Application for Allotment of Permanent Account Number
(fill-up all the details carefully)
Army
Navy
Air Force
Other Individuals
* 1. Full Name
(Initials are not permitted in first and last name. Applicant's proof of identity, proof of address and proof of date of birth should contain the exact name mentioned in this field)
* 3.Gender
Shri/Mr
Smt./Mrs.
Kumari/Ms
First Name
Middle
Last Name
Male
Female
* 4. Date of Birth
* 5. Father's Name
(Even married women should give father's name only. Prefix like Shri, Smt, Kumari, Late, Dr, CA, Ms, Mr, Mrs, M/s, Alias etc. are not allowed)
First Name
Middle
Last Name
* 6. Address
Flat/Door/Block No.
Name of Premises/Building/Village
Road/Street/Lane/Post Office
Area/Locality/Taluka/Sub-Division
Town/City/District
Pin (Indicating PIN is mandatory)
(R) Residential Address/ Office Address
(Fill all the Fields  same as address proof is to be submitted to NSDL).
* 7. Telephone No.
State/Union Territory
Mobile No.
Landline with STD Code
8. E- Mail ID
9. In case of a citizen of India, then
Please mention your AADHAAR number (if allotted)
In case AADHAAR number is provided, then proof of AADHAAR along with supporting documents is to be submitted to NSDL
Are you a salaried employee?
* 10. Source of Income
If you are engaged in a business/ profession, indicate nature of business or profession and the relevant
If you are not covered by (a) or (b) above, indicate sources of income, if any.
a)
c)
* 11. Documents enclosed
as proof of identity,
as proof of address and
  as proof of date of birth
b)
  DD /MM /YYYY
I have read all details and conditions carefully
* 2. Name you would like printed on the card (Prefix like Shri, Smt, Kumari, Late, Dr, CA, Ms, Mr, Mrs, M/s, Alias etc. are not allowed)