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*
Whether citizen of India
Yes
No
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*
Permanent Account Number (PAN)
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*
1.Name
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Title
Shri/Mr
Smt./Mrs.
Kumari/Ms
M/s
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*
2.Name as you would like it printed on the card
(Prefix like Shri, Smt, Kumari, Late, Dr, CA, Ms, Mr, Mrs, M/s, Alias etc. are not
allowed)
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Details of Parents.
(Prefix like Shri, Smt, Kumari, Late, Dr, CA, Ms, Mr, Mrs, M/s, Alias
etc. are not allowed.)
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Whether mother is single parent and you wish to apply for PAN by furnishing the name of your
mother only
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Yes
No
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* 3.Father's Name
(Mandatory field. Even married women should give father's name only.)
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Mother's Name(This field is optional.)
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*
4. Select Parent name which is to be printed on the card
(In case no option is provided then PAN card will be issued with father's
name)
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Father Name
Mother Name
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*
5. Date of Birth/Incorporation/Agreement/Partnership
or Trust Deed/Formation of Body of Individuals/
Association of Persons
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*
6. Gender
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Male
Female
TransGender
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7. Photo Mismatch
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8. Signature Mismatch |
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*
9. Address for Communication
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Residential
Office
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Office Name
(to be filled only in case of office address)
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Flat/Door/Block No. |
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Name of Premises/Building/Village |
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Road/Street/Lane/Post Office |
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Area/Locality/Taluka/Sub-Division |
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Town/City/District |
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State/Union Territory |
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PIN(Indicating PIN is mandatory) |
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Country |
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Zip |
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10. If you desire to update your other address, give required details &
Submit
proof of
other address also.
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* 11. Telephone No.
(Country code is compulsory)
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Country code (ISD code)
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E-mail ID |
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In case of a citizen of India, then |
AADHAAR
EID
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* 12. AADHAAR number :
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In case AADHAAR number is provided,
then proof of AADHAAR along with supporting documents is to be submitted to NSDL
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*
Name as per AADHAAR letter or
as per the enrollment ID of Aadhaar application form
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13. GSTN |
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14. Mention other Permanent Account Numbers (PANs) if any,inadvertently allotted to you.
Submit proof of surrendered PAN(s) along with the application.
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PAN1
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PAN2
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PAN3
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PAN4
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15. Verification |
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I/We
,the applicant,in the capacity of
do hereby declare
that what is stated above is true to the best of my information and belief.
I have enclosed
(number of documents) in support of proposed changes/corrections.
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Place |
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I/We have enclosed
as proof of identity,
as proof of address,
as proof of date of birth and
as proof of PAN allotted.
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Whether you wish to have?
Physical PAN Card & e-PAN Card
Only e-PAN Card
Fees Applicable
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Other Details |
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1. Depository Account Details
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DP ID:
Client ID:
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2. Payment Details
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Online Payment
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