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  Affix recentphotograph(3.5cm x 2.5cm)Affix recentphotograph(3.5cm x 2.5cm)Signature/ Left ThumbImpression across this photo ACKNOWLEDGEMENT NUMBER: CategoryPermanentAccount No.Name to beprinted on cardFather's NameNameOther AddressAddress forCommunicationDate of BirthTelephone No.AADHAAR No.Email ID BEYPG0403AShri AMIT GARGAMIT GARGShri SAT PAL GARG19-12-1988DHANDNEAR TEL EXCHANGEKAITHAL - 136020HaryanaAMIT191288.GARG@GMAIL.COM91 9999535079 Payment Mode Net Banking:  Your Payment of `  105 against transaction number 401-1099480 has been successfully processed.The following documents are enclosed as:Proof of Identity:Proof of Address:Proof of PAN:Proof of PAN to be cancelled:Any other document:Date: Copy of Elector's photo identity cardCopy of Elector's photo identity cardCopy of PAN card17-10-2014 Signature/ Left Thumb Impression of Applicant(inside the box without touching the sides and in BLACK INK ONLY )Service Tax Code (Registration Number): AAACN2082NST001Service Tax Registration Category: BUSINESS AUXILIARY SERVICES Individual Photo MismatchSignature MismatchSex Request for cancellation of PAN(s) PAN1:PAN2:PAN3:PAN4: SATPAL GARG ,#719 I/We, amit garg the applicant, do hereby declare that what is stated above is true to the best of my/our information and belief.(PLEASE READ INSTRUCTIONS GIVEN ON NEXT PAGE)CIN U72900MH1995PLC095642Proof of Date of birth: Copy of Matriculation certificate 881030215205556 Acknowledgement for Request for New PAN Card or/and Changes or Correction in PAN Data  Instructions: The above-mentioned 15-digit acknowledgement number is a unique reference number for your application for 'Request for NewPAN Card or/and Changes or Correction in PAN Data'. Kindly quote this number for tracking the status of your application on or any queries relating thereto. Save and print this acknowledgement.Application fee and mode of payment : Payment favouring 'NSDL-PAN'  can be made as follows: Sr. No.Address forCommunicationAmount payable () Mode of payment 1Indian105Credit card / Debit card/ Net Banking / Demand Draft (DD) payable atMumbai/Cheque to be deposited in any HDFC bank branch across the country   2Foreign971Credit card / Debit card / DD payable at Mumbai Please mention name of applicant and acknowledgement number on the reverse of cheque/DD. Individual applicants affix your recent colour  photograph (3.5 cm x 2.5 cm), sign the acknowledgement (inside the box providedwithout touching the sides and in BLACK INK  only) and enclose a Demand Draft (DD), if any, alongwith Proof of Identity, Proof of Address and (Proof of Date of Birth - Indian citizens only) as specified in the application form.Superscribe the envelope with 'APPLICATION FOR PAN - Acknowledgement Number' (e.g. 'APPLICATION FOR PAN -881010100000973').Send the documents as specified in point no. 4 above to Income Tax PAN Services Unit, NSDL e-Governance InfrastructureLimited, 5th floor, Mantri Sterling, Plot No. 341, Survey No. 997/8, Model Colony, Near Deep Bungalow Chowk, Pune -411016 Tel: 020-27218080; Fax: 020-27218081.Your acknowledgement, Demand Draft if any, and proofs, should reach NSDL within 15 days from the date of online application.Application will be processed only on receipt of relevant proofs and realisation of payment. Applications without proof of PAN will be processed on a good effort basis - (as mentioned in guidelines). 695342817
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