881030215265432
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Affix recent photograph (3.5cm x 2.5cm) Affix recent photograph (3.5cm x 2.5cm) Signature/ Left Thumb Impression across this photo ACKNOWLEDGE MENT NUMBER: Category Permanent Account No. Name to be printed on card Father's Name Name Other Address Address for Communication Date of Birth Telephone No. AADHAAR No. Email ID AMJPM5824D Shri KAUSHAL B MEHTA KAUSHAL B MEHTA Shri BHARAT R MEHTA 08-10-1982 VIMALNATH APP., 46, DIGVIJAY PLOT, OPP. OSWAL SCHOOL, JAMNAGAR - 361005 Gujarat [email protected] 91 9662518547 Payment Mode Net Banking: Your Payment of 105 against transaction number 401-1105240 has been successfully processed. The following documents are enclosed as: Proof of Identity: Proof of Address: Proof of PAN: Proof of PAN to be cancelled: Any other document: Date: Copy of AADHAR Card issued by the Unique Identification Authority of India Copy of AADHAR Card issued by the Unique Identification Authority of India Copy of PAN card 25-10-2014 Signature/ Left Thumb Impression of Applicant (inside the box without touching the sides and in BLACK INK ONLY) Service Tax Code (Registration Number): AAACN2082NST001 Service Tax Registration Category: BUSINESS AUXILIARY SERVICES Individual Photo Mismatch Signature Mismatch Sex Request for cancellation of PAN(s) PAN1: PAN2: PAN3: PAN4: A 204, I/We, KAUSHAL B MEHTA the applicant, do hereby declare that what is stated above is true to the best of my/our information and belief. (PLEASE READ INSTRUCTIONS GIVEN ON NEXT PAGE) CIN U72900MH1995PLC095642 Proof of Date of birth: Copy of Birth certificate issued by the Municipal Authority or any office authorised to issue Birth and Death Certificate by the Registrar of Birth and Deaths or the Indian Consulate 881030215265432 Acknowledgement for Request for New PAN Card or/and Changes or Correction in PAN Data
description
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Transcript of 881030215265432
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Affix recentphotograph(3.5cm x 2.5cm)
Affix recentphotograph(3.5cm x 2.5cm)
Signature/ Left ThumbImpression across this photo
ACKNOWLEDGEMENT NUMBER:
Category
PermanentAccount No.
Name to beprinted on card
Father's Name
Name
Other Address
Address forCommunication
Date of Birth
Telephone No.
AADHAAR No.
Email ID
AMJPM5824D
Shri KAUSHAL B MEHTA
KAUSHAL B MEHTA
Shri BHARAT R MEHTA
08-10-1982
VIMALNATH APP.,46, DIGVIJAY PLOT,OPP. OSWAL SCHOOL,JAMNAGAR - 361005Gujarat
[email protected] 9662518547
Payment Mode
Net Banking: Your Payment of ` 105 against transaction number 401-1105240 has been successfully processed.
The following documents are enclosed as:Proof of Identity:
Proof of Address:
Proof of PAN:Proof of PAN to be cancelled:
Any other document:
Date:
Copy of AADHAR Card issued by the Unique Identification Authority of India
Copy of AADHAR Card issued by the Unique Identification Authority of India
Copy of PAN card
25-10-2014
Signature/ Left Thumb Impression of Applicant(inside the box without touching the sides and in BLACK INK ONLY)
Service Tax Code (Registration Number): AAACN2082NST001Service Tax Registration Category: BUSINESS AUXILIARY SERVICES
Individual
Photo Mismatch Signature Mismatch Sex
Request for cancellation of PAN(s)PAN1: PAN2: PAN3: PAN4:
A 204,
I/We, KAUSHAL B MEHTA the applicant, do hereby declare that what is stated above is true to the best of my/our information and belief.
(PLEASE READ INSTRUCTIONS GIVEN ON NEXT PAGE)
CIN U72900MH1995PLC095642
Proof of Date of birth: Copy of Birth certificate issued by the Municipal Authority or any office authorised to issue Birth and Death Certificate by the Registrar ofBirth and Deaths or the Indian Consulate
881030215265432
Acknowledgement for Request for New PAN Card or/and Changes or Correction in PAN Data
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Instructions:
The above-mentioned 15-digit acknowledgement number is a unique reference number for your application for 'Request for NewPAN Card or/and Changes or Correction in PAN Data'. Kindly quote this number for tracking the status of your application onhttps://tin-nsdl.com or any queries relating thereto.
Save and print this acknowledgement.
Application fee and mode of payment: Payment favouring 'NSDL-PAN' can be made as follows:
Sr. No. Address forCommunication
Amount payable( ) Mode of payment
1 Indian 105 Credit card / Debit card/ Net Banking / Demand Draft (DD) payable atMumbai/Cheque to be deposited in any HDFC bank branch across the country2 Foreign 971 Credit card / Debit card / DD payable at Mumbai
Please mention name of applicant and acknowledgement number on the reverse of cheque/DD.
Individual applicants affix your recent colour photograph (3.5 cm x 2.5 cm), sign the acknowledgement (inside the box providedwithout touching the sides and in BLACK INK only) and enclose a Demand Draft (DD), if any, alongwith Proof of Identity, Proof ofAddress and (Proof of Date of Birth - Indian citizens only) as specified in the application form.
Superscribe the envelope with 'APPLICATION FOR PAN - Acknowledgement Number' (e.g. 'APPLICATION FOR PAN -881010100000973').Send the documents as specified in point no. 4 above to Income Tax PAN Services Unit, NSDL e-Governance InfrastructureLimited, 5th floor, Mantri Sterling, Plot No. 341, Survey No. 997/8, Model Colony, Near Deep Bungalow Chowk, Pune -411016Tel: 020-27218080; Fax: 020-27218081.
Your acknowledgement, Demand Draft if any, and proofs, should reach NSDL within 15 days from the date of online application.
Application will be processed only on receipt of relevant proofs and realisation of payment.
Applications without proof of PAN will be processed on a good effort basis - (as mentioned in guidelines).
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