Acknowledgment for request for new PAN Application (88103011909...

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Acknowledgment for request for new PAN card(Form 49A)

ACKNOWLEDGMENT NUMBER: 881030119090704

Affix recent
photograph
(3.5cm x 2.5cm)
Signature/Left
Thumb Impression
across this photo

Citizen of India
Category
Name
Name to be printed on card
Father's Name
Date of Birth
Residential Address

Office Address
Address for Communication
Telephone No
Aadhaar No.
Email Id

Y
Individual
Smt. MANJULA YADA
YADA MANJULA
Shri SATHYANARAYANA GONDRALA
12 - 08 - 1973
5-6-86/1
MAIN ROAD
MARIPEDA
WARANGAL - 506315
Andhra Pradesh

Affix recent
photograph
(3.5cm x 2.5cm)

Residential
91
9713364414
maheshkumar.iitk@gmail.com

Payment Mode
Net Banking: Your Payment of

96.00 against transaction number 400-964880 has been successfully processed.

I/We, the applicant, do hereby declare that what is stated above is true to the best of my/our information and belief.
The following documents are enclosed as:
Proof of Identity: Copy of ration card
Proof of Address: Copy of ration card
Proof of Identity of representative assessee:
Proof of Address of representative assessee:
Any other document:
Signature/Left Thumb Impression of Applicant
(inside the box without touching the sides & in BLACK INK ONLY)

Date: 05 - 09 - 2013

Service Tax Code (Registration Number): AAACN2082NST001

Service Tax Registration Category: BUSINESS AUXILIARY SERVICES

Instructions:
1. The acknowledgement number above is your unique reference number for PAN application. Kindly quote this number for tracking the status of your PAN
application on http://tin-nsdl.com or any queries relating thereto.
2. Sav e and print this acknowle dgme nt.
3. Application fe e and mode of payme nt: Payment favouring 'NSDL-PAN' can be made as follows:
Sr.
No.

Addre ss for
Communication

Indian

Foreign

Amount payable
(
)
96

962

M ode of payme nt
Credit card / Debit card/ Net Banking / Demand Draft (DD) payable at Mumbai/Cheque
to be deposited in any HDFC bank branch across the country (except Dahej).
Credit card / Debit card / Demand Draft (DD) payable at Mumbai

Ple ase me ntion name of applicant and acknowle dgme nt numbe r on the re v e rse of che que /DD.
4. Individual applicants affix your recent colour photograph (3.5 cm x 2.5 cm), sign the acknowledgment (inside the box provided without touching the sides
and in BLACK INK only) and enclose a DD, if any, alongwith Proof of Identity & Proof of Address as specified in the application form.
5. Superscribe the envelope with 'APPLICATION FOR PAN - Acknowle dgme nt Numbe r' (e.g. 'APPLICATION FOR PAN - 881010100000973').
th

6. Send the documents as specified in point no. 4 above to Income Tax PAN Se rv ice s Unit, NSDL e -Gov e rnance Infrastructure Limite d, 5 floor,
M antri Ste rling, Plot No. 341, Surv e y No. 997/8, M ode l Colony, Ne ar De e p Bungalow Chowk, Pune -411016 Tel: 020-27218080; Fax:
020-27218081.
7. Your acknowledgment, Demand Draft if any, and proofs, should reach NSDL within 15 days from the date of online application.
8. Application will be processed only on receipt of relevant proofs and realisation of payment.
9. PAN card will be despatched only to the communication address provided in your PAN application. Wherever the Representative Assessee (RA) details (
item no.14 in Form 49A ) are mentioned in the application, PAN card will be despatched to the RA's address.

05-09-2013 21:19