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Pan Correction Form

The document is a request form for making changes or corrections to an existing PAN (Permanent Account Number) card in India. It requests information such as: 1) Personal details of the applicant including name, date of birth, gender, photo, and signature. 2) Details of parents including father's name which will be printed on the card. 3) Address for communication whether a residence or office. 4) Contact details including phone number and email. 5) Aadhaar number if available and declaration of any other PAN numbers issued to the applicant.

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0% found this document useful (0 votes)
200 views

Pan Correction Form

The document is a request form for making changes or corrections to an existing PAN (Permanent Account Number) card in India. It requests information such as: 1) Personal details of the applicant including name, date of birth, gender, photo, and signature. 2) Details of parents including father's name which will be printed on the card. 3) Address for communication whether a residence or office. 4) Contact details including phone number and email. 5) Aadhaar number if available and declaration of any other PAN numbers issued to the applicant.

Uploaded by

omkarvaru
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Request For New PAN Card Orl And Changes Or Correction in PAN Data

Use Black Ink Only


Only 'Individuals' to affix
recent photograph
733756682 Only 'Individuals' to affix
recent photograph
(3.5 cm x 2.5 cm)
(3.5 cm x 25 cm) Permanent Account Number (PAN)

Signature/Left thumb impression


across this photo

in proof of identityladdress
Trull Name (Full expanded name fo be mentioned as appearing
documents: initials are not permitted) Kumari M/s
Please select title. Shri Smt Signature/Lef thumb impression
as applicable

Last Name /Surname


First Name
Middle Name
Name you would like it printed on the PAN card

2 Details of Parents (applicable only for individual applicants),


Father's Name : (Mandatory, Even married women should fill in father's name only)
Last Name /Surname
First Name

Middle Name
Mother's Name (optional)
Last Name / Surname
First Name
Middle Name
Select the name of either father or mother which you may like to be printed on PAN card (select one only)
(In case no option is provided then PAN card will be Issued with father's name) Father's name Mother's Name Please tick as applicabie)
Day Month Year
3 Date of Birth/ncorporation/AgreementPartnership/Trust Deed/
Formation of Body of individuals or Association of Persons
4 Gender (for Individual' applicant only) Male Female Transgender (Please tick as appl1cable) 5 Photo Mismatch

6 Signature Mismatch 7Address for Communication Residence Office (Please tick as applicable)

Name of Office (to be filed only in case of office 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 / Zip code Country Name

8 If you desire to update your other address also,give required details In additional sheet.
Country code Area/STD/Code Telephone / Mobile number
9 Telephone Number & Email ID details

Email ID

|10 AADHAAR number (if allotted)


Name as per AADHAAR letter/card

11Mention other Permanent Account Numbers (PANs) inadvertently allotted to you


PAN PAN 2 PAN 3 PAN 4

12 Verification
IWe the applicant, in the capacity of
do hereby declare that what is stated above is true to the best of mylour information and belief.
IWe have enclosed (number of documents) in support of proposed changes/corrections.
Place

DD M MY Y Y Y
Date
Signature/Left Thumb Impression of Applicant (inside the box)

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