IT PAN Form49aE
Form No. 49A
Application for Allotment of Permanent Account Number
[In the case of Indian Citizens/Indian Companies/Entities incorporated in India/
Unincorporated entities formed in India]
Under section 139A of the Income Tax Act, 1961
To avoid mistake (s), please follow the accompanying instructions and examples before filling up the form
Assessing officer (AO code)
Area code
Sign/ leftTumb impression across
this photo
AO type
Range code
AO No.
Sir,
I/We hereby request that a permanent account number be allotted to me/us.
I/We give below necessary particulars:
1 Full Name (Full expanded name to be mentioned as appearing in proof of identity/address documents: initials are not permitted)
D as applicable
Please select title,
Shri
Smt.
Kumari
M/s
Last Name / Surname
First Name
Middle Name
2 Abbreviation of the above name, as you would like it, to be printed on the PAN card
3 Have you ever been known by any other name?
Yes
No
Smt.
Kumari
Male
Female
(Please tick as applicable)
If yes, please give that other name
D as applicable
Please select title,
Shri
M/s
Last Name / Surname
First Name
Middle Name
4 Gender (for Individual applicants only)
(Please tick as applicable)
5 Date of Birth/Incorporation/Agreement/Partnership or Trust Deed/ Formation of Body of individuals or Association of Persons
Day
Month
Year
6 Father's Name (Only 'Individual' applicants: Even married women should fill in father's name only)
Last Name / Surname
First Name
Middle Name
7 Address
Residence Address
Flat/Room/ Door / Block No.
Name of Premises/ Building/ Village
Road/Street/ Lane/Post Office
Area / Locality / Taluka/ Sub‐ Division
Town / City / District
State / Union Territory
Office Address
Name of office
Flat/Room/ Door / Block No.
Name of Premises/ Building/ Village
Road/Street/ Lane/Post Office
Area / Locality / Taluka/ Sub‐ Division
Town / City / District
Pincode / Zip code
Country Name
State / Union Territory
Pincode / Zip code
8 Address for Communication
Country Name
Residence
Office
(Please tick as applicable)
9 Telephone Number & Email ID details
Country code
Area/STD Code
Telephone / Mobile number
Email ID
10 Status of applicant
Please select status,
D as applicable
Government
Individual
Hindu undivided family
Company
Partnership Firm
Association of Persons
Trusts
Body of Individuals
Local Authority
Artificial Juridical Persons
Limited Liability Partnership
11 Registration Number (for company, firms, LLPs, etc.)
12 In case of a citizen of India, then
Please mention your AADHAAR number (if allotted)
13 Source of Income
Please select status,
Salary
D as applicable
Capital Gains
Income from Business / Profession
Business/Profession code
[For Code: Refer instructions]
Income from House property
Income from Other sources
No income
14 Representative Assessee (RA)
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 the
column 1‐13.
Full Name (Full expanded name: initials are not permitted)
Please select title,
D as applicable
Shri
Smt.
Kumari
M/s
Last Name / Surname
First Name
Middle Name
Address
Flat/Room/ Door / Block No.
Name of Premises/ Building/ Village
Road/Street/ Lane/Post Office
Area / Locality / Taluka/ Sub‐ Division
Town / City / District
State / Union Territory
Pincode
15 Documents submitted as Proof of Identity(POI) and Proof of Address (POA)
as proof of identity and
I/We have enclosed
as proof of address.
[Please refer to the instructions (as specified in Rule 114 of I.T. Rules, 1962) for list of mandatory certified documents to be submitted as applicable]
16 I/We
do hereby declare that what is stated above is
, the applicant, in the capacity of
true to the best of my/our information and belief.
Place
D
Date
D M M
Y
Y
Y
Y
Signature / Left Thumb Impression of
Signature
/ Left Thumb Impression of
Applicant (inside the box)
I NSTRUCTI ONS FOR FI LLI NG FORM 49A
(a) Form to be filled legibly in BLOCK LETTERS and preferably in BLACK I NK. Form should be filled in English only
(b) Each box, wherever provided, should contain only one character (alphabet / number / punctuation sign) leaving a blank box after
each word.
(c) 'I ndividual' applicants should affix two recent colour photographs with white background(size 3.5 cm x 2.5 cm) in the space provided
on the form. The photographs should not be stapled or clipped to the form. The clarity of image on PAN card will depend on the
quality and clarity of photograph affixed on the form.
(d) Signature / Left hand thumb impression should be provided across the photo affixed on the left side of the form in such a manner
that portion of signature/ impression is on photo as well as on form.
(e) Signature / Left hand thumb impression should be w ithin the box provided on the right side of the form. The signature should not
be on the photograph affixed on right side of the form. I f there is any mark on this photograph such that it hinders the clear
visibility of the face of the applicant, the application will not be accepted.
(f) Thumb impression, if used, should be attested by a Magistrate or a Notary Public or a Gazetted Officer under official seal and stamp.
(g) AO code (Area Code, AO Type, Range Code and AO Number) of the Jurisdictional Assessing Officer must be filled up by the
applicant. These details can be obtained from the I ncome Tax Office or PAN Centre or websites of PAN Service Providers on
w w w .utiitsl.com or w w w .tin- nsdl.com .
(h) Guidelines for filling the Form 49A:
I te
m
No.
I tem Details
Guidelines for filling the form
1
Full Name
Please select appropriate title.
Do not use abbreviations in the First and the Last name/ Surname.
For example RAVI KANT should be written as :
Last Name/ Surname
R A
V
I
K
A
N
T
First Name
Middle Name
For example SURESH SARDA should be written as :
Last Name/ Surname
First Name
S A
R
D
A
S U
R
E
S
H
Middle Name
For example POONAM RAVI NARAYAN should be written as:
Last Name/ Surname
First Name
Middle Name
N A
R
A
Y
A
P O
O
N
A
M
R A
V
I
N
For example SATYAM VENKAT M. K. RAO should be written as :
Last Name/ Surname
First Name
Middle Name
R A
O
S A
T
Y
A
M
V E
N
K
A
T
M
K
For example M. S. KANDASWAMY( MADURAI SOMASUNDRAM KANDASWAMY) should be written as :
Last Name/ Surname
First Name
Middle Name
K A
N
D
A
S
W A
M A
D
U
R
A
I
S O
M A
S
U
N
D
M Y
R
A
M
Applicants other than 'I ndividuals' may ignore above instructions.
Non-I ndividuals should write their full name starting from the first block of Last Name/ Surname. I f the name is longer
than the space provided for the last name, it can be continued in the space provided for First and Middle Name.
For example XYZ DATA CORPORATI ON ( I NDI A) PRI VATE LI MI TED should be written as :
Last Name/ Surname
First Name
X Y
Z
D
A
T
A
I
)
P
R
I
V
A
A
C
O
T
E
R
P
O
R
A
L
I
M I
T
I
O
T
E
D
A
V
E
N
(
I
N
D
H
U
F
)
Middle Name
For example MANOJ MAFATLAL DAVE ( HUF) should be written as :
Last Name/ Surname
M
A
N
O
J
M A
F
A
T
L
A
L
D
(
First Name
Middle Name
I n case of Company, the name should be provided without any abbreviations. For example, different variations of
'Private Limited' viz. Pvt Ltd, Private Ltd, Pvt Limited, P Ltd, P. Ltd., P. Ltd are not allowed. I t should be 'Private
Limited' only.
I n case of sole proprietorship concern, the proprietor should apply for PAN in his/ her own name.
2
Abbreviation of
the full name to
be printed on
the PAN card
Name should not be prefixed with any title such as Shri, Smt, Kumari, Dr., Major, M/ s etc.
I ndividual applicants should provide full/ abbreviated name to be printed on the PAN card. Name, if abbreviated,
should necessarily contain the last name. For example:
SATYAM VENKAT M. K. RAO which is written in the Name field as :
Last Name/ Surname
First Name
Middle Name
R A
O
S A
T
Y
A
M
V E
N
K
A
T
M
K
Can be written as in ‘Name to be printed on the PAN Card’ column as
SATYAM VENKAT M. K. RAO or
S. V. M. K. RAO
or
SATYAM V. M. K. RAO
3
4
5
Have you ever
been known by
any other
name?
Gender
Date of
Birth/ I ncorporat
ion/ Agreement
/ Partnership or
Trust
Deed/ Formation
of
Body of
For non individual applicants, this should be same as last name field in item no. 1 above.
I f applicant selects 'Yes', then it is mandatory to provide details of the other name. I nstructions in I tem No. 1 with
respect to name apply here. Title should be similar to the title mentioned in I tem No. 1.
This field is mandatory for I ndividuals. Field should be left blank in case of other applicants.
Date cannot be a future date. Date: 2nd August 1975 should be written as:
D
D
M
M
Y
Y
Y
Y
0
2
0
8
1
9
7
5
I ndividuals/
Association of
Persons
6
Father’s Name
7
Address –
Residence and
office
Relevant date for different categories of applicants is:
I ndividual: Actual Date of Birth; Company: Date of I ncorporation;
Association of Persons: Date of formation/ creation; Trusts: Date of creation of Trust
Deed; Partnership Firms: Date of Partnership Deed; LLPs : Date of I ncorporation/ Registration; HUFs: Date of creation
of HUF and for ancestral HUF date can be 01-01-0001 where the date of creation is not available.
Applicable to I ndividuals only. I nstructions in I tem No.1 with respect to name apply here. Married woman applicant
should give father's name and not husband's name.
R - Residence Address:
For I ndividuals, HUF, AOP, BOI or AJP, residential address is mandatory. Other applicants should leave this field
blank.
O - Office Address:
(1) Name of Office and address to be mentioned in case of individuals having source of income as salary or
Business/ profession[ I tem No.13] .
(2) I n case of Firm, LLP, Company, Local Authority and Trust, name of office and complete address of office is
mandatory.
For all categories of applicants, it is necessary to mention complete address and the details of Town/ City/ District,
State/ Union Territory, and PI NCODE are mandatory.
8
Address for
communication
9
Telephone
Number and Email I D
I n case, a foreign address is provided then it is mandatory to provide Country Name along with ZI P Code of the
country.
I ndividuals/ HUFs/ AOP/ BOI / AJP may indicate either 'Residence' or 'Office' and other applicants should necessarily
indicate 'Office' as the Address for Communication.
All communication will be sent at the address indicated in this field.
(1) Telephone number should include country code(I SD code) and STD code or Mobile No. should include Country
code(I SD Code).
For example :
(i) Telephone number 23555705 of Delhi should be written as
Country code
9
1
STD Code
1
1
Telephone Number / Mobile number
2
3
5
5
5
7
0
5
Where ‘91’ is the country code of I ndia and 11 is the STD Code of Delhi.
