Você está na página 1de 2

https://www.myutiitsl.

com/panonlineservices/addPanApp

Form 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

Date: 21/07/2017
VleID:-CG085501095
Print

Application Number: A005829935


Coupon Number: A005829935

Assessing Officer(AO Code)


Area Code AO Type Range Code AO No

1. Full Name (Full expanded name: initials are not permitted):


Title:- SHRI Last Name:- SAHU Middle Name:- KUMAR First Name:- PRAVEEN
2. Abbreviation of the above name, as you would like it, to be printed on the PAN card:- PRAVEEN KUMAR SAHU
3. Have you been known by any other name? N
Last Name:- Middle Name:- First Name:-
4. Gender:- MALE
5.Date of Birth / Incorporation/Agreement/Partnership or Trust Deed/Formation of
20/01/1987
Body of Individuals/Association of Persons:-
6. Father's Name
Last Name:- SAHU Middle Name:- LAL First Name:- CHHANNU
:
Mother's Name
Last Name:- Middle Name:- First Name:-
:
The name of either father or mother which you
FATHER'S NAME
may like to be printed on PAN card :

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:-

1 of 2 7/21/2017, 19:35
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

9. Telephone Number & Email ID Details :-


Country Area/STD Telephone/Mobile Email
91 9770449111 PRAVEENSAHU76@GMAIL.COM
Code:- Code:- Number:- Address:-
10. Status of the Applicant:- Individual
11. Registration Number(for
Company,firms,LLP's etc):-
12. In case of a person, who is required to quote Aadhaar Number/
the Enrolment ID of Aadhaar Application form as per section
139AA
Please Mention your AADHAAR
776914378489
number(if alloted)
If Aadhaar number is not alloted,
please mention the enrolment ID of
Aadhaar application form
Name As per AADHAAR letter/card
or as per the Enrolment ID of PRAVEEN KUMAR SAHU
Aadhaar application form

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

Signature/Left thumb impression of


Place Date
the applicant

2 of 2 7/21/2017, 19:35

Você também pode gostar