Request For New PAN Card Or/ And Changes Or Correction in PAN Data

Only ‘Individuals’ to afx Only ‘Individuals’ to afx

recent photograph recent photograph
(3.5 cm × 2.5 cm) Permanent Account Number (PAN) (3.5 cm × 2.5 cm)

Please read Instructions ‘h’ & ‘i’ for selecting boxes on left margin of this form.

Signature / Left thumb

impression across this photo
1 Full Name (Full expanded name to be mentioned as appearing in proof of identity/address
documents: initials are not permitted)
Please select title,  as applicable Shri Smt Kumari M/s
Signature / Left thumb impression
Last Name / Surname
First Name
Middle Name
Name you would like it printed on the PAN card

2 Details of Parents (applicable only for Individual applicants)

Father’s Name (Mandatory. Even married women should fll in ather’s name only)
Last Name / Surname
First Name
Middle Name
Mother’s Name (optional)
Last Name / Surname
First Name
Middle Name
Select the name of either father or mother which you may like to be printed on PAN card (Select one only)
(In case no option is provided then PAN card will be issued with father’s name) Father’s Name Mother’s Name (Please tick as applicable)

3 Date of Birth/Incorporation/Agreement/Partnership/Trust Deed/ Formation of Body of individuals or Association of Persons

Day Month Year

4 Gender (for ‘Individual’ applicant only) Male Female Transgender (Please tick as applicable)
5 Photo Mismatch
6 Signature Mismatch
7 Address for Communication Residence Ofce (Please tick as applicable)
Name o Ofce (to be flled only in case o ofce address)
Flat/Room/ Door / Block No.
Name of Premises/ Building/Village
Road/Street/ Lane/Post Ofce
Area / Locality / Taluka / Sub- Division
Town / City / District
State / Union Territory Pincode / Zip code Country Name

8 If you desire to update your other address also, give required details In additional sheet.
9 Telephone Number & Email ID details
Country code Area/STD Code Telephone / Mobile number

Email ID
10 AADHAAR number (if allotted)
Name as per AADHAAR letter/card

11 Mention other Permanent Account Numbers (PANs) inadvertently allotted to you

PAN 1 PAN 2 PAN 3 PAN 4
12 Verification
I/We , the applicant, in the capacity of do hereby
declare that what is stated above is true to the best of my/our information and belief.
I/We have enclosed (number of documents) in support of proposed changes / corrections.
Place
D D M M Y Y Y Y
Date Signature / Let Thumb Impression o
Applicant (inside the box)
 INSTRUCTIONS FOR FILLING REQUEST FOR NEW PAN CARD OR/AND CHANGES OR CORRECTION IN PAN DATA

(a) Form to be illed legibly in BLOCK LETTERS and preerably in BLACK INK. Form should be filled in English only
(b) Mention 10 digit PAN correctly.
(c) Each box, wherever provided, should contain only one character (alphabet /number / punctuation sign) leaving a blank box ater
each word.
(d) ‘Individual’ applicants should aix two recent colour photographs with white background (size 3.5 cm x 2.5 cm) in the space
provided on the orm. The photographs should not be stapled or clipped to the orm. The clarity o image on PAN card will
depend on the quality and clarity o photograph aixed on the orm.
(e) Signature / Let hand thumb impression should be provided across the photo affixed on the left side of the form in such a
manner that portion o signature/impression is on photo as well as on orm.
() Signature /Let hand thumb impression should be within the box provided on the right side o the orm. The signature should
not be on the photograph aixed on right side o the orm. I there is any mark on this photograph such that it hinders the clear
visibility o the ace o the applicant, the application will not be accepted.
(g) Thumb impression, i used, should be attested by a Magistrate or a Notary Public or a Gazetted Oicer under oicial seal and
stamp.
(h) For issue o new PAN card without any changes- In case you have a PAN but no PAN card and wish to get a PAN card, ill
all column o the orm but do not tick any o the boxes on the let margin. In case o loss o PAN card, a copy o FIR may be
submitted along with the orm.
(i) For changes or correction in PAN data, ill all column o the orm and tick box on the let margin o appropriate row where change/
correction is required.
(j) Having or using more than one PAN is illegal. I you possess more than one PAN, kindly ill the details in Item No. 11 o this orm
and surrender the same.