(ii) Mobile number 9102511111 of I ndia should be written as
Country code
9
1
STD Code
Telephone Number / Mobile number
9
1
0
2
5
1
1
1
1
1
Where '91' is the country code of I ndia.
(2) I t is mandatory for the applicants to mention either their “Telephone number” or valid “e-mail id” so that they can
be contacted in case of any discrepancy in the application and/ or for receiving PAN through e-mail.
10
11
12
13
Status of
Applicant
Registration
number
I n case of
citizen of I ndia
Source of
I ncome
(3) Application status updates are sent using the SMS facility on the mobile numbers mentioned in the application
form.
This field is mandatory for all categories of applicants. I n case of ‘Limited Liability Partnership’, the PAN will be
allotted in ‘Firm’ status.
Not applicable to I ndividuals and HUFs. Mandatory for 'Company'. Company should mention registration number
issued by the Registrar of Companies. Other applicants may mention registration number issued by any State or
Central Government Authority.
AADHAAR number, if allotted, has to be quoted (supported by copy of AADHAAR letter/ card)
I t is mandatory to indicate at least one of the sources of incomes, as mentioned in the form. I n case, the income
from Business/ profession is selected by the applicant then an appropriate business/ profession code should be
mentioned.
Please refer the table given below to select the business/ profession code:
Code
01
02
03
04
14
Name and
address of
Representative
Assessee
Business/ Profession
Medical Profession and Business
Engineering
Architecture
Chartered Accountant/ Accountancy
Code
11
12
13
14
05
06
07
I nterior Decoration
Technical Consultancy
Company Secretary
15
16
17
08
09
10
Legal Practitioner and Solicitors
Government Contractors
I nsurance Agency
18
19
20
Business/ Profession
Films, TV and such other entertainment
I nformation Technology
Builders and Developers
Members of Stock Exchange, Share Brokers and SubBrokers
Performing Arts and Yatra
Operation of Ships, Hovercraft, Aircrafts or Helicopters
Plying Taxis, Lorries, Trucks, Buses or other Commercial
Vehicles
Ow nership of Horses or Jockeys
Cinema Halls and Other Theatres
Others
Section 160 of I ncome Tax Act, 1961 provides that any person(assessee) can be represented through Representative
Assessee. Therefore, this column should be filled in by representative assessee only as specified in Section 160 of
the I ncome-tax Act, 1961, such as, an agent of the non-resident, guardian or manager of a minor, lunatic or idiot,
Court of Wards, Administrator General, Official Trustee, receiver, manager, trustee of a Trust including Wakf.
This field will contain particulars of the Representative Assessee. This field is mandatory if applicant is minor,
deceased, idiot, lunatic or mentally retarded. Column 1 to 13 will contain details of person on whose behalf this
application is submitted.
Proof of I dentity and Proof of address is also required for representative assessee.
Proof of
I t is mandatory to attach proof of identity and proof of address with PAN application. Documents should be in
I dentity and
the name of applicant . List of documents which will serve as proof of identity and address for each status of
Proof of
applicant is as given below:
Address
documents
Document acceptable as proof of identity and address as per Rule 114 of I ncome Tax Rules, 1962
15
For I ndividuals and HUF
Sr.
Proof of I dentity ( Copy of)
No
1
2
3
4
5
6
7
8
9
10
11
12
13
School Leaving Certificate
Matriculation Certificate
Degree of recognised educational institution
Depository Account Statement
Bank Account Statement / Passbook
Credit Card
Water Bill
Ration Card
Property Tax Assessment Order
Passport
Voter I dentity Card
Driving License
Certificate of identity signed by Member of Parliament or Member of
Legislative Assembly or Municipal Councilor or Gazetted Officer in the
prescribed format.
Note : -
1.
2.
Electricity Bill*
Telephone Bill*
Employer Certificate*
Depository Account Statement*
Bank Account Statement / Passbook*
Credit Card Statement*
Rent Receipt*
Ration Card
Property Tax Assessment Order
Passport
Voter I dentity Card
Driving License
Certificate of address signed by Member of Parliament or
Member of Legislative Assembly or Municipal Councilor or
Gazetted Officer in the prescribed format.
Note:
I n case of Minor, any of the above mentioned documents as proof of identity
and address of any of parents/ guardians of such minor shall be deemed to be the proof
of identity and address for the minor applicant.
For HUF, an affidavit made by the Karta of Hindu Undivided Family stating
name, father’s name and address of all the coparceners on the date of application and
copy of any of the above documents in the name of Karta of HUF is required.
Other than I ndividuals and HUF
1
Company
2
Partnership Firm
3
Proof of address ( copy of)
Limited Liability Partnership
1.
Proof of Address is required
mentioned in item no. 7.
for
residence
address
2.
I n case of an I ndian citizen residing outside I ndia, copy of
Bank Account Statement in country of residence or copy of
Non-resident External(NRE) bank account statements.
Copy of Certificate of Registration issued by the Registrar of Companies.
Copy of Certificate of Registration issued by the Registrar of Firms or Copy of partnership
deed.
Copy of Certificate of Registration issued by the Registrar of LLPs
4
Trust
5
Association
of
Person,
Body of
I ndividuals, Local Authority, or Artificial
Juridical Person
16
Signature
impression
/
Thumb
Copy of trust deed or copy of certificate of registration number issued by Charity
Commissioner.
Copy of Agreement or copy of certificate of registration n umber issued by charity
commissioner or registrar of cooperative society or any other competent authority or any
other document originating from any Central or State Government Department establishing
identity and address of such person.
Application m ust be signed by (i) the applicant; or (ii) Karta in case of HUF; or (iii) Director of a Company;
or (iv) Authorised Signaturee in case of AOP, Bod y of I ndividuals, Local Authority and Artificial Juridical
Person; or (v) Partner in case of Firm/ LLP; or (vi) Trustee; or (vii) Representative Assessee in case of
Minor/ deceased/ idiot/ lunatic/ mentally retarded.
Applications not signed in the given manner and in the space provided are liable to be rejected.
GENERAL I NFORMATI ON FOR PAN APPLI CANTS
(a)
Applicants may obtain th e application form for PAN (Form 49A) from any I T PAN Service Centres(managed by UTI I TSL) or
TI N-Facilitation Centres(TI N-FCs)/ PAN Centres (managed by NSDL), or any other stationery vendor providing such forms or
download
from
the
I ncome
Tax
Department
website( w w w .incometaxindia.gov.in )/ UTI I TSL
website( w w w .utiitsl.com )/ NSDL website ( w w w .tin-nsdl.com) .
(b)
The fee for processing PAN application is Rs. 85/ - (plus service tax, as applicable). I n case, the PAN card is to be dispatched
outside I ndia then additional dispatch charge of Rs 850 will have to be paid by applicant.
(c)
Those already allotted a ten digit alphanumeric PAN shall not apply again as having or using more than one PAN is illegal.
However, request for a new PAN card with the same PAN or/ and Changes or Correction in PAN data can be made by filling up
'Request for New PAN Card or/ and Changes or Correction in PAN Data' form available from any source mentioned in (a)
above. The cost of application and processing fee is same as in the case of Form 49A.
(d)
Applicant will receive an acknowledgment containing a unique number on acceptance of this form. This acknow ledgment
number can be used for tracking the status of the application.
(e)
For more information / Application status enquiry contact:
Income-tax Department
NSDL
UTIITSL
Website
www.incometaxindia.gov.in
www.tin-nsdl.com
www.utiitsl.com
Call
Center
0124-2438000
020‐27218080
022-67931300
tininfo@nsdl.co.in
utiitsl.gsd@utiitsl.com
Email ID
SMS
Address
SMS
NSDLPANAcknowledgement
No. & send to 57575 to obtain
application status.
INCOME TAX PAN SERVICES
UNIT (Managed by National
Securities Depository Limited),
3rd Floor, Sapphire Chambers,
Near
Baner
Telephone
Exchange, Baner, Pune ‐ 411
045.
IT
PAN
Service
Centres(managed
by
UTIITSL) PB no 20, Plot
no 3, Sector- 11, CBDBelapur – Navi Mumbai
400614
ूपऽ 49क
ःथाई खाता संख्या हे तु आवेदन
आयकर अिधिनयम, 1961 की धारा 139क के अन्तगर्त
भारतीय नागिरकों / भारतीय कम्पिनयों/ भारत में िनगिमत संःथाओं /
भारत में गिठत अिनगिमत संःथाओं के मामले में
ऽुिट (ऽुिटयों) से बचने के िलए ूपऽ को भरने से पूवर् संलग्न अनुदेशों तथा उदाहरणों का अनुपालन करें
कर िनधार्रण अिधकारी (एओ कोड)
क्षेऽ कोड
इस फोटो के ऊपर हःताक्षर/अंगूठे का
िनशान
एओ ूकार
रें ज कोड
एओ संख्या
महोदय,
मैं/हम अनुरोध करता हूँ/करते हैं िक मुझे/हमें एक ःथाई खाता संख्या आबंिटत िककी जाए
मैं/हम नीचे आवँयक िववरण दे ता हूँ/दे ते हैं
1 पूरा नाम (पहचान ूमाण/पते के दःतावेज में यथा िदखाई पड़ने वाले के रूप में िवःतािरत नाम िलखा जाए: आद्याक्षरों की अनु मित नहीं है )
कृ पया उपािध चुनें
D
ौी
यथा लागू
ौीमती
कुमारी
सुौी
हां
नहीं
(यथा लागू कृ पया सही का िनशान लगाएं)
ौीमती
कुमारी
सुौी
पुरूष
ःऽी
(यथा लागू कृ पया सही का िनशान लगाएं)
अंितम नाम/उपनाम
ूथम नाम
मध्य नाम
2 उपयुक्
र् त नाम का संक्षेपाक्षर, िजससे आप पैन काडर् में छपवाना चाहते हैं
3 क्या आप कभी िकसी अन्य नाम से ज्ञात है ?
