Form 49A

Under section 139A of the Income-Tax Act, 1961

PAN Application Acknowledgment Receipt For 49A Form

( Physical Application )

Received Rs. 107.00/- (incl of taxes) from: SHRI GOBINATH MADASAMY

Application No./Coupon No.: U-N003893813
Name as to be printed on PAN card: GOBINATH MADASAMY
Gender MALE
Date of Birth/Incorporation 17/04/2000
Father's Name: MADASAMY
Aadhaar Number/EID Number: xxxx-xxxx-5933 (NOT, MATCHED)*
Name as per Aadhaar: GOPINATH MADASMY
Applicant's Contact details: 9994696286
Communication Address: RESIDENCE
Residence State: TAMIL NADU
Office State: TAMIL NADU
Proof of Identity: AADHAAR Card issued by UIDAI (In Copy)
Proof of Address: AADHAAR Card issued by UIDAI (In Copy)
Proof of DOB: AADHAAR Card issued by UIDAI (In Copy)
Date of Receipt: 31/12/2020 09:48:38
Mode of Pancard: Both physical PAN and e-PAN Card
Payment Ref No: 9588205945
Payment Date: 31/12/2019 09:52:33
*AADHAAR NOT MATCHED USING DEMOGRAPHIC DETAILS - WILL NOT BE LINKED WITH PAN.
*This Application will be accepted later again for processing, only after a successful Biometric authentication of the applicant's AADHAAR at any/nearest Branch Office of UTIITSL followed by re-submission of the application.

To know your PAN Application status, you may visit our website: http://www.utiitsl.com.
As per instruction from Income Tax Department, an authorized agency's agent may visit you for your identity and address verification as per the documents submitted by you with the PAN application form. You are requested
to ask authorization letter/ID card from the agent before verification.Your cooperation is solicited in this regard.

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