Item Item Details Guidelines for filling the form

No.
1 Full Name Please select appropriate title.
Do not use abbreviations in the First and the Last name/Surname.
For example RAVIKANT should be written as :

Last
R A V I K A N T
Name/Surname
First Name
Middle Name

For example SURESH SARDA should be written as :

Last
S A R D A
Name/Surname
First Name S U R E S H
Middle Name

For example POONAM RAVI NARAYAN should be written as:

Last
N A R A Y A N
Name/Surname
First Name P O O N A M
Middle Name R A V I

For example SATYAM VENKAT M. K. RAO should be written as :

Last
R A O
Name/Surname
First Name S A T Y A M
Middle Name V E N K A T M K

For example M. S. KANDASWAMY(MADURAI SOMASUNDRAM KANDASWAMY) should be

written as:
Last
K A N D A S W A M Y
Name/Surname
First Name M A D U R A I
Middle Name S O M A S U N D R A M
Applicants other than ‘Individuals’ may ignore above instructions.

Non-Individuals should write their ull name starting rom the irst block o Last Name/Surname. I the
name is longer than the space provided or the last name, it can be continued in the space provided
for First and Middle Name.
 For example XYZ DATA CORPORATION (INDIA) PRIVATE LIMITED should be written as :
Last
X Y Z D A T A C O R P O R A T I O N ( I N D
Name/Surname
First Name I A ) P R I V A T E L I M I T E D
Middle Name

For example MANOJ MAFATLAL DAVE (HUF) should be written as :

Last
M A N O J M A F A T L A L D A V E ( H U F )
Name/Surname
First Name
Middle Name

In case o Company, the name should be provided without any abbreviations. For example,
dierent variations o ‘Private Limited’ viz. Pvt Ltd, Private Ltd, Pvt Limited, P Ltd, P. Ltd., P. Ltd are
not allowed. It should be ‘Private Limited’ only.

In case o sole proprietorship concern, the proprietor should apply or PAN in his/her own name.
Name should not be preixed with any title such as Shri, Smt, Kumari, Dr., Major, M/s etc.

Abbreviation o the Individual applicants should provide ull/abbreviated name to be printed on the PAN card. Name, i
full name to be abbreviated, should necessarily contain the last name. For example:
printed on the PAN
SATYAM VENKAT M. K. RAO which is written in the Name ield as:
card
Last
Name/Surname
R A O
First Name S A T Y A M
Middle Name V E N K A T M K

Can be written as in ‘Name to be printed on the PAN Card’ column as SATYAM VENKAT M. K. RAO
or S. V. M. K. RAO or SATYAM V. M. K. RAO
For non-individual applicants, this should be same as last name ield in item no. 1 above.

2 Details of Parents Instructions in Item No.1 with respect to name apply here.
(Applicable to Father’s Name: It is mandatory or Individual applicants to provide ather’s name. Married woman
Individuals only) applicant should also give ather’s name and not husband’s name.
Mother’s Name: This is an optional ield.
Appropriate flag should be selected to indicate the name (out of the father’s name and mother’s
given in the orm) to be printed on the PAN card.
I none o the option is selected, then ather’s name shall be considered or printing on the PAN card.
3 Date of Birth/ Date cannot be a uture date. Date: 2nd August 1975 should be written as:
Incorporation/
D D M M Y Y Y Y
Agreement/
Partnership or 0 2 0 8 1 9 7 5
Trust Relevant date or dierent categories o applicants is:
Deed/Formation
Individual: Actual Date o Birth; Company: Date o Incorporation; Association o Persons: Date o
o Body o
ormation/creation; Trusts: Date o creation o Trust Deed; Partnership Firms: Date o Partnership
Individuals/
Deed; LLPs: Date o Incorporation/Registration; HUFs: Date o creation o HUF and or ancestral
Association of
HUF date can be 01-01-0001 where the date o creation is not available.
Persons
4 Gender This ield is mandatory or Individuals. Field should be let blank in case o other applicants.

