Www.utiitsl.com Forms Forms 49a 363f6u
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Form No. 49A Application for Allotment of Permanent Number [In the case of Indian Citizens/Indian Companies/Entities incorporated in India/ Unincorporated entities formed in India]
Only ‘Individuals’ to affix recent photograph (3.5 cm x 2.5 cm)
Only ‘Individuals’ to affix recent photograph (3.5 cm x 2.5 cm)
Under section 139A of the Income Tax Act, 1961 avoid mistake (s), please follow the accompanying instructions and examples before filling up the form
Assessing officer (AO code) Area code
Sign/ leftTumb impression across this photo
AO type
Range code
AO No. Signature/Left Thumb Impressi on
I/We hereby request that a permanent number be allotted to me/us. I/We give below necessary particulars:
1 Full Name (Full expanded name to be mentioned as appearing in proof of identity/address documents: initials are not permitted)
L
Please select title,
as applicable
Shri
Smt.
Kumari
M/s
Last Name / Surname First Name Middle Name
2 Abbreviation of the above name, as you would like it, to be printed on the PAN card
3 Have you ever been known by any other name?
Yes
No
(Pleasetick as applicable)
If yes, please give that other name
L
Please select title,
as applicable
Shri
Smt.
Kumari
Male
Female
M/s
Last Name / Surname First Name Middle Name
4 Gender (for Individual applicants only)
(Please tick as applicable)
5 Date of Birth/Incorporation/Agreement/Partnership or Trust Deed/ Formation of Body of individuals or Association of Persons Day
Month
Year
6 Father's Name (Only 'Individual' applicants: Even married women should fill in father's name only) Last Name / Surname First Name Middle Name
7 Address Residence Address Flat/Room/ Door / Block No. Name of Premises/ Building/ Village Road/Street/ Lane/Post Office Area / Locality / Taluka/ Sub- Division Town / City / District State / Union Territory
Pincode / Zip code
Country Name
Office Address Name of office Flat/Room/ Door / Block No. Name of Premises/ Building/ Village Road/Street/ Lane/Post Office Area / Locality / Taluka/ Sub- Division Town / City / District State / Union Territory
8 Address
for Communication
Pincode / Zip code
Residence
Country Name
Office
(Please tick as applicable)
9 Telephone Number & Email ID details Country code
Area/STD Code
Telephone / Mobile number
Email ID
10 Status of applicant Please select status,
LD
as applicable
Government
Individual
Hindu undivided family
Company
Partnership Firm
Association of Persons
Trusts
Body of Individuals
Local Authority
Artificial Juridical Persons
Limited Liability Partnership
11 Registration Number (for company, firms, LLPs, etc.)
12 Incase of a citizen of India, then Please mention your AADHAAR number (if allotted)
13 Source of income
Please select status,
Salary
L
as applicable
Capital Gains
Income from Business / Profession
Business/Profession code
Income from Other sources
[For Code: Refer instructions]
Income from House property
No income
14 Representative Assessee (RA) Full name, address of the Representative Assessee, who is assessable under the Income Tax Act in respect of the person, whose particulars have been given in the column 1-13.
Full Name (Full expanded name: initials are not permitted) Please select title,
L
Shri
as applicable
Smt.
Kumari
M/s
Last Name / Surname First Name Middle Name Address Flat/Room/ Door / Block No. Name of Premises/ Building/ Village Road/Street/ Lane/Post Office Area / Locality / Taluka/ Sub- Division Town / City / District State / Union Territory
Pincode
15 Documents submitted as Proof of Identity(POI) and Proof of Address (POA) I/We have enclosed
as proof of identity and
as proof of address. [Please refer to the instructions (as specified in Rule 114 of I.T. Rules, 1962) for list of mandatory certified documents to be submitted as applicable] , the applicant, in the capacity of
16 I/We
do hereby declare that what is stated above is true to the best of my/our information and belief. Place D D M M Y Date
Y
Y
Y
Signature/Left Thumb Impression of Applicant (inside the box)
Form to be filled legibly in BLOCK LETTERS and preferably in BLACK INK. Form should be filled in English only. Each box, wherever provided, should contain only one character (alphabet /number / punctuation sign) leaving a blank box after each word. ‘Individual' applicants should affix two recent colour photographs with white backgrounds (size 3.5 cm x 2.5 cm) in the space provided on the form. The photographs should not be stapled or clipped to the form. The clarity of image on PAN card will depend on the quality and clarity of photograph affixed on the form. d) Signature / Left hand thumb impression should be provided across the photo affixed on the left side of the form in such a manner that portion of signature/impression is on photo as well as on form e) Signature /Left hand thumb impression should be within the box provided on the right side of the form. The signature should not be on the photograph affixed on right side of the form. If there is any mark on this photograph such that it hinders the clear visibility of the face of the applicant, the application will not be accepted. f) Thumb impression, if used, should be attested by a Magistrate or a Notary Public or a Gazetted Officer under official seal and stamp. g) AO code (Area Code, AO Type, Range Code and AO Number) of the Jurisdictional Assessing Officer must be filled up by the applicant. These details can be obtained from the Income Tax Office Or IT PAN Service Centers may (managed by UTIITSL) Or UTIITSL website www.utiitsl.com h) Guidelines for filling the Form49A: a) b) c)
