Form No. 498 Application for Allotment of Permanent Account Number [nthe case of Indian Citizensitndian Companiesi€ tives incorporated En India Unincorparated anti formed in india) ‘See Rule 114 ‘anc rao) pee iow ne azarenjeg amet ae rape Eee tng oh Assessing offcer(A0 cole) ‘area code ‘AOtyee | Range code AD No. * x Tapastine Pasca ee rishi cals pasraacraae 11 FultNarme (Full expanded name ta be mentioned as sppebia in PROOF OFMeHyfte of bithvaddress documents: alas are not permite) Pease selact ie, [V/]as applicable sm. Rfruman [ws Wectapa aunts vat de Mane T 2 hibits tine above none, se AA I T i a [= [shail TI Ll Dian noni a a ae (ia al rere Please sect ts. [¥/]as applicatio (aanane sane Fret Nan aie Nome 4 Gender (for Individual applicants only) {5 Date of Bithincorporation/ ‘Day Month Yost TZ] [ois) (ase! © Details of Parents (applicable only for individual applicants) Fathor's Name (Mandatory. Evon married women should fill in father's name only) sei Last Name / Sunaime PIA! ‘EIEN | Fst Name | Zl Midd Name Mother's name (optonat Last Narne/ uname Fest Name idee Name Select the name of ether father of mathe which you may Bie tobe printed on PAN card (Select one only) {tr.case no opton is provided then PAN card wil be Issued wit father’s name) Father's name Methersname (Please tick as apical) 7 Address Residence Address Flat / Room / Door Block No Name o Premises! Bulking Vilage Road Steet Lane Post Ofice ‘ea /Localty Taluka Sub Division Town City /Dispict State Ueion Tertory L_opistiA Fiisiélolsfal | rap rA