5&6 Photo/signature Individuals issued a PAN card with incorrect/unclear photograph/signature should tick the box on
Mismatch the left margin.
7 Address for Indicate either Residence or Office address for communication as the case may be.
Communication-
(1) For Individuals, HUF, AOP, BOI or AJP, either o residential or oice address is mandatory.
Residence and
(2) In case o Firm, LLP, Company, Local Authority and Trust, Name o oice and complete
office
address o oice is mandatory.
For all categories o applicants, it is necessary to mention complete address and the details o
Town/City/District, State/Union Territory and PINCODE are mandatory.
In case, a oreign address is provided then it is mandatory to provide Country Name along with ZIP
Code o the country.
8 Update I applicant wishes to update other address, besides address or communication, box on let margin
other should be ticked and details o address be provided on an additional sheet in similar ormat as
address prescribed in Item No. 7.
9 Telephone (1) Telephone number should include country code (ISD code) and STD code or Mobile No.
Number and should include Country code (ISD Code).
E-mail ID For example :
(i) Telephone number 23555705 o Delhi should be written as
Country code STD Code Telephone Number / Mobile number
9 1 1 1 2 3 5 5 5 7 0 5

Where ‘91’ is the country code o India and 11 is the STD Code o Delhi.
(ii) Mobile number 9102511111 o India should be written as

Country code STD Code Telephone Number / Mobile number

9 1 9 1 0 2 5 1 1 1 1 1

Where ‘91’ is the country code o India.

(2) It is mandatory or the applicants to mention either their “Telephone number’’ or valid “e-mail
id’’ so that they can be contacted in case o any discrepancy in the application and/or or
receiving PAN through e-mail.
(3) Application status updates are sent using the SMS acility on the mobile numbers mentioned
in the application form.
10 AADHAAR Aadhaar Number
number (if As per provisions o section 139AA o Income Tax Act, 1961, Aadhaar number, i allotted shall
allotted) be provided or the purpose o linking o Aadhaar with PAN. Copy o Aadhaar letter/card shall be
provided as proo o Aadhaar.
Name as per Aadhaar letter/card
• I the Aadhaar is provided by the applicant, then name as per AADHAAR letter/card has to be
provided;
Supporting documents o Proo o Identity, Address and Date o Birth (other than Aadhaar) as
speciied in Rule 114(4) o Income Tax Rules, 1962 will be applicable or cases where there is
mismatch in PAN application and Aadhaar data or the applicant is covered by Ministry o Finance,
Government o India notiication No. 37/2017, F. No. 370133/6/2017-TPL dated May 11, 2017.
11 Mention other All PANs inadvertently allotted other than the one illed at the top o the orm (the one currently used)
Permanent should be mentioned and the copy o corresponding PAN card(s) to be submitted or cancellation
Account with the orm.
Number (PANs)
inadvertently
allotted to you
12 Signature / Thumb Application must be signed by (i) the applicant; or (ii) Karta in case o HUF; or (iii) Director o a
impression Company; or (iv) Authorised Signatory in case o AOP, Body o Individuals, Local Authority and
Artiicial Juridical Person; or (v) Partner in case o Firm/LLP; or (vi) Trustee; or (vii) Representative
Assessee in case o Minor/deceased/idiot/lunatic/mentally retarded.
Applications not signed in the given manner and in the space provided are liable to be rejected.
 GENERAL INFORMATION FOR APPLICANTS

(a) Applicants may obtain the ‘Request or New PAN Card or/and Changes or Correction in PAN Data’ Form in the ormat prescribed by
Income Tax Department rom any IT PAN Service Centres (managed by UTIITSL) or TIN-Facilitation Centres (TIN-FCs)/PAN Centres
(managed by NSDL e-Gov), or any other stationery vendor providing such orms or download rom the Income Tax Department
website ([Link]) / UTIITSL website ([Link]) / NSDL e-Gov website ([Link]).

(b) The ee or processing PAN application is ` 110/- (including goods & service tax). In case, the PAN card is to be dispatched
outside India then additional dispatch charge of ` 910/- will have to be paid by applicant.

