1. Asha Devi has applied for a Permanent Account Number (PAN) using Form 49A. She is providing her personal details like name, date of birth, address, father's name, and source of income which is salary. 2. She has included a copy of her Aadhaar card as proof of identity, address, and date of birth along with the application. 3. Asha Devi declares that the information provided in the application is true to the best of her knowledge.

1. Form 49A Application for Allotment of Permanent Account Number
[In the case of Indian Citizens/Indian Companies/Entities incorporated in India/
Unincorporated entities formed in India]
Under section 139A of the Income Tax Act, 1961
Date: 04/01/2019
VleID:- BR104403548
Print
Application Number: A015621520
Coupon Number: A015621520
PAN Card Mode:-
Both e-PAN and
physical PAN Card
Assessing Officer(AO Code)
Area Code AO Type Range Code AO No
PTN W 25 1
1. Full Name (Full expanded name: initials are not permitted):
Title:- SMT Last Name:- DEVI Middle Name:- First Name:- ASHA
2. Abbreviation of the above name, as you would like it, to be printed on the PAN card:- ASHA DEVI
3. Have you been known by any other name? N
Last Name:- Middle Name:- First Name:-
4. Gender:- FEMALE
5.Date of Birth / Incorporation/Agreement/Partnership or Trust Deed/Formation of Body
of Individuals/Association of Persons:-
01/01/1967
6.Details of Parents (applicable only for individual
applicants),
Whether mother is a single parents and you wish to apply for PAN by furnishing the name of your mother only?
No
6. Father's Name : Last Name:- SINGH Middle Name:- First Name:- BASUDEV
The name of either father or mother which you may
like to be printed on PAN card :
FATHER'S NAME
7. Address:-
Residential Address:-
Flat/Door/Block No.:- W/O - SHIVJEE SINGH
Name of Premises/Building/Village:- VILL - MOHANKHANDA

2. Road/Street/Lane/Post Office:- PO - HARNAUT,
Area/Locality/Taluka/Sub-Division:- PS - HARNAUT
Town/City/District:-
NALANDA
State/Union Territory:-
BIHAR
PIN Code:- 803110 Country:- INDIA
Official Address:-
Office Name:-
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 Code:- Country:-
8. Address for Communication:- RESIDENCE
9. Telephone Number & Email ID Details :-
Country
Code:-
91
Area/STD
Code:-
Telephone/Mobile
Number:-
9122577718
Email
Address:-
CYBERZONEHARNAUT123@GMAIL.COM
10. Status of the Applicant:- Individual
11. Registration Number(for
Company,firms,LLP's etc):-
12. In case of a person, who is required to quote Aadhaar Number/
the Enrolment ID of Aadhaar Application form as per section
139AA
Please Mention your AADHAAR
number(if alloted)
709603563639
If Aadhaar number is not alloted,
please mention the enrolment ID
of Aadhaar application form
Name As per AADHAAR letter/card
or as per the Enrolment ID of
Aadhaar application form
ASHA DEVI
13.Source of Income
SALARIED Capital Gains
Income from Business/Profession Income from Other sources
Income from House property No income
14. Full Name, address of the Representative Assessee, who is assessable under the Income Tax Act in respect of the
person, whose particulars have been given in colmns 1 to 13.
Last Name:- Middle Name:- First Name:-
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 Code:-
15. I/We have enclosed AADHAAR Card issued by UIDAI (In Copy) as Proof of Identity , AADHAAR Card issued by
UIDAI (In Copy) as Proof of Address and AADHAAR Card issued by UIDAI (In Copy) as Proof of DOB.
16. I/We ASHA DEVI ,the applicant,in the capacity of HIMSELF/HERSELF do hereby declare that what is stated above is
true to the best of my/our information and belief.
NALANDA

3. Place Date
Signature/Left thumb impression of the
applicant