PAN Card Changes Or Correction form Request For New PAN Card Or/ And Changes Or Correction in PAN Data
Please read Instructions for selecting boxes on left margin of this form
- 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 Last Name / Surname First Name Middle Name Name you would like it printed on the PAN card
- Place photograph (3.5 cm × 2.5 cm) Only
- Signature/Left thumb impression across this photo Signature / Left Thumb Impression of Applicant (inside the box)
- Details of Parents (applicable only for individual applicants) Last Name / Surname First Name Middle Name
- Mother’s Name (optional) 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)
- (In case no option is provided then PAN card will be Issued with father’s name) Father’s name Mother’s Name (Please tick as applicable)
- Date of Birth/Incorporation/Agreement/Partnership/Trust Deed/ Day Month Year 4 Gender (for ‘Individual’ applicant only) (Please tick as applicable)
- Photo Mismatch
- Signature Mismatch
- Address for Communication Residence Office (Please tick as applicable)
- Name of Office (to be filled only in case of office address) 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 / Zip code Country Name
- If you desire to update your other address also, give required details In additional sheet.
- Telephone Number & Email ID details Country code Area/STD/Code Telephone / Mobile number Email ID
- AADHAAR number (if allotted)
- Mention other Permanent Account Numbers (PANs) inadvertently allotted to you PAN 1 PAN 2
- 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. Formation of Body of individuals or Association of Persons Father’s Name : (Mandatory, Even married women should fill in father’s name only) PAN 3 PAN 4 Name as per AADHAAR letter/card Male Female Transgender