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r 011060001

The document is an application for a PAN card submitted by Ashwal Sharma on January 23, 2025, through a Common Service Center. The application includes details such as payment reference, user ID, and personal information including the father's name. The applicant has chosen to apply for both a physical PAN and e-PAN card.

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monupqrihar
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21 views

r 011060001

The document is an application for a PAN card submitted by Ashwal Sharma on January 23, 2025, through a Common Service Center. The application includes details such as payment reference, user ID, and personal information including the father's name. The applicant has chosen to apply for both a physical PAN and e-PAN card.

Uploaded by

monupqrihar
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Application Number: R011060001

Application Number Bar Code PY0017293270


Payment Reference: Inward Number Bar Code
Payment Date: 23/01/2025 Rs.107.00/-
Application Source: PSA - EOM - COMMON SERVICE CENTER - RAZAGANJ Application Date: 23/01/2025
User Id: COMM667-3453120771User Name: COMM667-3453120771
PAN CARD MODE : Both physical PAN and e-PAN Card Application Mode : Physical Application

B P L W 4 1 1

✔
S H A R M A
A S H W A L

A S H W A L S H A R M A

1 1 1 1 2 0 0 5

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 provided below.
Fathers’s Name (Mandatory except where mother is a single parent and PAN is applied by furnishing the name of mother only)
S H A R M A
A L B E L

Mothers’s Name (optional except where mother is a single parent and PAN is applied by furnishing the name of mother only)

(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) ✔

C / O A L B E L S H A R M A
B A I J A L K O T H I
M O R A R
M O R A R
G W A L I O R

M A D H Y A P R A D E S H 4 7 4 0 0 6 I N D I A
✔

9 1 9 1 7 4 7 1 1 3 7 0 0 2
[email protected]

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N O T A P P L I C A B L E W E F 0 1 1 0 2 0 2 4

A S H W A L S H A R M A

AADHAAR Card issued by AADHAAR Card issued by UIDAI


UIDAI (In Copy) (In Copy)
AADHAAR Card issued by UIDAI
(In Copy)

ASHWAL SHARMA HIMSELF/HERSELF

GWALIOR

2 3 0 1 2 0 2 5

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