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Form No. 49A Application For Allotment of Permanent Account Number
Form No. 49A Application For Allotment of Permanent Account Number
49A
Application for Allotment of Permanent Account Number
Only 'Individuals' Only 'Individuals'
to affix recent [In the case of Indian Citizens/Indian Companies/Entities to affix recent
colour incorporated in India/Unincorporated entities formed in India] colour
photograph photograph
See Rule 114
(3.5 cm x 2.5 cm) (3.5 cm x 2.5 cm)
A2106878
Sir, I/We hereby request that a permanent account number be allotted to me/us.
I/We give below necessary particulars: Signature of applicant (inside the box)
1 Full Name (Full expanded name to be mentioned as appearing in proof of identity/address documents: initials are not permitted)
Please select title, as applicable Shri Smt. Kumari M/s
3 Have you ever been known by any other name? Yes No (Please tick as applicable)
If yes, please give that other name. Please select title, as applicable Shri Smt. Kumari M/s
7 Address
Residence Address
Flat/Room/Door/Block No. N O ; A 1 2 2 1 1 T H B L O C K
Name of Premises/Building/Village B E M L T O W N S H I P
Road/Street/Lane/Post Office N E W T H I P P A S A N D R A P O S T
Area/Locality/Taluka/Sub-Division M A L L E S H P A L Y A
Town/City/District B A N G A L O R E U R B A N
State/Union Territory Pincode/Zipcode Country Name
KARNATAKA 5 6 0 0 7 5 INDIA
Page 1 of 3 / A2106878
Office Address
Name of Office
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/Zipcode Country Name
Email ID HARIBHAGYA2072@GMAIL.COM
10 Status of Applicant
Please select status, as applicable Government
Individual Hindu Undivided Family Company Partnership Firm Association of Persons
Trusts Body of Individuals Local Authority Artificial Juridical Persons Limited Liability Partnership
12 In case of a person, who is required to quote Aadhaar number/The Enrolment ID of Aadhaar application form as
per section 139AA
Please mention your AADHAAR number (if allotted) 8 5 5 8 7 1 9 2 3 4 2 0
If AADHAAR number is not allotted, please mention the enrolment ID of Aadhaar application form
Name as per AADHAAR letter/card or as per the Enrolment ID of Aadhaar application form
R H A R I C H A R A N
13 Source of Income
Please select, as applicable
Salary Capital Gains
Income from Business/Profession Business/Profession Code Income from Other sources
Income from House property No income
Page 2 of 3 / A2106878
Address
Flat/Room/Door/Block No. N O ; A 1 2 2 1 1 T H B L O C K
Name of Premises/Building/Village B E M L T O W N S H I P
Road/Street/Lane/Post Office N E W T H I P P A S A N D R A P O S T
Area/Locality/Taluka/Sub-Division M A L L E S H P A L Y A
Town/City/District B A N G A L O R E U R B A N
State/Union Territory Pincode/Zipcode Country Name
KARNATAKA 5 6 0 0 7 5 INDIA
15 Documents submitted as Proof of Identity (POI), Proof of Address (POA) and as Proof of Date of Birth (DOB)
I/We have enclosed AADHAAR CARD ISSUED BY UIDAI as proof of identity,
Place BANGALORE
D D M M Y Y Y Y
Date 0 2 0 5 2 0 1 9
Page 3 of 3 / A2106878
FROM: | TO:
HARI CHARAN | THEPANCARD.COM
CUSTOMER CODE: A2106878 | DOOR NO. 41, 4TH FLOOR, TOWER I,
NO;A122 11TH BLOCK BEML TOWNSHIP | SHAKTHI TOWERS,
NEW THIPPASANDRA POST MALLESH PALYA | #766, ANNA SALAI, CHENNAI,
BANGALORE URBAN | TAMIL NADU - 600002.
KARNATAKA - 560075. |