यिद हां तो वह अन्य नाम दें
कृ पया उपािध चुनें
D
ौी
यथा लागू
अंितम नाम/उपनाम
ूथम नाम
मध्य नाम
4 िलं ग (केवल व्यिष्ट आवेदकों के िलए)
5 जन्म/िनगमन/समझौता/साझे दारी अथवा न्यास िवले ख/व्यिष्टयों की सं ःथा अथवा व्यिक्तयों के सं घों के िनमार्ण की ितिथ
िदन
माह
वषर्
6 िपता का नाम (केवल व्यिष्ट आवेदक: िववािहत मिहलाओं को भी िपता का ही नाम दे ना चािहए)
अंितम नाम/उपनाम
ूथम नाम
मध्य नाम
7 पता
आवासीय पता
फ्लैट/कमरा/दरवाजा/ब्लाक संख्या
पिरसर/भवन/गांव का नाम
सड़क/गली/पथ/डाकघर
क्षेऽ/ःथान/तालुका/उप ूभाग
नगर/शहर/िजला
राज्य/संघ क्षेऽ
कायार्लय का पता
कायार्लय का नाम
फ्लैट/कमरा/दरवाजा/ब्लाक संख्या
पिरसर/भवन/गांव का नाम
सड़क/गली/पथ/डाकघर
क्षेऽ/ःथान/तालुका/उप ूभाग
नगर/शहर/िजला
िपन कोड/िजप कोड
दे श का नाम
राज्य/संघ क्षेऽ
िपन कोड/िजप कोड
8 पऽाचार का पता
दे श का नाम
आवास
9 दरू भाष सं ख्या व ई‐मे ल आईडी का ब्यौरा
दे श का कोड
कायार्लय
(यथा लागू कृ पया सही का िनशान लगाएं)
एसटीडी कोड
ई‐मेल आईडी
10 आवेदक का दजार्
कृ पया दजार् चु चुनें,
D
यथा लागू
सरकार
व्यिष्ट
िहन्दू अिवभािजत पिरवार
साझेदारी फमर्
व्यिक्तयों का संघ
न्यास
व्यिष्टयों की संःथा
कृ िऽम न्याियक व्यिक्त
िसिमत दे यता भागीदारी
11 पंजीयन सं ख्या (कंपनी, फमोर्ं, एलएलपी आिद के िलए)
)
12 यिद भारत के नागिरक है
हां
तो कृ पया आधार नंबर (यिद आबंिटत है )
नहीं
(यथा लागू कृ पया सही का िनशान लगाएं)
13 आय का ॐोत
कृ पया दजार् चुने,
वेतन
कारोबार/व्यवसाय से आय
कारोबार/व्यवसाय का कोड
लागू
अन्य ॐोतों से आय
कोड के िलए अनुदेश
गृह संपित्त से आय
कोई आय नहीं
14 ूितिनिध कर‐िनधार्िरती (आरए)
ूितिनिध कर िनधार्िरती का
D यथा
पूंजीगत अिभलाभ
पूरा नाम, पता िजसका उस व्यिक्त के बारे में कर िनधार्रण
िकया जाना है िजसका िववरण कॉलम 1-13 में िदया गया है ।
पूरा नाम (पूरा िवःतािरत नाम: आद्याक्षरों की अनुमित नहीं है )
कृ पया उपािध चुनें,
D
ौी
यथा लागू
ौीमती
कुमारी
सुौी
अंितम नाम/उपनाम
ूथम नाम
मध्य नाम
पता
फ्लैट/कमरा/दरवाजा/ब्लाक संख्या
पिरसर/भवन/गांव का नाम
सड़क/गली/पथ/डाकघर
क्षेऽ/ःथान/तालुका/उप ूभाग
नगर/शहर/िजला
राज्य/संघ क्षेऽ
िपन कोड
15 पहचान के ूमाण (पीओआई) तथा पते के ूमाण (पीओए) के रूप में ूःतु त दःतावेज
मैं/हम पहचान के ूमाण के रूप में
तथा पते के ूमाण के रूप में
संलग्न करता हूँ/करते हैं ।
यथा ूयोज्य सौपे जाने वाले अिनवायर् ूमािणत दःतावेजों की सूची के िलए कृपया अनुदेशों (आयकर िनयमावली, 1962 के िनयम 114 में यथािविनिदर् ंट
का संदभर् लें।
16 मैं/ हम
की है िसयत से, मेरी/ हमारी सवोर्त्तम जानकारी एवं िवँवास के अनुसार सही है ।
ंट )
आवेदक
ःथान
िदनांक
िद िद मा मा व
व
व
व
आवेदक के हःताक्षर/बाएं अंगठ
ू े का छाप
(खाने के भीतर)
प्रप49कपकोपभरनेपहे तुप�नद� श
(क) प्रपतड़रपबड़े प�र प म् सुपाे प
बंग्रर �प�र पाेर प ह परप
(ख) प्ुर कपख ररप�र ,
र पपा ा
पप�ेपक औरपकु � रप�र पाे प
ंपा�पादु पहु प ै , �र पकराऔप कपबड़ेपाे प
प्ुर कपजकदप
पकरप ्े ंाप कपख र पख औरपा ड़ प
र पा ा
रपप
र पा ा
(ह) 'वुददिष ' आारदकपप्रप�र पाद पह पकथ �ररप्ेप हरदपतैकग्र ैपकरप
3.5 र.��पप X 2.5
र.��.) �ा्क ंरपाका�रे पक पप्रपकरप
पा पतर ाेप ह रपह �ापकराऔप
प(बड़े/ ख
ं ु � /�ाे ��ान र) ाथ प
थपद परा�रा�पें ह�रपाका�ाेर प(आक ेप
थपकषै ा्औपबथा पदअऔा्परपकेर रप्ैरपक ैाप्ेपाका�ेेपकतप
क्ािषाा पप्रप्ेप�ा्क पह पाका�� ेपकतपहमरा्ा द�प ांपक् िषाा प्ेपषरााेपकेर ह�रप
(घ) प्रपकरपत ु�ंपओेप�ा्क पह पाका� ेपकरपर्ेपआे-् ेप का � ड़ेपकेर प/ त ुरप थपकरपबंहूठरपकतपा ्पइ प
पक ेपै और प�कप का � ड़े/ बंहूठरपकतपा ्पह ष पाथ पह �ापद र प�र पआप
रप
(ै.) प्रपकरपद ु�ंपओेपाद पह पख ररपकरपबनदेू प का थड़ेप/ त ुरप थपकरपबंहूठरपकतपा ्प र�पा ा
प्रपकरपद ु�ंपओेप�ा्क पह पाका�पेप्ेपर रंप ररपा ा
रपुादपइ पाका�पेप्ेपक प�ाकरप ै पद
रप का ेड़ेप
रपआारदकपकरप
ार ेर पकतपक् िष पािषपवु ा प्ेपत प पआपे रप पा पआारदरपका�पक ुापर रंप ह रप
(ा) ुादपबंहठ
ू र पकतपा ्पक पपु हप पे प पा प
ब�पक ेरपकतपक ु ाऔु�प�म ेप ांप रकरपकषै पै्पपकरप
थप ्ु प�्ाप�कु प
र पा ा
आारदकपदा े पड़रर �पक ेपकरपषरप ाेरपब�पक ेरपक प पओपक ैप(ड़ररपक ै,
(ा)
ख
ं ु ��) बाशुापाे प
ारत
रप�क �प�ैद कजर षपबथा पर षेरप्दकऔ लकपबथा प�क �पे
र पा ा
्पराप
रप
ओपपक े, ेर पक ैप ांप ओप
रपइरपकु्पे पक पआुकेपक ु ाऔुपबथा प्ैरपकरनक्पबथा प्ैरप रा पपतंपकपकतप
इैपwww.utitsl.com or www.tin-nsdl.com. प रपप राकप�कु प
प का प ै परप
( ) ह �ाप49 कपक पाेररपकरप�औ पादज षरद� जप:
मदपसं.
1.
मदपकापब्यपराप
्ूे पर �प
प्रपभरनेपहे तप
ु ेदशा�नद� शप
कृ्ु प �ाापज�षाकपक पामषर रप
पथ�प ांपबंषा�पर �प�र प ंसड़रापपत् पक पपु हपरपकेर रप
द ेरपकरप�औ पे�ाक नांपक पइ पपक ेप�औख प
र पा ा
:
अं�तमपनाम/पउ्नामपपपपपपप्मपनामपपपपपपपपपम ्धनामपपप
े�ाक दनाप
द ेरपकरप�औ प मेरजपज ेद पक पइ पपक ेप�औख प
प
र पा ा
:
अं�तमपनाम/पउ्नामपपपपपपप्मपनामपपपपपपपपपम ्हनामपपप
ेद पपपपपपपपपपपपपपपपपपप मेरजप
द ेरपकरप�औ प्र
ू �पे�ापपर े ुरपपक पइ पपक ेप�औख प
र पा ा
:
अं�तमपनाम/पउ्नामपपपपपपपपप्मपनामपपपपपपपपपम ्धनामपपप
पपपर े ुरपपपपपपपपपपपपपपपपपप्ूर�पपपपपपपपपपपपपपपे�ाप
द ेरपकरप�औ प ्ुप�पावकषप �.कर.े ुपपक पइ पपक ेप�औख प
अं�तमपनाम/पउ्नामपपपपपपपप्मपनामपपपपपपपपपम ््नामपपप
पपपपे ुपपपपपपपपपपपपपपपपपपप ्ुप�पपपपपपपपपपपावकषप �.कर.
द ेरपकरप�औ प �.
�औख प
र पा ा
:
.कंै का प��प(�देम प
�
र पा ा
मंदे�पकंै का ु��)
:
क पइ पपक ेप
अं�तमपनाम/पउ्नामपपपपपपपपप्मपनामपपपपपपपपपम ्धनामपपप
पपपपकंै का /��पपपपपपपपपपपपपप�देम पपपपपपपपपपप
'दवुदिषप'
�
ंमदे�प
रपबनुपपआारदकप ्ुअ
मा ांपबरद
म र ज पक पबरदर ख पकेपदर रप
आारदकपकरप ्र �, पथ�पर �प ंाप�्ा पकरपर �प�र पबर�
म ापद पब ु दड़ेपर�ारप
दलऔपखाप व:-
हैे-वुादिषपब्र प्ूे पर �, बंषा�पर �/
्र �पकरप् औरपकऔलखकप रपजमतपकेारप म प
�औखररपपुादपबंषा�पर �पाद पह पकथ परप रपतड़ प ै , ा प रपपथ�प ांप� ुपपर �पकरप
�औ पाद पह पकथ द�रप्ेप
ेरपेख प
प का प ै रपप
ै
द ेरपकरप�औ प अ ्पा प ैैपै ष पक े् ेर जरप(इंिैु ) प इारषप�औ��षर ैपपपक पइ प
पक ेप�औख प
र पा ा
:
अं�तमपनाम/पउ्नामपपपपपपपपपपपपप्मपनामपपपपपपपपपपपपपपम ्पनामप
ै
अ �पा प ैैपै ष पक े् ेर जरप(इंिैु ) प इारषप�औ��षर ैपपप
द ेरपकरप�औ प�र
प�हाऔ औपदारप( ापुूप ह) क पइ पपक ेप�औख प
ाा
:
�र
प�हाऔ औपदारप( ापुप
ू ह)
रप
अं�तमपनाम/पउ्नामपपपपपपपपपपपपप्मपनामपपपपपपपपपपपपपपम ््पनामप
कं्र�पकरप� �औरप�र पर �पपतर प�क �प ंसड़रापपत्पकरपादु प
र पा ा
रप द ेरपकरप
�औ पप इारषप�औ��षर ैपक प�ा�ानर�पपक े पर �ा: प . �औ.,पप इारषप�औ.,प्�.�औ, ्�.�औ.,
्�प�औ.
