Re-issue of Lost / Damaged PAN Card Fill in the simple form and proceed for payment information

1PAN CARD INFORMATION
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(Aadhaar is mandatory to be entered. Please enclose a self-attested copy of Aadhaar card along with the application form)
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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)
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3CONTACT DETAILS
4DOCUMENT PROOF
5INCOME SOURCE
6ADDRESS INFORMATION

Residence Address *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: 14-Nov-2018 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.

PAYMENT SUMMARY
Basic PAN Card Service i Free
Govt. Prescribed i
110
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GST @ 18%
Net Amount