Account

Permanent
Allotment of
Application
for
Form 49A Number incorporated
in Indial
Companies/Entitios
Citizens/lndian indiaj
f o r m e d in
of Indian entities
Tax Act, 1961
the case
n Unineoporated Income
139A of the
Under section Date: 03/02/2022

128
int

H-193HR
Signature / Let Trumb presscn
Sgnature Let Thumb
photo
mpresson accross fhs

Application Number: G055818725

Coupon Number: GO55818725

Assessing Officer(AO Code)

Range Code AO No
Area Code AO Type

name: initials are not permitted):

1. Full Name (Full expanded lFirst Name:-
Middle Name:
Title:- SHRI
Last Name:- KUMAR MANISH
it, to be printed on the PAN card:-
above name, as you would like
2. Abbreviation of the
MANISH KUMAR
other name? N
3. Have you been known by any
Last Name: Middle Name:- First Name:-
4. Gender of
or Trust Deed/Formation of Body
5.Date of Birth / Incorporation/Agreement/Partnership 01/01/2001
individuals/Associationof Persons:
6. Father's Name:
Last Name:- DAS Middle Name:- NIA First Name:- RAMOTAR

7. AddresS:-
Residential Address:-

Flat/Door/Block No.: WZ-485-C

Name of Premises/Building/Village:- BASAI DARAPUR
Road/Street/Lane/Post Office:- RAMESH NAGAR
Area/Locality/Taluka/Sub-Division:

Town/City/Dictrict: WEST DELHI Stato/UnionToritory:- DELHI PIN Code:- 110015 Country: INDIA
Official Address:
lorfice Name:
Flet/Door/Block No.
Name of Premises/Building/Village:
Road/Street/L.ane/Post Office:
Area/Locality/Taluka/Sub-Division:-
PIN Code: Country:
TownCity/District |state/Union Territory:
RESIDENCE
8.Address for Communication:
& Email ID Details
s. Telephone Number Email ASHISH.T1098@GMAIL.COM|
Country
Code:
Area/STD
Code:-
Telephone/Mobile|
Number: 7079498682||Address:
10.Status of the Applicant: Individual
11. Registration Number(for
Company.firms,LLP's etc):-
12. Please Mention your
861151469729
AADHAAR Number(if allotted) -
13.Source of Income
Business/Profess ion code:

the Income Tax Act in

Assessee, who is assessable under
14. Full Name, address of the Representative been given in colmns 1 to 13.
respect of the person, whose particulars have
Last Name:- Middle Name:- First Name:-
Flat/Door/Block No.:-
Name of Premises/Building/Village:-
Road/Street/Lane/Post Office:
Area/Locality/Taluka/Sub-Division:
Town/City/District:- State/Union Territory:- lPIN Code:

AADHAAR Card issued by UIDAI (ln Copy) as Proof of ldentity

15. IWe have enclosed of Address and AADHAAR Card
AADHAAR Card issued by UIDAI (In Copy) as Proof
ssued by UIDAI(InCopy) as Proof of DOB.
the capacity of HIMSELF/HERSELF do
16. IWe MANISH KUMAR ,the applicant,in is to the best of my/our information and
hereby declare that what is stated above true
belief.

BASAIDARAPUR

Signature/Left
Date thumb impression
Place
ofthe applicant
 Govermnent of Indin
aFrtre

1 g
Manish Kumar
PH fafa/boOB: 01/01/2001
MALE

8611 5146 9729

VID:9114 7495 2441 5435

Unque ldentification Authority of tndia

SR-11C01S
RAddress:
Ramotar Das, WZ-485-C, Wz Block, Basai
Derapur, Ramesh Nagar, West Delhi,
Delhi- 110015

8611 5146 9729

VID:9114 7495 2441 5435
1a471 euaicdot gov ins www.sutdn g t