ाा
रप
रप�औखररपकतपबरम�षापर रंप ै रपइ रपकराऔप'प इारषप�औ��षर ै'
रप�औख प
रप
्र
ू पा का �र��्ारपा औरपकै्पर�पकरप� �औरप�र , का औ��पक पका ुंपकरपर �प्ेप्ैरपकरप�औ प
आारदरपकेर पा ा
रपप
र �पकरपआहरपश�, श��ा�, कम� ेर, ैल.,प�र े, �ै
2.
पा इ्ु ेादपर रंप�औख प
्ैरपक ैाप्ेप्ूे प वुहदिष पआारदक पक प्ैरपक ैाप्ेपर �प�माकापकेररपकरप�औ प्ूे प/
र �पक प ंसड़रा प
ंसड़रा लपत्प
रपपप
्औकपरपके र प ह पुादप ंसड़रा्पत्, बंषा�पर �प�र पबषरा ुापत्प रप � �ािषप
त्प�माकाप�कु प
ह परप
र पा ा
ह प द ेरपकरप�औ प:
द
रपहतलैरपर �प�र प ्ुं�पार कषप �.कर.े ापप
अं�तमपनाम/पउ्नामपपपपपपपपपप्मपनामपपपपपपपपपपपपपपम ्ापनामप
े ापपपपपपपपपपपपपपपपपपपपपपपपपपपप ्ुप�पपपपपपपपपपपपपपपार कषप �.कर.
द
पपक ेपकलऔ�प�र प�औखप कारप ै प“्ैरपक ैाप्ेपर �प�माकाप�कु प
पपपपपपपपपपपपपपपपपपपपपपपपपप ्ु“�पार कषप �.कर.े ापबथा प
पपपपपपपपपपपपपपपपपपपपपपपपपप
ह”
.ा�. �.कर.े ाप
पपपपपपपपपपपपपपपपपपपपपपपपपप ्ु“�पा�. �.कर.े ाप
हैे-वुपदिषपआारदक पकरप�औ ,
3.
अु . आ्पका�प
�क �पबनु प
पक ेप ह पप
्े अा�प�दप ंखु पप1 �र पबंषा�पर �पहतलै प�र प
ुादपआादर कप “ ं”पक पाुरपकेारप ै पातपबनुेपर �पक पकु् े पबषरा ुापत्प रप
्औकपदपके र प ह परपर �पकरप ंतंपप�र प�दप ंखु पप1 करपबरमदरजपु ंपऔ हूप हर रप
�प
र �प रप
ह प व?
4.
5.
ररप
�औंहप
ष इषऔप
ै रप
पपक ेप�दप ंखु ंप1 �र पष इषऔपक प लऔरपखप�कु पहु प
ु पड़ररपदवििषद�ु प र ामपबषरा ुाप ै रपबनुुपआारदक पकरप� �औरप�र पइ रपमेअाषपा ड़ प
ाा
न�पषा�थ/षरह�रप
झरद ेर
रप
षा�थपा ा�पषा�थपर रंप प का�रपादर ंक:
हप
कतपषा�थ/ �झ्ार
कतपषा�थ/
�पपक ेप ह पद
बथा पनु प प�ाऔरखप
ाद
ाद
�.
0
2
0
�.
8
2 बहका प1975 क पइ पपक ेप�औख प
ा
ा
ा
ा
1
9
7
5
कतपषा�थप/वुपदिष�ु प
आारदक पकरप�ा�ानरंपाहगपकरप�औ प ंहापषा�थप ै :
करपषरक ुपक पत्प
वुददिषर: न�पपकतपा काप�ाकपषा�थ; कं्र�: षरह�रपकतपषा�थ; वु
औरररपकतपषा�थ/
षर� र
ा / ृ रपकतपषा�थ ;पनु प : नु द� प�ाऔरखपकरप ृ रपकतपषा�थ;प
वुरदअापु पकरप ंघप
झरद ेरप�ाऔरखपकतपषा�थ; औ औ्� : षरह�र/ ्ं �केरपकतपषा�थ,
कतपषा�थप
ाुू हपकरप ृ रपकतपषा�थपाथ प्ूाा प ाुू हपकरप�औ प
ंप करप ृ
6.
7.
�्ा पक पर �प
्ा -आा
कुऔ
ा ुप
प ांप
ा ेरखप ्औकप पर रंप ै पा ंपषा�थप01-01-0001
दअा ु पक प ंघ
झरद ेरपह��:
ाुू ह:
रपकतप
प का�प ै रपपप
कराऔपवुरदिषपु पकरप�औ पऔ हरू पर �पकरप ंतंपप�र पु ंप�दप ंखु 0 1 �र पाद पबरद
म र जप
औ हपू हरपरप�ाा ा ापकर�्पआारदकपब्ररप�्ा पक पर �पाेर ह�परप�कपब्ररप्षापक प
र �प
आ-पआवासी्प्ता:प
दवििषुु ,
ाुू ह,
ओ्�, त�ओआ पबथा प
ै रपबनुप
पआारदकपइ पकथ परपक पमेअा्पा ैरहररप
काप-पका्ार््पकाप्ता:प
(1) ारारपकरपत्प�र पआुपकरप
र्�पकरप�औ पआा
ापु पक े त े/ वुरा
�र पक ु ाऔुपक पर �प ांप्ा प दलऔेलखाप�कु प
�ुप्ा पबषरा ुाप
ुपा औरपवु्दिषाु पकरप� �औरप
र पा ा
प(�दप ख
ं ु �रप13)रपप
(2) ह�ाप औप औप्�, कं्र�, कथ � र�ुपप �पकेरप ांपनु प पकरप� �औरप�र प
क ु ाऔुपक पर �प ांपक ु ाऔुपक प्ेू प्ा पदर र पबषरा ुाप ै रप
आारदक पकतप ा�पशरलरु पकरप�औ प्ेू र प्ारपक प लऔराखपकेर पबषरा ुाप ै प�ेप
रहे/ज े/द औ , े जुु/ ंघपड़रर, ाथ प�्रपक ैपबषरा ुाप ै रपप
ुादप�ादर जपक प्ा पादु प
8.
्र ा ेपकरप�औ प
्ा प
बषरा ुाप ै रप
वुपदिषा/ ाुू ह/
ा प ै पा पदर जपक पर �पद ्पक ैपकरप
ओ्�/त�ओआ प/
र्�पु पा पआा
पबथा पक ु ाऔुपइं�हापकेप
कारप वप�ेपबदनुपआारदकप्र ा ेपकरप्ारपकरप�औ पक ु ाऔुपक प्ा पबषरा ुापत्प
रपक ु ाऔुपइं�हापकेर हररप
ा�प्र ा ेपइ प ह प्ेप ू�ााप�क प्ारप्ेपार रप
9.
थप�औखर प
ंहररपप
देू ा षप ख
ं ु इपाप (1)ुादपदेू ा षप ंखु कपक प लऔर खप�कु पहु प ै पा पदर जपक ैप(आ
-�रऔपआ ै�प
षरै�पक ैपबथा प� त इऔप ंखु पकरप� �औरप�र , दर जपक पक ैप(आ
बषरा ुाप ै रप
ै�पक ै)
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10
.
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ै � ुाप
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ा�प ै र
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कं्र�, कं्षरु पकरप्ं �क ेपदा े प
ेरप्ं �केरप ंखु ्पक प लऔररखपकेर हररपबनु�प
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12
.
13
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ा ेापकरपर हमेकप
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ं ु ,ं ुादपआंत ाषाप ै पा पइ क प लऔरकखप�कु प
कतपपषापप� रपकरप�औ प ंऔग्रऔपकेर ) रप
ह �ाप�र पुथ प दलऔऔलखापआुपक पक�प रपक�प कप
ुादपआारदकपदा े पक े त े/वुपा
क े त े/वुेा
पक े त े/वुेा
केर :
कै
01
ुपक ैपक प लऔर खप�कु प
03
04
05
06
07
र
परप(आप ेप्रप/ क ैाप
ाप �ू ाापकेर पबषरा ुाप ै रप
ा प ै पा प कप ्ुमअा(
ुपक ैपामरररपकरप�औ पकृ्ु पषरैरप�औलखापा �औक पक पबाऔ करप
क े त े/वुेा
ु
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केते
02
ुप रपआुपामर प
ेर
ुप�ेप
इं �षरुमेंहप
द
ाकर�कतप्े �जा
क े त े/वुेा
ुप
�हल� , षर और�ा रप�ेप
ऐ रपबनुपप�र ें र
13
रदरपऔरख क े/औरख प�ा�पक े
कं्र�प �ाा
11
12
ा काम्कऔ
आंामेकप ज
कै
14
ा
ू र पप्दु �हकत
षर� ाा प ांप�ाक
क
कषलपकप अ औार पकरप
दकुऔ, जरुेपदऔ औपाथ प
्-दऔ औ
15
16
कऔ प ांपु र पपदजार
, ाेक रष,
बेक रषपपबथा प
र औरक रषषेपक प्मेा और
17
षै अ � , औलेर, जक, त प
बथा पबनुापा लरजुाकप
ा रपाऔ र प
क रूर� ्रजा
र े / ाकतऔ
08
त��
10
14.
पषाषर�प
षरप ाेा�
के-
र � ा ्ा
क
का ��
ेक ेर ठर करद े
09
घड़
18
बथा
� रर�
19
लऔ ाथ
�थ षे
र �
20
आुके ब�पषरु�, 1961 कत प
Application for Allotment of Permanent Account Number
[In the case of Indian Citizens/Indian Companies/Entities incorporated in India/
Unincorporated entities formed in India]
Under section 139A of the Income Tax Act, 1961
To avoid mistake (s), please follow the accompanying instructions and examples before filling up the form
Assessing officer (AO code)
Area code
Sign/ leftTumb impression across
this photo
AO type
Range code
AO No.
Sir,
I/We hereby request that a permanent account number be allotted to me/us.
I/We give below necessary particulars:
1 Full Name (Full expanded name to be mentioned as appearing in proof of identity/address documents: initials are not permitted)
D as applicable
Please select title,
Shri
Smt.
Kumari
M/s
Last Name / Surname
First Name
Middle Name
2 Abbreviation of the above name, as you would like it, to be printed on the PAN card
3 Have you ever been known by any other name?
Yes
No
Smt.
