PAN Card Changes Or Correction form

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

  1. Full Name (Full expanded name to be mentioned as appearing in proof of identity/address documents: initials are not permitted)
  2. 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
  3. Place photograph (3.5 cm × 2.5 cm) Only
  4. Signature/Left thumb impression across this photo Signature / Left Thumb Impression of Applicant (inside the box)
  5. Details of Parents (applicable only for individual applicants) Last Name / Surname First Name Middle Name
  6. Mother’s Name (optional) Last Name / Surname First Name Middle Name
  7. Select the name of either father or mother which you may like to be printed on PAN card (select one only)
  8. (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)
  9. Date of Birth/Incorporation/Agreement/Partnership/Trust Deed/ Day Month Year 4 Gender (for ‘Individual’ applicant only) (Please tick as applicable)
  10. Photo Mismatch
  11. Signature Mismatch
  12. Address for Communication Residence Office (Please tick as applicable)
  13. 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
  14. If you desire to update your other address also, give required details In additional sheet.
  15. Telephone Number & Email ID details Country code Area/STD/Code Telephone / Mobile number Email ID
  16. AADHAAR number (if allotted)
  17. Mention other Permanent Account Numbers (PANs) inadvertently allotted to you PAN 1 PAN 2
  18. 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