Professional Documents
Culture Documents
1-merged
1-merged
L K N 7 1 4
_i
li,lrlrtjiit' i'i;lfri)
.1
I
:-*.1..... :
lyl:r i r; I:0r**Jf: Tran*H,*nal,]r ilti,: rs, :t\ :lp::t,. ,rl)'..1
I 1'1.1
s
{:rciriltlli*r rri hlril,/ lti ir}flalitJlrai! af ails{lr::tnlii:rl1 tl j"llrrti:;rr;
l..rr:i.iil:: '.],1 ?,.tjt:rrtll; ir;.rl:Ji,::,,1* r: *1.:i1tr:r it1{.liritl!ill tLtitiiltltt:j j.
I0 1 0 1 20 0 3
whether rnother is a single parerrl and you wish to apply tor PAN by furnishlnq the nilme your
of rnolher only? yes No (please tick as applicable)
lf yes, peasefill n mothers nanre in thr: appropriatej spar:e provirlccl
[.rclow.
Fathers'$ Name (Mandatory except where nlother is a singre parent and pAN is
applied by {urnishilrg the narne of rrr <lther oniy)
A F D UD
l
Mothers's Name {optiona I except where rnother is a s parent and PAN is applied by furn ishing name of mother only)
_.._a _ "T--_') -
I
I
T
I I l
ll
t.-.....i .t_'
i-t|llifr FAI'! r;r{j r1.ti.( I i j{1, ,,ri} l
(ln case no option is provided then pAN carcl wjll be issued with father's na
me except where mother is a single parent and you wish to apply for
PAN by furnishing name of the mother only)
r 'l ll1'' '. i ,itllr' l,l,ilii,iir tr,, i,ir':lt:', tt.t,..., it..l.r, ..,,.,i,,..r,r. l
Ll
T
A D
E,E
t\4
K A
A R
S
P
N
T
U
li !1,
lH I
R AN/ P U iR, i l
R A I\4 P
-T N D
II T I n t\ PRAD tr) H 4 ora IND I
l
l
l
t
1
{re}
1
i:l Addr**s f{1r 0sn?fiulti**ticn r' &asidsrx{:s Sft;cs {Pl*as* tiek as sppfic8h.le}
{} T*lephone N*mb*r & En:ait ltl *qttails
'liil$plt{.}nH I ltrl*l,rlt numl:,:l
f:uuiltry ts*ii l\r$lrl$Il) C{r*{j
";1't
i- i
0 1 2 4 9 1 1 1 0 5 9 9 5 0
llffiall l* S mail.com
''|
0 $trlLr$ llf applic$rrt
T iii:'rt:lnr:tl nl
lliLif rl,l
I Pa{rer$lli[r Frt*1
l{;l ; Pt t!rr':$
A.rsrlf iit:Ilft {}t pnla5tlrit
1r
['i
l:n C;ls& &{ s
ri
}er*srl, \irhi) i5 rcq*ir*{$ .r}
l
L
qLi&{q
il
--:--T----::-
I;I
Aii{rh*{{ r'1u,1}be{lThe f;.nr&lr$eut l$ *f Asdhitfit sppliciti{}n f*:tn ** per s*c1i*n 13!}AA
pl*s${ r1}*ll io* yeru r .4,{l} HAltll,: Lr nr}:}ii'} I I ii $llc} lt*tl i 9 1 B 0 1 5 4 1 5 9 3 3
tiAA.iliiAAn rumlxlr is r"r|.1l Bllotied. plr3fisfl {r1sn{ion tho snr$lmi}i]t ll} r:f Aacihaar *ppircntifin i*rfi1
I
I
.I'1". i, l
t:::
1a i
N A J R U D D I N 1
:. ....)
l*-l ,n*onr* in:n: srsin*ss i [:r*ir**riinri si-rsinesslFrnfcs$ion r$d* l- -|,,..i lF,:rr Cnl,l'. ll*f*r intlturLii.:nsl n lnr:*n:*'frQn: *lhsr $*urcss I
1d Repr*riiintalive Ass*ts** (fQA)
_:
li,li{idre it&r'*e 1
Arl{lr*ss
:
rjrt !r*t*hy ,j*r,:l:t.rar lnal ,.qltitiit is ntal*,J filtovr ig ttu{ ts the hcsi ql n-ryil}llr 1nF{}fi11,:liOn anrj lrcirei
RAMPUR
[l l:lr,tt:
dlul\'q7q
D MYYYY
l]f;to 0 9 0 1 2 0 2 4
Iti{]il;llur* r'1-e{1 Tlu-rmb lr:rpr*s:ton ui ,a.ltriif,nill iinsi{l* th* i}L}}ii
'r'
I