Kumari
Male
Female
(Please tick as applicable)
If yes, please give that other name
D as applicable
Please select title,
Shri
M/s
Last Name / Surname
First Name
Middle Name
4 Gender (for Individual applicants only)
(Please tick as applicable)
5 Date of Birth/Incorporation/Agreement/Partnership or Trust Deed/ Formation of Body of individuals or Association of Persons
Day
Month
Year
6 Father's Name (Only 'Individual' applicants: Even married women should fill in father's name only)
Last Name / Surname
First Name
Middle Name
7 Address
Residence Address
Flat/Room/ Door / Block No.
Name of Premises/ Building/ Village
Road/Street/ Lane/Post Office
Area / Locality / Taluka/ Sub‐ Division
Town / City / District
State / Union Territory
Office Address
Name of office
Flat/Room/ Door / Block No.
Name of Premises/ Building/ Village
Road/Street/ Lane/Post Office
Area / Locality / Taluka/ Sub‐ Division
Town / City / District
Pincode / Zip code
Country Name
State / Union Territory
Pincode / Zip code
8 Address for Communication
Country Name
Residence
Office
(Please tick as applicable)
9 Telephone Number & Email ID details
Country code
Area/STD Code
Telephone / Mobile number
Email ID
10 Status of applicant
Please select status,
D as applicable
Government
Individual
Hindu undivided family
Company
Partnership Firm
Association of Persons
Trusts
Body of Individuals
Local Authority
Artificial Juridical Persons
Limited Liability Partnership
11 Registration Number (for company, firms, LLPs, etc.)
12 In case of a citizen of India, then
Please mention your AADHAAR number (if allotted)
13 Source of Income
Please select status,
Salary
D as applicable
Capital Gains
Income from Business / Profession
Business/Profession code
[For Code: Refer instructions]
Income from House property
Income from Other sources
No income
14 Representative Assessee (RA)
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 the
column 1‐13.
Full Name (Full expanded name: initials are not permitted)
Please select title,
D as applicable
Shri
Smt.
Kumari
M/s
Last Name / Surname
First Name
Middle Name
Address
Flat/Room/ Door / Block No.
Name of Premises/ Building/ Village
Road/Street/ Lane/Post Office
Area / Locality / Taluka/ Sub‐ Division
Town / City / District
State / Union Territory
Pincode
15 Documents submitted as Proof of Identity(POI) and Proof of Address (POA)
as proof of identity and
I/We have enclosed
as proof of address.
[Please refer to the instructions (as specified in Rule 114 of I.T. Rules, 1962) for list of mandatory certified documents to be submitted as applicable]
16 I/We
do hereby declare that what is stated above is
, the applicant, in the capacity of
true to the best of my/our information and belief.
Place
D
Date
D M M
Y
Y
Y
Y
Signature / Left Thumb Impression of
Signature
/ Left Thumb Impression of
Applicant (inside the box)
I NSTRUCTI ONS FOR FI LLI NG FORM 49A
(a) Form to be filled legibly in BLOCK LETTERS and preferably in BLACK I NK. Form should be filled in English only
(b) Each box, wherever provided, should contain only one character (alphabet / number / punctuation sign) leaving a blank box after
each word.
(c) 'I ndividual' applicants should affix two recent colour photographs with white background(size 3.5 cm x 2.5 cm) in the space provided
on the form. The photographs should not be stapled or clipped to the form. The clarity of image on PAN card will depend on the
quality and clarity of photograph affixed on the form.
(d) Signature / Left hand thumb impression should be provided across the photo affixed on the left side of the form in such a manner
that portion of signature/ impression is on photo as well as on form.
(e) Signature / Left hand thumb impression should be w ithin the box provided on the right side of the form. The signature should not
be on the photograph affixed on right side of the form. I f there is any mark on this photograph such that it hinders the clear
visibility of the face of the applicant, the application will not be accepted.
(f) Thumb impression, if used, should be attested by a Magistrate or a Notary Public or a Gazetted Officer under official seal and stamp.
(g) AO code (Area Code, AO Type, Range Code and AO Number) of the Jurisdictional Assessing Officer must be filled up by the
applicant. These details can be obtained from the I ncome Tax Office or PAN Centre or websites of PAN Service Providers on
w w w .utiitsl.com or w w w .tin- nsdl.com .
(h) Guidelines for filling the Form 49A:
I te
m
No.
I tem Details
Guidelines for filling the form
1
Full Name
Please select appropriate title.
Do not use abbreviations in the First and the Last name/ Surname.
For example RAVI KANT should be written as :
Last Name/ Surname
R A
V
I
K
A
N
T
First Name
Middle Name
For example SURESH SARDA should be written as :
Last Name/ Surname
First Name
S A
R
D
A
S U
R
E
S
H
Middle Name
For example POONAM RAVI NARAYAN should be written as:
Last Name/ Surname
First Name
Middle Name
N A
R
A
Y
A
P O
O
N
A
M
R A
V
I
N
For example SATYAM VENKAT M. K. RAO should be written as :
Last Name/ Surname
First Name
Middle Name
R A
O
S A
T
Y
A
M
V E
N
K
A
T
M
K
For example M. S. KANDASWAMY( MADURAI SOMASUNDRAM KANDASWAMY) should be written as :
Last Name/ Surname
First Name
Middle Name
K A
N
D
A
S
W A
M A
D
U
R
A
I
S O
M A
S
U
N
D
M Y
R
A
M
Applicants other than 'I ndividuals' may ignore above instructions.
Non-I ndividuals should write their full name starting from the first block of Last Name/ Surname. I f the name is longer
than the space provided for the last name, it can be continued in the space provided for First and Middle Name.
For example XYZ DATA CORPORATI ON ( I NDI A) PRI VATE LI MI TED should be written as :
Last Name/ Surname
First Name
X Y
Z
D
A
T
A
I
)
P
R
I
V
A
A
C
O
T
E
R
P
O
R
A
L
I
M I
T
I
O
T
E
D
A
V
E
N
(
I
N
D
H
U
F
)
Middle Name
For example MANOJ MAFATLAL DAVE ( HUF) should be written as :
Last Name/ Surname
M
A
N
O
J
M A
F
A
T
L
A
L
D
(
First Name
Middle Name
I n case of Company, the name should be provided without any abbreviations. For example, different variations of
'Private Limited' viz. Pvt Ltd, Private Ltd, Pvt Limited, P Ltd, P. Ltd., P. Ltd are not allowed. I t should be 'Private
Limited' only.
I n case of sole proprietorship concern, the proprietor should apply for PAN in his/ her own name.
2
Abbreviation of
the full name to
be printed on
the PAN card
Name should not be prefixed with any title such as Shri, Smt, Kumari, Dr., Major, M/ s etc.
I ndividual applicants should provide full/ abbreviated name to be printed on the PAN card. Name, if abbreviated,
should necessarily contain the last name. For example:
SATYAM VENKAT M. K. RAO which is written in the Name field as :
Last Name/ Surname
First Name
Middle Name
R A
O
S A
T
Y
A
M
V E
N
K
A
T
M
K
Can be written as in ‘Name to be printed on the PAN Card’ column as
SATYAM VENKAT M. K. RAO or
S. V. M. K. RAO
or
SATYAM V. M. K. RAO
3
4
5
Have you ever
been known by
any other
name?
Gender
Date of
Birth/ I ncorporat
ion/ Agreement
/ Partnership or
Trust
Deed/ Formation
of
Body of
For non individual applicants, this should be same as last name field in item no. 1 above.
I f applicant selects 'Yes', then it is mandatory to provide details of the other name. I nstructions in I tem No. 1 with
respect to name apply here. Title should be similar to the title mentioned in I tem No. 1.
This field is mandatory for I ndividuals. Field should be left blank in case of other applicants.
Date cannot be a future date. Date: 2nd August 1975 should be written as:
D
D
M
M
Y
Y
Y
Y
0
2
0
8
1
9
7
5
I ndividuals/
Association of
Persons
6
Father’s Name
7
Address –
Residence and
office
Relevant date for different categories of applicants is:
I ndividual: Actual Date of Birth; Company: Date of I ncorporation;
Association of Persons: Date of formation/ creation; Trusts: Date of creation of Trust
Deed; Partnership Firms: Date of Partnership Deed; LLPs : Date of I ncorporation/ Registration; HUFs: Date of creation
of HUF and for ancestral HUF date can be 01-01-0001 where the date of creation is not available.
Applicable to I ndividuals only. I nstructions in I tem No.1 with respect to name apply here. Married woman applicant
should give father's name and not husband's name.
R - Residence Address:
For I ndividuals, HUF, AOP, BOI or AJP, residential address is mandatory. Other applicants should leave this field
blank.
O - Office Address:
(1) Name of Office and address to be mentioned in case of individuals having source of income as salary or
Business/ profession[ I tem No.13] .
(2) I n case of Firm, LLP, Company, Local Authority and Trust, name of office and complete address of office is
mandatory.
For all categories of applicants, it is necessary to mention complete address and the details of Town/ City/ District,
State/ Union Territory, and PI NCODE are mandatory.
8
Address for
communication
9
Telephone
Number and Email I D
I n case, a foreign address is provided then it is mandatory to provide Country Name along with ZI P Code of the
country.
I ndividuals/ HUFs/ AOP/ BOI / AJP may indicate either 'Residence' or 'Office' and other applicants should necessarily
indicate 'Office' as the Address for Communication.
All communication will be sent at the address indicated in this field.
(1) Telephone number should include country code(I SD code) and STD code or Mobile No. should include Country
code(I SD Code).
For example :
(i) Telephone number 23555705 of Delhi should be written as
Country code
9
1
STD Code
1
1
Telephone Number / Mobile number
2
3
5
5
5
7
0
5
Where ‘91’ is the country code of I ndia and 11 is the STD Code of Delhi.
(ii) Mobile number 9102511111 of I ndia should be written as
Country code
9
1
STD Code
Telephone Number / Mobile number
9
1
0
2
5
1
1
1
1
1
Where '91' is the country code of I ndia.
(2) I t is mandatory for the applicants to mention either their “Telephone number” or valid “e-mail id” so that they can
be contacted in case of any discrepancy in the application and/ or for receiving PAN through e-mail.
10
11
12
13
Status of
Applicant
Registration
number
I n case of
citizen of I ndia
Source of
I ncome
(3) Application status updates are sent using the SMS facility on the mobile numbers mentioned in the application
form.
This field is mandatory for all categories of applicants. I n case of ‘Limited Liability Partnership’, the PAN will be
allotted in ‘Firm’ status.
Not applicable to I ndividuals and HUFs. Mandatory for 'Company'. Company should mention registration number
issued by the Registrar of Companies. Other applicants may mention registration number issued by any State or
Central Government Authority.
