16 | Operon of Sips, Honea, Aaa Hacer [Li [Pinatas Lover iso oer Commpew Vee SS"Document aecepeable as proot of identity and dress ax por Rule 14 of income Ta eles. ‘NUnibcr or Taxpayer idemufication Member duly attested by Apostlte™ C vies chien are tignatories to is. a 2 yin eapect of pe jcountica wih arglsiunatorics to” the ‘laste Cogwention of Tai) or by she Tndion iembaacy or Hh, Te is mandatory to provide KYC details in cass of an application filed by « Forcien Institutional investor or « Qualified Foreign Investor, os preseribed under the regulations isqued by Securitics and Exchange Board of India C SEDI ), Plonas reFe ne aidelines fied by” she Sccuraticn nnd Hactvomge Bora of inn ( it} ad Provension of Mhoney Lewmdering Act for “pplication must be signed by (the applicant Ovi) Karta in care of HUF or GiDiector of Company or (iv) Authorized Sianataree i= AREER ody oo Nath te ila aul Seton Ou Hume cine a Fen Oe ety Hee Oe ‘Sphoeincometmuindiasoysia "wrist setae ¢ Fae ea REAR anpticanon e107. Ga sate, the PAN eat 4, Applicant will receive an acknowlodument containing 25 digit unique number on acceptance of this form. This ucknowledument Reccived ©1077 Ginclusive of applicable taxes) PAN Service Center Name Autorized Signatory Ci date arm [UTI inastrucure Technology & Services Lid 1/26 Sunight Bulaing, Asaf Al Road, New Delhi -1 10002 “Tolophone: (011) 28211262/23211273-28211274 E-mallID.=pan.dalhig@utis.com. UT! Infissructure Technology & Services L1d29.Netli Subhash Road, Ground Floor, Onp Gi Kotkata! 001 Telopane: ssp sat08ss9: Saas avhaaato EY Pans ( OA) B8atszT Enea 1 Rolisnassalcon | UTI inastruciure Technology & Services Lid. 0-1, Ft Floor, Thru -VHKe Industrial Estat, Gundy, Chennai-600032 “Woonona: 044-72500426/044-22500183 _E-mal I-chennal@ulisl com "AAYKAR SAMPARK KENDRA (ASK); Toll Free Nos 1800-180-1961 mkolnmusite com