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AADHAAR number if allotted has to be quoted (ed by copy of AADHAAR Letter/Card)
Code 1 2 3 4 5 6 7 8 9 10
Business/Profession Medical Profession and Business Engineering Architecture Chartered ant/ancy Interior Decoration Technical Consultancy Company Secretary Legal Practitioner and Solicitors Government Contractors Insurance Agency
Code 11 12 13 14 15 16 17 18 19 20
Business/Profession Films, TV and such other entertainment Information Technology Builders and Developers of Stock Exchange, Share Brokers and Sub-Brokers Performing Arts and Yatra Operation of Ships, Hovercraft, Aircrafts or Helicopters Plying Taxis, Lorries, Trucks, Buses or other Commercial Vehicles Ownership of Horses or Jockeys Cinema Halls and Other Theatres Others
1. In case of Minor, any of the above mentioned documents as proof of Identity and Address of any of parents/guardians of such minor shall be deemed to be the proof of identity and address for the minor applicant.
2. For HUF an affidavit made by the Karta of Hindu Undivided Family stating name, father’s name and address of all the coparceners on the date of application and copy of any of the above documents in the name of Karta of Huf is required.
1. Proof of Address is required for residential address mentioned in item no. 7 2. In case of an Indian Citizen residing outside India, copy of Bank statement in country of residence or copy of Non-resident External ( NRE ) bank statement
or State
a. b. c.
d.
Authorized Signatory
Navi Mumbai UTI Infrastructure Technology & Services Ltd. P. B NO 20, Plot no 3, Sector-11 CBD- Belapur, Navi Mumbai- 400614 Telephone: (022) 67931300 Fax : (022) 67931399 Email ID : [email protected]
New Delhi UTI Infrastructure Technology & Services Ltd. Ground Floor, Jeevan Tara Building Opp Patel Chowk Metro Station 5, Parliament Street, New Delhi- 110001 Telephone : (011) 23741282-86 Fax: (011 ) 23741280 Email ID :- [email protected]
Only ‘Individuals’ to affix recent photograph (3.5 cm x 2.5 cm)
Only ‘Individuals’ to affix recent photograph (3.5 cm x 2.5 cm)
Under section 139A of the Income Tax Act, 1961 avoid mistake (s), please follow the accompanying instructions and examples before filling up the form
Assessing officer (AO code) Area code
Sign/ leftTumb impression across this photo
AO type
Range code
AO No. Signature/Left Thumb Impressi on
I/We hereby request that a permanent number be allotted to me/us. I/We give below necessary particulars:
1 Full Name (Full expanded name to be mentioned as appearing in proof of identity/address documents: initials are not permitted)
L
Please select title,
as applicable
Shri
Smt.
Kumari
M/s
Last Name / Surname First Name Middle Name
2 Abbreviation of the above name, as you would like it, to be printed on the PAN card
3 Have you ever been known by any other name?
Yes
No
(Pleasetick as applicable)
If yes, please give that other name
L
Please select title,
as applicable
Shri
Smt.
Kumari
Male
Female
M/s
Last Name / Surname First Name Middle Name
4 Gender (for Individual applicants only)
(Please tick as applicable)
5 Date of Birth/Incorporation/Agreement/Partnership or Trust Deed/ Formation of Body of individuals or Association of Persons Day
Month
Year
6 Father's Name (Only 'Individual' applicants: Even married women should fill in father's name only) Last Name / Surname First Name Middle Name
7 Address Residence Address Flat/Room/ Door / Block No. Name of Premises/ Building/ Village Road/Street/ Lane/Post Office Area / Locality / Taluka/ Sub- Division Town / City / District State / Union Territory
Pincode / Zip code
Country Name
Office Address Name of office Flat/Room/ Door / Block No. Name of Premises/ Building/ Village Road/Street/ Lane/Post Office Area / Locality / Taluka/ Sub- Division Town / City / District State / Union Territory
8 Address
for Communication
Pincode / Zip code
Residence
Country Name
Office
(Please tick as applicable)
9 Telephone Number & Email ID details Country code
Area/STD Code
Telephone / Mobile number
Email ID
10 Status of applicant Please select status,
LD
as applicable
Government
Individual
Hindu undivided family
Company
Partnership Firm
Association of Persons
Trusts
Body of Individuals
Local Authority
Artificial Juridical Persons
Limited Liability Partnership
11 Registration Number (for company, firms, LLPs, etc.)
12 Incase of a citizen of India, then Please mention your AADHAAR number (if allotted)
13 Source of income
Please select status,
Salary
L
as applicable
Capital Gains
Income from Business / Profession
Business/Profession code
Income from Other sources
[For Code: Refer instructions]
Income from House property
No income
14 Representative Assessee (RA) Full name, address of the Representative Assessee, who is assessable under the Income Tax Act in respect of the person, whose particulars have been given in the column 1-13.