(c) It is mandatory to attach proo o identity, proo o address and proo o date o birth with PAN application. Changes or corrections
desired in PAN particulars should be supported by any one or combination o the relevant documents mentioned below :

Document acceptable as proof of identity, address and date of birth as per Rule 114 of Income Tax Rules, 1962
Proof of Identity Proof of Address Proof of date of birth
Indian Citizens (including those located outside India)
Individuals & HUF
(i) Copy of (i) Copy of Copy of the following documents
a. Aadhaar Card issued by the Unique a. Aadhaar Card issued by the Unique if they bear the name, date, month
Identiication Authority o India; or Identiication Authority o India; or and year of birth of the applicant,
b. Elector’s photo identity card; or b. Elector’s photo identity card; or namely:-
c. Driving License; or c. Driving License; or a. Aadhaar Card issued by the Unique
d. Passport; or d. Passport; or Identifcation Authority o India; or
e. Ration card having photograph o e. Passport o the spouse; or b. Elector’s photo identity card; or
the applicant; or . Post oice passbook having address c. Driving License; or
. Arm’s license; or o the applicant; or d. Passport; or
g. Photo identity card issued by the g. Latest property tax assessment e. Matriculation Certifcate or Mark
Central Government or State order; or Sheet o recognized board; or
Government or Public Sector h. Domicile certiicate issued by the . Birth Certifcate issued by the
Undertaking; or Government; or Municipal Authority or any ofce
h. Pensioner card having photograph i. Allotment letter of accommodation authorized to issue Birth and Death
o the applicant; or issued by Central or State Certifcate by the Registrar o Birth
i. Central Government Health Government o not more than three and Death or the Indian Consulate
Service Scheme Card or Ex- years old; or as defned in clause (d) o sub-
Servicemen Contributory Health j. Property Registration Document; or section (1) o section 2 o the
Scheme photo card; or Citizenship Act, 1955 (57 o1955);
(ii) Copy of following documents of or
(ii) Certiicate o identity in Original not more than three months old g. Photo identity card issued by
signed by a Member o Parliament (a) Electricity Bill; or the Central Government or State
or Member o Legislative Assembly (b) Landline Telephone or Broadband Government or Public Sector
or Municipal Councilor or a Gazetted connection bill; or Undertaking or State Public Sector
oicer, as the case may be; or (c) Water Bill; or Undertaking; or
(d) Consumer gas connection card or h. Domicile Certifcate issued by the
(iii) Bank certificate in Original on letter
book or piped gas bill; or Government; or
head rom the branch (alongwith
(e) Bank account statement or as per i. Central Government Health
name and stamp of the issuing
Note 2; Service Scheme photo Card or Ex-
oicer) containing duly attested
or Servicemen Contributory Health
photograph and bank account
() Depository account statement; or Scheme photo card; or
number of the applicant
(g) Credit card statement; or j. Pension payment order; or
(iii) Certiicate o address in Original k. Marriage certifcate issued by
signed by a Member o Parliament Registrar o Marriages; or
or Member o Legislative Assembly l. Afdavit sworn beore a magistrate
or Municipal Councilor or a Gazetted stating the date of birth.
oicer, as the case may be; or
(iv) Employer certiicate in original.
Note: Note:
1. In case o Minor, any o the above 1. Proo o Address is required or
mentioned documents as proof of residence address mentioned in
identity and address o any o item no. 7.
parents/guardians of such minor 2. In case o an Indian citizen residing
shall be deemed to be the proof outside India, copy o Bank Account
o identity and address or the minor Statement in country o residence or
applicant. copy o Non-resident External (NRE)
2. For HUF, an aidavit made by the bank account statements (not more
Karta o Hindu Undivided Family than three months old) shall be the
stating name, ather’s name and proof of address.
address of all the coparceners on
the date o application and copy o
any o the above documents in the
name of Karta of HUF is required as
proo o identity, address and date o
birth.
Other than Individuals and HUF
1 Company Copy o Certiicate o Registration issued by the Registrar o Companies.
2 Partnership Firm Copy o Certiicate o Registration issued by the Registrar o Firms or Copy o
partnership deed.
3 Limited Liability Partnership Copy o Certiicate o Registration issued by the Registrar o LLPs
4 Association o Persons (Trust) Copy o trust deed or copy o certiicate o registration number issued by Charity
Commissioner.
5 Association o Persons, Body o Copy o Agreement or copy o certiicate o registration number issued by charity
Individuals, Local Authority, or commissioner or registrar o cooperative society or any other competent authority or
Artificial Juridical Person any other document originating rom any Central or State Government Department
establishing identity and address o such person.

