Form No.

49AA
Only Only
‘Individuals’ to Application for Allotment of Permanent Account Number ‘Individuals’ to
affix recent affix recent
[Individuals not being a Citizen of India/Entities incorporated outside India/
photograph photograph
Unincorporated entities formed outside India]
(3.5cmx2.5cm) (3.5cmx2.5cm)
See Rule 114

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

Sign/Left Thumb Assessing officer (AO code) Signature/Left Thumb

Impression across this Impression
photo Area code 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 necessary particulars:
1 Full Name (Full expanded name to be mentioned as appearing in proof of identity/address documents: initials are not permitted)

Please select title, √ as applicable Shri/Mr Smt/ Mrs Kumari/Ms 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

Yes No (Please tick as applicable)
name?
If yes, please give that other name
Please select title, √ as applicable Shri/Mr Smt/ Mrs Kumari/Ms M/s
Last Name / Surname
First Name
Middle Name
4 Gender (for Individual applicants only) Male Female Transgender (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 Details of Parents(applicable only for individual applicants)

Whether mother is a single parent and you wish to apply for PAN by furnishing the name of your mother only?

Yes No (please tick as applicable)

If yes, please fill in mother’s name in the appropriate space provide below.
Father’s Name (Mandatory except where mother is a single parent and PAN is applied by furnishing
the name of mother only)
Last Name / Surname
First Name
Middle Name
Mother’s Name (optional except where mother is a single parent and PAN is applied by furnishing the
name of mother only)
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)

Father’s name Mother’s name (Please tick as applicable)

(In case no option is provided then PAN card will be issued with father’s name except where mother is a
single parent and you wish to apply for PAN by furnishing name of the mother only)’.
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 Pincode / Zip code Country Name

8 Address for Communication Residence 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, √ as applicable Government

Individual Hindu undivided family Company Partnership Firm Association of Persons

Trusts Body of Individuals Local Authority Artificial Juridical Limited Liability
Persons Partnership
11 Registration Number (for company, firms, etc.)

12 Country of Citizenship ISD Code of the Country of Citizenship

13 Source of Income Please select status, √ as applicable
Salary Capital Gains
Income from Business / Business/Profession code [For Code: Refer Income from Other sources
Profession instructions]
Income from House property No income
14 Representative or Agent of the Applicant in India
Full name, address of the Representative or Agent
Full Name (Full expanded name: initials are not permitted)
Please select title, √ as applicable Shri/Mr Smt/Mrs Kumari/Ms 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/Zip code

15 Documents submitted as Proof of Identity(POI) and Proof of Address (POA)

I/We have enclosed as proof of identity, as
proof of address, and as mandatory certified documents.

[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]

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 December31, 2010 on Anti Money Laundering.]
(a) In case of Individuals Please select √ as applicable
Marital Status √ Single Married Divorced Widow/Widower

Citizenship Status I Foreigner P Person of Indian Origin O Overseas citizen of India

In case of Foreigner, country of Citizenship

Occupation details Private sector service Public sector/Govt. service Business Professional

Agriculturist Retired Housewife Student Others

(b) In case of non Individuals Please select √ as applicable
R Private Company U Public Company D Body Corporate

S Financial Institution N Non Government Organization C Charitable Organization

( c) Gross Annual Income - INR

Networth (Assets less liabilities) in INR

(d) In case of a Public Company, whether listed on a stock exchange Yes No Please select √ as applicable

If yes, then indicate name of the stock exchange

(e) In case of Non-individuals
Does it have few persons or persons of the same family holding beneficial ownership and control
Yes No Please select √ as applicable
[“Control”: Control shall include the right to appoint majority of the directors or to control the management or policy decisions exercisable by a
person or persons acting individually or in concert, directly or indirectly, including by virtue of their shareholding or management rights or
shareholders 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 Please select √ as applicable
Foreign exchange, Money Changer Services Yes No
Gaming/Gambling/Lottery services(Casinos and Betting Syndicates) 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 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 stated above is true to the best of my/our information and belief.

Place

D D M M Y Y Y Y Signature / Left Thumb Impression of

Date Applicant (inside the box)