AADHAAR number, if allotted, has to be quoted (supported by copy of AADHAAR letter/ card)
I t is mandatory to indicate at least one of the sources of incomes, as mentioned in the form. I n case, the income
from Business/ profession is selected by the applicant then an appropriate business/ profession code should be
mentioned.
Please refer the table given below to select the business/ profession code:
Code
01
02
03
04
14
Name and
address of
Representative
Assessee
Business/ Profession
Medical Profession and Business
Engineering
Architecture
Chartered Accountant/ Accountancy
Code
11
12
13
14
05
06
07
I nterior Decoration
Technical Consultancy
Company Secretary
15
16
17
08
09
10
Legal Practitioner and Solicitors
Government Contractors
I nsurance Agency
18
19
20
Business/ Profession
Films, TV and such other entertainment
I nformation Technology
Builders and Developers
Members of Stock Exchange, Share Brokers and SubBrokers
Performing Arts and Yatra
Operation of Ships, Hovercraft, Aircrafts or Helicopters
Plying Taxis, Lorries, Trucks, Buses or other Commercial
Vehicles
Ow nership of Horses or Jockeys
Cinema Halls and Other Theatres
Others
Section 160 of I ncome Tax Act, 1961 provides that any person(assessee) can be represented through Representative
Assessee. Therefore, this column should be filled in by representative assessee only as specified in Section 160 of
the I ncome-tax Act, 1961, such as, an agent of the non-resident, guardian or manager of a minor, lunatic or idiot,
Court of Wards, Administrator General, Official Trustee, receiver, manager, trustee of a Trust including Wakf.
This field will contain particulars of the Representative Assessee. This field is mandatory if applicant is minor,
deceased, idiot, lunatic or mentally retarded. Column 1 to 13 will contain details of person on whose behalf this
application is submitted.
Proof of I dentity and Proof of address is also required for representative assessee.
Proof of
I t is mandatory to attach proof of identity and proof of address with PAN application. Documents should be in
I dentity and
the name of applicant . List of documents which will serve as proof of identity and address for each status of
Proof of
applicant is as given below:
Address
documents
Document acceptable as proof of identity and address as per Rule 114 of I ncome Tax Rules, 1962
15
For I ndividuals and HUF
Sr.
Proof of I dentity ( Copy of)
No
1
2
3
4
5
6
7
8
9
10
11
12
13
School Leaving Certificate
Matriculation Certificate
Degree of recognised educational institution
Depository Account Statement
Bank Account Statement / Passbook
Credit Card
Water Bill
Ration Card
Property Tax Assessment Order
Passport
Voter I dentity Card
Driving License
Certificate of identity signed by Member of Parliament or Member of
Legislative Assembly or Municipal Councilor or Gazetted Officer in the
prescribed format.
Note : -
1.
2.
Electricity Bill*
Telephone Bill*
Employer Certificate*
Depository Account Statement*
Bank Account Statement / Passbook*
Credit Card Statement*
Rent Receipt*
Ration Card
Property Tax Assessment Order
Passport
Voter I dentity Card
Driving License
Certificate of address signed by Member of Parliament or
Member of Legislative Assembly or Municipal Councilor or
Gazetted Officer in the prescribed format.
Note:
I n case of Minor, any of the above mentioned documents as proof of identity
and address of any of parents/ guardians of such minor shall be deemed to be the proof
of identity and address for the minor applicant.
For HUF, an affidavit made by the Karta of Hindu Undivided Family stating
name, father’s name and address of all the coparceners on the date of application and
copy of any of the above documents in the name of Karta of HUF is required.
Other than I ndividuals and HUF
1
Company
2
Partnership Firm
3
Proof of address ( copy of)
Limited Liability Partnership
1.
Proof of Address is required
mentioned in item no. 7.
for
residence
address
2.
I n case of an I ndian citizen residing outside I ndia, copy of
Bank Account Statement in country of residence or copy of
Non-resident External(NRE) bank account statements.
Copy of Certificate of Registration issued by the Registrar of Companies.
Copy of Certificate of Registration issued by the Registrar of Firms or Copy of partnership
deed.
Copy of Certificate of Registration issued by the Registrar of LLPs
4
Trust
5
Association
of
Person,
Body of
I ndividuals, Local Authority, or Artificial
Juridical Person
16
Signature
impression
/
Thumb
Copy of trust deed or copy of certificate of registration number issued by Charity
Commissioner.
Copy of Agreement or copy of certificate of registration n umber issued by charity
commissioner or registrar of cooperative society or any other competent authority or any
other document originating from any Central or State Government Department establishing
identity and address of such person.
Application m ust be signed by (i) the applicant; or (ii) Karta in case of HUF; or (iii) Director of a Company;
or (iv) Authorised Signaturee in case of AOP, Bod y of I ndividuals, Local Authority and Artificial Juridical
Person; or (v) Partner in case of Firm/ LLP; or (vi) Trustee; or (vii) Representative Assessee in case of
Minor/ deceased/ idiot/ lunatic/ mentally retarded.
Applications not signed in the given manner and in the space provided are liable to be rejected.
GENERAL I NFORMATI ON FOR PAN APPLI CANTS
(a)
Applicants may obtain th e application form for PAN (Form 49A) from any I T PAN Service Centres(managed by UTI I TSL) or
TI N-Facilitation Centres(TI N-FCs)/ PAN Centres (managed by NSDL), or any other stationery vendor providing such forms or
download
from
the
I ncome
Tax
Department
website( w w w .incometaxindia.gov.in )/ UTI I TSL
website( w w w .utiitsl.com )/ NSDL website ( w w w .tin-nsdl.com) .
(b)
The fee for processing PAN application is Rs. 85/ - (plus service tax, as applicable). I n case, the PAN card is to be dispatched
outside I ndia then additional dispatch charge of Rs 850 will have to be paid by applicant.
(c)
Those already allotted a ten digit alphanumeric PAN shall not apply again as having or using more than one PAN is illegal.
However, request for a new PAN card with the same PAN or/ and Changes or Correction in PAN data can be made by filling up
'Request for New PAN Card or/ and Changes or Correction in PAN Data' form available from any source mentioned in (a)
above. The cost of application and processing fee is same as in the case of Form 49A.
(d)
Applicant will receive an acknowledgment containing a unique number on acceptance of this form. This acknow ledgment
number can be used for tracking the status of the application.
(e)
For more information / Application status enquiry contact:
Income-tax Department
NSDL
UTIITSL
Website
www.incometaxindia.gov.in
www.tin-nsdl.com
www.utiitsl.com
Call
Center
0124-2438000
020‐27218080
022-67931300
tininfo@nsdl.co.in
utiitsl.gsd@utiitsl.com
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ूपऽ 49क
ःथाई खाता संख्या हे तु आवेदन
आयकर अिधिनयम, 1961 की धारा 139क के अन्तगर्त
भारतीय नागिरकों / भारतीय कम्पिनयों/ भारत में िनगिमत संःथाओं /
भारत में गिठत अिनगिमत संःथाओं के मामले में
ऽुिट (ऽुिटयों) से बचने के िलए ूपऽ को भरने से पूवर् संलग्न अनुदेशों तथा उदाहरणों का अनुपालन करें
कर िनधार्रण अिधकारी (एओ कोड)
क्षेऽ कोड
इस फोटो के ऊपर हःताक्षर/अंगूठे का
िनशान
एओ ूकार
रें ज कोड
एओ संख्या
महोदय,
मैं/हम अनुरोध करता हूँ/करते हैं िक मुझे/हमें एक ःथाई खाता संख्या आबंिटत िककी जाए
मैं/हम नीचे आवँयक िववरण दे ता हूँ/दे ते हैं
1 पूरा नाम (पहचान ूमाण/पते के दःतावेज में यथा िदखाई पड़ने वाले के रूप में िवःतािरत नाम िलखा जाए: आद्याक्षरों की अनु मित नहीं है )
कृ पया उपािध चुनें
D
ौी
यथा लागू
ौीमती
कुमारी
सुौी
हां
नहीं
(यथा लागू कृ पया सही का िनशान लगाएं)
ौीमती
कुमारी
सुौी
पुरूष
ःऽी
(यथा लागू कृ पया सही का िनशान लगाएं)
अंितम नाम/उपनाम
ूथम नाम
मध्य नाम
2 उपयुक्
र् त नाम का संक्षेपाक्षर, िजससे आप पैन काडर् में छपवाना चाहते हैं
3 क्या आप कभी िकसी अन्य नाम से ज्ञात है ?