Foreign Citizens
Individuals not being a Citizen of India
Proof of Identity Proof of Address
(a) Copy o passport, or (a) Copy o Passport, or
(b) Copy o Person o Indian Origin (PIO) card issued by (b) Copy o Person o Indian Origin (PIO) card issued by
Government o India, or Government o India, or
(c) Copy o Overseas Citizen o India (OCI) card issued by (c) Copy o Overseas Citizen o India (OCI) card issued by
Government o India, or Government o India, or
(d) Copy o other national or citizenship Identiication Number (d) Copy o other national or citizenship Identiication Number or
or Taxpayer Identiication Number duly attested by Taxpayer Identiication Number duly attested by “Apostille’’
“Apostille’’ (in respect o countries which are signatories (in respect o the countries which are signatories to the
to the Hague Convention o 1961) or by the Indian Hague Convention o 1961) or by the Indian Embassy or
Embassy or High Commission or Consulate in the High Commission or Consulate in the country where the
country where the applicant is located or authorised applicant is located, or authorised oicials o overseas
oicials o overseas branches o Scheduled Banks branches of Scheduled Banks registered in India or
registered in India. (e) Copy o Bank account statement in the country o residence,
or
() Copy o Non-resident External (NRE) bank account
statement in India, or
(g) Copy o Certiicate o Residence in India or Residential
permit issued by the State Police Authorities, or
(h) Copy o Registration certiicate issued by the Foreigner’s
Registration Oice showing Indian address, or
(i) Copy o Visa granted & Copy o appointment letter or
contract rom Indian Company & Certiicate (in original) o
Indian address issued by the employer.
 For other than Individuals (Foreign companies/Entities incorporated outside India/Unincorporated entities formed outside India)
(a) Copy o Certiicate o Registration issued in the country (a) Copy o Certiicate o Registration issued in the country
where the applicant is located, duly attested by where the applicant is located, duly attested by “Apostille’’
“Apostille’’ (in respect o the countries which are (in respect o the countries which are signatories to the
signatories to the Hague Convention o 1961) or by the Hague Convention o 1961) or by the Indian Embassy or
Indian Embassy or High Commission or Consulate in the High Commission or Consulate in the country where the
country where the applicant is located, or authorised applicant is located, or authorised oicials o overseas
oicials o overseas branches o Scheduled Banks branches o Scheduled Banks registered in India, or
registered in India, or
(b) Copy o registration certiicate issued in India or o approval
(b) Copy o registration certiicate issued in India or o approval granted to set up oice in India by Indian Authorities.
granted to set up oice in India by Indian Authorities.
Proof of PAN
(a) Copy o PAN Card; or
(b) Copy o PAN Allotment Letter
Note: No other document shall be accepted as Proof of PAN. I proo is not provided then application shall be accepted on a
‘good effort basis’.
Supporting document required for changes in PAN data
Case/Applicant type Document acceptable for change of name/father’s name
Married ladies - change of name on account of marriage - Marriage certiicate or
- Marriage invitation card or
- Copy o passport showing husband’s name
- Publication o name change in oicial gazette or
- Certiicate issued by a Gazetted oicer (only or change
in applicant’s name)
Individual applicants other than married ladies - Publication o name change in oicial gazette or
- Certiicate issued by a Gazetted oicer (only or change
in applicant’s name)
Companies - ROC’s certiicate or name change
Firms / Limited Liability Partnerships - Revised partnership deed
- Registrar o Firm/LLP’s certiicate or name change
AOP/Trust/BOI/AJP/LOCAL authority - Revised Deed/ Agreement
- Revised registration certiicate

(d) Applicant will receive an acknowledgement containing a unique number on acceptance o this orm. This acknowledgement
number can be used for tracking the status of the application.
(e) For more inormation / Application status enquiry contact:

Mode Income-tax Department NSDL e-Gov

Website [Link] [Link]
Call Center 1800-180-1961 020-27218080
Email ID tininfo@[Link]
SMS SMS NSDLPAN <space>
Acknowledgement No. & send to 57575 to obtain application status.
For example → Type ‘NSDLPAN 881010101010100’ and
send to 57575
Address INCOME TAX PAN SERVICES UNIT (Managed by NSDL
e-Governance Inrastructure Limited), 5th Floor, Mantri Sterling, Plot
No. 341, Survey No. 997/8, Model Colony, Near Deep Bungalow
Chowk, Pune - 411 016.