Application for Allotment of Permanent Account Number [For an Individual not being a Citizen of India]

Part A: Personal Information

1.

Name

(Refer Note 1)

2.

Gender

(Select one)

(i) Male

(ii) Female

(iii) Transgender

3.

Date ofBirth

dd/mm/yyyy

4.

Aadhaar Number, if any

5.

Country of Citizenship

6.

Citizenship Type

(Select one)

(i) Foreigner

(ii) Person of Indian origin

(iii) Overseas Citizen of India

7.

Passport Number, if any

8.

Taxpayer Identification Number (TIN) in the country of residence

9.

Residence Address

(Refer Note 2)

10.

Office Address

(Refer Note 2)

11.

Contact Details

(i)

Mobile Number

Country Code

Number

(drop down)

(ii)

Email ID

(iii)

Landline No. with

Country/ISD Code and Area/STD Code (if any)

Part B: Source of Income

12.

Source of Income

(Select one or more)

(i) Salary

(ii) Income from Business/Profession

(iii) Income from House Property

(iv) Capital Gains

(v) Income from Other Sources

(vi) No Income

Part C: Details of Parents

13.

Whether mother/father is a single parent?

(Select one)

(i) Yes

(ii) No

14.

Father‘s Name

(Refer Note 1)

15.

Mother‘s Name

(Refer Note 1)

16.

Name of parent to be printed on

(i) Father

Permanent Account Number card (Select one)

(ii) Mother

Part D: Assessing Officer (AO Code)

17.

(i)

Area Code

(ii)

AO Type

(iii)

Range Code

(iv)

AO No.

Part E: Representative Assessee, if applicable (Refer Note 3)

18.

Name

(Refer Note 1)

19.

Permanent Account Number, if any

20.

Aadhaar Number (if Permanent

Account Number is not available)

21.

Address

(Refer Note 2)

22.

Contact Details

(i)

Mobile Number

Country Code

Number

(drop down)

(ii)

Email ID

(iii)

Landline No. with STD Code (if any)

Part F: Communication Address

23.

Address for Communication (Select one)

(i) Residence

(ii) Office

(iii) Representative Assessee Address

Part G: Declaration by Applicant or by Representative Assessee on behalf of the Applicant

24.

Documents submitted as Proof of Identity, Proof of Address and Proof of Date ofBirth of the Applicant (Refer Note 4)

(i)

Proof of Identity

(Refer Note 5)

(ii)

Proof of Address

(Refer Note 5)

(iii)

Proof of Date ofBirth

(Refer Note 5)

25.

Documents submitted as Proof of Identity, Proof of Address of Representative Assessee

(Refer Note 4)

(i)

Proof of Identity

(Refer Note 5)

(ii)

Proof of Address

(Refer Note 5)

Verification and Declaration

e. I, … … … … … ., in the capacity of ………..(Self/Representative Assessee) do hereby declare that what is stated above is true to the best of my knowledge and belief.

f. I declare that the applicant does not possess Permanent Account Number and shall be liable for legal consequences under the Act. if this declaration is found to be incorrect.

Place

Date

(Signature or Left Hand Thumb Impression of Applicant or Representative Assessee)

(Name:- ……………………….)

Designation:- … … … … … …..

Annexure

Particulars

A-1

Proof of Identity

A-2

Proof of Address

A-3

Proof of Date ofBirth