यिद हां तो वह अन्य नाम दें
कृ पया उपािध चुनें
D
ौी
यथा लागू
अंितम नाम/उपनाम
ूथम नाम
मध्य नाम
4 िलं ग (केवल व्यिष्ट आवेदकों के िलए)
5 जन्म/िनगमन/समझौता/साझे दारी अथवा न्यास िवले ख/व्यिष्टयों की सं ःथा अथवा व्यिक्तयों के सं घों के िनमार्ण की ितिथ
िदन
माह
वषर्
6 िपता का नाम (केवल व्यिष्ट आवेदक: िववािहत मिहलाओं को भी िपता का ही नाम दे ना चािहए)
अंितम नाम/उपनाम
ूथम नाम
मध्य नाम
7 पता
आवासीय पता
फ्लैट/कमरा/दरवाजा/ब्लाक संख्या
पिरसर/भवन/गांव का नाम
सड़क/गली/पथ/डाकघर
क्षेऽ/ःथान/तालुका/उप ूभाग
नगर/शहर/िजला
राज्य/संघ क्षेऽ
कायार्लय का पता
कायार्लय का नाम
फ्लैट/कमरा/दरवाजा/ब्लाक संख्या
पिरसर/भवन/गांव का नाम
सड़क/गली/पथ/डाकघर
क्षेऽ/ःथान/तालुका/उप ूभाग
नगर/शहर/िजला
िपन कोड/िजप कोड
दे श का नाम
राज्य/संघ क्षेऽ
िपन कोड/िजप कोड
8 पऽाचार का पता
दे श का नाम
आवास
9 दरू भाष सं ख्या व ई‐मे ल आईडी का ब्यौरा
दे श का कोड
कायार्लय
(यथा लागू कृ पया सही का िनशान लगाएं)
एसटीडी कोड
ई‐मेल आईडी
10 आवेदक का दजार्
कृ पया दजार् चु चुनें,
D
यथा लागू
सरकार
व्यिष्ट
िहन्दू अिवभािजत पिरवार
साझेदारी फमर्
व्यिक्तयों का संघ
न्यास
व्यिष्टयों की संःथा
कृ िऽम न्याियक व्यिक्त
िसिमत दे यता भागीदारी
11 पंजीयन सं ख्या (कंपनी, फमोर्ं, एलएलपी आिद के िलए)
)
12 यिद भारत के नागिरक है
हां
तो कृ पया आधार नंबर (यिद आबंिटत है )
नहीं
(यथा लागू कृ पया सही का िनशान लगाएं)
13 आय का ॐोत
कृ पया दजार् चुने,
वेतन
कारोबार/व्यवसाय से आय
कारोबार/व्यवसाय का कोड
लागू
अन्य ॐोतों से आय
कोड के िलए अनुदेश
गृह संपित्त से आय
कोई आय नहीं
14 ूितिनिध कर‐िनधार्िरती (आरए)
ूितिनिध कर िनधार्िरती का
D यथा
पूंजीगत अिभलाभ
पूरा नाम, पता िजसका उस व्यिक्त के बारे में कर िनधार्रण
िकया जाना है िजसका िववरण कॉलम 1-13 में िदया गया है ।
पूरा नाम (पूरा िवःतािरत नाम: आद्याक्षरों की अनुमित नहीं है )
कृ पया उपािध चुनें,
D
ौी
यथा लागू
ौीमती
कुमारी
सुौी
अंितम नाम/उपनाम
ूथम नाम
मध्य नाम
पता
फ्लैट/कमरा/दरवाजा/ब्लाक संख्या
पिरसर/भवन/गांव का नाम
सड़क/गली/पथ/डाकघर
क्षेऽ/ःथान/तालुका/उप ूभाग
नगर/शहर/िजला
राज्य/संघ क्षेऽ
िपन कोड
15 पहचान के ूमाण (पीओआई) तथा पते के ूमाण (पीओए) के रूप में ूःतु त दःतावेज
मैं/हम पहचान के ूमाण के रूप में
तथा पते के ूमाण के रूप में
संलग्न करता हूँ/करते हैं ।
यथा ूयोज्य सौपे जाने वाले अिनवायर् ूमािणत दःतावेजों की सूची के िलए कृपया अनुदेशों (आयकर िनयमावली, 1962 के िनयम 114 में यथािविनिदर् ंट
का संदभर् लें।
16 मैं/ हम
की है िसयत से, मेरी/ हमारी सवोर्त्तम जानकारी एवं िवँवास के अनुसार सही है ।
ंट )
आवेदक
ःथान
िदनांक
िद िद मा मा व
व
व
व
आवेदक के हःताक्षर/बाएं अंगठ
ू े का छाप
(खाने के भीतर)
प्रप49कपकोपभरनेपहे तुप�नद� श
(क) प्रपतड़रपबड़े प�र प म् सुपाे प
बंग्रर �प�र पाेर प ह परप
(ख) प्ुर कपख ररप�र ,
र पपा ा
पप�ेपक औरपकु � रप�र पाे प
ंपा�पादु पहु प ै , �र पकराऔप कपबड़ेपाे प
प्ुर कपजकदप
पकरप ्े ंाप कपख र पख औरपा ड़ प
र पा ा
रपप
र पा ा
(ह) 'वुददिष ' आारदकपप्रप�र पाद पह पकथ �ररप्ेप हरदपतैकग्र ैपकरप
3.5 र.��पप X 2.5
र.��.) �ा्क ंरपाका�रे पक पप्रपकरप
पा पतर ाेप ह रपह �ापकराऔप
प(बड़े/ ख
ं ु � /�ाे ��ान र) ाथ प
थपद परा�रा�पें ह�रपाका�ाेर प(आक ेप
थपकषै ा्औपबथा पदअऔा्परपकेर रप्ैरपक ैाप्ेपाका�ेेपकतप
क्ािषाा पप्रप्ेप�ा्क पह पाका�� ेपकतपहमरा्ा द�प ांपक् िषाा प्ेपषरााेपकेर ह�रप
(घ) प्रपकरपत ु�ंपओेप�ा्क पह पाका� ेपकरपर्ेपआे-् ेप का � ड़ेपकेर प/ त ुरप थपकरपबंहूठरपकतपा ्पइ प
पक ेपै और प�कप का � ड़े/ बंहूठरपकतपा ्पह ष पाथ पह �ापद र प�र पआप
रप
(ै.) प्रपकरपद ु�ंपओेपाद पह पख ररपकरपबनदेू प का थड़ेप/ त ुरप थपकरपबंहूठरपकतपा ्प र�पा ा
प्रपकरपद ु�ंपओेप�ा्क पह पाका�पेप्ेपर रंप ररपा ा
रपुादपइ पाका�पेप्ेपक प�ाकरप ै पद
रप का ेड़ेप
रपआारदकपकरप
ार ेर पकतपक् िष पािषपवु ा प्ेपत प पआपे रप पा पआारदरपका�पक ुापर रंप ह रप
(ा) ुादपबंहठ
ू र पकतपा ्पक पपु हप पे प पा प
ब�पक ेरपकतपक ु ाऔु�प�म ेप ांप रकरपकषै पै्पपकरप
थप ्ु प�्ाप�कु प
र पा ा
आारदकपदा े पड़रर �पक ेपकरपषरप ाेरपब�पक ेरपक प पओपक ैप(ड़ररपक ै,
(ा)
ख
ं ु ��) बाशुापाे प
ारत
रप�क �प�ैद कजर षपबथा पर षेरप्दकऔ लकपबथा प�क �पे
र पा ा
्पराप
रप
ओपपक े, ेर पक ैप ांप ओप
रपइरपकु्पे पक पआुकेपक ु ाऔुपबथा प्ैरपकरनक्पबथा प्ैरप रा पपतंपकपकतप
इैपwww.utitsl.com or www.tin-nsdl.com. प रपप राकप�कु प
प का प ै परप
( ) ह �ाप49 कपक पाेररपकरप�औ पादज षरद� जप:
मदपसं.
1.
मदपकापब्यपराप
्ूे पर �प
प्रपभरनेपहे तप
ु ेदशा�नद� शप
कृ्ु प �ाापज�षाकपक पामषर रप
पथ�प ांपबंषा�पर �प�र प ंसड़रापपत् पक पपु हपरपकेर रप
द ेरपकरप�औ पे�ाक नांपक पइ पपक ेप�औख प
र पा ा
:
अं�तमपनाम/पउ्नामपपपपपपप्मपनामपपपपपपपपपम ्धनामपपप
े�ाक दनाप
द ेरपकरप�औ प मेरजपज ेद पक पइ पपक ेप�औख प
प
र पा ा
:
अं�तमपनाम/पउ्नामपपपपपपप्मपनामपपपपपपपपपम ्हनामपपप
ेद पपपपपपपपपपपपपपपपपपप मेरजप
द ेरपकरप�औ प्र
ू �पे�ापपर े ुरपपक पइ पपक ेप�औख प
र पा ा
:
अं�तमपनाम/पउ्नामपपपपपपपपप्मपनामपपपपपपपपपम ्धनामपपप
पपपर े ुरपपपपपपपपपपपपपपपपपप्ूर�पपपपपपपपपपपपपपपे�ाप
द ेरपकरप�औ प ्ुप�पावकषप �.कर.े ुपपक पइ पपक ेप�औख प
अं�तमपनाम/पउ्नामपपपपपपपप्मपनामपपपपपपपपपम ््नामपपप
पपपपे ुपपपपपपपपपपपपपपपपपपप ्ुप�पपपपपपपपपपपावकषप �.कर.
द ेरपकरप�औ प �.
�औख प
र पा ा
:
.कंै का प��प(�देम प
�
र पा ा
मंदे�पकंै का ु��)
:
क पइ पपक ेप
अं�तमपनाम/पउ्नामपपपपपपपपप्मपनामपपपपपपपपपम ्धनामपपप
पपपपकंै का /��पपपपपपपपपपपपपप�देम पपपपपपपपपपप
'दवुदिषप'
�
ंमदे�प
रपबनुपपआारदकप ्ुअ
मा ांपबरद
म र ज पक पबरदर ख पकेपदर रप
आारदकपकरप ्र �, पथ�पर �प ंाप�्ा पकरपर �प�र पबर�
म ापद पब ु दड़ेपर�ारप
दलऔपखाप व:-
हैे-वुादिषपब्र प्ूे पर �, बंषा�पर �/
्र �पकरप् औरपकऔलखकप रपजमतपकेारप म प
�औखररपपुादपबंषा�पर �पाद पह पकथ परप रपतड़ प ै , ा प रपपथ�प ांप� ुपपर �पकरप
�औ पाद पह पकथ द�रप्ेप
ेरपेख प
प का प ै रपप
ै
द ेरपकरप�औ प अ ्पा प ैैपै ष पक े् ेर जरप(इंिैु ) प इारषप�औ��षर ैपपपक पइ प
पक ेप�औख प
र पा ा
:
अं�तमपनाम/पउ्नामपपपपपपपपपपपपप्मपनामपपपपपपपपपपपपपपम ्पनामप
ै
अ �पा प ैैपै ष पक े् ेर जरप(इंिैु ) प इारषप�औ��षर ैपपप
द ेरपकरप�औ प�र
प�हाऔ औपदारप( ापुूप ह) क पइ पपक ेप�औख प
ाा
:
�र
प�हाऔ औपदारप( ापुप
ू ह)
रप
अं�तमपनाम/पउ्नामपपपपपपपपपपपपप्मपनामपपपपपपपपपपपपपपम ््पनामप
कं्र�पकरप� �औरप�र पर �पपतर प�क �प ंसड़रापपत्पकरपादु प
र पा ा
रप द ेरपकरप
�औ पप इारषप�औ��षर ैपक प�ा�ानर�पपक े पर �ा: प . �औ.,पप इारषप�औ.,प्�.�औ, ्�.�औ.,
्�प�औ.
ाा
रप
रप�औखररपकतपबरम�षापर रंप ै रपइ रपकराऔप'प इारषप�औ��षर ै'
रप�औख प
रप
्र
ू पा का �र��्ारपा औरपकै्पर�पकरप� �औरप�र , का औ��पक पका ुंपकरपर �प्ेप्ैरपकरप�औ प
आारदरपकेर पा ा
रपप
र �पकरपआहरपश�, श��ा�, कम� ेर, ैल.,प�र े, �ै
2.
पा इ्ु ेादपर रंप�औख प
्ैरपक ैाप्ेप्ूे प वुहदिष पआारदक पक प्ैरपक ैाप्ेपर �प�माकापकेररपकरप�औ प्ूे प/
र �पक प ंसड़रा प
ंसड़रा लपत्प
रपपप
्औकपरपके र प ह पुादप ंसड़रा्पत्, बंषा�पर �प�र पबषरा ुापत्प रप � �ािषप
त्प�माकाप�कु प
ह परप
र पा ा
ह प द ेरपकरप�औ प:
द
रपहतलैरपर �प�र प ्ुं�पार कषप �.कर.े ापप
अं�तमपनाम/पउ्नामपपपपपपपपपप्मपनामपपपपपपपपपपपपपपम ्ापनामप
े ापपपपपपपपपपपपपपपपपपपपपपपपपपपप ्ुप�पपपपपपपपपपपपपपपार कषप �.कर.
