Form 49AA

Application (PAN Card India) for allotment of Permanent Account Number - Form 49AA
Date: 23-Jul-2017
Under section 139A of the Income-Tax Act, 1961
To avoid mistakes, please refer Guidelines and Instructions
Status of the Applicant.*
Please select this first
To,
The Assessing Officer
AREACODE AO Type Range Code AO No
Sir,
 I/We hereby request that a permanent account number be allotted to me/us.
 I/We give below the necessary details:

1. Full Name (Full expanded name mentioned as appearing in proof of identity/address documents: initials are not permitted)*
Last Name/Surname
First Name
Middle Name
2. Abbreviations of the above name, as you would like it, to be printed on the PAN card *
3. Have you been known by any other name?
4. Gender (for Individual applicants only) *
5. Date of Birth / Incorporation/Agreement/Partnership or Trust Deed/Formation of Body of Individuals/Association of Persons *  
6. Details of Parents(applicable only for Individual applicants) *
Father's Name(Mandatory - Even married woman should fill in father'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)

7. Address *
  Residential Address
Flat/Door/Block Number
Name of Premises/Building/Village
Road/Street/Lane/Post Office
Area/Locality/Taluka/Sub-Division
Town/City/District
State/Union Territory
Pincode
Country Name
Office Address
Name of the Office
Flat/Door/Block Number
Name of Premises/Building/Village
Road/Street/Lane/Post Office
Area/Locality/Taluka/Sub-Division
Town/City/District
State/Union Territory
Pincode
Country Name
8. Address for Communication *
9. Telephone number Telephone ISD Code

Area/STD Code

Telephone/Mobile number*
Email ID *
12. Country Of Citizenship *
ISD Code Of the Country Of Citizenship*

13. Source Of Income *
  Are you a salaried Employee?  
Are you are engaged in a business / profession?
 Income from House Property
 Capital Gains
 Income from Other source
 No Income

14. Representative or Agent of the Applicant in India
Full name and address of the Representative Assessee, who is assessable under the Income Tax Act in respect of the person, whose particulars have been given above
Last Name/Surname
First Name
Middle Name
Flat/Door/Block Number
Name of Premises/Building/Village
Road/Street/Lane/Post Office
Area/Locality/Taluka/Sub-Division
Town/City/District
State/Union Territory

15.Documents submitted as Proof of Identity(POI),Proof of Address(POA)
Which of these documents are you submitting as an Identity Proof *
Which of these documents are you submitting as an Address Proof *

16. KYC Details* [To be filled in by foreign institutional investor or a Qualified foreign investor, as prescribed under the regulations issued by the Securities and Exchange Board of India (SEBI)]
["Control" as defined under SEBI(Substantial Acquisition of Shares and Takeovers) Regulations,1997
"Beneficial Owner" as defined in the para 5.1 of SEBI circular dated December 31,2010 on Anti Money laundering.]
(a) Incase of Individuals
Marital status                         Single                         Married                       Divorced                             Widow/Widower
Citizenship status                                                          Foreigner                   Person of Indian Origin       Overseas Citizen of Indian
Incase of Foreigner, country of Citizenship
Occupation Details                    Private Sector     Public Sector/Govt.service     Business     Professional     Agriculturist     Retired     Housewife     Student     Others
(b) Incase of Non individuals
                                   Private Company                         Public Company                                              Body Corporate                    
                                   Financial Institution                      Non Government Organization                       Charitable Organization
(c)Gross Annual Income- INR
(d)Incase of a Public Company, whether listed on a stock exchange           Yes                 No        
If yes , then indicate the name of the stock exchange
(e)Incase of a Non-individuals
Does it have few persons or persons of the same family holding beneficial ownership and control          No
["Control" :Control shall include the right appointment majority of the directors or to control the management or policy decisions exercisable by a person or a persons acting individually or in
concert, directly or indirectly by virtue of their share holding or management rights or share holders agreements or voting agreements or in any other manner.
"Beneficial Owner" means the natural person who ultimately owns or controls the applicant and/or the person on whose behalf a transaction is being conducted, and includes a person
who exercises ultimate effective control over a juridical person]
(f)Is the entity involved / providing any of the following services
Foreign exchange, Money Changer Services           Yes                 No
Gaming/Gambling/Lottery services (Casino and Betting Syndicate)           Yes                No
Money Lending, Pawning           Yes                 No
(g)Whether the applicant or the applicant's authorised signatories/trustees/office bearers is
(i) a politically exposed person           Yes                 No
(ii) related to a politically exposed person           Yes                  No
[for definition of a politically exposed person refer to guidelines issued under the Prevention of Money Laundering Act (PMLA)]
(h)Taxpayer identification Number in the country of residence

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

Place