Application Number: 6041911524 Coupon Number: 6041911524 Assessing Officer(AO Code) [Area Code (0 Type [Range Code [kone frive:- sur 1. Full Name (Full expanded names Tnitals ae sat permitted): esse Name:- KUMARI = KUMARI Kunpereviation of the above name, as you would ike fo be Printed on the PAN card: CHANCHLA '2. Have you been known by any other name? N [Last Name: lk Gender F ndioann, eorporation/AgreementParinership or Tosi DesaFSaSion of Body of Inowacannoscesee sien — [. Fathers Name [Middle Namo WA Names BEVENDRA—] 2a/Locality/Taluka/Sub-Division= fown/City/District:-_ SITAMARHI Official Address:- ice Name: la/DooriBlock No. atelUnion Territory:- BIHAR PIN Code:- 643520 DEVENDRA KUMAR YADAV yARA PRI jountry:- INDIAame of Promises/Building/Vilage:- (RoadrStreetLaneiPost Office reall ocality/Taluka/Sub-Division: [Town/Gity/District:- jUnion Territory:- [a Adcress for Communication:- RESIDENCE. [fB- Telophone Number & Email ID Details = ce” is j7321904734| MARL.COM (0, Status of the Applicant:- (1. Rogistration Number(for |Company,firms,LLP's etc): 2. Please Mention your AADHAAR 35434425720 |—_Business/Profession code person, whose particulars have been given in colmns 1 to 13. [i4. Full Name, address of the Representative Assesseo, who is assessable under the Income Tax Act in respect of the [SHRI st Name:-_ YADAV Jide Narno:- KUMAR First Name:- DEVENDRA [FlatiDooriBlock No. jARD NI2Z |[Name of Premises/Bullding/Village:- PUR PACHASI [Road/Street/Lane/Post Office:- JOGIYARA [Area/Localty/Taluka/Sub-Division'= UPR [tatefUnion Territory:- BIHAR _JPIN Code:- 843320 (in Copy) _as Proof of DOB. '5. UWe have enclosed AADHAAR Card issued by UIDAI (In Copy) as Proof of Identity , DHAAR Card issued by UIDAI (In Copy) as Proof of Address and AADHAAR Card issued by DAL iG. We CHANCHLA KUMARI ,the applicant.in the capacity of HIMSELF/HERSELF do hereby |\tectare that what is stated above Is true to the best of my/our information and belief. RAMPUR é4 Pee) Sigaturelco than Place Date Tmpreseion ofthe applicantET FH /Emolment No. 405020100374 TUREEHE RA PEaRg S8318220635"% SET on FARR Your 3321 3412 5720 ar at 3321 3412 5720 » AY ogeeeee (CHANCHLA KUMARI Sencer: rows Date of Birth/Incorporation: 12/10/2008 041911524 Fotners Name: DEVENORA YADAV Aadhase number: xocm00-5720. (MENTIONED, MATCHED)* Name per Aahaa: HANCHLLA KUMAMRE Avplcant's Contact deta: 7321904734 / PRAMODPASWAN39@GMAIL.COM Communion Adres: esioence escence State: amar Ofc state: Not Mentioned Proof etty AAADHAAR Card issued by UIDAS (In Copy) Proof adress: [AADMAAR Card issued by UIDAS (in Copy) Pro of 008: AADMAAR Card issued by UIDAS (I Copy) Date of Receipt: Centre Contact Detads:_7070741401 / PRAMODPASWANGD@GHAIL.COM ‘Toknow your PAN Application status, you may Vist our website hap //ewwaiahcome Per the documents nabs Tag Department an authorized agency's agcat may vsk you for your identity and adden verification ax the the PAN application form. You quested to ask suri the documents submitted tank suhorization itter/ID card from the agent ea 7 hone seat oat Soren seat en ee ‘ut from here