Change/Correction in PAN Card Fill in the simple form and proceed for payment information

1PAN CARD INFORMATION
Correction/Change in PAN Card Holder's Name   Correction/Change in PAN Card Holder's Father’s Name
Correction in Date Of Birth (as printed on card)   Correction/Change in Address for Communication
Correction/Change in Signature (as printed on card)   Correction/Change in Gender
Correction/Change in Photo (as printed on card)
2PERSONAL INFORMATION
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(Name should be exactly as per the ID proof. ID proof should have expansion of the initials)
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(Name on the PAN Card should be based on the name of the applicant)
3CONTACT DETAILS
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4DOCUMENT PROOF
5INCOME SOURCE
6ADDRESS INFORMATION

Residence Address *i

Office Address (Optional) i

DECLARATION

I have enclosed ________________________ as proof of identity, ________________________ as proof of address and ________________________ as proof of date of birth.

I ________________________, the applicant, in the capacity of do hereby declare that what is stated above is true to the best of my information and belief.

Date: 26-Jun-2017 City of residence ________________________

* Mandatory. Please ensure the name in the ID Proof matches  (Name of the Applicant). If the name does not match, the application would not be accepted.