द
पपक ेपकलऔ�प�र प�औखप कारप ै प“्ैरपक ैाप्ेपर �प�माकाप�कु प
पपपपपपपपपपपपपपपपपपपपपपपपपप ्ु“�पार कषप �.कर.े ापबथा प
पपपपपपपपपपपपपपपपपपपपपपपपपप
ह”
.ा�. �.कर.े ाप
पपपपपपपपपपपपपपपपपपपपपपपपपप ्ु“�पा�. �.कर.े ाप
हैे-वुपदिषपआारदक पकरप�औ ,
3.
अु . आ्पका�प
�क �पबनु प
पक ेप ह पप
्े अा�प�दप ंखु पप1 �र पबंषा�पर �पहतलै प�र प
ुादपआादर कप “ ं”पक पाुरपकेारप ै पातपबनुेपर �पक पकु् े पबषरा ुापत्प रप
्औकपदपके र प ह परपर �पकरप ंतंपप�र प�दप ंखु पप1 करपबरमदरजपु ंपऔ हूप हर रप
�प
र �प रप
ह प व?
4.
5.
ररप
�औंहप
ष इषऔप
ै रप
पपक ेप�दप ंखु ंप1 �र पष इषऔपक प लऔरपखप�कु पहु प
ु पड़ररपदवििषद�ु प र ामपबषरा ुाप ै रपबनुुपआारदक पकरप� �औरप�र पइ रपमेअाषपा ड़ प
ाा
न�पषा�थ/षरह�रप
झरद ेर
रप
षा�थपा ा�पषा�थपर रंप प का�रपादर ंक:
हप
कतपषा�थ/ �झ्ार
कतपषा�थ/
�पपक ेप ह पद
बथा पनु प प�ाऔरखप
ाद
ाद
�.
0
2
0
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8
2 बहका प1975 क पइ पपक ेप�औख प
ा
ा
ा
ा
1
9
7
5
कतपषा�थप/वुपदिष�ु प
आारदक पकरप�ा�ानरंपाहगपकरप�औ प ंहापषा�थप ै :
करपषरक ुपक पत्प
वुददिषर: न�पपकतपा काप�ाकपषा�थ; कं्र�: षरह�रपकतपषा�थ; वु
औरररपकतपषा�थ/
षर� र
ा / ृ रपकतपषा�थ ;पनु प : नु द� प�ाऔरखपकरप ृ रपकतपषा�थ;प
वुरदअापु पकरप ंघप
झरद ेरप�ाऔरखपकतपषा�थ; औ औ्� : षरह�र/ ्ं �केरपकतपषा�थ,
कतपषा�थप
ाुू हपकरप ृ रपकतपषा�थपाथ प्ूाा प ाुू हपकरप�औ प
ंप करप ृ
6.
7.
�्ा पक पर �प
्ा -आा
कुऔ
ा ुप
प ांप
ा ेरखप ्औकप पर रंप ै पा ंपषा�थप01-01-0001
दअा ु पक प ंघ
झरद ेरपह��:
ाुू ह:
रपकतप
प का�प ै रपपप
कराऔपवुरदिषपु पकरप�औ पऔ हरू पर �पकरप ंतंपप�र पु ंप�दप ंखु 0 1 �र पाद पबरद
म र जप
औ हपू हरपरप�ाा ा ापकर�्पआारदकपब्ररप�्ा पक पर �पाेर ह�परप�कपब्ररप्षापक प
र �प
आ-पआवासी्प्ता:प
दवििषुु ,
ाुू ह,
ओ्�, त�ओआ पबथा प
ै रपबनुप
पआारदकपइ पकथ परपक पमेअा्पा ैरहररप
काप-पका्ार््पकाप्ता:प
(1) ारारपकरपत्प�र पआुपकरप
र्�पकरप�औ पआा
ापु पक े त े/ वुरा
�र पक ु ाऔुपक पर �प ांप्ा प दलऔेलखाप�कु प
�ुप्ा पबषरा ुाप
ुपा औरपवु्दिषाु पकरप� �औरप
र पा ा
प(�दप ख
ं ु �रप13)रपप
(2) ह�ाप औप औप्�, कं्र�, कथ � र�ुपप �पकेरप ांपनु प पकरप� �औरप�र प
क ु ाऔुपक पर �प ांपक ु ाऔुपक प्ेू प्ा पदर र पबषरा ुाप ै रप
आारदक पकतप ा�पशरलरु पकरप�औ प्ेू र प्ारपक प लऔराखपकेर पबषरा ुाप ै प�ेप
रहे/ज े/द औ , े जुु/ ंघपड़रर, ाथ प�्रपक ैपबषरा ुाप ै रपप
ुादप�ादर जपक प्ा पादु प
8.
्र ा ेपकरप�औ प
्ा प
बषरा ुाप ै रप
वुपदिषा/ ाुू ह/
ा प ै पा पदर जपक पर �पद ्पक ैपकरप
ओ्�/त�ओआ प/
र्�पु पा पआा
पबथा पक ु ाऔुपइं�हापकेप
कारप वप�ेपबदनुपआारदकप्र ा ेपकरप्ारपकरप�औ पक ु ाऔुपक प्ा पबषरा ुापत्प
रपक ु ाऔुपइं�हापकेर हररप
ा�प्र ा ेपइ प ह प्ेप ू�ााप�क प्ारप्ेपार रप
9.
थप�औखर प
ंहररपप
देू ा षप ख
ं ु इपाप (1)ुादपदेू ा षप ंखु कपक प लऔर खप�कु पहु प ै पा पदर जपक ैप(आ
-�रऔपआ ै�प
षरै�पक ैपबथा प� त इऔप ंखु पकरप� �औरप�र , दर जपक पक ैप(आ
बषरा ुाप ै रप
ै�पक ै)
पै�पक ै)
प द े रपकरप�औ प:
i)पादलऔरऔपक पषर औरह रपरैतपेप23555705 इ पाे प�औखर प ह
दर जपक पक ैपपपपपप
!
षरै�पक ैपपपपपपपपदेू ा षप ंखु � / � त इऔप ंखु ेप
�ेप
प
9 1
1
1
2
3 5 5 5 7 0 5
पं '91' ा ेापक पदर जपक ैप ै पाथ पादलऔर� पक प
षरै�पक ैप11
ै पर
ii)पपा ेापक प� त इऔपरैतपेप9102511111 इ पाे प�औखर प ह परप
दर जपक पक ैपपपपपप
षरै�पक ैपपपपपपपपदेू ा षप ंखु � / � त इऔप ंखु प
9 1
9
1
0
2
5
1 1 1 1 1
पं '91' ा ेापक पदर जपक ैप ै पर
(2) आारदक पकरप�औ पब्र प'देू ा षप ख
ं ु 1' बथा पाैपप' -�रऔपआ पै�' क प
लऔर खपकेर पबषरा ुाप ै पा �कपआारदरप�र प�क �प�ा ंहषापकरप� �औरप�र प -�रऔपकरप
� ु �प रपाथ / बथा प्ैरपप राकपकेररप र ामप र रप ं्काप�कु प
प कररप
(3) आारदरपकतपबदुारपदकथबषापआारदरपह �ाप�र प दलऔमलखाप� त इऔप ंखु रप्ेप
10
.
11
आारदकपकतप
ै � ुाप
प �प
प �म ाप पक पपु हपकेारप म पार �प
ा�प ै र
ु पड़ररपआारदकपकतप ा�पशरलरु पकरप�औ पबषरा ुाप ै रप' ���ापद षु्ापप
� �औरप�र प्ैरप'ह�ा' कतप ै � ुाप रपआतंाषाप�कु प
ह रप
्ं �केरप ंखु दप वु�दिषकपाथ पा नदऔ
ू पब�ाा द ाप्मेा े प्ेपऔ हूपर रंपरपप'कं्र�' करप�औ पबषरा ुारप
कं्र�, कं्षरु पकरप्ं �क ेपदा े प
ेरप्ं �केरप ंखु ्पक प लऔररखपकेर हररपबनु�प
आारदरप�क �पे जुकपबथा पकरनकाप ेक ेपप �पकेरपदा े प
12
.
13
झरद ेर' करप
ा ेापकरपर हमेकप
करप� �औरप�र प
आुपक प
ापप
्ं �केरप ंखु लपक प लऔरकखपकेप कारप वरप
आप ेप ख
ं ु ,ं ुादपआंत ाषाप ै पा पइ क प लऔरकखप�कु प
कतपपषापप� रपकरप�औ प ंऔग्रऔपकेर ) रप
ह �ाप�र पुथ प दलऔऔलखापआुपक पक�प रपक�प कप
ुादपआारदकपदा े पक े त े/वुपा
क े त े/वुेा
पक े त े/वुेा
केर :
कै
01
ुपक ैपक प लऔर खप�कु प
03
04
05
06
07
र
परप(आप ेप्रप/ क ैाप
ाप �ू ाापकेर पबषरा ुाप ै रप
ा प ै पा प कप ्ुमअा(
ुपक ैपामरररपकरप�औ पकृ्ु पषरैरप�औलखापा �औक पक पबाऔ करप
क े त े/वुेा
ु
�ा�क् पपवुुा
केते
02
ुप रपआुपामर प
ेर
ुप�ेप
इं �षरुमेंहप
द
ाकर�कतप्े �जा
क े त े/वुेा
ुप
�हल� , षर और�ा रप�ेप
ऐ रपबनुपप�र ें र
13
रदरपऔरख क े/औरख प�ा�पक े
कं्र�प �ाा
11
12
ा काम्कऔ
आंामेकप ज
कै
14
ा
ू र पप्दु �हकत
षर� ाा प ांप�ाक
क
कषलपकप अ औार पकरप
दकुऔ, जरुेपदऔ औपाथ प
्-दऔ औ
15
16
कऔ प ांपु र पपदजार
, ाेक रष,
बेक रषपपबथा प
र औरक रषषेपक प्मेा और
17
षै अ � , औलेर, जक, त प
बथा पबनुापा लरजुाकप
ा रपाऔ र प
क रूर� ्रजा
र े / ाकतऔ
08
त��
10
14.
पषाषर�प
षरप ाेा�
के-
र � ा ्ा
क
का ��
ेक ेर ठर करद े
09
घड़
18
बथा
� रर�
19
लऔ ाथ
�थ षे
र �
20
आुके ब�पषरु�, 1961 कत प