Certificate to be used by a Member of Parliament/Member of Legislative Assembly/Municipal Councillor or Gazetted Officer as address and identity proof for PAN application

If any individual wants to apply for new PAN card but he has no documents as a proof address and proof of Identity then he can take certificate form Member of Parliament / Member of Legislative Assembly / Municipal Councillor or Gazetted Office. The format of such certificate is given below. Kindly note that this is considered as proof of address or proof of Identity only when certified is accompanied with the photo copy of the I-Card of the issuer.

Annexure -A (for form 49A)

(Certificate to be used by a Member of Parliament/Member of Legislative Assembly/Municipal Councillor or Gazetted Officer under sub-rule (4) of rule 114 of the Income-tax Rules, 1962)

Affix same  photograph as affixed
on PAN application form

 

  (To be attested by issuing authority with his/her signature & rubber stamp appearing half on the photograph and half on the certificate)

I hereby certify that I know Sh./Smt/Kum…………………………………. son/daughter of …… …………………………and his/her personal particulars as given  below are correct to the best of my knowledge and belief. I recommend issue of PAN card by the Income-tax Department to him/her.

 

Name

 

 

Father’s Name

(even in case of married ladies father’s name is to be provided)

 
Date of Birth  
Residence Address

(if applicant has resided at more than one place during last one year then all such address with dates should be mentioned)

 
Office Address  
Previous Name                             (in case of change in name)  

 

Details of issuer of certificate                                                            


(Signature)

Full Name:

Department/Organisation/Constituency:

Office address with location:

Identity Card No:


(Enclose a photocopy of I-card)   


Office Seal

Telephone:

 Mobile:

 Date :

Place:

Comments

  1. says

    I did like to know what if the address provided by the applican’s is prohibitate,prohibitate by the realy owner that it maybe a dispossess address from, than u.

  2. Yana says

    Is it mandatory to enclose photocopy of I’d of the issuer of the certificate.if it not enclosed the pan card application will be rejected ?

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