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

Fields marked with * (asterisk) are mandatory. . To avoid mistake(s), please refer guidelines and instructions .
* Whether citizen of India Yes No
* Permanent Account Number (PAN) AIDPL5604L
* 1. Name (Initials are not permitted in first and last name. Applicant's proof of identity, proof of address and proof of date of birth should contain the exact name mentioned in this field)
Title Shri/Mr Smt./Mrs. Kumari/Ms M/s
Last Name/Surname First Name Middle Name
LOKESH
* Name as you would like it printed on the card (Prefix like Shri, Smt, Kumari, Late, Dr, CA, Ms, Mr, Mrs, M/s, Alias etc. are not allowed)
LOKESH
Details of Parents. (Prefix like Shri, Smt, Kumari, Late, Dr, CA, Ms, Mr, Mrs, M/s, Alias etc. are not allowed.)
* 2. Father's Name (Mandatory field. Even married women should give father's name only.)
Last Name/Surname First Name Middle Name
SINGH JAGVIR
3. Mother's Name (This field is optional.)
Last Name/Surname First Name Middle Name

*4. Select Parent name which is to be printed on the card

(In case no option is provided then PAN card will be issued with father's name) Father Name Mother Name
* 5. Date of Birth/Incorporation/Agreement/Partnership DD MM YYYY
or Trust Deed/Formation of Body of Individuals/ 4 JUL 1988
Association of Persons
* 6. Gender Male Female TransGender
7. Photo Mismatch
8. Signature Mismatch
* 9. Address for Communication Residential Office
Office Name (to be filled only in case of office address)
Flat/Door/Block No. 2430/2 FRONT OF GATE NO 8
Name of Premises/Building/Village LITTLE ANGLES SCHOOL
Road/Street/Lane/Post Office PATEL NAGAR
Area/Locality/Taluka/Sub-Division
Town/City/District SONEPAT
State/Union Territory Haryana
PIN (Indicating PIN is mandatory) 131001
Country -- Please select --
Zip
10. If you desire to update your other address, give required details & Submit proof of other address also.
Country code (ISD code)
INDIA (91)
* 11. Telephone No.
(Country code is compulsory) Mobile No. Telephone No.
Area/STD Code Telephone No./Mobile No.
9467520549
E-mail ID LOKESH.SINGH0407@GMAIL.COM
In case of a citizen of India, then AADHAAR EID
282794714910
* 12. AADHAAR number : In case AADHAAR number is provided,
then proof of AADHAAR along with supporting documents is to be submitted to NSDL
* Name as per AADHAAR letter
or LOKESH
as per the enrollment ID of Aadhaar application form
13. GSTN
14. Mention other Permanent Account Numbers (PANs) if any,inadvertently allotted to you. Submit proof of surrendered PAN(s) along with the application.
PAN1 PAN2
PAN3 PAN4
15. Verification
I/We LOKESH ,the applicant,in the capacity of Himself/herself do hereby declare that what is stated above is true
to the best of my information and belief.
I have enclosed 2 (number of documents) in support of proposed changes/corrections.
Place SONEPAT
DD MM YYYY
Verified today, the 17 - 05 - 2018
I/We have enclosed Copy of AADHAAR Card issued by the Unique Identification Authority of India as
proof of identity, Copy of AADHAAR Card issued by the Unique Identification Authority of India as proof of address,
Copy of Mark sheet of recognised board as proof of date of birth and
Copy of PAN card as proof of PAN allotted.
Other Details
1. Depository Account Details
DP ID: Client ID:
2. Payment Details
Net Banking ( 110.00 ) List of Banks available
For Paperless PAN Application: Yes No
DSC Self Guidelines for DSC
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