Application for Allotment of Permanent Account Number [For an Entity incorporated outside India/ an Unincorporated Entity formed outside India]

1.

Name

(Refer Note 1)

2.

Date of Incorporation/ Agreement/ Partnership or Trust Deed/ Formation of Body of Individuals or Association of Persons

dd/mm/yyyy

3.

Taxpayer Identification Number (TIN) in the Country of Residence

4.

Office Address

(Refer Note 2)

5.

Communication Address

(Refer Note 2)

6.

Status

(Refer Note 3)

7.

Registration Number (for Company, Firm, Limited Liability Partnership, Association of Persons, Body of Individuals, Artificial Juridical Person and Trust), if any

8.

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

9.

Source of Income

(select one or more)

(ii) Salary

(ii) Income from Business/Profession

(iii) Income from House Property

(iv) Capital Gains

(v) Income from Other Sources

(vi) No Income

Part C: Assessing Officer (AO Code)

10.

(i)

Area Code

(ii)

AO Type

(iii)

Range Code

(iv)

AO No.

Part D: Representative Assessee/Authorized Representative (Refer note 4)

11.

Name

(Refer Note 1)

12.

Permanent Account Number, if any

13.

Aadhaar Number/ Foreign Passport (if Permanent Account Number is not

available)

14.

Address

(Refer Note 2)

15.

Contact Details

(i)

Mobile Number

Country Code

Number

(drop down)

(ii)

Email ID

(iii)

Landline No. with STD Code (if any)

Part E: Declaration by Applicant or by Representative Assessee/Authorized Representative on behalf of the

Applicant

16.

Documents submitted as Proof of Identity, Proof of Address and Proof of Date of Incorporation/Agreement/ Partnership or Trust Deed/ Formation of Body of Individuals or Association of Persons of the Applicant (Refer Note 5)

(i)

Proof of Identity

(Refer Note 6)

(ii)

Proof of Address

(Refer Note 6)

(iii)

Proof of Date of

Incorporation/Agreement/

Partnership or Trust Deed/

Formation of Body of Individuals or Association of Persons

(Refer Note 6)

17.

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

(Refer Note 5)

(i)

Proof of Identity

(Refer Note 6)

(ii)

Proof of Address

(Refer Note 6)

Verification and Declaration

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

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

Designation … … … … .

Place

Date

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

Annexure

Particulars

A-1

Proof of Identity

A-2

Proof of Address

A-3

Proof of Date of Incorporation/Agreement/ Partnership or Trust Deed/ Formation of Body of Individuals or Association of Persons