PAN Card Correction #004

PAN Number

Category of Applicant

Gender *MaleFemaleTransgenderNot Required

Please select items that needs to be corrected/changed *

NameDate of BirthFather's NameAddress for CommunicationGenderMobile NumberEmail AddressDuplicate/Same as oldDamaged PAN CardLost PAN CardMinor to Major PAN CardePAN to Physical PAN Card

Document for Proof of Identity *

Document for Proof of Identity

Applicant's Title :

Name *

Have you ever been known by any other name?YesNo

Please give the other 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 NameMother's Name

Father's Name

Mother's Name

Mobile Number *Your 10 digit Mobile Number

Email Address *

Document for Proof of Date of Birth *

Date of Birth *

Aadhaar Number

Address for Communication *ResidenceOffice

Document for Proof of Address *

Document for Proof of Address

Flat/Room/Door/Block No.

Road/Area/Post Office

City/District

State

Area Pin Code

Country

Source of Income

SalaryIncome from Business/ProfessionIncome from House PropertyCapital GainsIncome from Other SourcesNo Income

Do you want to have a Representative AssesseeYesNoRepresentative Assessee details to be filled only in special cases like minor, lunatic, idiot, etc., as provided u/s 160 of Income-tax Act, 1961

Title :

Name

Flat/Room/Door/Block No.Address of Parent / Guardian / Representative Assessee (RA)

Road/Area/Post Office

City/District

State

Area Pin Code

Country

I , the applicant, in the capacity of do hereby declare that what is stated above is true to the best of my information and belief. I have read and agree to the Terms and Conditions.

Place: *Please enter your city

Date

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