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Copy to be kepl with application Tax Invoice cum Acknowledgement receipt of PAN Application (Form 49A) |_| ine carpetergeneratad recep and des ratreaute Sate, oni Pan 32 a l eae = a ein eee == oe Name on Card |PATEL DASHRATHEHAI = Rae meee 3 Sa g See ean aiertan RIND a Pot een ha eee rel enrages r | Proof of Address | AADHAAR Card issued by the Unique Identification Authortty of Inia masa” eae aero pe ee ae ee peer oar oa caret om OR se ean an eae ‘Total(Rounded Off) 2107.00 ema Eeteeteeetaas [nc ue F ~~ ‘Assessing officer (AO code) Form No. 494 Application for Allotment of Permanent Account Number lin the case of cian Cittzens/indian CompaniesJEnSties incorporated in india! Unincorporated entities formed jp ba) ‘Soe Rule 14 Tear ihe) ee een he czar arn a mang te ng pao ‘Area code ‘AO Tyee ‘Range code, Br ie 2 Te t see Sir, We hereby request that @ permanent account number be alata to metus We give below necessary particulars 1 Full Name (Full expanded name to be mentioned as appearing in proof ot identityidate of birth/address documents: Intals are not permitted) exe Beton, Spas oa TR ag Pease select tile, [V’]as applicable FSi Smt. Kumar [mis LastName /Suneme > gala) First Name, as Jefe Mae Name ‘Abbreviations of the above name, as you would lke it, to be printed on the PAN card PERE eae ieafs Have you ever been known by any other name? ye, please give that ane ame ere. Jit Prease select te, [¥] 2s apptcabie [sna Lastname /Sumame { First Name Middle Name ‘Gonder (for mdlvidual applicants only) [EF fale Monta (a). OB Yoor [

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