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com/panonlineservices/addPanApp
Date: 21/07/2017
VleID:-CG085501095
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7. Address:-
Residential Address:-
Flat/Door/Block No.:- MADHUBAN NAGAR
Name of Premises/Building/Village:- BORSI
Road/Street/Lane/Post Office:- DHANORA ROAD
Area/Locality/Taluka/Sub-Division:- DURG
Town/City/District:- State/Union Territory:-
PIN Code:- 491001 Country:- INDIA
DURG CHHATTISGARH
Official Address:-
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https://www.myutiitsl.com/panonlineservices/addPanApp
Office Name:-
Flat/Door/Block No.:-
Name of Premises/Building/Village:-
Road/Street/Lane/Post Office:-
Area/Locality/Taluka/Sub-Division:-
Town/City/District:- State/Union Territory:- PIN Code:- Country:-
8. Address for Communication:- RESIDENCE
13.Source of Income
SALARIED Capital Gains
Income from Business/Profession Income from Other sources
Income from House property No income
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 colmns 1 to 13.
Last Name:- Middle Name:- First Name:-
Flat/Door/Block No.:-
Name of Premises/Building/Village:-
Road/Street/Lane/Post Office:-
Area/Locality/Taluka/Sub-Division:-
Town/City/District:- State/Union Territory:- PIN Code:-
15. I/We have enclosed Copy of AADHAAR Card issued by UIDAI as Proof of Identity , Copy of AADHAAR card
issued by UIDAI as Proof of Address and Copy of AADHAAR card issued by UIDAI as Proof of DOB.
16. I/We PRAVEEN KUMAR SAHU ,the applicant,in the capacity of HIMSELF/HERSELF do hereby declare that
what is stated above is true to the best of my/our information and belief.
DURG
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