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Pan Correction Form

The document is a request form for obtaining a new Permanent Account Number (PAN) card or making changes/corrections to existing PAN data. It includes sections for personal details, parental information, date of birth, gender, address, contact information, AADHAAR number, and verification. Applicants must provide supporting documents and sign the form to confirm the accuracy of the information provided.

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entershivam23
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26 views1 page

Pan Correction Form

The document is a request form for obtaining a new Permanent Account Number (PAN) card or making changes/corrections to existing PAN data. It includes sections for personal details, parental information, date of birth, gender, address, contact information, AADHAAR number, and verification. Applicants must provide supporting documents and sign the form to confirm the accuracy of the information provided.

Uploaded by

entershivam23
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Request For New PAN Card Or/ And Changes Or Correction in PAN Data

recent photograph recent photograph


(3.5 cm × 2.5 cm) Permanent Account Number (PAN) (3.5 cm × 2.5 cm)

Please read Instructions ‘h’ & ‘i’ for selecting boxes on left margin of this form.

Signature / Left thumb


impression across this photo
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
Signature / Left thumb impression
Last Name / Surname
First Name
Middle Name
Name you would like it printed on the PAN card

2 Details of Parents (applicable only for Individual applicants)


Whether mother is a single parent and you wish to apply for PAN by furnishing the name of your mother only? Yes No (please tick as applicable)

Father’s Name (Mandatory except where mother is a single parent and PAN is applied by furnishing the name of mother only)
Last Name / Surname
First Name
Middle Name
Mother’s Name (optional except where mother is a single parent and PAN is applied by furnishing the name of mother only)
Last Name / Surname
First Name
Middle Name
Select the name of either father or mother which you may like to be printed on PAN card (Select one only)
Father’s Name Mother’s Name (Please tick as applicable)

3 Date of Birth/Incorporation/Agreement/Partnership/Trust Deed/ Formation of Body of individuals or Association of Persons


Day Month Year

4 Gender (for ‘Individual’ applicant only) Male Female Transgender (Please tick as applicable)
5 Photo Mismatch
6 Signature Mismatch
7 Address for Communication Residence (Please tick as applicable)

Flat/Room/ Door / Block No.


Name of Premises/ Building/Village

Town / City / District


State / Union Territory Pincode / Zip code Country Name

8 If you desire to update your other address also, give required details In additional sheet.
9 Telephone Number & Email ID details
Country code Area/STD Code Telephone / Mobile number

Email ID
10 AADHAAR number (if allotted)
Name as per AADHAAR letter/card

11 Mention other Permanent Account Numbers (PANs) inadvertently allotted to you


PAN 1 PAN 2 PAN 3 PAN 4
12 Verification
I/We , the applicant, in the capacity of do hereby
declare that what is stated above is true to the best of my/our information and belief.
I/We have enclosed (number of documents) in support of proposed changes / corrections.
Place
D D M M Y Y Y Y Signature / Left Thumb Impression of
Date Applicant (inside the box)

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