FormNo.
49A ApplicationforAllotmentofPermanentAccountNumber [InthecaseofIndianCitizens/IndianCompanies/EntitiesincorporatedinIndia/ UnincorporatedentitiesformedinIndia]
Undersection139AoftheIncomeTaxAct,1961
Toavoidmistake(s),pleasefollowtheaccompanyinginstructionsandexamplesbeforefillinguptheform
Assessingofficer(AOcode)
Sign/leftTumbimpressionacross thisphoto
Areacode
AOtype
Rangecode
AONo.
Sir, I/Weherebyrequestthatapermanentaccountnumberbeallottedtome/us. I/Wegivebelownecessaryparticulars:
1 FullName(Fullexpandednametobementionedasappearinginproofofidentity/addressdocuments:initialsarenotpermitted)
Pleaseselecttitle, asapplicable
Shri
Smt.
Kumari
M/s
LastName/Surname FirstName MiddleName
2 Abbreviationoftheabovename,asyouwouldlikeit,tobeprintedonthePANcard
3 Haveyoueverbeenknownbyanyothername?
Ifyes,pleasegivethatothername
Pleaseselecttitle, asapplicable
Yes
No
(Pleasetickasapplicable)
Shri
Smt.
Kumari
M/s
LastName/Surname FirstName MiddleName
4 Gender(forIndividualapplicantsonly)
Male
Female
(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 Pincode/Zipcode CountryName
OfficeAddress Nameofoffice
Flat/Room/Door/BlockNo. NameofPremises/Building/Village Road/Street/Lane/PostOffice Area/Locality/Taluka/SubDivision Town/City/District
State/UnionTerritory
Pincode/Zipcode Residence
CountryName Office
(Pleasetickasapplicable)
8 AddressforCommunication 9 TelephoneNumber&EmailIDdetails
Countrycode Area/STDCode
Telephone/Mobilenumber
EmailID
10 Statusofapplicant
Pleaseselectstatus, Individual Trusts asapplicable Hinduundividedfamily BodyofIndividuals Company LocalAuthority PartnershipFirm ArtificialJuridicalPersons Government AssociationofPersons LimitedLiabilityPartnership
11 RegistrationNumber(forcompany,firms,LLPs,etc.) 12 IncaseofacitizenofIndia,then
PleasementionyourAADHAARnumber(ifallotted)
13 SourceofIncome
Salary IncomefromBusiness/Profession IncomefromHouseproperty Business/Professioncode
[ForCode:Referinstructions]
Pleaseselectstatus, CapitalGains
asapplicable
IncomefromOthersources Noincome
14 RepresentativeAssessee(RA)
Fullname,addressoftheRepresentativeAssessee,whoisassessableundertheIncomeTaxActinrespectoftheperson,whoseparticularshavebeengiveninthe column113.
FullName(Fullexpandedname:initialsarenotpermitted)
Pleaseselecttitle, 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 asproofofaddress. [Pleaserefertotheinstructions(asspecifiedinRule114ofI.T.Rules,1962)forlistofmandatorycertifieddocumentstobesubmittedasapplicable] asproofofidentityand
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)
