Acknowledgment for Request for New PAN Card or/and Changes or Corre...

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Acknowledgment for Request for New PAN Card or/and Changes or Correction in PAN Data
ACKNOWLEDGMENT NUMBER: 881020207803400
Category Permanent Account Number (PAN) Name Name to be printed on card Father's Name Date of Birth Address for Communication Individual A YWPS0719E Shri BHUPINDER PAL SINGH BHUPINDER PAL SINGH Shri A VTAR SINGH 09 - 01 - 1981 HOUSE NO 402 SECTOR 78 VPO SOHANA SAS NAGAR MOHALI - 140308 Punjab

Affix recent photograph (3.5cm x 2.5cm) Signature/Left Thumb Impression across this photo

Affix recent photograph (3.5cm x 2.5cm)

Other Address Telephone No. Aadhaar No. Email ID Photo Mismatch PAN1: PAN2: Signature Mismatch PAN3: PAN4:

91

9650927666

SINGH.BHUPI@GMAIL.COM Sex

Request for cancellation of PAN(s)

Payment Mode
Credit Card / Debit Card: Your Payment of 96.00 against transaction number 401-395257 has been successfully processed. I/We, the applicant, do hereby declare that what is stated above is true to the best of my/our information and belief. The following documents are enclosed as: Proof of Identity: Copy of voter's identity card Proof of Address: Copy of voter's identity card Proof of PAN: Copy of PAN card Proof of PAN to be cancelled: Any other document: Signature/Left Thumb Impression of Applicant (inside the box without touching the sides & in BLACK INK ONLY) Date: 10 - 10 - 2012

Service Tax Code (Registration Number): AAACN2082NST001 Service Tax Registration Category: BUSINESS AUXILIARY SERVICES

Instructions:
1. The above-mentioned 15-digit acknowledgment number is a unique reference number for your application for 'Request for New PAN Card or/and Changes or Correction in PAN Data'. Kindly quote this number for tracking the status of your application on www.tin-nsdl.com or any queries relating thereto. 2. Save and print this acknowledgment. 3. Application fee and mode of payment: Payment favouring 'NSDL-PAN' can be made as follows: Sr. No. 1 Address for Communication Indian Amount payable ( ) 96 Mode of payment Credit card / Debit card / Net Banking / Demand Draft (DD) payable at Mumbai/Cheque to be deposited in any HDFC bank branch across the country (except Dahej). DD payable at Mumbai

Foreign

962

Please mention name of applicant and acknowledgment number on the reverse of cheque/DD. 4. Individual Applicants affix your recent colour photograph, sign the acknowledgment (inside the box provided without touching the sides and in BLACK INK only) and enclose a Demand Draft (DD)/Cheque, if any, alongwith Proof of Identity and Proof of Address as specified in the application form. 5. Superscribe the envelope with 'APPLICATION FOR Change request PAN - Acknowledgment Number' (e.g., 'APPLICATION FOR Change request PAN - 881010200000973'). 6. Send the documents as specified in point no. 4 above to Income Tax PAN Services Unit, National Securities Depository Limited, 3 rd floor, Sapphire Chambers,Near Baner Telephone Exchange, Baner Pune -411045 Tel: 020-2721 8080; Fax: 020-2721 8081. 7. Your acknowledgment, DD if any, and proofs, should reach NSDL within 15 days from the date of online application. 8. Application will be processed only on receipt of relevant proofs and realisation of payment. 9. Applications without proof of PAN will be processed on a good effort basis - (as mentioned in guidelines).

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