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Fields marked asterisk (*) are mandatory.

PERSONAL DETAILS
Name in Full*
First Name
Middle Name

Last Name

Father/ Husband/ Guardian Name*

First Name

Middle Name

Last Name

Residential Address
C/o
House No and Name*

Street No and Name*

Landmark*

State*

District*

Sub District / Tehsil

Village/ City*
--Select--

Please Mention

Pincode*
Telephone / Landline.(With STD Code)

+91

Sex*

Male

FemaleDate of Birth*

Mobile No.*

Occupation*

Category

--Select--

Provide your IT PAN or fill Form 60 below:

I.T PAN(In Capitals)
Form 60/61

Form of declaration filled by a person who does not have

either a Permanent Account Number or General Index
Registration Number and who makes payment in cash in
respect of transaction specified in clause (a) to (h) of rule
114B
Full Name of Declarant*
Address of Declarant*
First Name

Particulars of Transaction
accounts(s)*(b)

(a) Opening of*

Issue of Debit*
Amount of Transaction*
Are you assessed to tax?*

No

Yes

Income per annum*

Educational Qualification*

--Select--

Email ID
KYC Document

151530019163
Yes

No

Aadhar Number(if applicable)

SA04186695 sarnYour SCRN (Small Customer Reference No.)

is SC14126628, which is valid for 30 days.
Please note down this reference number for the next session / future use.
This reference number is also being sent on your above mentioned mobile
number.

Form No. 49A

Form No. ITS 49A

Application for Allotment of Permanent Account Number

Under Section 139A of the Income Tax Act, 1961
Fields marked with * (asterisk) are mandatory. . To avoid mistake(s), please
refer guidelines and instructions .
*If you are a Defence Personnel select the appropriate category
Navy

Army

Air Force

Other Individuals

Don`t know AO details?

For Non International Taxation AO details Click here
For International Taxation AO details Click here

* Area Code * AO Type

* Range Code* AO Number

Sir,
I/We hereby request that a permanent account number be allotted to me/us.
I/We give below necessary particulars:
* 1. Full Name (Initials are not permitted in first and last name. Applicant's proof of identity,
proof of address and proof of date of birth should contain the exact name mentioned in this
field)
Title

Shri/Mr

Last Name/Surname

Smt./Mrs.

Kumari/Ms

First Name

M/s

Middle Name

* 2. Name you would like printed on the card (Prefix like Shri, Smt, Kumari, Late, Dr, CA,
Ms, Mr, Mrs, M/s, Alias etc. are not allowed)

3. Have you ever been known by any other name? Yes

No

Male

* 4. Gender

Female

* 5. Date of
Birth/Incorporation/Agreement/Partn DD
ership or Trust Deed/Formation of
Body of Individuals/Association of
Persons

MM

YYYY

* 6. Father's Name (Even married women should give father's name only. Prefix like Shri,
Smt, Kumari, Late, Dr, CA, Ms, Mr, Mrs, M/s, Alias etc. are not allowed)
Last Name/Surname

First Name

Middle Name

* 7. Address
(R) Residential Address

(O) Office Address

Name of
Office
Flat/Door/Blo
ck No.

Flat/Door/Blo
ck No.

Name of
Premises/Bui
lding/Village

Name of
Premises/Bui
lding/Village

Road/Street/L
ane/Post
Office

Road/Street/L
ane/Post
Office

Area/Locality/
Taluka/SubDivision

Area/Locality/
Taluka/SubDivision

Town/City/Dis
trict

Town/City/Dis
trict

State/Union
Territory

-- Please select --

State/Union
Territory

Pin (Indicating
PIN is
mandatory)

Pin (Indicating
PIN is
mandatory)

Country
Name

Country
Name

Zip

Zip

* 8. Address for communication

Residential

-- Please select --

In case office address is

selected as communication
address, proof of residence
address as well as office
address is to be submitted to

Office

NSDL.

Country code (ISD code)

Tel
Mobile No.
ephone
No.

* 9. Telephone No.
(Country code is compulsory)

Area/STD Code

Telepho
ne
No./Mobi
le No.

E-mail ID
* 10. Status of the Applicant
Individual (P)

Partnership Firm (F)

Body of Individuals (B)

Hindu Undivided Family (H)

Association of Persons (A)

Local Authority (L)

Company (C)
Limited Liability Partnership (E)

Trust (T) Artificial Juridical Person (J)

Government (G)

11. Registration Number (In case of Firms, companies etc.)

12. In case of a citizen of India, then
Please mention your
AADHAAR number (if
allotted)

In case AADHAAR number is provided, then

proof of AADHAAR along with supporting documents is to
be submitted to NSDL

* 13. Source of Income

(a
)

Are you a salaried employee?

(b
)

If you are engaged in a business/ profession, indicate nature of business or

profession and the relevant
code

(c)

If you are not covered by (a) or (b) above, indicate sources of income, if any.

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 column
1 to 13
(Representative Assessee details to be filled only in special cases like minor, lunatic,
idiot, etc., as provided u/s 160 of Income-tax Act, 1961)

Appointing Representative Assessee ?

Yes

No

* 15. Documents enclosed

I/We have enclosed

-- Please select --

as proof of
identity,
-- Please select --

as proof of address and

-- Please select --

as proof of date of birth

* 16. 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.

Place

DD
01 -

Verified today, the

MM
03 -

YYYY
2015

Other Details
1. Depository Account Details
DP ID:

Client ID:

2. Payment Details (select appropriate mode of payment and fill relevant details)

Demand Draft/Cheque (in favour of 'NSDL - PAN' for

Demand Draft number
YYYY

for

dated DD

MM

105.00

drawn on

Bank, payable at Mumbai.

Cheque number
for

105.00)

dated DD

MM

YYYY

105.00

drawn on

Bank, deposited at HDFC

Bank,

Branch

at

location (city/town).

Credit Card / Debit Card (

Net Banking (

105.00 plus applicable bank charges)

105.00)

List of Banks available

Submit

Income Tax PAN Services Unit

AO Code search for PAN
Search on City (by selecting the appropriate alphabet)
A B C D E F G H I J K L M N O P Q R S T U V W X Y Z
Search has found 2 number of AO Code records in LAKHIMPUR

Select Ward/Circle/Range/
Commissioner
ITO3(4),LAKHIMPUR- --1

Description

Area AO Range AO
Code Type Code Number
LKN W

43

ITO3(5),LAKHIMPUR- --2

LKN W

43

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