Full Name (Full expanded name: initials are not permitted) Please select title,
L
Shri
as applicable
Smt.
Kumari
M/s
Last Name / Surname First Name Middle Name Address Flat/Room/ Door / Block No. Name of Premises/ Building/ Village Road/Street/ Lane/Post Office Area / Locality / Taluka/ Sub- Division Town / City / District State / Union Territory
Pincode
15 Documents submitted as Proof of Identity(POI) and Proof of Address (POA) I/We have enclosed
as proof of identity and
as proof of address. [Please refer to the instructions (as specified in Rule 114 of I.T. Rules, 1962) for list of mandatory certified documents to be submitted as applicable] , the applicant, in the capacity of
16 I/We
do hereby declare that what is stated above is true to the best of my/our information and belief. Place D D M M Y Date
Y
Y
Y
Signature/Left Thumb Impression of Applicant (inside the box)
Form to be filled legibly in BLOCK LETTERS and preferably in BLACK INK. Form should be filled in English only. Each box, wherever provided, should contain only one character (alphabet /number / punctuation sign) leaving a blank box after each word. ‘Individual' applicants should affix two recent colour photographs with white backgrounds (size 3.5 cm x 2.5 cm) in the space provided on the form. The photographs should not be stapled or clipped to the form. The clarity of image on PAN card will depend on the quality and clarity of photograph affixed on the form. d) Signature / Left hand thumb impression should be provided across the photo affixed on the left side of the form in such a manner that portion of signature/impression is on photo as well as on form e) Signature /Left hand thumb impression should be within the box provided on the right side of the form. The signature should not be on the photograph affixed on right side of the form. If there is any mark on this photograph such that it hinders the clear visibility of the face of the applicant, the application will not be accepted. f) Thumb impression, if used, should be attested by a Magistrate or a Notary Public or a Gazetted Officer under official seal and stamp. g) AO code (Area Code, AO Type, Range Code and AO Number) of the Jurisdictional Assessing Officer must be filled up by the applicant. These details can be obtained from the Income Tax Office Or IT PAN Service Centers may (managed by UTIITSL) Or UTIITSL website www.utiitsl.com h) Guidelines for filling the Form49A: a) b) c)
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AADHAAR number if allotted has to be quoted (ed by copy of AADHAAR Letter/Card)
Code 1 2 3 4 5 6 7 8 9 10
Business/Profession Medical Profession and Business Engineering Architecture Chartered ant/ancy Interior Decoration Technical Consultancy Company Secretary Legal Practitioner and Solicitors Government Contractors Insurance Agency
Code 11 12 13 14 15 16 17 18 19 20
Business/Profession Films, TV and such other entertainment Information Technology Builders and Developers of Stock Exchange, Share Brokers and Sub-Brokers Performing Arts and Yatra Operation of Ships, Hovercraft, Aircrafts or Helicopters Plying Taxis, Lorries, Trucks, Buses or other Commercial Vehicles Ownership of Horses or Jockeys Cinema Halls and Other Theatres Others
1. In case of Minor, any of the above mentioned documents as proof of Identity and Address of any of parents/guardians of such minor shall be deemed to be the proof of identity and address for the minor applicant.
2. For HUF an affidavit made by the Karta of Hindu Undivided Family stating name, father’s name and address of all the coparceners on the date of application and copy of any of the above documents in the name of Karta of Huf is required.
1. Proof of Address is required for residential address mentioned in item no. 7 2. In case of an Indian Citizen residing outside India, copy of Bank statement in country of residence or copy of Non-resident External ( NRE ) bank statement
or State
a. b. c.
d.
Authorized Signatory
Navi Mumbai UTI Infrastructure Technology & Services Ltd. P. B NO 20, Plot no 3, Sector-11 CBD- Belapur, Navi Mumbai- 400614 Telephone: (022) 67931300 Fax : (022) 67931399 Email ID : [email protected]
New Delhi UTI Infrastructure Technology & Services Ltd. Ground Floor, Jeevan Tara Building Opp Patel Chowk Metro Station 5, Parliament Street, New Delhi- 110001 Telephone : (011) 23741282-86 Fax: (011 ) 23741280 Email ID :- [email protected]
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