FORM NO. 49A
Application For Allotment of Permanent Account Number
( Under Section 139A of the Income-Tax Act, 1961. )

(To avoid mistake(s), please follow the accompanying instructions and examples carefully before filling up the form)

To

The Assessing Officer

                                                                    
                                                                     
                                                                    

Sir,

Whereas my/our total income/ the total income of                                                                        
In respect of which I/We am/are assessable under the income-tax act, 1961, during the accounting year ending on              
DD MM YYYY
exceeded rupees                                        the minimum amount which is not chargeable to income-tax:

Whereas my/our case doesn't fill under sub-section (1) of section 139 and I am/we are carrying on business the total sales/turnover/gross receipts of which are or is likely to exceed fifty thousand rupees in the accounting year ending on
            DD MM YYYY
exceeded rupees                                        the minimum amount which is not chargeable to income-tax:

Whereas my/our case does not fill under sub-section 139A, and I my/we required to furnish a return of income under sub-section (1A) of section 139 for the accounting year ending on
             DD MM YYYY

And whereas no Permanent Account Number has been allotted to me/us.

* Though earlier PAN had been allotted to across, no permanent account number under new series has been allotted;
* I/we hereby request that a permanent account number/permanent account number under new series be allotted to me/us;

* Applicable in places notified by the Board under Subsection(4) of Section 139A of the Income Tax Act, 1961.
I/we give below the necessary particulars:-

Please fill as applicable       ( Shri / Smt./ Kumari / M/s )
1. Full Name (no initials please)
Last Name/Surname
                                                                              
First Name                                                                             
Middle Name                                                                             
2. Have you ever been known by any other name? (Yes/No)
If yes, please give other name (no initials please)
Please fill as applicable  ( Shri / Smt./ Kumari / M/s )
Last Name/Surname                                                                                   
First Name                                                                             
Middle Name                                                                           
3. Address

A. Residential Address
Flat/Door/Block No.                                                    
Name of Premises/Building/Village                                                 
Road/Street/Lane/Post Office                                                 
Area/Locality/Teluka/Sub-Division                                                  
Town/City/District                                                   
State/Union Territory                                                  
Pin                                                  
B. Office Address
Flat/Door/Block No.                                                    
Name of Premises/Building/Village                                                 
Road/Street/Lane/Post Office                                                 
Area/Locality/Teluka/Sub-Division                                                  
Town/City/District                                                   
State/Union Territory                                                  
Pin                                                  
4. Email Address                                                 
5. Status of the Applicant  (Individual/Hindu Undivided Family/Company/Firm/Association Of Person/Association Of Persons(Trust)/Body Of Individuals/Local AuthorityArtificial Judicial Person)
6. If any individual, please give Father's Name (no initials please)
Last Name/Surname                                                 
First Name                                                 
Middle Name                                                 
7. Sex (For Individual Applicant only) (Male/Female)
8. Date of   (Birth /Incorporation/Agreement/Partnership or Trust Deeds/Formation Of Body Of Individuals/Association Of Persons)
9. Whether citizen of India?  (Yes/No)
10. Registration Number (In case of Firms, Companies etc.)                                                  
11. Source(s) of Income  ( Saleries / House Property / Business 0r Profession /Capital Gains / Income From Other Source(s) )
12. Particulars of Business, if any
HEAD OFFICE
Name of Office
                                                                                     
Flat/Door/Block No.                                                
Name of Premises/Building/Village                                                
Road/Street/Lane/Post Office                                                
Area/Locality/Taluka/Sub-Division                                                
Town/City/District                                                
State/Union Territory                                                
Pin                                                
  • Nature of Business
                                               
  • Tax Deduction Amount No. if any
                                               
  • Date of commencement
    DD MM YYYY
  • No. of Branches
                                               
BRANCHES (If required, please add in the given boxes below)
Name of Branch (No.1)                                                                              
Flat/Door/Block No.                                                
Name of Premises/Building/Village                                                
Road/Street/Lane/Post Office                                                
Area/Locality/Taluka/Sub-Division                                                
Town/City/District                                                
State/Union Territory                                                
Pin                                                
  • Nature of Business
                                               
  • Tax Deduction Account No, if any

                                               
  • Date of commencement :

    DD MM YYYY
Name of Branch (No.2)
                                                                     
Flat/Door/Block No.                                                
Name of Premises/Building/Village                                                
Road/Street/Lane/Post Office                                                
Area/Locality/Taluka/Sub-Division                                                
Town/City/District                                                
State/Union Territory                                                
Pin                                                
  • Nature of Business
                                               
  • Tax Deduction Account No, if any
                                               
  • Date of commencement
    DD MM YYYY

13. If Firm/Hindu Undivided Family/Association of Persons/Body of Individuals/Company, the names, Addresses etc. of Partners/Members/Directors/ (For information about more persons, please add separate sheet(s) in the format given below)

DETAILS OF PARTNERS/MEMBERS/DIRECTORS
a) Number of (Partners/Members/Directors)
No.

Please fill as applicable

(Shri / Smt. / Kumari / M/S)
b) Full Name of the first member/partner etc. (no initials please)
Last Name/Surname                                                                     
First Name                                                                     
Middle Name                                                                     
c) Address
Flat /Door/Block No.                                                                     
Name of Premises/Building/Village                                                             
Road/Street/Lane/Post Office                                                             
Area/Locality/Taluka/SubDivision                                                             
Town/City/District                                                             
State/Union Territory                                                             
Pin                                                             
Last Name/Surname                                                                  
First Name                                                                  
Middle Name                                                                  
c) Address
Flat /Door/Block No.                                                                  
Name of Premises/Building/Village                                                             
Road/Street/Lane/Post Office                                                             
Area/Locality/Taluka/SubDivision                                                             
Town/City/District                                                             
State/Union Territory                                                             
Pin                                                             
14. Full Name, address of the representative assessable under the Income Tax Act in respect of the person, whose particulars have been given in column 1 to 13 (Please see Instruction no.14)
Please fill as applicable (Shri / Smt. / Kumari / M/S)
Full Name(no initials please)
Last Name/Surname                                                             
First Name                                                             
Middle Name                                                             
Address
Flat/Door/Block No.                                                             
Name of Premises/Building/Village                                                             
Road/Street/Lane/Post Office                                                             
Area/Locality/Taluka/Sub-Division                                                             
Town/City/District                                                         
State/Union Territory                                                   
Pin                                             
15.(i) Permanent Account Number, if any allotted earlier*
(ii) GIR No., if any allotted earlier
(iii) Ward/Circle/Range

I/We,                                                                     , the applicant, do hereby declare that what is stated above is true to the best of my/our information and belief.

*Applicable in places notified by the Board under Subsection(4) of Section 139A of the Income Tax Act, 1961.
Verified today, the
    DD MM YYYY